What Is Post-Narcissist Stress Disorder (PNSD)? Causes, Symptoms, And Treatments

Updated February 20, 2023by BetterHelp Editorial Team

Post-traumatic stress disorder—commonly referred to as PTSD—is a disorder that develops after a person has experienced or witnessed a traumatic event. While not everyone who experiences a traumatic event will develop PTSD, for those who do, the symptoms can feel debilitating. Post-narcissist stress disorder, or PNSD, is a form of PTSD that can come from interacting with a narcissist.

Understanding Narcissism

To understand what post-narcissist stress disorder is, one must first identify the characteristics that make a person a narcissist. Narcissistic personality disorder is a type of personality disorder characterized by a person having an inflated sense of their own importance, an excessive need for admiration or attention, and a lack of empathy for others. Some even experience narcissistic rage. People who have close relationships with narcissists may develop post-narcissist stress disorder.

Toxic Relationships Can Take A Toll

Common traits of narcissism include:

  • Exhibiting an exaggerated sense of self-importance

  • Requiring excessive or constant admiration

  • Preoccupied with fantasies about power, beauty, success, or brilliance

  • Acting in an arrogant or haughty manner

  • Wanting to be the center of attention always

  • Taking advantage of or manipulating others for self-gain

  • Unwillingness to recognize the needs and feelings of others

  • Being envious of others or believing that others envy them

Narcissists generally find it difficult to handle anything that they perceive as criticism. When faced with what they believe to be criticism, they may become angry or impatient, react with rage or contempt, or have difficulty controlling their emotions or behavior. 

The Long-Term Effects Of Being In A Relationship With A Narcissist

Being in a relationship with a narcissist can take an emotional toll. A narcissist’s constant need for attention often leaves partners feeling as if there is no time to take care of themselves. This lack of self-care coupled with the emotional strain of a relationship with a narcissist can cause one to feel overwhelmed or bewildered.

What Causes Post-Narcissist Stress Disorder?

Narcissists are generally manipulative. Therefore, the experience of being with them can cause long-term emotional trauma. Some people who have been in a relationship with a narcissist may experience similar symptoms as those who have been exposed to trauma or disaster and develop PTSD. This effect of the relationship and the emotional trauma that it causes is often called post narcissist stress disorder (PNSD).

A relationship with a narcissist can cause feelings of fear, distrust, heightened emotional responses, or self-doubt. Symptoms of post-narcissist stress disorder may even be triggered by simple things such as a song on the radio, the smell of cologne when someone passes by, or a nightmare about past events with the narcissist.

How Do You Know You’re In A Toxic Relationship With A Narcissist?

Being in a relationship with a narcissist may be anything but pleasant. The negative impact that a narcissist’s behavior can have on a partner can be significant. Being able to identify if you are in a relationship with a narcissist could be the first step in addressing the issue and seeking help to prevent further emotional or physical harm.

The following are signs that you may be in a relationship with a narcissist:

  1. They have an “all-about-me” attitude. One thing that will be evident, usually from the start, is that narcissists seem to have an uncanny way of taking a conversation and turning it around to focus on them. They seem to have an insatiable need for attention, and if that need is not met, they can become resentful or act irrationally.

  2. They ooze with charm in the beginning. At the beginning of a relationship with a narcissist, is it normal to feel like you have met Prince Charming or the love of your life. A narcissist will shower you with flattery and affection. Make no mistake: this is a manipulation tactic that many narcissists later use for their own personal gain.

  3. Narcissists generally have no boundaries. People with narcissistic personality disorder show little concern and often deliberately disregard the wishes of others as well as any personal boundaries that their intimate partners try to establish. They have no problem overstepping boundaries and will likely become offended when their behavior is called out. Their blatant disregard for others often leads to breaking promises or falling short of meeting obligations. They may borrow money and never repay it, for example, and show little or no remorse for their actions.

  4. They view others as having lesser value or importance than themselves. These beliefs, known as delusions of grandeur, cause them to believe that they are truly superior to others.

  5. Narcissists revel in taking credit for a job well-done but rarely want the responsibility of seeing a job through.

  6. You feel alone or isolated. Narcissists gain control in relationships by making their partners feel isolated from other friends or loved ones. By separating targets from loved ones, narcissists make victims become dependent upon them for everything. Isolation techniques that narcissists may employ include controlling finances, not allowing you to work or go to school, restricting the use of an automobile or phone, and not allowing you to visit your friends or loved ones alone.

  7. Narcissists will likely view even the kindest and most constructive advice as a personal attack against them.

Narcissists generally do not see their behavior as inappropriate and may find it hard to believe that they have any kind of problem. Because of their inability to see their behavior as flawed, they often refuse treatment of any kind. In fact, they are unlikely to take any type of advice as anything other than a personal attack. Their reluctance to admit the need for intervention means that those who are closely associated with them are left to deal with the consequences of the narcissist’s behaviors and attitude.

