What is PTSD Hypervigilance?

What is PTSD Hypervigilance?

One of the many hyper-arousal symptoms of Post Traumatic Stress Disorder is hyper vigilance and this refers to the experience of being constantly tense and ‘on guard’- your brain is on high alert in order to be certain danger is not near.

This state of increased awareness, anxiety, and sensitivity to the environmental around you often manifests as a need to always scan your surroundings for potential threats. With the brain resources on constant alert, the results can be inappropriate or even aggressive reactions in everyday situations.

People displaying hypervigilance can be so involved in their scrutiny of whats around them, that they tend to ignore their family and friends. Often, they will overreact to loud sounds and bangs, unexpected noises, smells, etc. They can get really agitated and irritated, when they move into a crowded or noisy area as there is too much to scrutinise.

Even familiar surroundings and people can be an issue as hyper vigilance can make people acutely aware of subtle details normally ignored – body language, a persons voice and tone, their mood, their expressions – all things which are continually assessed.

Some of the common behaviours of hypervigilance are:

  • Lack of objectivity – reading too much into situations
  • An over awareness of what people see or think about us
  • Looking for others to betray constantly
  • Constantly concerned about others
  • Not being aware of what is obvious to others
  • Over scrutiny/analysing behaviour of situations

Sleep and Hypervigilance

Often, hypervigilance affects sleep, as the smallest noise can fully wake you up, and the surge of adrenaline can make it very difficult to get back to sleep.It takes a great deal of energy to remain on alert PTSD Exhausting, Tiredness

The founder of PTSD UK, Jacqui Suttie remembers how hyper vigilance affected her sleep, ‘When I could eventually get to sleep, I would wake up at least once an hour during the night – the smallest noise would wake me up with such a panic, I would be sweating, terrified and became so fearful of the dark. Frozen with fear, I’d need to get my husband to get up and check the house – several times a night. I’d be so tired the next day, but too scared to nap in the house on my own – it was such a difficult time, even with just the lack of sleep alone!’

Regardless of the lack of sleep, hypervigilance, and the anxiety levels this brings, can invariably cause exhaustion. We discuss more details on why having PTSD makes you so tired in our blog post here.


Hypervigilance from PTSD can result in being suspicious of people and their motives. This can result in feelings of paranoia around others: ‘What are they really thinking about us?’ ‘What are they planning to do to us?’, ‘Why are they with me?’.

It can feel like you’re waiting for the betrayal, watching the other person looking for clues in order to prepare for it.  However, some people are not prepared to ‘wait’ for the betrayal and may end an otherwise healthy relationship.


Hypervigilance from PTSD can often be mistaken for paranoia as it tends to over-estimate the potential for danger at any given moment. However, unlike someone suffering with paranoia, a hypervigilant person is aware of their symptoms. It can be a vicious cycle however, as a they may be so aware of their fears and hypersensitivity that they then think of themselves as paranoid – but it’s important to make the distinction.


PTSD panic can often cause our minds to take a current situation and give it an extremely negative spin – allowing it to take us down all sorts of roads of worry and ‘what ifs’. This, in turn, can create many more negative situations, which can lead to a spiral of doubt, failure and so worsening PTSD symptoms.

How to cope with hypervigilance

Reducing your symptoms of hyper vigilance requires a lot of self-control and a conscious effort to identify things or incidences that provoke anxiety, and shift your focus away from such anxiety cues.  Try to ‘catch yourself out’ when you sense yourself spiraling down your own personal hypervigilant thought patterns.

It can also help to be “in the moment” for a few minutes – perhaps focusing on your breathing in and out slowly – this will give your mind time to calm itself.

Writing down your negative thoughts can also help to see patterns on when your hypervigilance and help control your mind a little more. To see why writing can help PTSD in general, you can read our blog post here.

Into the Light also mentions a helpful tactic: ‘instead of thinking “My partner is late again…it’s the third time this week…..perhaps he is losing interest me or doesn’t care about me anymore..I wonder if he’s having an affair … why was he checking his phone last night? This relationship is almost certainly over.”

Perhaps try something along the lines of “My partner is late again … it’s the third time this week and I’m finding this difficult. We need to sit down together and work out a good communication plan when he’s going to be late so I can still relax and enjoy my evening.”’

It’s important to note that a diagnosis is very important with PTSD and hypervigilance particularly as Healthcare Professionals have noted that antidepressants should be avoided, as they may induce suicidal tendencies.

SOURCES: Buzzle, About Health, Brainworks Neurotherapy, Wikipedia, This Tangled Web, Into the Light,

QUOTE: The boy who was raised as a dog by Dr Bruce Perry and Maia Szalavitz: page 194: Basic Books: Published 2006)

IMAGE: Severalls – Silent Alarm by Rob Walker

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