Hypervigilance And Link With PTSD

By Alisen Boada|Updated May 9, 2022
CheckedMedically Reviewed By Chante’ Gamby, LCSW

Please be advised, the below article might mention topics that include sensitive content such as trauma or assault.

When you struggle with hypervigilance and its symptoms, your mind is constantly telling you to look out for danger, similar to PTSD or paranoia. Hypervigilance causes you to enter a room and always make sure to notice the exits. With hypervigilance, a slight change in someone’s tone puts you on edge, sudden movements and noises get your heart racing, you’re constantly checking to see if anyone’s behind you and always make sure to notice the exits. With hypervigilance, a slight change in someone’s tone puts you on edge, sudden movements and noises get your heart racing, you’re constantly checking to see if anyone’s behind you.

hypervigilance and PTSD

Is Being Hypervigilant Keeping You From Living Your Life?

Going through a traumatic event can leave us feeling like we can never let our guard down again. But you deserve to be able to enjoy life without the exhaustion of feeling you always need to protect yourself. Exploring new coping strategies can help you manage your fears in ways that support your long-term health and well-being.

What Causes Hypervigilance? How Is It Linked To PTSD?

Hypervigilance means being in a state of high alert for any threats in your environment. Though this is a way our body protects us in potentially dangerous situations, like walking through a dark alley alone at night, anxiety and trauma can keep alertness in overdrive even in our day-to-day lives. Chronic hypervigilance is often caused by post-traumatic stress disorder (PTSD) after going through an intensely painful experience. Severe accidents, military combat, assault, and ongoing abuse can trigger and maintain our body’s “flight or fight” response to guard against a repeat of the trauma.

Unfortunately, this leaves us overreacting to threats that aren’t always there. The ongoing surveillance and sensitivity to everything around you can take a toll on your physical and emotional health. Anxiety disorders can also cause us to be prepared for disaster at any moment. But coping strategies like mindfulness and cognitive behavioral therapy (CBT) can help us care for our needs while teaching our minds to feel safe again.


When living in a hostile or abusive environment, noticing the slightest cue can mean all the difference in giving you enough time to get out of harm’s way. But our minds may not totally realize when we’re free from hazards, so we remain in hypervigilance for longer than necessary. This can look like preparing for all worst-case scenarios, reading into signs that actually don’t mean danger, or experiencing constant jumpiness.

The ongoing overestimation of threats can make us feel as though we need to avoid any situation or place that can possibly put us at risk again. For example, a serious car accident can lead you to drive excessively slowly, frequently check your mirrors, or even stop driving altogether. Whether it’s making escape plans or closely reading people’s body language, hypervigilance keeps us ready for a threat that may not exist.

Circumstances beyond your control may have been unfairly brought on hypervigilance, but the fatigue and isolation of always being on guard is a burden you shouldn’t have to continue carrying. Instead, you can retrain your mind to manage fear in ways that let you enjoy life again. There are many proven treatments to successfully relieve the PTSD or anxiety that may be behind your hypervigilance. And you don’t need to go through this alone. Finding support groups with people who can relate to your experience can put you in touch with helpful resources for your needs.

Is Hypervigilance Behind Your Decisions?

The distress of constant alertness can affect our decisions without us realizing it. Knowing the physical, emotional, and behavioral symptoms caused by hypervigilance can help us see how it influences our life choices.


Our body produces adrenaline whenever we believe we are in danger. Hypervigilance often causes increased heart rate, dilated pupils, faster breathing, sweating, and elevated blood pressure. This ongoing “flight or fight” reflex makes us easily startled by unexpected sounds and movements, like feeling a fast, knee-jerk reaction when you hear an expected knock at the door. Being in an environment with too much going on can feel overwhelming and interfere with our ability to focus on what we’re doing. Hypervigilance can also cause difficulty sleeping, making us more likely to be fatigued or anxious.


We’re not always aware of the emotions that lie behind our need for hypervigilance. Trauma can take a drastic toll on our ability to recognize and regulate our feelings. In addition to fear, anxiety, and panic, the chronic stress caused by hypervigilance can lead to mood swings and overreactions, from irritability to sudden outbursts of anger. Anger is a common emotional response to trauma and the threat of potential danger because it helps focus our attention on survival.


The constant tension of hypervigilance can turn us toward unhealthy ways of drowning out our fears to give us a sense of control. But turning to the wrong coping habits can reinforce the anxiety that causes this in the first place.

Overworking is thought to be a coping strategy for PTSD and hypervigilance. While working long hours seems productive, an obsessive impulse to work can cause us to neglect our relationships, sleep, and health. In this case, overworking isn’t done out of enjoyment but to avoid the difficult emotions caused by trauma or to feel prepared for potential disasters.

“A mental health professional is a valuable resource for helping you toward the goal of feeling safe again. Working with someone who is remote and affordable creates one less barrier to taking the first step toward recovery.”

