As 2025 closes, many people reflect on their health. They notice fatigue that lingers. Pain that cycles. Symptoms that flare during periods of emotional strain. At Highlands in Bloom (HiB), we hear a consistent pattern. When stress stays high, the body struggles to stabilize.
Some clients describe long-term exposure to narcissistic relationship dynamics. These include gaslighting, emotional volatility, chronic invalidation, and control. Popular culture often claims a direct link between narcissism and autoimmune disease. Science does not support that claim in its simplest form.
What science does support is more nuanced. Chronic stress and trauma exposure disrupt immune regulation through sustained activation of stress-response systems and inflammatory pathways (Slavich & Irwin, 2014). That disruption increases autoimmune risk and worsens flares in vulnerable people.
This distinction matters.
Clarifying the statistic on women and autoimmune disease
Autoimmune disease does not affect 80 percent of women. Research shows something different.
Epidemiologic reviews often report that about 75–80% of people with autoimmune disease are women (Fairweather et al., 2008; Ngo et al., 2014). This statistic describes sex distribution among diagnosed cases. It does not describe prevalence among women overall.
The National Institutes of Health also notes that autoimmune diseases disproportionately affect women, but it does not provide one combined percentage across all autoimmune conditions (National Institute of Allergy and Infectious Diseases [NIAID], n.d.).
Autoimmune conditions affect millions of people. They often include fatigue, pain, GI distress, cognitive fog, mood symptoms, and sleep disruption. Stress can worsen all of these.
What clinicians discussed at Evolution of Psychotherapy
At the Evolution of Psychotherapy conference, clinicians discussed how chronic relational stress affects mental health. Several speakers addressed narcissistic personality traits and relational harm.
One prominent voice is Dr. Ramani Durvasula. Her clinical focus centers on recognizing narcissistic patterns and supporting recovery from emotionally abusive dynamics.
- Faculty bio (Evolution of Psychotherapy): https://www.hmpglobalevents.com/faculty/evolutionofpsychotherapy/3831 HMP Global Events
She does not claim that narcissism causes autoimmune disease. She focuses on psychological harm and nervous system strain. That framing aligns with the medical literature on stress physiology and immune regulation.
What research actually shows – chronic stress immune regulation
Chronic stress alters immune signaling
Psychoneuroimmunology research shows a consistent pattern. Chronic stress can increase inflammatory signaling. It can also disrupt regulation of the stress-response system.
Slavich and Irwin describe a well-cited model that links social threat and adversity to inflammatory pathways (Slavich & Irwin, 2014).
- PubMed record: https://pubmed.ncbi.nlm.nih.gov/24417575/ PubMed
- Free full text (PMC): https://pmc.ncbi.nlm.nih.gov/articles/PMC4006295/ PMC
These changes do not create autoimmune disease in everyone. They do increase vulnerability. They can also worsen symptom severity and reduce recovery capacity.
PTSD links to autoimmune risk
Large population studies show a consistent association between stress-related disorders (including PTSD) and later autoimmune disease.
A major Swedish registry study found increased autoimmune risk after a clinical diagnosis of stress-related disorders (Song et al., 2018).
- JAMA full article: https://jamanetwork.com/journals/jama/fullarticle/2685155 JAMA Network
- PubMed record: https://pubmed.ncbi.nlm.nih.gov/29922828/ PubMed
- Free full text (PMC): https://pmc.ncbi.nlm.nih.gov/articles/PMC6583688/ PMC
Association does not equal causation. The signal still matters clinically. It supports screening and integrated care planning.
Childhood adversity matters
Early-life stress can shape stress physiology and immune function across the lifespan.
Miller, Chen, and Parker outline a strong evidence base linking childhood stress exposure to later risk for chronic diseases, including autoimmune-related vulnerability (Miller et al., 2011).
- PubMed record: https://pubmed.ncbi.nlm.nih.gov/21787044/ PubMed
- Free full text (PMC): https://pmc.ncbi.nlm.nih.gov/articles/PMC3202072/ PMC+1
Early exposure to abuse, neglect, or chronic instability can produce long-term threat activation. That activation can persist for decades.
Studies do not isolate “narcissistic abuse”
Medical research rarely uses the term “narcissistic abuse.” Researchers typically measure trauma exposure, PTSD, chronic stress, depression, anxiety, and adverse childhood experiences.
Current evidence does not identify narcissistic traits as an independent causal factor in autoimmune disease. Evidence supports a broader pathway: chronic threat exposure, stress dysregulation, and immune imbalance (Slavich & Irwin, 2014; Song et al., 2018).
For readers who want a plain-language medical summary of the 2018 JAMA findings, Harvard Health provides a clinician-written overview (Harvard Health Publishing, 2018/2020).
Harvard Health blog: https://www.health.harvard.edu/blog/autoimmune-disease-and-stress-is-there-a-link-2018071114230
A biologically plausible model
Chronic emotionally abusive relationships can create predictable physiological strain:
- Persistent hypervigilance
- Disrupted sleep
- Anxiety or depressive symptoms
- Reduced sense of safety
- Impaired emotional regulation
These states keep the nervous system in threat mode. Threat mode can increase inflammatory signaling. It can also reduce immune flexibility (Slavich & Irwin, 2014).
This model fits the evidence. It avoids oversimplification.
Why women experience this intersection more often
Women carry most autoimmune diagnoses. Reviews describe strong sex differences across many autoimmune conditions (Fairweather et al., 2008).
Women also face higher exposure to certain chronic stressors, including caregiving burden and interpersonal trauma. This creates a convergence. It increases vulnerability. It also increases symptom load when stress stays high.
What this means for treatment
Effective care must address both biology and environment.
Medical coordination
Clients need consistent medical follow-up. Autoimmune conditions require monitoring, medication management, and flare planning. Mental health care should not replace medical care. It should complement it.
Nervous system regulation
Trauma-informed therapy reduces baseline threat activation. Somatic approaches help regulate autonomic response. Skills-based therapies support emotional containment.
The goal is stability. The goal is not emotional suppression.
Sleep as intervention
Sleep loss worsens inflammation and pain sensitivity. Treatment plans should protect sleep aggressively. This includes routines, environmental support, and clinical intervention when needed.
Relational safety
Boundaries help in some situations. In others, boundaries fail. Clients may need safety planning, documentation, or structured support. Education on narcissistic patterns can reduce confusion and self-blame. Dr. Ramani Durvasula’s work often supports this phase of insight and clarity.
Screen for PTSD and depression
Given the strong association between stress-related disorders and later autoimmune disease, screening should be part of comprehensive care (Song et al., 2018).
What we should not claim
We should not claim that narcissism directly causes autoimmune disease. That claim exceeds current evidence.
We should not dismiss lived experience either. Many clients feel worse in chronically invalidating environments. Science supports that observation through stress physiology.
Accuracy protects credibility. Nuance protects clients.
The bottom line – chronic stress immune regulation
Science supports this conclusion:
Chronic stress and trauma exposure can disrupt immune regulation. These disruptions can increase inflammatory signaling and worsen autoimmune symptoms in susceptible individuals (Slavich & Irwin, 2014; Song et al., 2018).
As we move into 2026, Highlands in Bloom remains committed to integrated care. We address the nervous system, we support medical stability, and we help clients build safer environments. Healing requires all three.
References
Harvard Health Publishing. (2018, July 11). Autoimmune disease and stress: Is there a link?
Highlands in Bloom
Residential Treatment Center for Autoimmune + Mental Health
Agoura Hills, California
(805) 892-6313
Licensed by CDSS • Certified by DHCS • JCAHO Accredited