What Is Hypervigilance? Signs, Side Effects, Coping Tips

PAYING ATTENTION TO your surroundings is a natural instinct. It’s what helps you feel safe. But, when you become so overly alert that you’re on edge and actively searching for threats, it can lead to an unhealthy behavioral pattern, known as hypervigilance.

“When a person experiences hypervigilance subconsciously, they’re always anticipating an attack—as a result, the person is constantly on edge, on guard, and prone to overreacting,” explains therapist Chase Cassine, L.C.S.W.

In a state of high alert, you might anticipate a physical threat or a traumatic event repeating itself, he adds. “Usually, the person is not under a real attack, but rather overanalyzing and overacting to information gathered by this instinct.”

Hypervigilance isn’t a diagnosable condition. But, it can be a symptom of a mental health disorder, like post-traumatic stress disorder (PTSD), anxiety, or schizophrenia, Cassine says.

It’s also often the result of trauma. Survivors of childhood abuse or assault, victims of police violence, or people who’ve experienced military combat may be more likely to be hypervigilant.

“It can be transient or chronic,” says Alicea Ardito, M.S.W., L.C.S.W., a therapist with Choosing Therapy. “It may occur in response to current anxiety, fear, or worry, or as a manifestation of a prior trauma or threat.”

Hypervigilant behaviors are usually involuntary. They might make you feel on edge, constantly scan your surroundings, startle easily, or have abnormal or disproportionate reactions to normal sounds, sights, or situations, she explains. All of this can lead to a number of physical health symptoms and have a long-term mental health impact.

What Is Hypervigilance?

Some level of vigilance is a good thing. “It’s how we humans managed survival early on and how in normal circumstances we measure if our safety is or could be compromised,” explains Elizabeth Keohan, L.C.S.W.-C, a licensed Talkspace therapist.

Hypervigilance, however, is a state of being on high alert disproportionate to your true surroundings or excessively concerned with your surroundings, she says.

Hypervigilance often includes “safety-seeking behaviors,” like avoidance, escape, or going on the attack, says Matt Glowiak, Ph.D., L.C.P.C., a therapist with Choosing Therapy.

People can experience it in a focused or broad way, he adds. For example, someone may be hypervigilant in the presence of police officers but be relaxed around others. Others might be hypervigilant around everyone.

Hypervigilance also resembles paranoia in some ways, but it’s not the same. “A notable difference is that with hypervigilance, there is a real perceived threat,” Glowiak says. “With paranoia, the threat stems from a delusion.”

What Are Hypervigilant Behaviors?

Hypervigilant behaviors vary from person to person, but they typically include:

• Constantly canvassing your surroundings
• Being easily rattled or startled
• Overanalyzing others’ behaviors or the things they say
• Overreacting to everyday stimuli (like loud noises or certain sights) that pose little or no threat
• Anticipating unrealistic worst-case scenarios
• Struggling with sleep
• Feeling trapped or claustrophobic

What Does It Feel Like to Be Hypervigilant?

Being in a state of hypervigilance can bring many physical symptoms, or a “somatic response,” Keohan says.

Some physical symptoms of hypervigilance, according to Cassine, include:

• Dilated pupils
• Insomnia or sleep disturbances
• Increased heart rate
• Shallow breathing
• Sweating
• Restlessness
• Fatigue

Constantly being on high alert means your brain continuously releases the hormones cortisol and adrenaline, which over time can be toxic to your immune system, Glowiak says. You may get sick more often and take longer to recover.

“People may experience headaches, stomachaches, irritable bowel, and other physical manifestations that stem directly from compromised mental health,” he says.

The Mental Health Effects

Hypervigilance takes a lot of mental energy—you’re focusing most of your emotional energy in a negative direction, Glowiak says.

It can interfere with your day-to-day life and overburden your senses. You might have relationship problems, struggle to feel joy, or find it hard to work productively.

“It keeps people in an opposite state of mindfulness, not present, always living in a pre-lived worry,” Keohan says.

Why Are You Hypervigilant?

Hypervigilance can be a symptom of mental health disorders, like anxiety, PTSD, or schizophrenia.

You might also be predisposed to hypervigilance if you come from a family with a history of psychiatric conditions or from an oppressed group or culture that’s experienced intergenerational trauma, Glowiak says.

“This makes sense given that there are many real threats in the world,” he says. “Not being mindful of them or protecting oneself continually may pose threats ultimately leading toward harm or death.”

Hypervigilance can become so routine that you positively reinforce it for yourself, Glowiak explains. For instance, you might attribute your safety to constantly checking things in your environment.

All that’s going on in society—like Covid-19 and other illnesses, mass shootings, police brutality, and legislation aimed at restricting rights—can heighten trauma and alarm, Glowiak says.

“While it’s healthy to proceed cautiously, it’s unhealthy to build one’s life around anything and everything negative that can happen,” he says. “True wellness comes from acknowledging the threat but still living life to the best of one’s ability.”

How to Cope With Hypervigilance?

You may need psychotherapy to address the root cause of hypervigilance, Ardito says. This could include cognitive behavioral therapy, exposure therapy, eye movement desensitization and reprocessing therapy, or medication.

There are also several ways to work through hypervigilance on your own, therapists say:

• Understand what’s triggering the behavior. This helps you recognize when you’re starting to feel overwhelmed and moving into a high-alert pattern.

• Learn to pause before emotionally reacting. Count to 10, take a deep breath, and slowly scan your surroundings to objectively examine whether threats exist.

• Try grounding techniques. When you find yourself canvassing your surroundings, connect to something that you immediately recognize that feels safe and secure.

• Practice mindfulness meditation to stop worrying about the unknown and feel safer.

• Create a self-care routine that includes activities that you enjoy, exercise, and getting plenty of sleep. This will help your mental state overall.

Whenever hypervigilance is impairing your daily life and interfering with your regular habits and relationships, it’s a good idea to talk to a mental health professional, Keohan says.

“I work with clients to consider not necessarily what is ‘wrong’ but what could possibly be ‘better’ whenever we are trying to change behaviors,” she says. “In almost all circumstances, we can’t change our lives immediately, but we can always choose to respond differently or learn to modify.”