What Is Hypervigilance? Managing The Symptoms Of Posttraumatic Stress Disorder (PTSD)

Updated March 6, 2023by BetterHelp Editorial Team

Content warning: This article mentions trauma, combat, and other sensitive topics. 

Additionally, please note that BetterHelp is not an emergency resource. If you need help for PTSD now, the links and phone numbers below can connect you with services immediately. All of the following are available 24/7.

  • Crisis Text Line: Text HOME to 741741

  • Veterans Crisis Line: Call 1-800-273-8255 (and press 1) or text 838255. For support for the deaf and hard of hearing community, please use your preferred relay service or dial 711, then 1-800-273-8255.

  • The PTSD Foundation of America (a faith-based organization): 1-877-717-7873

  • The National Suicide Prevention Lifeline: 1-800-273-8255

  • The National Domestic Violence Hotline: 1-800-799-7233

Although posttraumatic stress disorder (PTSD) is commonly associated with war veterans, assault, and other intense experiences, trauma can affect anyone: regardless of their background or identities. 

According to the American Psychological Association (APA), PTSD may develop after any kind of traumatic event. This could be combat or a terrorist attack, but it might also be a crime, accident, or natural disaster. The symptoms of PTSD are varied and complex, and one of the most common signs is hypervigilance: a near-constant state of high alert.

In the face of immediate danger, it makes sense to feel more alert and “on guard” – but when you’re constantly scanning your environment for possible dangers, it can take a toll on your mental and physical health. The negative effects of hypervigilance snowball over time, and can make it difficult for people to focus on conversations and remain grounded in the present moment. 

Because hypervigilance can make it difficult to function in daily life, some researchers have devoted themselves to studying the link between PTSD and hypervigilance. Promisingly, proactive treatment can help people overcome this debilitating symptom. Learn more about the role of hypervigilance in PTSD, and how therapy and other interventions can help people restore their sense of calm and well-being.

Feeling Tense, On Guard, Or Uneasy?

What Are The Symptoms Of Hypervigilance?

Generally, people experiencing hypervigilance report feeling “on guard,” hyper-aware, and always on the lookout for danger. That said, hypervigilant behaviors look slightly different for every person, and may include:

  • Overreacting to loud or unexpected sounds or smells

  • Constantly scanning the environment, which may look like “darting eyes”

  • Appearing jumpy and jittery

  • Constant concern about others’ actions 

  • Obsessive avoidance of perceived threats, which may include certain places or people

  • Physical symptoms, including dilated pupils, increased heart rate, elevated blood pressure, and poor sleep

These behaviors and symptoms can vary widely in their severity. In general, people with hypervigilance recognize their symptoms, but they don’t always acknowledge the intensity of their reactions and behaviors. They may defend their actions and argue they’re necessary to ensure their safety.

While hypervigilance is a primary symptom of PTSD, these behaviors may also occur in people with other anxiety disorders, including panic disorder and social phobia. Many researchers believe that anxiety naturally boosts hypervigilance, which increases a person’s level of threat detection. This results in a distressing feedback loop of anxiety, threat detection, and over-alertness. 

Hypervigilance Vs. Paranoia

Paranoia and hypervigilance are sometimes used interchangeably, but there are some important distinctions between the two terms.

Whereas people with hypervigilance are usually aware of their symptoms, a person with paranoia tends to express beliefs that are not based in reality, and their symptoms are commonly associated with schizophrenia. Left untreated, paranoia can escalate to delusions, coupled with a deep suspicion of others’ intentions and motivations. 

While these behaviors differ in terms of a person’s awareness of their symptoms, both paranoia and hypervigilance are characterized by feelings of fear and distrust.

What Are The Other Symptoms Of PTSD?

Hypervigilance is one of the most common symptoms of PTSD, but not everyone with this diagnosis will experience this symptom. Other common signs of PTSD are typically divided into four categories, according to the APA:

  1. Intrusion, which includes intrusive thoughts, upsetting dreams, and flashbacks to the traumatic event

  2. Avoidance of people, places, activities, objects, and situations that trigger traumatic memories

  3. Changes in cognition and mood, including an inability to remember important aspects of the trauma and distorted thoughts about the causes or consequences of the event

  4. Changes in arousal and reactivity, which can include hypervigilance, angry outbursts, and reckless behavior

If you believe your symptoms align with PTSD, consult a licensed doctor to ensure a proper diagnosis. Depending on the person and the nature of the trauma, PTSD symptoms may appear within days or develop months later, and can persist for years at a time.  

