Part of the reason we humans have survived as long as we have is that our brain is wired to look out for danger. While this has certainly served us well, in some cases, our brains become overly sensitive, seeking out danger when there isn’t any. 

When this happens, it’s called hypervigilance. 

What is hypervigilance?

Hypervigilance in itself isn’t a diagnosis. Instead, it’s a symptom that can come as a result of various mental health conditions. Essentially it involves you feeling in a state of high alert (even if you are somewhere safe), and is often linked to previous trauma and/or anxiety. You may feel like you need to be aware of potential dangers, whether physical or emotional. This alertness can affect your physical health and your relationships with others.

Common conditions linked to hypervigilance include:

• post-traumatic stress disorder (PTSD)
• anxiety and anxiety-related conditions
• schizophrenia

Symptoms of hypervigilance

While hypervigilance in itself is a symptom, it also has specific symptoms itself. These can be broken down into physical, behavioural and emotional symptoms.

Physical symptoms

Common physical signs of hypervigilance include a faster heartbeat, quick and shallow breathing pattern, higher blood pressure and dilated pupils. These are similar to anxiety symptoms and when they are constant they can lead to exhaustion for the person experiencing them. 

Behavioural symptoms

If you’re in a hypervigilant state, you may find you jump easily at sudden noises. You may also misinterpret what someone is saying to you and take it in the wrong way leading you to react in a hostile way in an attempt to defend yourself. 

Emotional symptoms

Emotionally, you may notice an increased sense of fear and panic, including fear of judgement from others. You may become withdrawn, experience mood swings and develop black and white thinking.

Once triggered, hypervigilance may cause enhanced or intense emotional responses – activating a fight or flight response. Emotions are raised to the point of alarm or even panic.

- Counsellor Greg Savva

If you recognise these symptoms, visiting your doctor to learn more is a great first step. They can discuss your symptoms, rule out other causes and help you find the right support.

Causes of hypervigilance

Often hypervigilance is caused by trauma and is often felt by those with PTSD. When this is the case, hypervigilance causes people to constantly scan for new threats, especially if triggered by something. 

Sometimes it is caused by another mental health condition where fear and stress are present. For example, those with anxiety may become hypervigilant in new situations. Schizophrenia can also cause hypervigilance, often exacerbating other symptoms like paranoia. Those with obsessive compulsive disorder may also experience hypervigilance as the condition is rooted in anxiety and intrusive thoughts. 

You may be triggered by a number of things, including a feeling of being trapped, loud/sudden noises, anticipating judgement and feeling emotional distress.

Treatment for hypervigilance

Depending on the cause of your hypervigilance, it’s likely you will be referred to a psychotherapist for further support. In order to help the symptom, it’s important to treat the underlying cause. Typically, this will involve therapeutic approaches and possibly medication.

Therapeutic approaches

The type of therapy offered will be decided according to your circumstances and what will be most likely to support you. The options you may discuss include cognitive behavioural therapy (CBT), eye movement desensitisation and reprocessing (EMDR), exposure therapy or somatic therapy.

The aim of CBT is to help you understand the link between thoughts, feelings and behaviour. During sessions, you’ll be encouraged to build awareness around your experiences and consider healthier responses and coping mechanisms. 

EMDR uses eye movement techniques to help you process traumatic memories and alter the way they are stored in the brain to make them easier to manage. In this video, counsellor and supervisor Anne-Millne-Riley (BA, NRHP MICHT) explains more.

Exposure therapy looks to help you face experiences and situations that may feel overwhelming in a safe environment so you can learn how to cope. Doing this slowly and with the support of a therapist can ensure you feel safe throughout the process and eventually pull that feeling of safety through into your everyday life.

Somatic therapy looks at the way the body can hold trauma, and how physical movements can help to process them. There are various somatic approaches your therapist might use, including somatic experiencing, brainspotting and emotional freedom technique. 

Medication

If your condition is severe, you may be offered medication to support you as you undergo therapy. The aim here is to help you function better so you are able to engage in therapy and feel better able to cope with your symptoms.

If you are ever in any doubt about the treatment you’re receiving, be sure to talk it through with your doctor or therapist. Recovery from mental health conditions is rarely linear, but it’s important to speak up if you think you would benefit from a different approach. 

Self-help tips

In terms of managing hypervigilance outside of therapy sessions, there are some self-help ideas that could support you. These are generally focused on reducing stress and anxiety which can make hypervigilance worse. 

• Carve out time to relax each day. Self-care activities like yoga, journaling, meditation and reading can help to bring down stress levels, so be sure to prioritise this.
• Try being more mindful. Mindfulness exercises and meditations can help you be more present in the moment which can be especially helpful for those experiencing trauma and anxiety.
• Set boundaries. Try not to burn yourself out or overwhelm yourself with commitments and start building healthy boundaries. Communicate with loved ones. Discussing how you’re feeling can help others see your point of view and can clear up miscommunication. 
• Get some gentle exercise. Moving your body can support both mental and physical well-being, releasing endorphins and reducing stress. 

Hypervigilance can feel all-consuming at times but know that you’re not alone and that reaching out for help is the first step to overcoming it. With the support of professionals, you can start reducing hypervigilance and allow yourself to sit back and relax, safe in the knowledge that you’re OK.

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