Hypervigilance in Adults: Symptoms, Causes, and Help

October 29, 2025

Authored by: Adam Moore, MPharm

Edited by: Jemma Strain, B.S. Psychology

It’s normal to feel guarded from time to time, especially in situations where you really need to look out for yourself. For example, when crossing a busy road or navigating an unfamiliar environment at night.

So, yes, it’s good to be aware of your surroundings. But what about the times when you can’t relax in a relatively safe environment? For example, meeting up with friends, going to the movies, and sitting at a restaurant are all simple pleasures that shouldn’t typically call for scanning the room for threats.

If you, or someone you care about, feels like they’re always anxiously aware of their surroundings, then hypervigilance could be underlying this state. Hypervigilance is a heightened alertness to your surroundings, and is associated with mental health conditions such as anxiety disorder and post-traumatic stress disorder (PTSD).

If hypervigilance is affecting your ability to participate fully in daily life, a mental health professional can guide you on how to best manage this state. This page can also help you understand hypervigilance in adults by discussing:

What hypervigilance is
The symptoms of hypervigilance
The causes of hypervigilance
Triggers of hypervigilance and coping strategies
Therapy for hypervigilance
How Mission Connection can help with overcoming hypervigilance

What Is Hypervigilance?

The American Psychiatric Association (APA) defines hypervigilance as a “heightened state of sensory sensitivity and alertness where a person constantly scans their environment for signs of danger or threat.”¹

As mentioned earlier, this response can be useful in genuinely dangerous situations, but if someone is in this state most of the time, it can be exhausting and disruptive to day-to-day life. In fact, people often described hypervigilance as feeling “on edge,” like they’re unable to relax, or being easily startled even in safe environments.¹

Hypervigilance affects both the mind and body, and is linked to certain mental health conditions such as anxiety and PTSD. For example, people who live with chronic anxiety often see threats in social cues that would be considered neutral to most people. Small changes in facial expressions, body language, or tones of voice could be misinterpreted as threatening or a cause for worry. Moreover, this hyperawareness can create an unhelpful cycle where attention to subtle signals worsens threat perception and maintains a state of anxiety.⁶ Therefore, early intervention is often important for ensuring that hypervigilance does not worsen over time.

The Symptoms of Hypervigilance

Recognizing the symptoms of hypervigilance can help people identify when “normal” awareness has shifted into an unhealthy level of alertness.² The following sections explore the physical, psychological, and emotional symptoms of hypervigilance.

Physical Symptoms

If hypervigilance is a state you experience regularly, you might frequently notice physical symptoms such as:

Rapid heartbeat or palpitations: When in a state of stress, the body’s natural response is to increase heart rate and blood flow, so that it’s more prepared to react quickly to danger. This is known as the “fight or flight” response
Muscle tension: Constant readiness can lead to chronic pain, jaw clenching, or headaches
Sweating or trembling: During fight or flight, hormones such as adrenaline and cortisol increase, raising body temperature and causing muscles to tremble in preparation for action
Sleep disturbances: Difficulty relaxing can lead to insomnia or restless sleep, which can contribute to even greater anxiety³
Fatigue: Staying alert for long periods of time can sap your energy and impact sleep. Therefore, it’s not uncommon for those who struggle with hypervigilance to feel exhausted

Psychological and Emotional Symptoms

Hypervigilance is commonly associated with the following psychological and emotional symptoms:

Constant scanning: Feeling the need to monitor surroundings for potential threats
Irritability or frustration: When in a state of high alert, it’s easy to be set off by small noises, movements, or changes that otherwise wouldn’t be bothersome
Difficulty concentrating: When the brain is in high alert mode, we often prioritise looking out for threats rather than focusing on the here and now
Intrusive thoughts: Anxiety is related to intrusive beliefs or thoughts that can play on repeat in the mind. This process is called “rumination” and can take people out of the ability to focus on the present moment⁴
Emotional exhaustion: Remaining on high alert for a long time can be taxing emotionally. This can lead to feelings of being overwhelmed or detached

Causes of Hypervigilance

There isn’t one singular cause of hypervigilance; everyone’s circumstances and experiences are unique. However, research has identified some common sources of this state, which we discuss in the following sections.

