A community member submitted this question: “Why does narcissistic abuse cause panic attacks?” I’ve looked into it thoroughly. Here’s what I came up with.

The reason narcissistic abuse can cause panic attacks is because it puts you in a constant state of hyper-vigilance, causes anxiety and traumatic conditioning, erodes your identity and independence, and causes you to develop an overwhelming fear of consequences. 

In this article, I’ll guide you through each of these to help you understand the reason narcissistic abuse can cause panic attacks.

1.) You’re In a Constant State of Hyper-Vigilance

When you’re subjected to narcissistic abuse, you might find yourself in a constant state of hyper-vigilance, always on the lookout for the next outburst or critical comment.1 

This continuous state of alertness can be incredibly taxing on your nervous system, making you more prone to panic attacks. 

For example, let’s say you’re at a family dinner, and you’ve been conditioned to fear your partner’s or parent’s unpredictable reactions.

A group of people at a family dinner.

Even something as simple as passing the salt can become a source of anxiety, fearing it might trigger a negative response. 

Your heart starts racing, your breathing becomes shallow, and suddenly, you’re experiencing a panic attack, all because your body and mind are conditioned to anticipate danger at every turn.

2.) The Gaslighting Causes Extreme Anxiety 

Narcissistic abuse often involves a tactic known as gaslighting, where the abuser denies your reality, making you question your perceptions and sanity.2 

This constant doubt and confusion can lead to intense anxiety, manifesting as panic attacks.3 

For instance, imagine you recall a specific event that upset you, but your abuser flatly denies it ever happened, insisting you’re remembering it wrong or making it up. 

This repeated denial of your reality can make you feel like you’re losing your grip on what’s true and what’s not, leading to a profound sense of unease and distress. 

In moments of heightened stress or when faced with situations that remind you of these gaslighting episodes, you might experience panic attacks as your body’s way of reacting to the intense fear and confusion caused by the abuse.

Related: 100 Common Gaslighting Phrases (Survey)

3.) Narcissistic Abuse Causes Traumatic Conditioning

Living with narcissistic abuse can lead to traumatic conditioning, where your body and mind become primed to react to specific triggers that remind you of past abuse, even in safe environments. 

This is because the brain associates specific words, tones of voice, or situations with the trauma experienced during the abuse, leading to an automatic panic response when encountered again. 

For instance, hearing someone raise their voice, even in a non-threatening context, can remind you of past episodes of verbal abuse. 

A woman having a panic attack.

This association triggers a flood of stress hormones as your body prepares to respond to the perceived threat, leading to a panic attack. 

The source of these attacks is the learned association between specific stimuli and the traumatic experiences of abuse, causing your body to react as if it’s in immediate danger, even when it’s not.4

4.) You Lose Your Identity and Independence

Narcissistic abuse often erodes your sense of self-identity and independence, making you overly reliant on the abuser for validation and decision-making.5 

This dependency can create a profound internal conflict and anxiety, as you may feel lost and uncertain about your own thoughts and feelings. 

For example, if you’ve been in a long-term relationship with a narcissistic partner who has dictated most of your life choices, from what you wear to how you should think and feel, trying to make even small decisions on your own can become overwhelming. 

When faced with a situation that requires you to assert your independence or express a personal preference, the fear of potential backlash or the realization of your dependency can trigger a panic attack. 

The attack stems from the intense anxiety over making a “wrong” choice that could upset your abuser or the fear of realizing how much of your own autonomy has been surrendered.

5.) You Develop an Intense Fear of Consequences

A common source of panic attacks in individuals recovering from narcissistic abuse is the ingrained fear of consequences for actions that the abuser might disapprove of. 

This fear can be paralyzing, leading to heightened anxiety and panic attacks even after the abusive relationship has ended. 

For instance, consider you’re about to make a decision that goes against what the narcissistic abuser would have wanted or approved of, like applying for a job they would have deemed unsuitable.

The mere act of filling out the application can trigger a panic attack driven by the deep-seated fear of potential punishment or backlash, even if the abuser is no longer in your life. 

This response stems from the conditioning during the abusive relationship, where disobedience or failure to conform to the narcissist’s wishes often led to severe emotional or even physical consequences.

For more helpful information like this, visit Unfilteredd’s Institute of Healing from Narcissistic Abuse today.


That’s the end of this article.

Thanks so much for reading through to the end!

If you have any questions or would like to share your perspective, please comment below. Your engagement is always welcomed.

Our Latest Articles

About the Author

Hey, I’m Elijah.

I experienced narcissistic abuse for three years. 

I create these articles to help you understand and validate your experiences.

Thank you for reading, and remember, healing is possible even when it feels impossible.

Unfilteredd has strict sourcing guidelines and only uses high-quality sources to support the facts within our content. You can learn more about how we ensure our content is accurate, actionable, inclusive, and trustworthy by reading our editorial process.

  1. Arlin Cuncic. (2023. November, 6). Effects of Narcissistic Abuse. Verywell Mind. https://www.verywellmind.com/effects-of-narcissistic-abuse-5208164 ↩︎
  2. WebMD. (2024. February, 25). What Is Gaslighting in Relationships? WebMD. https://www.webmd.com/mental-health/what-is-gaslighting-in-relationships ↩︎
  3. Iryna Horkovska. (2023. March, 20). What Is Gaslighting? How to Spot It and Stop It. Calmerry. https://calmerry.com/blog/emotional-abuse/what-is-gaslighting/ ↩︎
  4. VanElzakker, M. B., Dahlgren, M. K., Davis, F. C., Dubois, S., & Shin, L. M. (2014). From Pavlov to PTSD: the extinction of conditioned fear in rodents, humans, and anxiety disorders. Neurobiology of learning and memory113, 3–18. ↩︎
  5. Kim Saeed. (2018. August, 22). Healing from Identity Loss After Narcissistic Abuse. Psych Central. https://psychcentral.com/blog/liberation/2018/08/healing-from-identity-loss-after-narcissistic-abuse ↩︎


  1. Good article. My observations: We the victims are left with forever ANGER. thanks again for your incite.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.