Hypervigilance: causes, symptoms and treatment

We may have seen at one point someone nervous, with a high energy level, looking around like watching or waiting for something to happen, trying to observe everything without missing a single detail.

While in some cases it may seem like it can be adaptive, the truth is that it is easy to observe that it is in constant tension which can be extremely harmful if it continues over time. The subject in question is hypervigilant, which we will discuss throughout this article..

    Hypervigilance: concept and symptoms

    Hypervigilance is considered a state of tension and high energy consistent over time wherein the subject suffering from it exhibits an apparent increase in level of consciousness, being hypersensitive and responding quickly and vigorously to sensory stimulation.

    The subject who suffers from it usually exhibits hyperprosexia, in which the level of attention is much higher than usual and often focuses on any stimuli and details of the surrounding context. This usually happens with the feeling of having great mental clarity. While this may sound so positive that it makes it easier to detect and scan the environment, the truth is, it usually interferes with its proper analysis by shifting the focus of attention from element to element. so that, although it seems contradictory, the excess of attention span would result in strong distractibility.

    Hyperreactivity also manifested by those who suffer from hypervigilance generates that their reactions tend to be inappropriate and thoughtless. They have a high level of anxiety so that it is often experienced unpleasantly by those who suffer from it. This, combined with the high energy level, can cause the person to become irritable or even hostile.

    But because our energy reserves are limited, prolonged hypervigilance over time can lead to fatigue and eventually passivity, a rough attitude and even depression.

    Causes and contexts of occurrence

    Although it can sometimes appear without being pathological, hypervigilance can be a symptom (not a disorder per se) indicative of a mental or even physical disorder.

    Within the framework of psychopathology, it is frequent to appear during a chronic delusional disorder or during a schizophrenia (in particular of the paranoid type), in which the subject expects specific phenomena which correspond to his interpretation of the world. It also often appears in anxiety disorders and obsessive-compulsive disorders, as well as during manic episodes. It is also common for hypervigilance to occur after going through a traumatic experience such as war or rape (actually being 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 generalized, Be the subject ready to respond in an extremely reactive manner to what he remembers about this situation. For example, a person who has been assaulted will tend to be over-prepared for anything that might indicate that they will be attacked again, given a possible threat from a smile from a stranger or someone touching them. .

    Another moment in which hypervigilance usually appears is intoxication by substances, generally those of an excitatory or psychoanaleptic character such as cocaine or psychodysleptic such as certain hallucinogens or the sativa variant of cannabis.

    Effects and symptoms in everyday life

    Hypervigilance can cause serious harm to the patient. First of all, the characteristic hyperprosexia will prevent him from focusing on a particular stimulation, which will complicate the subject’s performance in his work or academic life. At the psychological level, this can lead to cognitive biases and distortions, as well as changes in behavior or avoidance of stimuli and situations.

    On the social level, this can also pose problems: the environment can feel despised and they can misinterpret a large number of situations, which can lead the subject to lose his social support or even to be isolated.

    Outraged, the high level of energy maintained over time causes exhaustion and can lead to weakness, decreased immune system or even organic problems such as heart, respiratory, endocrine or muscle problems.


    Hypervigilance is not seen as a disorder per se, but rather as a symptom. The treatment to be used will largely depend on its origin.

    However, it is common for anxiety and a high level of activation in almost all cases, which is why techniques such as cognitive restructuring, live or imaginative exposure, systematic desensitization, and relaxation techniques are recommended. Outsourcing what causes hypervigilance is also a good idea (in pathological and non-pathological cases), so techniques such as psychodrama, role play, or expressive therapies may show some use. Benzodiazepines and other anti-anxiety drugs, as well as some antidepressants such as SSRIs, can be helpful in alleviating any discomfort that may occur during treatment. In the event of psychotic symptoms, also of neuroleptics.

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

    Bibliographical references:

    • Barlow, DH and Durand, VM (2003): Psychopathology. Madrid: Thomson.
    • Goodman, HH (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: saved.

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