Substance abuse is another unhealthy way we may attempt to manage the fear and anxiety behind hypervigilance. Up to 50-66% of people who experience PTSD also struggle with Substance Abuse Disorder. Alcohol and other drugs can temporarily restore the relaxing chemicals in our brains that trauma has depleted, giving us a sense of relief from the ongoing adrenaline rush of hypervigilance. Chronic anxiety can lower our impulse control, making it easier to self-medicate when we feel distressed.

The overstimulation caused by hypervigilance can also cause us to avoid social situations, isolating us from loved ones and other sources of support. When we’re left on our own with troubling thoughts, negative emotions and perception of threats can seem even more powerful. Isolation can also make you feel like you’re alone in your struggle. But according to the National Center for PTSD, 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Reaching out to others who know what you are going through, whether through support groups or group therapy, can help you navigate the way to recovery.

Coping With Hypervigilance And Its Symptoms

There are skills and habits to help manage the impulse to continually be on guard and reduce the impact hypervigilance has on our lives.


Recovering from trauma and anxiety disorders can take time, patience, and practice. One of the best ways to support ourselves through this process is to practice a bit of self-care. Tending to our basic needs, like eating, sleep, and exercise can seem challenging but will do wonders for your resilience and sense of well-being. If you’re thinking, “How can a complex issue like hypervigilance require such simple solutions?” it’s important to realize that at the end of the day, we’re human, biological beings who rely on energy to sustain ourselves. Of course, we do need other things in life (like shelter and social interaction), but you may be surprised at how much of our well-being depends on energy (food, sleep, and exercise). Don’t just brush aside this information if it seems obvious—try to push yourself to prioritize these three things, and you’ll likely notice a shift.

If hypervigilance affects your sleep, try setting a regular bedtime and exercise at some point (enough to sweat) during the day. If you find yourself lying awake worrying, turn to something calming like a favorite book or herbal tea.

Eating regularly maintains a steady blood sugar level, which can help us manage how hypervigilance affects our moods. Try starting off the day with a solid breakfast, eating small portions of slow-release energy foods (like whole grains and nuts) spaced throughout the day, and avoid foods that can spike your blood sugar (like candy and soda).

Studies have shown that exercise can help relieve the symptoms of PTSD and support recovery. Even gentle physical activities (like yoga, walking, or tai chi) release soothing endorphins and keep us focused on the present.


Practicing mindfulness teaches us how to become aware of what’s happening in the moment. This involves noticing thoughts, emotions, and sensations without judging them or pushing them away. Mindfulness can help untangle our expectations of danger from what is actually going on around us. It also reveals how the overwhelming emotions that drive us to hypervigilance cannot harm us, even though they are painful and upsetting.

One of the first steps toward practicing mindfulness is to just notice your breathing. This can help put you in touch with what’s happening in your body and guide you to how anxiety might be affecting your mindset. Are you breathing quickly? Can you slow this down? Are you holding tension anywhere else in your body? Where is that strain coming from? Can you sit with the unease without pushing it away?

Speaking With An Expert To Alleviate Paranoia And Anxiety Symptoms

While there are many healthy things you can do to cope with hypervigilance, it can be challenging to face its underlying causes alone. PTSD and anxiety disorders are tied to painful experiences that our mind has tried to protect us from. Revisiting them can feel safer with the guidance and support of someone dedicated to your recovery.

Research shows that online therapy can be a powerful tool in reducing PTSD symptoms like hypervigilance. For example, this study found that therapist-assisted internet-based cognitive behavior therapy can be an effective and more time-efficient treatment option for people with PTSD than face-to-face treatment. Researchers go on to say that online therapy maintains the therapeutic alliance or relationship found in more traditional therapy treatment settings, which means you will still have the opportunity to develop a strong connection to your counselor.

BetterHelp can connect you with licensed mental health experts online who specialize in techniques to help you work through trauma and how it affects your experience of the world. Working with someone who is remote—and therefore available anywhere, anytime—creates one less barrier to taking the first step toward recovery. BetterHelp also offers affordable pricing options typically comparable with the co-pays of most insurance plans. Consider the following reviews of BetterHelp counselors from people experiencing similar issues.

Counselor Reviews

“Erin is the best counselor I’ve ever had the pleasure of working with. She works with me on things I’ve turned over and over in my head and reframes them so that they seem much less daunting. She understands PTSD and trauma better than anyone I’ve spoken to and is really helping me unpack some of it. Thank you, Erin!”
Is Being Hypervigilant Keeping You From Living Your Life?
“Joseph takes a caring, individualized approach for what I need to cover for my mental health, whether it’s talking about past traumas or an ongoing crisis. He is attentive and recalls details that I wouldn’t have expected him to, which really helps me know that there’s a genuine rapport. I am a military and police veteran with divorce and relationship issues, post traumatic stress, and major depression. Sometimes I feel like I just want to update Joseph on what’s going on in life when I don’t really have a general direction in the conversation that I want to go in, and he shows interest even when I’m just venting. I would absolutely recommend him to a friend or coworker.”