Hypervigilance and PTSD

Hypervigilance is a classic symptom of post-traumatic stress disorder (PTSD). This is because traumatic events like accidents, assault, or witnessing violence can be life-altering and make someone much more guarded and sensitive to threats. In fact, research shows that trauma can alter areas of the brain responsible for fear processing and emotional regulation.^5,9 So, in short, people with PTSD are more likely to struggle with chronic hypervigilance.

Anxiety Disorders

In anxiety disorders, chronic worry is often part of the experience. Therefore, generalized anxiety, panic disorder, and social anxiety can all create patterns of heightened alertness. This is because worry primes the nervous system to look for signs of threat, increasing sensitivity and awareness in spaces that would typically be considered safe.⁶

Chronic Stress

In a state of high alert, stress hormones, such as cortisol and adrenaline, are released – key players in the fight or flight response. But when you’re exposed to these stress hormones time and time again, the brain becomes wired for threat detection. This can make someone more likely to remain stressed even when the source of the threat is gone.⁷

Environmental and Lifestyle Factors

People lead significantly different lives depending on their experiences, such as their upbringing, where they live, career choices, and so on. Some people’s lives are more stressful by nature. For instance, due to living in an unsafe neighbourhood or experiencing childhood trauma. Therefore, their threat detection system may be more naturally wired than others.

Lifestyle factors can also play a part in hypervigilance. For example, drinking a lot of coffee or energy drinks, or having a poor sleep routine, can worsen hypervigilance and make it harder to relax.^3,8

Neurobiological and Developmental Factors

Studies show that we can be predisposed to stress genetically.⁷ What’s more, being exposed to stressors during the developmental years of youth, when our brains are still forming emotional and regulatory systems, can shape the future in terms of worry and hypervigilance.⁷

Hypervigilance Triggers

withdrawal, and lead to physical symptoms such as headaches or gastrointestinal issues. In other words, it can erode quality of life.^7,11

For this reason, early treatment for hypervigilance matters. But a key step in treatment is recognizing what sets hypervigilance off in the first place.

Hypervigilance triggers vary from person to person, but commonly include:¹⁰

Loud or sudden noises (for example, sirens or slamming doors)
Crowded or confined spaces
Being approached unexpectedly
Physical touch or invasion of personal space
Reminders of past trauma (smells, locations)
Periods of stress, illness, or fatigue

Mapping personal triggers, by journaling, for example, can go a long way towards prevention and coping.¹⁰

Ways of Coping With Hypervigilance

The negative effects of hypervigilance are well-documented in studies, highlighting the need for effective coping strategies.¹¹

The following coping strategies can help you feel more grounded and calm in moments that cause you to be hyperalert. It may help to experiment with a few to determine the right strategies for your needs.

Grounding Techniques

Grounding shifts attention from perceived threats back to the present, as focusing on physical sensations can help break the cycle of worry. For example, the 5-4-3-2-1 technique can shift your attention to the here and now.¹² This involves noticing five things you see, four you feel, three you hear, two you smell, and one you taste.

Breathing Regulation

Slow, deep breaths are a proven pathway to regulating stress hormones and promoting calm. The best part about this practice is that this can be done anywhere, at any time, such as at the office, on the bus, or just when you’re out and about.¹³

Mindfulness and Acceptance

Many studies support mindfulness for anxiety and trauma-related symptoms.¹⁴
A common practice in mindfulness is meditation; setting aside time, ideally free from distraction, to observe your thoughts and sensations in a non-judgemental way.

Further, noticing and accepting that you’re experiencing an anxious thought can reduce its power over you. For example, I notice that I’m fearful of something going wrong in this situation.

Lifestyle Changes

Research links caffeine consumption to higher anxiety symptoms, and sleep-deprivation studies show increased anxiety after poor sleep.^3,8Therefore, reducing stimulants (such as caffeine or nicotine) and improving sleep hygiene can help people remain relaxed and less alert for longer.

