Hypervigilance and Your Health

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

The 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 hypervigilance symptoms and managing the underlying cause.

This article will explore what hypervigilance feels like and its medical and mental health causes. It also covers diagnosis, treatment, and coping mechanisms.

What Is Hypervigilance?

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, most people walking down a dark street alone at night would pay extraordinary attention to their surroundings.

Others are hypervigilant about 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 also be overly aware of physical sensations—for example, the pressure of a waistband or fabric rubbing across your skin can be distracting.

What Does Hypervigilance Feel Like?

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

You may feel so anxious every time you get on an airplane that you can't sit still, eat, or read a magazine. If you are hypervigilant in almost every environment, this 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

Causes of Hypervigilance

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), 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. 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

Usually, 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 impossible to be consciously aware of and focused on all these messages.

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

However, any message that your brain considers dangerous 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 it 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.

Life Experiences

Life events and experiences can play a significant 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.

And when you suffer from hypervigilance, these triggers don't just trigger you when they occur—you subconsciously search for them, sensing an aggressive fight even when people are joking around.

Diagnosis of Hypervigilance

Hypervigilance can affect your peace of mind and be distressing for those close to you. The first step in getting relief from your symptoms lies in accepting 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 they can help you explain your problem to your practitioner. Your healthcare provider will ask you questions about your symptoms and health and perform a physical examination.

In the context of hypervigilance, one of the most critical 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.

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

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

Is Hypervigilance Treatable?

Medications aren't generally considered the first therapeutic choice for 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 with an approach you feel comfortable with. You may need to talk through specific 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, managing the illness can reduce your hypervigilance and also help your overall health.

For example, if you are diagnosed with an endocrine condition, then medication or surgery may be necessary. 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.

Summary

Hypervigilance is an uncomfortable and sometimes disabling condition with several potential causes. Speaking with a healthcare provider is essential to making the correct diagnosis to optimize your treatment plan.

Counseling is often a key component of treatment. If your feelings of hypervigilance are caused by an underlying medical problem, addressing those causes can also bring relief.