You know narcissistic abuse can affect your confidence, mood and relationships. But could it also be affecting your physical health? We examine the emerging science behind the hidden toll on men
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You start second-guessing yourself. At first, it’s subtle. A dismissive comment here. A cutting joke there. An argument that somehow ends with you apologising – even though you’re not entirely sure what you’ve done wrong.
Over time, you find yourself walking on eggshells, constantly monitoring what you say and do to avoid conflict. That knot in your stomach is always there – as are the days when you dread coming home.
Many men who have experienced toxic or emotionally manipulative relationships describe a similar pattern. They become more anxious, more withdrawn and less confident. Sleep suffers. Motivation drops. The gym sessions that once felt routine become harder to face. Friends notice they’re not quite themselves anymore.
Most people assume these are purely emotional consequences. But what if the stress doesn’t stay in your head?
Scientists are increasingly interested in how chronic relationship stress affects the body as well as the mind.
While there is no direct evidence that a toxic partner can directly “damage” your immune system, research suggests that prolonged exposure to emotional conflict, manipulation and psychological stress may influence some of the biological systems that help keep us healthy.
The connection isn’t straightforward, and it certainly isn’t inevitable. Not everyone who experiences a toxic relationship will develop health problems. Human health is far too complex for that.
But a growing body of evidence suggests that living in a constant state of emotional tension may affect the systems that regulate stress, inflammation and immune function.
The stress response connection
To understand why, it helps to look at how the body responds to stress.
One of the key players is the hypothalamic-pituitary-adrenal (HPA) axis, a network that helps regulate our response to perceived threats. When something triggers stress, the body releases hormones including cortisol, often referred to as the primary stress hormone.
In the short term, this response is useful. Cortisol helps mobilise energy, sharpen attention and regulate inflammation, preparing the body to deal with challenges. The problem isn’t stress itself; it’s when stress becomes chronic.
Research by neuroscientist Bruce McEwen, who pioneered the concept of “allostatic load”, showed that repeated activation of the body’s stress-response systems can create cumulative wear and tear over time. Rather than returning to a baseline state, the body may remain stuck in a heightened state of alertness.
In a toxic relationship, this might be fuelled by constant criticism, emotional manipulation, coercive control, unpredictability or ongoing conflict.
Even when there is no physical threat, the brain may continue to interpret the environment as stressful, repeatedly activating the same biological pathways.
What happens to the immune system?
The link between stress and immunity has been studied for decades.
Research led by psychologist Sheldon Cohen has found that people experiencing chronic stress are often more vulnerable to infections and can display altered immune responses.
Meanwhile, studies by Janice Kiecolt-Glaser and colleagues have shown that relationship conflict and hostile interactions between partners can affect markers of immune function and even slow wound healing.
Importantly, scientists no longer think of the process as a simple case of “high cortisol equals poor immunity”. The reality appears to be much more nuanced.
While cortisol initially helps suppress inflammation, prolonged exposure to stress may alter how immune cells respond to the hormone.
Some research suggests chronic stress can contribute to what is known as glucocorticoid resistance, a phenomenon in which immune cells become less sensitive to cortisol’s anti-inflammatory effects.
When that happens, the body’s ability to regulate inflammation may become less efficient.
The inflammation link
Inflammation is an essential part of the immune response. Without it, the body would struggle to fight infections or repair damaged tissue.
Problems arise when low-grade inflammation persists over long periods.
Research by George Slavich and Michael Irwin has highlighted how chronic social stress can be associated with elevated levels of inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6). Elevated levels of these markers have also been linked to a range of health conditions, including cardiovascular disease, metabolic disorders and depression.
That doesn’t mean a difficult relationship automatically leads to chronic inflammation or illness. Many factors influence inflammatory processes, including sleep quality, exercise habits, diet, alcohol consumption, genetics and underlying health conditions.
However, researchers increasingly believe that chronic interpersonal stress may be one piece of a much larger puzzle.
Why men may be particularly vulnerable
For many men, one of the biggest challenges is recognising the impact of emotional abuse in the first place.
Research into male victims of psychological abuse and intimate partner violence suggests men are often less likely to seek support, partly because of stigma and cultural expectations surrounding masculinity.
Many feel pressure to cope alone, minimise their experiences or dismiss their symptoms as simply part of everyday relationship struggles.
The result can be months or even years of unresolved stress.
During that time, sleep may deteriorate, exercise habits may become inconsistent and alcohol consumption may increase. All these factors can compound the effects of stress and contribute to poorer physical and mental health outcomes.
Looking after number one
The science does not support simplistic claims that narcissistic abuse or toxic relationships directly destroy the immune system. Human biology is far more complex than that.
What the evidence does suggest is that chronic relationship stress can influence the body’s stress-response systems, which in turn may affect immune function and inflammation.
Over time, these changes could contribute to poorer health outcomes in some individuals.
In other words, the relationship is not direct, guaranteed or fully understood. But it is biologically plausible, supported by a growing body of research and increasingly recognised by experts studying the connection between stress and health.
For men living with ongoing emotional manipulation, coercive control or chronic relationship conflict, the consequences may extend beyond mental wellbeing alone.
Looking after your psychological health isn’t simply about protecting your mood – it may also be an important investment in your long-term physical health.
• If you’re in a abusive relationship and need help, Men’s Advice Line is a specialist helpline, webchat, and email support service designed specifically for male victims of domestic abuse and violence.
