What Is Hypervigilance?

Medically Reviewed by Smitha Bhandari, MD on February 25, 2024
3 min read

Your brain is designed to be aware of potential dangers in your surroundings. It's how early humans survived. Sensing the presence of predators or other threats helped them stay safe. But our brains shouldn't be in this excited state of extra-sensitivity all of the time. This is known as hypervigilance.

While hypervigilance isn’t a diagnosis, it is a symptom that can show up as a part of a variety of other mental health conditions. Hypervigilance is related to anxiety. When you feel particularly on guard, nervous, or worried about a situation or event, you may experience a heightened level of awareness or arousal.

Hypervigilance — the elevated state of constantly assessing potential threats around you — is often the result of a trauma. People who have been in combat, have survived abuse, or have posttraumatic stress disorder (PTSD) can exhibit hypervigilance.

PTSD can be caused by a wide variety of incidents. Some of these traumatic events include:

  • Living through a dangerous event
  • Experiencing a serious or frightening injury
  • Seeing another person get seriously hurt or die
  • Feeling horror or extreme fear
  • Experiencing trauma of any kind, and having no support afterward
  • Living through multiple losses or traumas back-to-back

Sometimes, hypervigilance is a symptom of a mental health condition, including anxiety or schizophrenia. When you're navigating conditions that include symptoms of fear, avoidance, or extreme stress reactions, you might experience irrational or exaggerated fear over a situation or event. This fear can cause your nervous system to be excessively aware or scanning for threats to your safety. 

Hypervigilance is a symptom of a psychological or mental condition, but it can have physical symptoms too. These changes can cause real discomfort and disruption in your life.

Research has shown that some of the most common symptoms of hypervigilance include:

  • Fixation on potential threats (dangerous people, animals, or situations)
  • An increased startle reflex (more likely to jump or be jarred by sudden sounds)
  • Dilated pupils
  • Higher heart rate
  • Elevated blood pressure
  • Behavioral (obsessive) avoidance of certain situations
  • Overestimation of threats or dangers

Children who have experienced traumatic events like child abuse, neglect, natural disasters, or wars, can exhibit signs of hypervigilance, too. Their developing brains are still learning to assess situations and form appropriate relationships. Severe trauma can disrupt that process.

Hypervigilance can have a serious impact on your behavior and quality of life. You may have a hard time sleeping or relaxing, which can make your sense of anxiety even worse. You could feel "on edge" or have angry outbursts.

If you have feelings of hypervigilance, you may change your behavior because of how you're feeling. It may be hard to focus or talk to others, and you want to stay away from large, noisy events.

Hypervigilance can also cause you to feel suspicious of people in your life. It can even reach a state of paranoia. Hypervigilance can lead you to catastrophize, or believe that the worst possible thing is about to happen.

This heightened sense of perception, driven by fear or anxiety, can cause strain on your relationships and impact your ability to go to work or school. But there are ways that you can manage this symptom.

One of the main treatments for people with hyperarousal — a condition that can include hypervigilance from PTSD — is therapy.

PTSD affects each person differently, so while some people might find therapy helpful in managing hypervigilance, others may find medication or a combination of medication and therapy most helpful. A mental health professional can help you decide what treatments or resources might be most helpful.

There are a few ways to manage extreme anxiety or feelings of hypervigilance in the moment and on a day-to-day basis. Experts recommend:

  • Taking a break — try yoga or gentle stretching, listen to upbeat music, or meditate.
  • Taking deep breaths — slowly inhale, hold for a beat, and then exhale.
  • Counting — count to 10 (or 20) very slowly, while taking deep breaths.
  • Getting exercise — movement helps your physical and mental health.
  • Talking to someone — let a trusted friend or family member know how you're feeling.

If you're struggling with hypervigilance or other mental health symptoms that you're having trouble managing, it's best to reach out to a mental health professional. These highly trained individuals have a wealth of experience and can help you navigate the unique challenges of your situation.