You may experience sweating, faster heart rate and shallow breathing with this state of increased alertness. You may be sensitive to your surroundings and feel alert to hidden dangers that might not be real.

Hypervigilance is a state of increased alertness. If you’re in a state of hypervigilance, you’re extremely sensitive to your surroundings. It can make you feel like you’re alert to any hidden dangers, whether from other people or the environment. Often, though, these dangers are not real.

Hypervigilance can be a symptom of mental health conditions, including:

These can all cause your brain and your body to constantly be on high alert. Hypervigilance can have a negative effect on your life. It can affect how you interact with and view others, or it may encourage paranoia.

There are physical, behavioral, emotional, and mental symptoms that can go with hypervigilance:

Physical symptoms

Physical symptoms may resemble those of anxiety. These may include:

  • sweating
  • a fast heart rate
  • fast, shallow breathing

Over time, this constant state of alertness can cause fatigue and exhaustion.

Behavioral symptoms

Behavioral symptoms include jumpy reflexes and fast, knee-jerk reactions to your environment. If you’re hypervigilant, you may overreact if you hear a loud bang or if you misunderstand a coworker’s statement as rude. These reactions may be violent or hostile in a perceived attempt to defend yourself.

Emotional symptoms

The emotional symptoms of hypervigilance can be severe. These can include:

  • increased, severe anxiety
  • fear
  • panic
  • worrying that can become persistent

You may fear judgment from others, or you may judge others extremely harshly. This may develop into black-and-white thinking in which you find things either absolutely right or absolutely wrong. You can also become emotionally withdrawn. You may experience mood swings or outbursts of emotion.

Mental symptoms

Mental symptoms of hypervigilance can include paranoia. This may be accompanied by rationalization to justify the hypervigilance. It can also be difficult for those who experience frequent hypervigilance, like those with PTSD, to sleep well.

Long-term symptoms

If you experience recurring hypervigilance, you may start to develop behaviors to calm your anxiety or counteract perceived threats. If you fear assault or danger, for example, you may start carrying a concealed weapon. If you have severe social anxiety, you may rely on day dreaming or non-participation in events. These symptoms can result in social isolation and damaged relationships.

Hypervigilance can be caused by different mental health conditions:


Anxiety is one of the most common causes of hypervigilance. If you have generalized anxiety disorder, you might be hypervigilant in new situations or environments that you’re unfamiliar with.

If you have social anxiety, you may be hypervigilant in the presence of others, especially new people or people you don’t trust.


PTSD is another common a cause of hypervigilance. PTSD can cause you to be tense. You may constantly scan the area for perceived threats.


Schizophrenia can also cause hypervigilance. Hypervigilance can worsen other symptoms of the condition, such as paranoia or hallucinations.

Common triggers

There are some common triggers that can cause or contribute to episodes of hypervigilance. These include:

  • feeling trapped or claustrophobic
  • feeling abandoned
  • hearing loud noises (especially if they’re sudden or emotionally charged), which can include yelling, arguments, and sudden bangs
  • anticipating pain, fear, or judgment
  • feeling judged or unwelcome
  • feeling physical pain
  • feeling emotional distress
  • being reminded of past traumas
  • being around random, chaotic behaviors of others

To treat hypervigilance, your doctor will determine the underlying cause of the condition. Treatment may be different depending on what’s causing it. You’ll likely be referred to a therapist or psychiatrist.


Cognitive behavioral therapy (CBT): CBT is often effective at helping to treat anxiety. In these sessions, you’ll talk about your past experiences as well as your current problems and fears. Your therapist will guide these conversations. Your therapist can help you identify what causes your hypervigilance and how to deal with it.

Exposure therapy: Exposure therapy can be helpful if you have PTSD. Exposure therapy allows you to safely face fears and memories of trauma slowly so that you can learn how to manage the flashbacks and anxiety.

Eye movement desensitization and reprocessing (EMDR): EMDR combines exposure therapy with guided eye movements. This can ultimately change how you react to traumatic memories.

Online therapy options

Read our review of the best online therapy options to find the right fit for you.

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Severe cases of anxiety and PTSD may require more intensive treatment, including prescription medications. Medications can include:

  • antidepressants
  • beta blockers
  • non-addictive anti-anxiety medications, like buspirone

Schizophrenia may also be treated with medications, such as antipsychotics.

Learn more: Complementary and alternative treatments for schizophrenia »

Through therapy, you may learn new ways to cope with episodes of hypervigilance and anxiety. Here are some strategies that can help:

  • Be still and take slow, deep breaths.
  • Search for objective evidence in a situation before reacting.
  • Pause before reacting.
  • Acknowledge fears or strong emotions, but don’t give in to them.
  • Be mindful.
  • Set boundaries with others and yourself.