Strategies To Cope With Hypervigilance

If you’re experiencing hypervigilance, it’s likely that you’re also living with other PTSD symptoms. To support a full recovery, it’s important to treat all symptoms of PTSD. A licensed medical professional can give you the knowledge and tools you need to begin the journey.

The following coping strategies for hypervigilance are recommended by medical doctors as well as mental health professionals. Feel free to adapt these ideas to meet your specific needs, and always consult with your medical team for a personalized treatment plan.

1. Notice And Write Down Your Thoughts

In the moment, it can be difficult to stop yourself from entering the spiral of hypervigilant thought patterns – but whenever possible, make an effort to “catch yourself” before these thoughts escalate. 

To recognize and prevent the spiral, it may help to write down recurring thought patterns as they come up, or to confide in a trusted loved one about your thoughts and feelings. By recording your thoughts in a visual form – on a notepad, an online document, or even your phone notes – you’ll develop a better sense of when and why those thoughts occur.  

Regardless of mental health status, we all experience some negative or distressing thoughts on occasion. Writing them down can help you question whether those thoughts are rational, and redirect your thoughts and energy toward more enriching, life-giving activities. 

2. Get Active

For many people, physical activity has a positive impact on their mental health, regardless of their specific diagnosis. Among people with PTSD, research suggests that aerobic exercise can reduce the feeling of “hyperarousal” associated with hypervigilance and other PTSD symptoms. In terms of exercise, any movement counts: you can dance, do yoga, run around the park with your dog, or walk with a friend.

3. Practice Positive Self-Talk

At first, positive self-talk may feel awkward or uncomfortable, but it can have significant benefits for your mental health: whether you’re struggling with hypervigilance, paranoia, or another challenge. 

Your inner critic may have a powerful microphone, but if you imagine talking to yourself like you would with a friend, positive self-talk often becomes easier and more natural over time.

To improve your self-talk, consider trying some of the following tips:

  • Challenge yourself and ask whether your thoughts are true (often, they’re not – especially in the context of hypervigilance!). Try to find another explanation or way to look at the current situation.

  • Stop the thought or negative self-talk with the “thought stopping” technique: imagine yourself literally stopping, squashing, or “zapping” a negative thought away.

  • Focus on your strengths. If you notice you’ve said two unkind things to yourself, replace those comments with two kind expressions that highlight your unique strengths or abilities.

4. Build Your Support System

Hypervigilance and other PTSD symptoms can make people feel isolated from their loved ones and acquaintances. Yet during this time, people often benefit from all the social support, love, and compassion they can get.

Some people find that in-person or online support groups provide a sense of community and solidarity with people whose symptoms mirror their own. Other people confide in close friends, family and other loved ones. 

In any case, it’s usually helpful to lean on a variety of people. When you build a healthy, sustainable support system, you don’t have to ask one person for more support than they’re able to provide. 

5. Connect With A Therapist

A licensed therapist can become a foundational part of your support system. They’re trained to provide a mix of compassion and research-backed insights, and can help you manage the effects of hypervigilance and other PTSD symptoms. 

Today, a growing number of people use online therapy to invest in their mental health while balancing active lifestyles. If you’re struggling to find the time or finances to begin therapy, an online platform like BetterHelp may be the solution. BetterHelp features thousands of board-certified therapists, and each one has at least three years of professional experience. Many specialize in helping people with PTSD and other anxiety disorders, and they can offer the tools and reassurance you need to overcome your symptoms.

Research suggests that online therapy can be just as effective as face-to-face options. A 2019 review of 10 studies found that internet-based cognitive behavioral therapy (iCBT) can be a valuable intervention for adults with PTSD. While more research is always needed, the researchers cite several other studies that describe iCBT as an accessible, affordable, and clinically-effective treatment for PTSD and other mental health conditions.

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!”

Feeling Tense, On Guard, Or Uneasy?
“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.”


Hypervigilance is one of the trademark symptoms of PTSD. Almost universally, it’s an intense and distressing experience – but with the help of your support system and therapist, you can restore your sense of calm and clarity in the present moment. 

Learning about hypervigilance is the first step. With this knowledge, you can connect with a mental health professional and proceed confidently to the next stage of your journey.

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

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