The Link Between Narcissism and Anxiety

Last Updated on June 29, 2022 by Alexander Burgemeester

If you have never suffered from anxiety you are lucky and I envy you.

An accepted definition of anxiety involves elements of uncontrolled fear of events or event which simultaneously overwhelms and causes a person to freeze or assume frenetic activity to prevent the feared consequences from happening.

For example, a person with social phobia would normally exhibit elements of anxiety when asked to meet new people or enter a room full of people whom they know they were expected to talk to.

In such circumstances, they will experience internal changes such as negative self-talk “you are no good at events like these” and somatic changes such as a pounding heart, sweating, confusion and even palpitations.

What is the accepted link between anxiety and narcissism?

The relationship between narcissistic personality disorder and anxiety is a confusing one since the received wisdom is that because of their grandiose sense of entitlement, anxiety is rarely associated with it.

Indeed, there have been many psychological studies into ether relationship between self-presentation,

anxiety and narcissism which would seem to support this contention.

Akehurst and Thatcher (2010) looked at self-presentation in exercise classes. Where most people suffered anxiety about their bodies, Narcissists on the whole, did not.

In decision-making, too some neurotypicals lay awake at night when the implications of tough decisions they have made, have had negative implications for the lives of others – to make someone redundant; to withhold medical care; to turn down a request for help, for example.

In the same position, the narcissist sleeps the sleep of the innocent, knowing that they have made the only decision they could, heedless of the impact on others.

The real relationship between anxiety and narcissism, however, is much more complicated.

The narcissist’s anxiety for social approval

Narcissists need their narcissistic supply. In this, they are at the mercy of the giver.

They cannot control it. Without their supply from colleagues, fans, and Facebook “friends”, and family they have no ability to self-regulate their own sense of self-worth which is very dependent on external feedback.

So, if something they say or do is ignored or their performance given a lukewarm review or praise, they are lost and puzzled and their feelings of self-worth can be compromised.

This can present itself as frustration and hot temper, but the root cause and feeling is anxiety.

Thoughts such as for example: “what do they think of me?” and their reaction to it inside, is different to the outward presentation.

Inward anxiety gnaws at them whilst they lash out at an ungrateful audience/ family/co-worker.

Indeed, the DSM describes generalized anxiety disorder as having an “overzealous” need for approval about their performance.

Their anxieties may be the same as the frightened child giving their first solo performance in front of an audience, but their behavior and outward signs may be completely different. Some narcissists may indeed suffer with GAD.

The relationship between shame and anxiety in Narcissism

Yet there is still more and in it a different view of the relationship between anxiety and narcissism.

In a recent review article Pincus, Wright and Cain (2014) suggested a third manifestation of anxiety in narcissists.

The article presented case studies of one typical narcissist and two atypical narcissists seen in psychotherapy.

In their article, they distinguish between narcissistic grandiosity and narcissistic vulnerability.

They argue that in therapy, the grandiose narcissist is more likely to receive an accurate diagnosis whilst the vulnerable, anxious narcissist is not.

They label narcissists who has overt anxiety as “pathological narcissism” and claim that in many cases these people are misdiagnosed and unfairly treated in therapy:

“In patients with significant pathological narcissism, depressed mood is characterized by emptiness and agitation but not sadness.

Additionally, their mood and anxiety symptoms reports are typically infused with resentment, anger, envy, and shame.

Finally, clinicians should recognize the perpetuating influences of entitled expectations and perfectionism on mood and anxiety symptoms.

Perfectionism in narcissism can be particularly pernicious, leading to both lack of positive reinforcement from occupational, social, and recreational activities and social withdrawal to hide an imperfect self”

Narcissism and “disorders” the anxiety of the social media age.

In yet another facet of the relationship between anxiety and narcissism, we have the influence of new media.

Much social psychology research is now focussing on our relationship with social media and online friendships as they appear more and more to replace conventional relationships.

There is some suggestion that a dependence on online relationships may in some cases become pathological.

A recent study into the psychological attributes of “addicted” Facebook users suggested that such people are more likely to have narcissistic traits (Not necessarily full-blown personality disorder).

The same users are also deemed to suffer significant anxieties in connection with the self-presentation aspects of self, associated with Facebook exposure.

The double-edged sword of gaining a narcissistic supply from social media is that it is fickle and less controllable than those in a conventional social circle.

An example of this came from a friend of mine who worked in a college in England where the principal was known to be a man with a narcissistic edge.

The college used a wide range of social media to portray its successes and the principal was usually at the center of many images.

These high-profile postings backfired when memes began to pop up using the much-publicized images of the Principal –

dressed as anything from James Bond (a publicity picture for a charity event) to the 100% lycra cycling outfit being unfavorably compared to Sir Bradley Wiggins.

The principal reacted with fury, expelling students and trying to have the Facebook pages removed. Memes can be cruel to narcissists.


  1. Akehurst s, & Thatcher, J (2010) Narcissism, social anxiety and self-presentation in exercise  Personality and Individual Differences Volume 49, Issue 2, July 2010, Pages 130–135
  2. Pincus,A Wright, A & Cain N: Personality Disorders: Theory, Research, and Treatment © 2014 American Psychological Association 2014, Vol. 4, No. 4,
  3. Rosen, L. D et al: Is Facebook creating “iDisorders”? The link between clinical symptoms of psychiatric disorders and technology use, attitudes and anxiety in Computers in Human Behavior Volume 29, Issue 3, May 2013, Pages 1243–1254
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Alexander Burgemeester

Alexander Burgemeester has a Master in Neuropsychology. He studied at the University of Amsterdam and has a bachelor's in Clinical Psychology. Want to know more?

2 thoughts on “The Link Between Narcissism and Anxiety”

  1. Very important topic ! I am grateful for your articles and explanations. I am past the narcissistic hurt that my mother caused me. I believe NONE of her B.S. and have come so far ! It was a therapist ( very experienced with CBT) in my early twenties who got me out of my own way. And to realize NOTHING I could do to change her. But a lot I could do , to change myself. It took through my twenties and thirties for the anger and crazy stuff to settle , lo g enough to grab a hold and do the work I was taught. She left Connecticut for Florida when I was 25. Best thing that happened. I then and there , answered , my former therapists due , ” are you better off without her in your life or not. She knew how I felt from a ten page doubled sided letter I had sent her in no uncertain terms , also a suggestion from former therapist. I learned I could only change myself , NEVER anyone else. I became strong , I controlled the relationship by teaching her , how to treat me ! Things changed ; never completely , but she stopped most of her Bolognese and nonsense! She is deceased and I was the only one of out of 3 brothers and two sisters to be there at hospice when she died……..

  2. The last three years there’s something going very wrong in are upside down society. I haven’t felt much joy in my life, going on three years. Seeing and reading your article, truly is a blessing. (This is why) Eight years ago I was love bomb by a unicorn, and did she ever make me feel like I finally found my soul mate. This what discovered before I was broken and left in the darkest place I could Fandom even existed To help some understand, im not one to give up. You hit “me” odds are your going to get a schooling. when something happens that i don’t understand, you can bet one way or another Ii will. My narcissist ex /daughter/ and sister have very hi anxiety. They will destroy anyone to hide there anxiety and the prescription drugs they take. All three of them are the most evil narcissist that I have witnessed. Something has to change? I’m sorry to explain it this way, there bat shit crazy and have “guns”.


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