Understanding Hypervigilance and Trauma

Hypervigilance and trauma are closely connected. Hypervigilance is a heightened state of awareness that one adopts to protect them from dangerous or threatening situations. It is most common in cases of complex trauma where a person has been in an environment of uncertainty or potential danger for an extended period of time. This includes child abuse, serving or living in a war zone, and domestic abuse.

Connecting Hypervigilance and Trauma

While the connection between trauma and hypervigilance is obvious for some, others can take years to connect their behavior and feelings to traumatic adverse life experiences. Not everyone who experiences trauma develops PTSD, however they may still develop protective behavioral patterns and coping mechanisms. Developing hypervigilance in order to remain safe from potential threats may be your body’s attempt to keep you safe, but it can cause intensely challenging effects and disrupt sleep, cause strained relationships, and affect career prospects.

What Is Hypervigilance?

Hypervigilance is when the brain becomes hyper-alert to danger and potential threat [1]. The human response to threat is a survival mechanism and has been integral to keeping us alive when faced with the danger of predators. Normally, the human nervous system releases stress signals only in situations of perceived danger.  When the nervous system becomes chronically dysregulated, stress signals are released in unnecessary or inappropriate situations.  This maladaptive trait is known as hypervigilance [1].

Hypervigilance can cause safe places, people, and situations to appear threatening. Even in well-known, familiar surroundings, people with hypervigilance can feel acutely aware of subtle details such as body language, tone of voice, mood changes, private conversations, and expressions of those around them. This can make socializing or working highly stressful.

Common symptoms of hypervigilance include:

  • Fixation on potential threats
  • An increased startle reflex, meaning you are more likely to jump because of sudden sounds
  • Inability to focus and concentrate on conversations
  • Dilated pupils
  • Increased heart rate
  • High blood pressure
  • Avoiding certain situations
  • Overestimating potential threats or dangers
  • Lack of objectivity – reading too much into situations
  • An intense awareness of what people think of you
  • A reluctance to meet new people or try new things
  • An intense worry or concern for others’ well-being

It is also common for hypervigilance to interfere with sleep, resulting in fatigue, reduced concentration, and difficulty focusing. Sleep deprivation often intensifies the feelings of paranoia, further fueling hypervigilant behaviors.

It is common for people with hypervigilance not to view their reactions as extreme or intense. It is likely that these reactions or behaviors feel necessary for the person to feel safe and secure. However, when hypervigilance begins getting in the way of daily activities and relationships, it is time to consider addressing it through psychotherapy or medication.

Hypervigilance itself isn’t a diagnosis; it is a symptom that can show up as a part of a mental health condition such as anxiety or PTSD, and the method of treatment will depend on the underlying cause of hypervigilance.

Trauma as a Cause of Hypervigilance

Hypervigilance is a common result of exposure to trauma[1] and is a key component of post traumatic stress disorder (PTSD), which affects around 8 million U.S. adults in a given year [2]. Research has shown that exposure to traumatic stress can cause changes to the limbic system and the hypothalamic–pituitary–adrenal axis, both of which can be linked to symptoms of hyperarousal [3]. 

In addition to PTSD related to assault, war, or illness, hypervigilance can develop in response to community violence, adverse childhood experiences, and instability in early life. Research has shown that in some cases hypervigilance emerges as a pervasive response to living in unstable or adverse environments [4].

Overcoming Hypervigilance and Trauma

Therapy is generally considered the best way of overcoming trauma and is more effective the earlier the intervention. There is a range of therapies used to address trauma, such as cognitive behavioral therapy (CBT), exposure therapy, and eye movement desensitization and reprocessing (EMDR) therapy. There is no one size fits all approach to trauma, and the best approach for you depends on the kind of trauma you have experienced and what modality you respond best to. Therapy can help you process and understand traumatic events as well as conditions in your childhood that may have caused you to become hypervigilant. Therapists provide a safe space to access traumatic memories and provide behavioral strategies and grounding techniques to help you remain in control when you are triggered or becoming increasingly anxious as a result of a hypervigilant response to perceived threat. However painful and disabling the effects of hypervigilance, they can be overcome through early therapeutic intervention and professional assistance. Memories of trauma will stay, but they will gradually have less control over you and your emotions.

References

[1] Dalgleish T, Moradi AR, Taghavi MR, Neshat-Doost HT, Yule W. An experimental investigation of hypervigilance for threat in children and adolescents with post-traumatic stress disorder. Psychol Med. 2001;31(3):541–7. Crossref, Medline, Google Scholar 

[2] “VA.Gov | Veterans Affairs”. Ptsd.Va.Gov, 2020, 

https://www.ptsd.va.gov/understand/common/common_adults.asp#:~:text=About%207%20or%208%20out,have%20gone%20through%20a%20trauma. Accessed 16 Oct 2020.


[3] Weiss, S.J. (2007), Neurobiological Alterations Associated With Traumatic Stress. Perspectives in Psychiatric Care, 43: 114-122. https://doi.org/10.1111/j.1744-6163.2007.00120.x

[4] Tung EL, Johnson TA, O’Neal Y, Steenes AM, Caraballo G, Peek ME. Experiences of community violence among adults with chronic conditions: qualitative findings from Chicago. J Gen Intern Med. 2018;33(11):1913–20. Crossref, Medline, Google Scholar

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