Hyperwatch: what is it and what are its causes?

Psychological disorders such as schizophrenia and mania or the use of hallucinogenic drugs and noradrenergic agonists can cause hypervigilance, that is, a pathological increase in the level of consciousness, which causes a subjective feeling of lucidity but also a distraction.

In this article we will describe what is hypervigilance and what are its main causes.

    What is hypervigilance?

    One can define hypervigilance as a phenomenon which consists of increased level of alertness, attention and awareness. Although the concept is generally associated with psychopathology, particularly the spectrum of psychosis and manic episodes typical of bipolar disorder, hypervigilance can also occur in people without such disorders.

    However, the term is generally used to refer to psychopathological facts. In this sense, hypervigilance has been described mainly as a prodrome in the development of certain psychological disorders, linked both to conscious mental activity and to the temporary or permanent alteration of its biological basis: the central nervous system.

    Conceptually, hypervigilance falls into the category of disturbance of consciousness. More precisely, it is the most representative phenomenon of positive alterations (or by enlargement) of consciousness. On the other hand, the decrease in vigilance is one of the disorders of deficient consciousness.

    People who suffer from hypervigilance often report a subjective feeling of increased clarity of consciousness accompanied by an increase in the number of movements, Including those necessary for the spoken language; in relation to this last point, hypervigilance is associated with tachypsychia (acceleration of mental activity).

    However, studies show that increasing the level of consciousness does not imply an improvement in attentional tasks: experiences of hypervigilance usually occur simultaneously with a state of distraction, for which subjects are more able to cope. shift the center of attention in response to not necessarily relevant stimuli.

    Causes of this disorder of consciousness

    There are two sets of root causes that can cause hypervigilance. The first of these includes two groups of psychological disorders with a clear biological basis: psychotic disorders and manic episodes.

    The other major cause of hypervigilance is the consumption of psychoactive substances. like cocaine, amphetamines and hallucinogens.

    1. Schizophrenia and other psychoses

    According to the DSM diagnostic manuals, psychotic disorders are characterized by the presence of hallucinations (which are usually auditory in functional disorders), rigid delusions, disorganization of language (manifested for example in flight ideas) and behavior, as well as symptoms such as emotional flattening.

    Psychotic outbreaks are episodes in which there is a breakdown in contact with reality, usually due to intense stress and / or substance use, Especially if they have hallucinogenic effects to some extent (including cannabis). Hypervigilance sometimes occurs in the context of an epidemic, which may or may not precede a diagnosis of schizophrenia.

    2. Manic episodes

    Mania is defined as a pathological increase in energy, alertness and brain activation levels, As well as the ambiance. When repeated manic episodes occur in the same person, the diagnosis of bipolar disorder is used; this is why the onset of mania is more decisive than that of depression, which is also characteristic.

    One of the most obvious signs of manic episodes is hypervigilance. In these cases, it is very common for the person to show hyperactive and thoughtless behavior, an increased rate of thought and speech, distraction due to the appearance of irrelevant external stimuli, or a reduction in the subjective need to sleep. .

    3. Hallucinogenic substances

    Hallucinogens, psychedelics or psychotomimetics it is a group of psychoactive substances that cause significant alterations in perception, cognition and emotions. Their name is misleading, as they rarely cause true hallucinations; for example, many hallucinogens cause or distort visual sensitivity.

    The most characteristic substance of this group is lysergic acid or LSD, Which was very popular in the middle of the twentieth century. The mechanism of action of this drug is related to its ability to interact with the receptors for dopamine, adrenaline and serotonin, and in general its consumption generates a feeling of euphoria and heightened awareness of the eye. .

    Other well-known hallucinogens are mescaline (obtained from the peyte cactus), ayahuasca (associated with experiences of personal importance), psilocybin (commonly known as “hallucinogenic mushrooms”) and ecstasy or MDMA, a nightlife settings.

      4. Norepinephrine agonists

      Norepinephrine is one of the most important neurotransmitters in the human central nervous system, in addition to acting as a hormone in the endocrine system. Its functions are linked to cerebral arousal (or activation); these include maintaining wakefulness, managing the focus of attention, or fight-and-flight responses.

      The two main psychoactive substances with agonistic effects on norepinephrine are cocaine and amphetamine. Cocaine blocks norepinephrine collection, As well as dopamine, serotonin and adrenaline, through presynaptic terminals; amphetamine has similar effects but also potentiates the release of dopamine.

      On the other hand, there are also several drugs that have been approved for use and which, since they improve noradrenergic activity, could cause hypervigilance if consumed in excessive doses. Antidepressants such as MAOIs, tricyclics or reboxetine (The major selective norepinephrine reuptake inhibitor) are good examples.

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