Moving Forward: PTSD And Hyperarousal

Updated December 27, 2022by BetterHelp Editorial Team

Looking To Ease The Symptoms Of PTSD?

Many people living a post-traumatic stress disorder (PTSD) diagnosis may experience hyperarousal, or a state of being constantly aware and on alert to potential dangers, as a symptom. 

While being on alert can serve people well in the short-term, long-term feelings of hyperarousal can lead to extended periods of elevated stress hormones and the eventual breakdown of bodily systems.

Post-Traumatic Stress Disorder (PTSD) Defined

Post-traumatic stress disorder (PTSD) is an anxiety disorder that occurs following a traumatic event or a series of traumatic events. While PTSD was once narrowly defined as a disorder unique to post-combat war veterans, it’s growing in its scope and can include people from a wide variety of backgrounds. 

PTSD can affect anyone who has experienced trauma or an ongoing series of traumas. However, not everyone who experiences trauma will go on to develop PTSD. Those at a higher risk for developing PTSD include people who have had an anxiety or depressive disorder, or a family history of anxiety or depression. 

Environmental factors may also serve as potential risk factors for developing PTSD. For example, someone lacking a stable support system may be more at risk.

Receiving a PTSD diagnosis typically requires experiencing symptoms for at least one month following a traumatic event. Although it was once necessary to experience symptoms within a certain time frame to qualify for a diagnosis, PTSD is now recognized as a disorder that can develop from three months to several years after a traumatic event.

PTSD is its own diagnosis, but compounding PTSD is another facet that is only recently gathering the attention it deserves. Compounding PTSD is any form of PTSD in which the trauma experienced was not a single, isolated event, but was an ongoing cycle of trauma. 

The most common source of compounding PTSD is physical or emotional abuse. There may be other ways to receive a compounding PTSD diagnosis. For example, witnessing repeated trauma as a healthcare provider or first-responder.

Symptoms Of PTSD

Post-traumatic stress disorder (PTSD) symptoms vary to some degree among different PTSD patients, depending upon the person's background, source of trauma, and system of support. Overall, there are four core PTSD symptoms, with several sub-symptoms such as difficulty sleeping, anger, and outbursts. 

The four core symptoms of PTSD include memories, avoidant behavior, behavior changes, and mood swings. The memory of a traumatic incident often arrives without notice or without a desire remember it which then causes significant distress. Within these memories, there are often gaps or confusion regarding details of the event. Memories may come in flashbacks or they may manifest in the form of nightmares or other sleep disturbances.

Looking To Ease The Symptoms Of PTSD?

Avoidant behavior involves avoiding triggers by refusing to visit certain places, entertain certain thoughts, or see certain people. In order to qualify as a PTSD symptom, avoidant behavior must have a significant impact on your life. 

For some, this may look like isolating yourself when you used to be outgoing or friendly, while for others, it may look like increased anger or irritability. Mood swings are also a typical symptom of PTSD, wherein people with the disorder move from pain to joy to fear to anger and back again, without feeling as though they can control or manage the emotions.

PTSD can come with other mental health illnesses and self-destructive behavior such as self-harm. Coping mechanisms, wellness professionals, PTSD support groups or other strong support system are available to help manage severe symptoms such as hyperarousal. 

PTSD And Hyperarousal

Symptoms of hyperarousal are characterized by feelings of vigilance, fear, and hesitance and often manifests in jumpy behavior, constantly being on edge, or a feeling of walking on eggshells. Additionally, loud noises may be overwhelming and painful, while surprises, even from people you trust, can send someone into a panic attack. 

PTSD essentially forces an individual into a state of chronic stress, which means constantly living in a fight-flight-freeze mode. In this mode, even everyday occurrences can take on heightened sensations and can make daily living an arduous task.

Effects Of Hyperarousal

In cases where adrenaline is necessary, for instance moving quickly to escape a real danger, hyperarousal is immensely useful. When your body is constantly hyperaroused, however, many of your physical and mental systems begin to break down. Experiencing post-traumatic stress disorder (PTSD) can lead to chronic stress. 

When experiencing hyperarousal over longer periods of time, your brain essentially begins to prioritize its functions. This means that mood regulation and other nonessential functions become secondary to accommodate the constant need to potentially fight, flight, or freeze. 

In your body, chronic stress can manifest as sleeplessness or oversleeping, loss of appetite or excessive appetite, depression, and brain fog. Symptoms of hyperarousal exacerbates the other symptoms of PTSD and is arguably the most painful, exhausting symptom and can lead to a host of other mental and physical disorders.

