Hyperarousal

What is hyperarousal?

Hyperarousal is a state in which your senses are heightened and your thoughts, emotions — and even some bodily processes — work overtime. It’s like being in “fight-or-flight” mode all the time, only there’s no present danger.

In fight-or-flight, your heart pumps harder. Your breathing gets deeper and faster. All of your body systems — from your eyes to your skin to your liver — work to help you notice and move away from danger.

Your sympathetic nervous system (SNS) controls this feeling of fight-or-flight — and it’s meant to be temporary. Your SNS releases chemicals (neurotransmitters) that send your brain and body into action. Once you’re safe, your parasympathetic nervous system helps to settle things down again.

Except in hyperarousal, you’re not usually dealing with a threat that’s right in front of you. Often, the thing you’re worried about happened a long time ago. Hyperarousal can occur as part of health conditions like post-traumatic stress disorder (PTSD) or insomnia.

What are the symptoms of hyperarousal?

In hyperarousal, you may have physical or emotional symptoms, including:

• Being constantly on the lookout for potential danger or threats (hypervigilance)
• Thinking or worrying about things a lot, even after situations have been resolved
• Feeling jumpy or easily startled
• Feeling that your heart is racing, pounding or flip-flopping (heart palpitations)
• Vivid memories or flashbacks of traumatic situations from your past
• Extreme sensitivity to sounds, smells, textures or sights (sensory reactivity)
• Having a hard time falling asleep, staying asleep (insomnia) or restless sleep even when you’re tired
• Outbursts of anger or rage
• Trembling or shaking
• Breathing fast or feeling dizzy or lightheaded
• Sweating or feeling hot or flushed

What are the most common causes of hyperarousal?

Conditions that affect how you regulate emotions, thoughts or actions can cause hyperarousal, including:

• Acute stress disorder
• Anxiety disorders
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder
• Insomnia
• Post-traumatic stress disorder (PTSD)

Certain substances like cocaine, caffeine, nicotine and alcohol can also cause hyperarousal.

How is hyperarousal treated?

As hyperarousal has many causes, treatment depends on why it’s happening in your particular situation. In many cases, treatment may be a combination of psychotherapy, stress and anxiety management techniques and medication.

Because the treatments can vary, your healthcare provider is the best source of information about possible treatments. They can help you understand your options and decide which are best for you.

What can I do at home?

Hyperarousal isn’t a symptom you can self-diagnose or self-treat. Sometimes, people with hyperarousal feel stuck or overwhelmed. If this is the case, there are some things you can do in the short term to feel better. You can even plan ahead and have some of these items on hand for events you know might be stressful, like going to a concert or moving your child to college.

Powerful sensory stimulation may help reduce feelings of hyperarousal. These include things like:

• Sucking on a very sour candy or strong mint
• Drinking very cold liquid
• Placing an icepack or cool washcloth on your face, the back of your neck or the inside of your wrist
• Taking a cool shower

To get longer-term relief, you’ll want to develop new techniques to calm your sympathetic nervous system. If a healthcare provider diagnoses you with a condition that causes hyperarousal, they can guide you through possible approaches to manage or minimize the effects.

Some examples of common self-management strategies for hyperarousal include:

• Breathing exercises. You breathe in and out all the time, without thinking about it. But slowing down to think about each breath — even for a few minutes — helps your body calm down. This helps you move away from the fight-or-flight response of hyperarousal.
• Meditation. In hyperarousal, thoughts, emotions and sensations clutter your mind. Meditation can help you clear the clutter so you can stay in the present moment.
• Stress management. Everyone experiences stress. But in hyperarousal, you continue to feel the effects of stress long after the triggering event. Learning how to manage daily stressors is an important part of feeling better.
• Cut back on stimulants. Substances like caffeine and tobacco (nicotine) activate your nervous system, which contributes to your feelings of arousal. If you have a condition that’s linked to hyperarousal, you may want to consider avoiding or limiting your use of these substances.
• Avoid recreational drugs and alcohol. Steer clear of alcohol and nonprescription drugs like amphetamines, cannabis (marijuana), cocaine and opioids that can cause hyperarousal — or make it worse.

What are the possible complications of hyperarousal?

Hyperarousal makes it hard for you to relax. Your body is adaptable, but it wasn't meant to handle such high levels of stress for prolonged periods. Hyperarousal can contribute to chronic pain, high blood pressure, heart problems and even increase your risk for Type 2 diabetes.

Hyperarousal can also disrupt your work and social life. It can even interfere with your relationships, affecting how you respond to others. Hyperarousal may lead to outbursts or behaviors you later regret or feel ashamed of. But treatment and stress management can help.

When should a healthcare provider treat hyperarousal?

You should always see a healthcare provider if you suspect you have hyperarousal. While similar to stress, it’s more severe, and so are its long-term effects. If your provider diagnoses it, you should see them as recommended.

If you or a loved one are having thoughts of hurting yourself or suicide, call or text the Suicide and Crisis Lifeline at 988. Someone is available to help you 24/7.