At certain times, hypervigilance — staying highly alert — is useful. But when it happens all too often, you may start to feel depleted. Here’s why and how to cope.

Tense muscles. Room scan. A feeling that something “bad” is about to happen and you’re unable to relax in your environment. Sound familiar?

Living with hypervigilance can not only make it difficult to enjoy the present moment, but it can also take away from your relationships, work, school, and overall quality of life.

The good news is that support and treatment options are available, once you identify the causes of this symptom. Professional resources and self-care may help you cope.

Put simply, hypervigilance is a biological adaptation to stress. It’s your brain’s method of trying to keep you out of harm’s way by being highly alert and aware of your surroundings.

According to a 2016 review, researchers have found that it generally shows up in two scenarios.

The first is a looming threat, common with anxiety disorders. The second is a reminder of a previous threat, common with post-traumatic stress disorder (PTSD) and other trauma manifestations.

Hypervigilance is not a diagnosis on its own. It’s a symptom. This means that it’s part of a set of other symptoms.

Some common diagnoses associated with hypervigilance include:

A guard dog analogy

You may find it helpful to think of hypervigilance as a guard dog working overtime.

Sometimes, the guard dog barks at intruders, and rightfully so. But other times, the guard dog barks at things that don’t pose a direct threat, like leaves blowing into the yard or a mailman two blocks away.

As you can imagine, when the guard dog in your brain is on high alert at all times, it can drain your mental, physical, and emotional faculties. In a word, it’s exhausting.

But you can train the guard dog.

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Hypervigilance looks different for everyone, but there are some signs that many people share. These include:

Emotional symptoms

  • emotional outbursts
  • fearing the worst without an obvious cause
  • feeling overwhelmed in crowded or noisy places
  • overreacting to stimuli or to those around you, compared with what’s usual for you
  • persistent worry

Behavioral symptoms

  • heightened awareness of surroundings
  • hyperekplexia (intense startle response)
  • inability to focus on what’s in front of you
  • scanning the room for suspicious behavior, weapons, or dangers

Physical symptoms

  • difficulty sleeping
  • enlarged pupils
  • increased heart rate
  • quick breathing
  • restlessness
  • sweating

Interpersonal symptoms

  • avoiding social interaction
  • taking things personally
  • focusing intently on people’s expressions or tone of voice
  • friction in relationships at home, work, or school

Hypervigilance examples

Can you see yourself in any of these scenarios? Hypervigilance may look like:

  • an employee who interprets criticism as a personal attack and lashes out
  • a war veteran who ducks and runs for cover when they hear a car backfiring
  • a member of a marginalized community who experiences panic walking down the street
  • a survivor of sexual assault who jumps when someone hugs them from behind
  • a shooting survivor who scans a nightclub looking for someone with a gun
  • a person with childhood trauma who can’t sleep until their partner texts back
  • a car accident survivor who is so focused on the freeway, they feel overwhelmed by music and can’t focus on a conversation with their passengers
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Trauma can rewire the brain to put you on high alert.

Research from 2019 suggests that those with trauma experience increased activity in their amygdala, the part of your brain that sends out the “code red” signal.

This means that your brain will alert the other systems in your body to get ready for an incoming threat — even if there’s no direct danger present.

Some cues may include:

  • anticipating pain
  • chaotic environments
  • claustrophobia
  • loud noises
  • scenarios that remind you of a past trauma

Researchers are still trying to pin down why anxiety disorders manifest with hypervigilance.

Research from 2014 suggests that anxiety spurs selective attention in your brain. Then, it creates a feedback loop: You look for a specific threat and you get more anxious, which causes you to look for more threats. On and on it goes.

Research from 2015 suggests hypervigilance may result from miscommunication between two parts of the brain, the amygdala and the bed nucleus of the stria terminalis (BNST).

Some triggers may include:

  • new environments
  • social situations
  • things outside your comfort zone, like trying a new food or being the passenger when you’d typically drive

Sometimes. It all depends on where it’s coming from.

If you’ve experienced a recent event that shook you up, like a near-miss car accident, your hypervigilance may go away on its own within a few hours or a couple of days if you didn’t develop PTSD.

But for many, hypervigilance sticks around. If this is your case, it’s highly advisable to reach out for support and determine the underlying cause.

Hypervigilance is a natural feature of your limbic system, which manages your fight-or-flight response. It comes in handy in several scenarios, including:

  • walking home late at night by yourself
  • meeting online dates in person
  • driving through a thunderstorm
  • traveling in a foreign country
  • babysitting or taking care of minors

Because it protects you in precarious situations, a small dose of hypervigilance is actually a good thing from time to time.

Your treatment for hypervigilance will depend on the underlying condition. In other words, you would treat the cause of your symptom, instead of just the symptom itself.


A mental health professional may recommend several types of therapy to treat mental health conditions that have hypervigilance as a symptom.

These include:


A doctor may recommend medication as part of your treatment for anxiety or PTSD. These medications will depend on your other symptoms and your specific needs.

About benzodiazepines

For anxiety, your doctor may suggest a classification of medications known as benzodiazepines, like Xanax or Ativan. These are meant for short-term use only.

In 2020, the Food and Drug Administration (FDA) required a black box warning to be added to this medication. This is because benzodiazepines may cause serious long-term side effects, including dependency, memory loss, or brain damage.

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Complementary and alternative medicine (CAM) is gaining traction in the Western medicine model.

Some supplements and herbs may help reduce symptoms associated with anxiety, including hypervigilance. More research is still needed, though.

Ask your doctor about:

If your hypervigilance is the result of stress, some self-care strategies may help. These include:

When to seek help

Some self-care strategies may help. But when hypervigilance begins taking away from your quality of life, or you feel hypervigilant in “safe” settings, you may benefit from additional support.

Here are some resources to explore:

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Hypervigilance is a natural biological process. In small doses, it’s useful.

However, for those who live with trauma, anxiety, or other mental health conditions, ongoing hypervigilance may take away from your relationships, work, and more.

In this case, a professional will be able to provide you with an accurate diagnosis and work with you on a treatment plan. Self-care strategies for relaxation may also help.

Remember, the overactive guard dog in your mind doesn’t run the household — you do. It’s possible to take your power back. You’ve got this.