Hypervigilance (A complete guide)

Hypervigilance can lead to various kinds of compulsive behaviors as well and makes a person extremely aware of everything that is going on around them at all times.

This state of being means that a person is even more aware about what is happening in their surroundings.

People gradually become very aware of what’s around them.

Hypervigilance can also be an indication of post traumatic stress disorder (PTSD). 


Hypervigilance involves more than just paying extra attention to what is going on around you.

Hypervigilance is a condition that entails being so aware of what’s happening around you to the point where it is a detriment to your quality of life.

If you are hypervigilant, you are continuously looking out for danger, no matter if it’s real or non-existent.

People who suffer from hypervigilance are often on the lookout for something that could jump out at them or harm them at any moment in time.

This prevents a person from being able to remain fully at ease in any situation, environment or point in time.

Not only is hypervigilance considered a defining feature of PTSD, it can also be a characteristic of anxiety disorders, fear, and other psychological conditions.

Hypervigilance is also a defining feature of conditions such as dementia, schizophrenia, and paranoia.

Individuals who are hypervigilant will be continually on watch and predisposed to overreaction.

They always maintain a thorough sense of awareness of their environments, often looking for threats or ways of escape.

Due to the fact that you constantly need to be aware, hypervigilance can leave you exhausted and may interfere with your personal and professional relationships. 


There are several causes of hypervigilance, some of which are described below: 

Hostile environment:

Hypervigilance is a mode of defending yourself from aggressive circumstances.

These symptoms often appear when the individual is in a hostile environment. It can happen in an atmosphere where you observe a threat of any kind.

An example of this can be walking home alone late at night through an unfamiliar neighborhood, where you might keep an eye out for strangers who could potentially follow you home.

This will cause the person to be on high alert and waiting for any possible danger to emerge.

Hypervigilance is a way of someone being able to keep themselves as safe as possible. 

PTSD and Schizophrenia:

Chronic hypervigilance is a common result of PTSD, usually in people who have been in unsafe surroundings for an extensive period of time or experienced trauma such as serving in the army or navy.


Hypervigilance can also be related to dementia and Alzheimer’s along with other neurological conditions.

Some people are so upset by hypervigilance that they keep themselves from circumstances or surroundings that aggravate their hypervigilance.

This can have a great impact on their quality of life. 

Hypervigilance (A complete guide)


Hypervigilance symptoms largely manifest in one of the four following categories:

1.     Overestimating a hazard:

Hypervigilant patients will be on the lookout for fears that are either questionable or overstated.

This may look like closing themselves off to prevent being attacked, sitting close to an exit door so they can escape a situation if they feel uncomfortable, or sitting with your back to a wall so individuals can’t steal anything from behind your back. 

2.     The compulsive avoidance of supposed threats:

This comprises evading daily habits, routines or commutes where hazardous conditions might arise.

This might look like avoiding public transit, gravitating toward areas with less populated areas.

In very severe cases, an individual may develop agoraphobia. 

3.     Being easily startled:

Being easily startled involves jumping at any unexpected sound, movement or sight at any hour of the day.

Some people who suffer from hypervigilance experience this condition when they’re in a new situation.

An external stimuli is likely to produce hypervigilant reactions and would encourage someone to be on guard in order to prevent themselves from being suddenly startled. 

4.     Epinephrine-induced biological indications:

Epinephrine, also known as adrenaline, is a hormone frequently associated with the fight or flight reflex. with the fight or flight reflex.

People who have hypervigilance will frequently have an increased presence of epinephrine in their system, which manifests itself in widened pupils, an amplified heart rate, and raised blood pressure.

Adrenaline is also viewed as protective, allowing a person to keep themselves feeling as protected as possible.


The treatment of hypervigilance can vary depending on the symptoms that manifest as well as the severity of these behaviors.

Treatment options will also depend on whether or not the person suffering from hypervigilance knows that their behavior is irregular.

The first step in treatment would be to remove the person from a situation in which they would feel a sense of real danger or from situations where they would feel an immense amount of stress.

Treatment may include psychotherapy, mindfulness training and prescription medication. 

Cognitive behavioral therapy: CBT is supposed to help show you that you cannot control every aspect of the world around you.

CBT works with the patient to help understand their thoughts, behaviors and feelings and how you can change them to help you lead a happier life with less stress.

Exposure treatment: This method of treatment exposes you to the trigger and allows you to work on reacting to the stimuli in a productive manner.

Repeated exposure is thought to lessen the severity of a person’s reactions.

Eye movement desensitization and reprocessing: this treatment method uses eye movements as a way to help you manage your feelings and overcome stressful situations.

Although this is a newer form of therapy, it’s meant to help individuals cope with hypervigilance.

Mindfulness training: Mindfulness includes living in the present and focusing on what is with you in the here and now.

Mindfulness training may include exercises such as deep breathing, meditations and focusing on your surroundings.

Mindfulness is also a common treatment for a variety of psychological conditions.

One way in which people practice mindfulness is through regular meditation and breathing exercises.

Medications: Hypervigilance can often be treated with antidepressants, beta blockers or anxiolytic medications.

While medicine may not cure hypervigilance, it can certainly treat the symptoms associated with it.

Medication is a common treatment approach for a variety of psychological conditions and is one that should be reviewed carefully with a mental health professional.

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FAQs on Hypervigilance:

Is hypervigilance similar to or different from paranoia?

Hypervigilance is often thought of as being on your guard and examining what is going on around you at all times.

On the other hand, paranoia is often viewed as a state where the person experiences delusions that are not based in a reality of any kind.

Hypervigilance also focuses on the here and now of a situation, whereas paranoia worries about what might happen to someone in the future. 

What are some things I can do to help alleviate the symptoms of hypervigilance?

Hypervigilance relief will vary from person to person.

With this in mind, several people find that meditation, reading, or smelling something relaxing such as lavender essential oils will help ease the pain that is associated with hypervigilance.

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Interested in Learning More? Check out these books on hypervigilance:

PTS(D) on a Shoestring Budget: A no-nonsense, non-technical guide to coping and healing for any trauma survivor from a survivor (Healing on a Shoestring Budget Book 1)

How to Kill Your Batman: A Guide for Male Survivors of Childhood Sexual Abuse Using Batman to Heal Hypervigilance

Conquering Mental Fatigues: PTSD & Hypervigilance Disorder- Post War


  • Kimble M, Boxwala M, Bean W, et al. The impact of hypervigilance: evidence for a forward feedback loop. J Anxiety Disord. 2014;28(2):241-245. doi:10.1016/j.janxdis.2013.12.006