An Overview of Hypervigilance

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Hypervigilance is a state of being constantly tense, on guard, and exceptionally aware of your environment. There are many causes of hypervigilance, including psychological conditions such as anxiety and medical illnesses such as thyroid disease. Recreational and therapeutic drugs can also produce this effect.

Diagnosis of hypervigilance is based on your medical history and clinical examination. Some diagnostic tests such as blood tests and imaging tests may help identify the cause. The treatment is based on reducing the symptoms of hypervigilance and also managing the underlying cause.

Man yelling with hands on head
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Hypervigilance is an unpleasant feeling. Not only do you notice sensations more readily, but you're also likely to be unable to divert your attention from them.

Most people have experienced brief moments of hypervigilance. For example, people who are watching a horror movie or visiting in a themed "haunted house" are often terrified by otherwise normal noises, such as a door creaking. And most visitors to the local zoo find themselves anxiously looking down on the ground after visiting the snake exhibit.

Others are hypervigilant when it comes to very specific things, such as high pitched sounds or physical discomfort. For example, when you hear a beeping noise in the other room, you may notice it right away and become highly distracted or agitated by it. You can be overly aware of physical sensations too—the pressure of a waistband or fabric rubbing across your skin can be distracting.

Chronic Hypervigilance

Hypervigilance usually goes beyond simple annoyance, however, and you can find yourself constantly scanning your environment for threats.

You may be so anxious every time you get on an airplane that you can't sit still, eat, or look at a magazine. And if you are hypervigilant in almost every environment, the feeling can interfere with your life.

People living with hypervigilance can experience any of the following symptoms:

  • Jumpiness
  • Paranoia
  • Frequent head jerking and scanning the environment with your eyes
  • Distraction from important tasks, from speaking with others, and from entertainment
  • Agitation
  • Anger
  • Depression
  • Isolation
  • Sleep disturbance
  • A sense of helplessness
  • Dependence on others
  • A tendency to fight or argue with others
  • Exhaustion
  • A change in appetite

If you have chronic symptoms of hypervigilance, it is vital that you speak with a healthcare professional, because this condition can make it difficult for you to maintain your health, relationships, and work life.


There are a number of risk factors that make you more prone to hypervigilance. Post-traumatic stress disorder (PTSD), fibromyalgia, hyperthyroidism, adrenal disease, sleep deprivation, anxiety, and schizophrenia are a few of the medical disorders that increase the likelihood of hypervigilance.

Medical Conditions

Medical illnesses can make you more sensitive to your surroundings (you feel things more intensely) or more alert (you anticipate negative sensations, experiences, or events) or both.

For example, sleep deprivation can make you jumpy, anxious, and prone to pain. Endocrine tumors, like pheochromocytoma, can produce an impending sense of doom. And drug intoxication or withdrawal often temporarily induces extreme paranoia.

Fibromyalgia is associated with sensory overload, allodynia (a sensation of pain in response to non-painful touch) and sensitivity to noise and light.

Threat Perception

Normally, the human brain perceives a lot of information about the surrounding environment, including everything that is seen, smelled, touched, heard, and even tasted. It is not possible to be consciously aware of and focused on all of these messages.

To effectively manage the input of information, the brain has a filtering process. Sensory messages that are considered unimportant are quieted.

Any message that your brain considers dangerous, however, gets extra attention. Loud noises, dangerous animals or bugs, threatening people, and painful physical sensations can all cause harm, so you react to them.

Hypervigilance is watching out for a threat. And while your mind knows that isn't necessary to be constantly on the lookout for dangerous animals, like wolves or lions, in an urban apartment building, you may listen anxiously for any sign of an elevator malfunction—while others chat away or check their phones without any concern about the elevator.

Hypervigilance is a highly personalized response, depending on what your brain has learned is a danger.

Life Experiences

Life events and experiences can play a big role in hypervigilance.

Children who witnessed parental fighting in the home may be jumpy around loud voices. Adults who were bullied may become nervous around people who have characteristics similar to those of their former bullies. A person who survived a fire may overreact to the smell of a campfire, the sound of a smoke alarm.

And when you suffer from hypervigilance, these triggers don't just trigger you when they occur—you will subconsciously search for them, sensing an aggressive fight even when people are joking around, or noticing smoke floating from a household candle.


