How Narcissistic Abuse Causes Anxiety (and Recovery Tips) Narcissistic abuse can severely impact your mental health, with anxiety being one of the most common side effects. Victims often experience prolonged emotional manipulation, criticism, and gaslighting — all of which can trigger or worsen anxiety. You may develop a constant fear of rejection, walking on eggshells to avoid upsetting the narcissist. Their unpredictable moods cause hypervigilance, leaving you mentally exhausted. Gaslighting m