Hyperarousal Treatment

The treatment to manage hyperarousal for people with post-traumatic stress disorder (PTSD) is incorporated into standard PTSD treatment. Typically, the first course of action in treating PTSD is working through the trauma or the individual traumas leading up to your diagnosis. PTSD treatment will likely begin with talk therapy. 

Initially, your therapist will teach you some self-soothing techniques so that when you begin to talk about the trauma, you will be able to better manage your emotional responses. Then you will walk your therapist through the event or events responsible for your PTSD while taking note of any details that are prominent or conspicuously missing. 

Your therapist can then identify which portions of the trauma have become stuck in your brain.

Next, your therapist can walk you through your memories in a safe space. Together, you can manage settings as you discuss a traumatic experience. This invaluable service is an extremely important aspect of treatment because it allows you to feel and explore the symptoms of PTSD without the fear of being embarrassed, harmed, or exposed. 

Working through your experiences with a trusted therapist can help you gradually develop stronger, more effective coping methods. These methods might include meditation, mantra, and positive self-talk. 

Learning how to pay close attention to your breath or grounding yourself by using mindfulness and deep breathing strategies can be very helpful when processing traumatic memories and experiencing symptoms.

Ultimately, the goal of any therapeutic approach is rewiring the brain's response to the traumatic event and to safely process the event and heal. When a traumatic event is stored away before it is processed (as is the case in PTSD), one cannot fully heal until it has been reopened and evaluated to understand it better. 

Two common ideas behind PTSD therapy are exposure therapy through Eye Movement Desensitization and Reprocessing therapy. 

Talking To A Therapist

Post-traumatic stress disorder (PTSD) is treatable and seeing an in-person or online therapist for treatment can be an immense help. Most PTSD treatments last between 12 and 18 weeks at which point the person with PTSD and the therapist can reevaluate and determine if additional therapy is needed. 

During treatment, the person with PTSD will work with the therapist to develop new behaviors and thought patterns regarding the source of their trauma and walk through their trauma story step-by-step in a safe, controlled environment through behavioral therapy. 

This form of treatment may require some emotional fortitude but can dramatically improve one’s quality of life by reducing many of the symptoms of PTSD. If you or anyone you know has experienced any of the symptoms of PTSD, including hyperarousal, but are unsure of seeing a therapist, consider online therapy. 

Online therapy can be done in the comfort of your home and has been proven to be as effective as face-to-face therapy. Research with a Veteran population has shown that individual and group therapy via videoconferencing with a therapist yielded similar results in the reduction of symptoms as those found in traditional therapy. 

Research has also shown that there was a strong therapeutic alliance between the person receiving the therapy and the therapist. 

How BetterHelp Can Support You

If you’re ready to start your healing journey, one of BetterHelp’s online licensed therapists can help you. BetterHelp has many well-known, reviewed, and licensed therapists. With expertise in PTSD treatment, your therapist will guide you through your trauma story with gentleness and patience. 

You will learn how to manage your symptoms of PTSD, including hyperarousal, with the goal of lessening and eventually overcoming them. Although the road getting there can be difficult, treating and ultimately overcoming PTSD is possible.

You’ll be able to meet with your therapist wherever you feel most comfortable receiving treatment and at a time that’s convenient for you. Read below for some reviews of BetterHelp counselors from people experiencing similar issues.


Post-traumatic stress disorder (PTSD), especially hyperarousal, can make everyday life more challenging. Despite the hardships this disorder may initially bring, finding the right help can make all the difference in returning to a life not controlled by trauma. When we understand what we are experiencing, we can better assess what we need to heal from our trauma.

Counselor Reviews

Tina was able to diagnose my PTSD pretty soon after starting our sessions and helped me process a lot of unresolved childhood trauma 

I am really lucky to have Justin as my therapist. I write to him so much about my everyday life in solitude, and dating problems, family problems and traumas, and he goes through all the messages and really helps me even with the replies. And after every video session, I feel quite relieved and see progress and how I am slowly becoming a stronger and wiser human being, who doesn’t need to repress as much family pain anymore. Because there is someone who knows what he’s doing to help me deal with the problems we all have sometimes. And Justin helps me to motivate me to work towards my life goals. Personal, and career wise. After almost 5 years of swirling in nothingness, like a fly without a head, I finally feel like there is lots to achieve and with baby steps, will be achieved with less stress. Thank you, Justin! 

You Don't Have To Face Post Traumatic Stress Disorder Alone.

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