Hypervigilance can affect your peace of mind and it can be distressing for those who are close to you. The first step in getting relief of your symptoms lies in accepting the fact that you can be diagnosed and that treatment can be effective.

Talk to your healthcare provider about your symptoms. Bring a trusted friend or family member if you feel that they could help you explain your problem to your practitioner. Your healthcare provider will ask you questions about your symptoms and your health and will do a physical examination.

In the context of hypervigilance, one of the most important aspects of your physical examination is the measurement of your vital signs—temperature, heart rate, breathing rate, and blood pressure. Many illnesses that are associated with hypervigilance can alter your vital signs.

Your healthcare provider may suggest further evaluation, depending on your symptoms and physical examination findings.

Additional evaluations can include:

  • A psychiatric consultation
  • Blood tests: A complete blood count (CBC), thyroid tests, and electrolyte tests
  • A urinalysis and toxicology screening
  • A brain computerized tomography (CT) or magnetic resonance imaging (MRI) test
  • An abdominal or neck CT, MRI, or ultrasound

Hypervigilance is considered an aspect of illness and not an illness itself. If you suspect that hypervigilance could be a problem for you, talk to your healthcare provider about it. That may help shape the direction of your treatment.


Medications aren't generally considered the first therapeutic choice in the treatment of hypervigilance. Typically, counseling and coping techniques are effective, and treatment of the underlying condition is vital.

Counseling and Coping

It is best to find a therapist who has an approach that you feel comfortable with. You may need to talk through certain experiences and events that could have led to your current fears,

Over time, you can learn to develop a more balanced perspective about your worries.

Coping techniques that can reduce hypervigilance include:

  • Dealing with stress
  • Yoga
  • Meditation
  • Mindfulness
  • Deep breathing

Medical Mangement

If an illness has caused your hypervigilance, then management of the illness can reduce your hypervigilance and will also help your overall health.

For example, if you are diagnosed with an endocrine condition, then medication or surgery may be necessary. And there are effective medical treatments that can alleviate symptoms of schizophrenia. Sleep deprivation can have numerous causes, and the management can include lifestyle management, medication, or treatment for sleep apnea.

If you are using a recreational drug or a medication that is producing hypervigilance as a side effect, then stopping it is advisable.

Keep in mind that you should work with your healthcare provider to plan a tapering schedule for any medication or recreational drug to avoid withdrawal symptoms.

A Word From Verywell

Some people are so distressed by hypervigilance that they remove themselves from situations or environments that ramp up their hypervigilance. This can be a good approach if the situations are few and far between, and are not important in the overall scheme of your life.

However, if staying away from your triggers leads to isolation or interferes with your ability to be productive, you may benefit from counseling so that you can more fully enjoy life. While you may feel hopeless at times, remember that, with time and effort, you can overcome hypervigilance.

Frequently Asked Questions

  • Can PTSD cause hypervigilance?

    Yes, post-traumatic stress disorder (PTSD) can involve hypervigilance. Other risk factors for hypervigilance include adrenal disease, anxiety, fibromyalgia, hyperthyroidism, schizophrenia, and sleep deprivation.

  • How is hypervigilance tested?

    Hypervigilance can be tested through a psychiatric consultation. Hypervigilance often affects a person's vital signs, so a healthcare provider will note changes in temperature, heart rate, breathing rate, or blood pressure.

    Tests may be done to look for medical causes of hypervigilance symptoms, including a complete blood count (CBC), thyroid test, electrolyte test, urinalysis, toxicology screening, computerized tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Kleshchova O, Rieder JK, Grinband J, Weierich MR. Resting amygdala connectivity and basal sympathetic tone as markers of chronic hypervigilance. Psychoneuroendocrinology. 2019;102:68-78. doi:10.1016/j.psyneuen.2018.11.036

  3. Sluka KA, Clauw DJ. Neurobiology of fibromyalgia and chronic widespread painNeuroscience. 2016;338:114–129. doi:10.1016/j.neuroscience.2016.06.006

  4. BMJ Best Practice. Post-traumatic stress disorder.

  5. National Institute of Mental Health. Post-Traumatic Stress Disorder.

By Adrienne Dellwo
Adrienne Dellwo is an experienced journalist who was diagnosed with fibromyalgia and has written extensively on the topic.