You Deserve To Feel Safe

Hypervigilance can trick us into thinking the world is against us, even when the dangers we’ve escaped in our past are long gone. Rediscovering a sense of calm with therapy, healthy coping strategies, and support from those who understand our experience can make the road to recovery seem less perilous. Take the first step.

Frequently Asked Questions (FAQs)

What Does Hypervigilance Feel Like?

Hypervigilance is a state of increased alertness. You're constantly aware of your environment, and you may fear that someone (or something) will hurt you. A person in this state will take extra precautions to protect themselves against a perceived threat. If you're in a state of hypervigilance, you're extremely sensitive to your surroundings. It can make you feel like you're alert to any hidden dangers, whether from other people or the environment. Hypervigilance can severely impact a person's mental health. It's a common symptom of Post-Traumatic Stress Disorder (PTSD), the mental health condition that affects millions of Americans.

In addition to PTSD, other mental health conditions could also be why someone is experiencing hypervigilance. For example, those with anxiety disorders can be sensitive to their surroundings. A highly anxious individual, for example, may be hyper-aware of what's going on around them. Some people with anxiety disorders are conditioned to believe that there's an imminent threat to their safety. Hypervigilance can vary in severity depending on the mental health condition. For example, a person with bipolar disorder may be hyper-aware of their surroundings to a great extent during a manic episode or psychosis. Doctors treat people with bipolar disorder using antipsychotics during mania, and these medications can help the symptoms of hypervigilance. When hypervigilance actions impact your mental health, it's crucial to get help. Please consult with your doctor or primary care physician before considering any medication options.

What Is The Cause Of Hypervigilance?
There are several reasons you may be experiencing a hypervigilance, including PTSD, bipolar disorder, or a generalized anxiety disorder. If you're experiencing this due to a mental health issue, there are numerous ways to manage your symptoms, including going to therapy. Counseling can help people confront the feeling and find ways to cope. Some forms of treatment include cognitive behavioral therapy or exposure therapy. Exposure therapy can a person understand their hypervigilance, learn their triggers, and work through them. People who have a generalized anxiety disorder condition also can benefit from exposure therapy. Whatever the causes of hypervigilance, it's crucial to get treatment.
Is Hypervigilance A Mental Disorder?
Hypervigilance isn't (in itself) a mental disorder. However, it's a symptom of many common mental health conditions. Psychologists who have medically reviewed hypervigilance have found that it's linked to PTSD. People experiencing hypervigilance may be worried that there's something "wrong" with them. That’s understandable, but it’s important to remember that if you find yourself on guard and frightened, there's nothing wrong with you. You're not defective; you're experiencing hypervigilance. When traumatic events happen, they impact our mind and body. Sometimes the reason people experience hypervigilance is because there's something in their environment that reminds them of previous trauma. That's where exposure therapy or EMDR (Eye Movement Desensitization Reprocessing) can help. Trauma therapy is an important step that you can take to heal. Whether you see a therapist online or in your local area, it's something that you can use to help your health from your emotional wounds. 

How Do You Calm Down?

When you're in a state of hyper-arousal, and your body and mind feel out of control, it’s common to feel helpless. It's upsetting and scary to believe that your life is in danger, but there are grounding exercises that can help. Some medically reviewed grounding exercises have been documented to help address hypervigilance. These techniques will likely bring you back to a calm state. If you have trouble learning how to ease your symptoms, it's okay to ask for the help of a licensed therapist.

What Are The Symptoms Of Hypervigilance?

Hypervigilance is a mental state where a person feels unusually alert and hyper-aware of their surroundings. You could be sensitive to sounds or things you see. When a person is in a state of hypervigilance, they perceive things as dangerous in their environment, when in reality, they're benign.

Symptoms can vary from person to person and depend on the mental health condition that they have. Here are some common physical signs:

  • Racing heart
  • Sweating a noticeable amount
  • Difficulty breathing, or shallow breaths

These symptoms, coupled with feelings of imminent danger, are signs of hypervigilance. 

In addition to physical symptoms, you may have a strong reaction when hearing a loud noise like the siren of a police car or an ambulance.

What Is Hypervigilance Behavior?

A person who is displaying hypervigilance is reacting because of anxiety or previous traumatic experiences. When the body and mind are in a state of arousal, they become reactive to their surroundings. Here are some examples of typical behavior.

  • Marked irritability
  • Sleep problems, including insomnia
  • Appearing afraid of danger around the corner and checking for it
  • Reckless and self-destructive behavior
  • Reactive startle response
  • Difficulty focusing

If you're experiencing a combination of these symptoms, you are probably in a hypervigilance state. It's okay to ask for help when you feel that way. A mental health professional can support you in understanding your symptoms and seeking out an effective treatment.

You Don't Have To Face Post Traumatic Stress Disorder Alone.
Speak With A Licensed PTSD Therapist Today
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