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Hypervigilance: causes, symptoms and treatment

Hypervigilance: causes, symptoms and treatment

July 13, 2024

It is possible that at some point we have seen someone nervous, with a high level of energy, who looks everywhere as if searching or waiting for something to happen, trying to observe everything without letting him miss the smallest detail.

Although in some cases it may seem that this could be adaptive, the truth is that it is easy to observe that it is continuously in tension, which can be extremely harmful if it is prolonged over time. The subject in question is showing hypervigilance, which we will talk about throughout this article .

  • Related article: "The 16 most common mental disorders"

Hypervigilance: concept and symptoms

Hypervigilance is understood as a state of tension and high consistent energy over time in which the subject that suffers it presents an apparent enlargement of the level of consciousness, being hypersensitive and reacting quickly and energetically to sensory stimulation.

The subject who suffers from it usually manifests hyperprosexia, in which the level of attention is much higher than usual and frequently focuses on any stimulus and detail of the surrounding context. It is usually given along with the sensation of having great mental lucidity. Although this may seem positive in such a way that it would make it easier to detect and analyze the environment, the truth is that it is usually a detriment in its correct analysis by shifting the focus from one element to the other continuously, from way that although it seems contradictory the excess of attentional capacity would cause a high distraction.

Hyper-reactivity also manifested by those who present hypervigilance generates that their reactions tend to be little adaptive and little thought . They have a high level of anxiety, so that it is usually lived unpleasantly by those who suffer from it. This together with the high level of energy can lead to the person becoming irritable or even hostile.

But given that our energy reserves are limited, prolonged hypervigilance over time can cause tiredness to appear and eventually lead to passivity, a sullen attitude and even depression.

Causes and contexts of appearance

Although it can appear at specific moments without needing to be pathological, hypervigilance can be a symptom (not a disorder per se) indicative of some mental or even physical alteration.

In the context of psychopathology, its occurrence is frequent in the course of a chronic delusional disorder or during schizophrenia (especially the paranoid type), in which the subject is in expectation of concrete phenomena that correspond to his interpretation of the world . It also usually appears in anxiety disorders and obsessive disorders, as well as during manic episodes. It is also common for hypervigilance to appear after experiencing a traumatic experience such as war or rape (in fact, it is a possible symptom of post-traumatic stress disorder or acute stress disorder).

In the case of a traumatic experience, the threatening situation itself may become widespread , the subject being prepared to respond in an extremely reactive way to what the situation remembers. For example a person who has suffered an aggression will tend to over-prepare to any element that may indicate that he will be attacked again, considering a possible threat the smile of a stranger or that someone touches them.

Another time in which hypervigilance usually appears is in substance poisoning, generally by those of an excitatory or psychoanalytic character such as cocaine or psychodysleptic like some hallucinogens or the sativa variant of cannabis.

Effects and symptoms in daily life

Hypervigilance can cause serious damage to those who suffer from it . To begin with, the characteristic hyperprosexia will make it difficult for him to concentrate on a specific stimulation, which hinders the subject's own performance in his work or academic life. At a psychological level, it can generate biases and cognitive distortions, as well as behavioral changes or avoidance of stimuli and situations.

At a social level it can also cause problems: the environment can feel underestimated and a large number of situations can be misinterpreted, which can lead to the subject losing social support or even being isolated.

Further, the high level of energy maintained over time produces exhaustion and it is possible that weakness may arise, decreased immune system or even organic problems such as cardiac, respiratory, endocrine or muscular.


Hypervigilance is not considered a disorder in itself, but rather a symptom. The treatment to be used will depend to a great extent on what originated it .

Despite this, it is common that in almost all cases there is anxiety and a high level of activation, so that techniques such as cognitive restructuring, live or imagination exposure, systematic desensitization and relaxation techniques are recommended. Externalizing what causes hypervigilance is also a good idea (both in pathological and non-pathological cases), with which techniques such as psychodrama, role-playing or expressive therapies can show some usefulness. Benzodiazepines and other anxiolytics, as well as some antidepressants such as SSRIs, may be useful to alleviate possible discomfort while therapy is being performed. In cases of psychotic symptoms, also neuroleptics.

In clinical cases of organic etiology it may be useful to apply different medical procedures and / or drugs, such as the use of antagonists such as naloxone in case of drug use.

Bibliographic references:

  • Barlow, D. H. and Durand, V. M. (2003): Psychopathology. Madrid: Thomson.
  • Goodman, H. H. (Ed.). (1987). General psychiatry. Mexico: The Modern Manual. (Orig. 1984).
  • Lemos, S. (2000): General psychopathology. Madrid: Synthesis.
  • Vallejo-Ruiloba, J. (1991): Clinical cases. Psychiatry. Barcelona: Salvat.

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