Progressive Muscle Relaxation (PMR)

PMR is a useful technique that can ground you in the here and now. By tensing and releasing the muscles in a calm, controlled manner, you can calm the nervous system and reduce palpitations during anxious moments. PMR can also be practiced alongside a guided meditation, further reducing overthinking and anxiety.¹⁵

Supportive Relationships

It’s well known that it’s good to talk, as secure, supportive relationships help regulate the nervous system and lower stress levels.¹¹ Therefore, it’s important to build and maintain a reliable network of friends and family – and share concerns with them.

Tracking Progress

Taking note of events, places, and triggers that cause a stress response can be a great tool for coping in future scenarios that would ordinarily be cause for concern. Likewise, jotting down successes as they happen is a great way to track progress and improve confidence.^16-18

Therapy for Hypervigilance

While coping strategies can be highly effective in getting hypervigilance under control, sometimes, it can be too difficult to cope with alone. In such cases, professional support can be invaluable.

The following options for therapy for hypervigilance have a proven evidence base.

Cognitive Behavioral Therapy (CBT)

CBT helps reframe threat appraisals, reduce catastrophic thinking, and teach graded exposure to feared but safe situations. Therefore, CBT is considered to be an effective treatment for trauma-related hypervigilance and anxiety.^12,19

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR treatment involves recalling traumatic memories while following eye movement prompts as a means to process these events in a controlled way. It’s shown by research to be an effective therapy approach for PTSD-related hypervigilance.²⁰

Medication

Evidence supports the role of medication in reducing PTSD and anxiety symptoms when appropriate.21 However, they tend to work best alongside therapy.

The following medications may be prescribed to help manage hypervigilance symptoms:

SSRIs (selective serotonin reuptake inhibitors): These prevent the breakdown of serotonin (a mood-boosting chemical), promoting emotional balance21
SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): These work in a similar way to SNRIs except that they also block reuptake of norepinephrine. They may be useful if SSRIs haven’t proven to be effective²¹

Medication choices should be individualized and monitored by a clinician.

Overcoming Hypervigilance

Healing hypervigilance is about rewiring the nervous system in a way that reduces the tendency to detect threats on a chronic basis, but without erasing awareness.

Effective recovery typically includes making note of triggers and patterns, maintaining supportive relationships, and partaking in coping strategies, consistent therapy, and medication if needed.

The good news is that with time and structured care, many adults significantly reduce hypervigilance and reclaim calm and balance in their day-to-day lives.^5,12,21

Finding Calm With Mission Connection

While being in a state of high alert is useful in dangerous situations, it’s not always welcome in day-to-day life where there are no apparent threats. It may be a relief to know that, if you or someone you love struggles with hypervigilance, recovery is possible. While the techniques discussed can be used as a toolkit for grounding yourself in the present and avoiding states of stress, many people may benefit from extra support.

Mission Connection is here to provide support for hypervigilance. Our team is on hand to help people regain their confidence, reduce incidences of hyperawareness in daily life, and improve overall quality of life as a result.

We provide a variety of evidence-based treatment options that can be tailored to your specific needs, whether you require immediate support or more long-term continued help. Our telehealth services also mean that you can fit therapy for hypervigilance into your schedule flexibly, allowing you to receive care from the comfort of your home.

By also offering comprehensive medication monitoring alongside various therapies, Mission Connection can be a guiding light toward overcoming hypervigilance. If you’re ready to explore our treatment options, contact us today or complete our confidential contact form for more information.

References

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Armour, C., Arnold, M., Elhai, J. D., & Forbes, D. (2017). PTSD’s symptom structure and correlates: The role of hyperarousal. Journal of Anxiety Disorders, 49, 70–77.
Rauch, S. L., Shin, L. M., & Phelps, E. A. (2006). Neurocircuitry models of PTSD and extinction: Human neuroimaging research. Biological Psychiatry, 60(4), 376–382. 10.1016/j.biopsych.2006.06.004
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Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52(2), 145–161. 10.1177/0022146510395592
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Shapiro, F. (2018). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures. Guilford Press.
Baldwin, D. S., & Polkinghorn, C. (2005). Evidence-based pharmacotherapy of anxiety disorders. International Journal of Neuropsychopharmacology, 8(2), 293–302. 10.1017/S1461145704004874