What Is Hypervigilance? Managing The Symptoms Of Posttraumatic Stress Disorder (PTSD)
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.
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:
Intrusion, which includes intrusive thoughts, upsetting dreams, and flashbacks to the traumatic event
Avoidance of people, places, activities, objects, and situations that trigger traumatic memories
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
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.
“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!”
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.
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. 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 to calm your nervous system.
What Causes Hypervigilance?
There are various causes of hypervigilance. Post-traumatic stress disorder, for example, or an anxiety disorder, such as GAD, may lead to hypervigilance. Other anxiety disorders, too, can lead to hypervigilance symptoms, including social anxiety disorder and panic disorder. Soothing the nervous system and establishing coping techniques for times where perceived threats lead to hypervigilance can help you manage hypervigilance. Therapy can help you do this and can be an excellent way to work on or treat hypervigilance as a symptom. If you believe that you may have an anxiety disorder, PTSD, or another mental health condition, you may seek professional medical advice from a medical or mental health provider who can help. They might also be able to help you find the underlying cause of hypervigilance if you don't know what it might be related to. Hypervigilance isn't the only symptom of these disorders. Other symptoms, such as irritability, can actually be a symptom of both PTSD and anxiety. Some things, such as sleep deprivation, may worsen symptoms and lead to other concerns, so self-care is often essential.
How Do You Calm Down Hypervigilance?
There is objective evidence that mental health support can help with anxiety and PTSD symptoms, which can include hypervigilance. Medical reviewers confirm through peer reviewed studies that therapy is helpful for those who live with PTSD. There are a number of ways to find a healthcare professional to work on this concern with. Sometimes, hypervigilance can create a forward feedback loop, where someone focuses on the perceived threat or nervousness and experiences an increase in feelings of anxiety due to this focus. Understanding hypervigilance and working with a professional can help.
How Do I Know If I'm Hypervigilant?
Someone who experiences hypervigilance may know it because of the increased startle reflex it comes with. Perceived threats may make you feel as though you're on high alert, cause hair trigger stress, or lead to otherwise hypervigilant behavior. Traumatic memories may also lead to this heightened state. For example, those who have survived domestic violence may experience heightened symptoms around loud noises, such as slamming doors or similar stimuli.
If you are still unsure if you are hypervigilant, consider discussing your symptoms and experiences with medical doctors or wellness professionals who have relevant experience working with hypervigilant patients. They can provide medical advice, diagnosis or treatment based on the symptoms you are experiencing.
If you or someone you know has experienced domestic violence or is currently experiencing domestic violence, please contact the National Domestic Violence Hotline at 1-800-799-7233 or text "START" to 88788.
Does Hypervigilance Cause Insomnia?
Hypervigilance can certainly pair with insomnia. When you feel high-alert, as someone does when experiencing hypervigilance, it can be challenging to sleep. However, professional medical guidance and support can help.
Discovering Online Therapy With BetterHelp
A licensed online therapist can address things like depression, anxiety, anger, hypervigilance, raising children, PTSD, and other specific mental health conditions, problems, or illnesses. Qualified & experienced therapists help people feel their best, improve mental health, and strengthen or heal relationships. Online therapy is designed to make it as easy as possible to get the help and support you need without having to even leave the house.
All 20,000+ licensed mental health professionals and therapists currently available on the BetterHelp.com platform are experienced practitioners. Our online therapists come from a wide array of different backgrounds, practices, beliefs and cultures.
Therapy is a personal experience, and not everyone will go into it seeking the same things. But keeping these things in mind can ensure that you will get the most out of online therapy for hypervigilance and PTSD, regardless of what your specific goals are. If you’re still wondering if therapy is right for you, and how much therapy costs, please contact us at firstname.lastname@example.org. BetterHelp specializes in online therapy to help address all types of mental health concerns, including hypervigilance and PTSD If you’re interested in individual therapy, please reach out to email@example.com. For more information about BetterHelp as a company, please find us on
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