Tips for Helping Someone Who Has Post-Narcissist Stress Disorder

Once a relationship with a narcissist has ended, victims may experience periods of helplessness, rage, anxiety, or depression. Knowing the symptoms of post-narcissist stress disorder can be helpful if you want to contribute to helping a survivor of post-narcissist stress disorder.

  • Validate their feelings – Even if you can’t seem to comprehend what they are going through, it’s important to acknowledge their feelings. They may feel sad, angry, or bitter. A relationship with a narcissist can be emotionally taxing, which means many survivors have to relearn healthy ways to express their emotions.

  • Listen without judgment or criticism – Remember that they just came out of a relationship where they were constantly criticized or made to feel inferior. Survivors want to tell their story and their truth, as they remember it. Give them the chance to speak and listen to them. Validate their feelings without offering suggestions of how you think they should feel.

  • Provide unconditional love and support – People who have just ended a relationship, especially a relationship with a narcissist, often must build a brand new support system. This is because narcissists employ isolation tactics and separate victims from anyone who might be supportive. Sometimes, all a person may need is your unconditional support and encouragement to help them begin to heal.

Living With Post-Narcissist Stress Disorder

Post-narcissist stress disorder can cause overwhelming feelings of stress and fear and can leave you wondering if life will ever be “normal” again. While symptoms may last for extended periods and may vary in intensity, it is possible to learn to cope with the symptoms of post-narcissist stress disorder and return to a sense of normalcy.

A few measures you can implement to help yourself cope with post-narcissist stress disorder include:

  • Get Plenty Of Sleep And Rest. Lack of sleep can cause increased anxiety and may trigger worsening PNSD symptoms. Make sure to purposefully plan for at least 8 hours of sleep each night. This will give your body and your mind time to recuperate and begin anew the next day.

  • Begin A Lifestyle Of Healthy Habits. Learning relaxation techniques such as deep breathing, yoga, and meditation can help activate your body’s natural relaxation response. This can help ease symptoms of PNSD. Avoid alcohol and drugs as these substances may worsen symptoms and can interfere with treatment. Eat a healthy diet with balanced, nutritious meals. Avoid processed and fried foods as well as refined sugars and starches, which can cause mood swings.

  • Challenge Yourself. Trauma can make you feel vulnerable at times. Memories don’t go away overnight, and healing doesn’t happen in the blink of an eye. Still, you can remind yourself that there is more to you than weakness or vulnerability. You have strengths, and you can use them to help others. Donate your time to a charity or a senior center. Reach out to another person in need. Anything you can do to feel strong and capable can help you begin to take control of your life.

  • Knowing When It’s Time To Get Help. If you are experiencing symptoms of post-narcissist stress disorder, you may want to make an appointment to see your doctor or a mental health professional. Depending on the severity of your symptoms, your primary care provider may feel that it is appropriate to prescribe medication to help manage some of the symptoms related to stress. 

Your physician may also recommend a visit with a mental health professional to help address the symptoms of post-narcissist stress disorder and to provide guidance on effective coping mechanisms. 

When You Need Help….

If the idea of adding another appointment or errand to your life makes you feel more stressed, that doesn’t mean there aren’t other options.

Online counseling services are a growing trend as people realize the need to deal with emotional and mental health issues. Online mental health service providers such as BetterHelp give individuals an opportunity to connect with licensed, professional counselors, marriage and family therapists, clinical social workers, and psychiatrists when and where it is most convenient. Online therapy also has the benefit of removing any potential added anxiety someone might have about going into an office and potentially being seen there.

Post-narcissist stress disorder is likely to be treated similarly to PTSD. A recent publication looked at how effective online cognitive behavioral therapy is for treating anxiety disorders, including PTSD. (Cognitive behavioral therapy is a common talk therapy technique that challenges unhelpful thoughts and behaviors to build new patterns.) The publication looked at 38 different studies and found that online CBT is more effective than a waiting list or an online discussion group and is just as effective as face-to-face CBT.

Many others are already using BetterHelp for similar issues. Here are some of their recent reviews about their BetterHelp counselors:

“He is very clear in what he says, he openly calls things by its name and gives real help. He listens, he gives advice and reassurance where needed. It often is difficult to deal with a narcissistic person and to have a therapist that openly acknowledges narcissistic patterns is a great help. I appreciate his openness very much.” 

Toxic Relationships Can Take A Toll

“In my very first session with DeWanda I was very relieved and impressed with how she made me feel safe. Her spiritual insight was very important to me, as well as her knowledge of dealing with a narcissist. This has been a very stressful and unexpected revelation and her professional compassion came through loud and clear. I am looking forward to her guidance on my healing journey!!” 


Although the trauma you experienced from a relationship with a narcissist was real, it does not have to control your life. Even on days when stress levels are increased or you feel overwhelmed, it is possible to achieve a sense of control and learn to cope with post-narcissist stress disorder. Living life to its fullest is still possible. Don’t wait. If you need help managing the symptoms of post narcissist stress disorder, reach out to a qualified BetterHelp therapist today.

For additional help & support with your concerns

The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet Started