From sweaty pits and trouble sleeping to sitting with your back to the wall and scanning for weapons, being on high alert 24/7 is no fun.

Chronic edginess can be a sign of a mental health condition, but it’s not always. Unfortunately, figuring out whether you’ve got social anxiety, generalized anxiety, or another reason for feeling this way can be tricky.

So, let’s dive into the nuts and bolts of hypervigilance — and the possible causes that might be behind yours.

What exactly *is* hypervigilance, then?

Hypervigilance is heightened alertness.

It can feel like being in constant danger — but the danger isn’t real.

Folks who experience hypervigilance become uber-sensitive to the sights, sounds, and people around them. It can be a symptom of:

If you constantly feel like you’re on high alert, a range of coping mechanisms, therapy options, and medications are available to help.

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Let’s keep it 💯: Hypervigilance alone is not a medical condition. It’s more like a set of symptoms or behaviors that *might* point to an underlying mental health issue.

Traumas, such as combat or abuse, can lead to hypervigilance. If you have chronic pain or another chronic medical condition, you may become hypervigilant to your body or symptoms.

Recent research suggests that people in urban centers who experience more community violence or run-ins with police might also live with hypervigilance.

Physical effects: How your body deals with hypervigilance

Hypervigilance isn’t a recognized, stand-alone condition, but it causes very real and uncomfortable symptoms.

This is because when you’re hypervigilant, your body stays in the state of “fight, flight, or freeze” that kicks in when you perceive a threat. In this state, your brain releases chemicals called neurotransmitters that affect many parts of your body.

TBH, everybody processes mental stress differently. These are some of its *possible* physical effects:

  • unexplained sweating
  • racing heart
  • fast, shallow breathing
  • restlessness
  • dilated pupils
  • muscle tension

If you’re hypervigilant for days, weeks, or months on end, you might also experience extreme fatigue from the constant state of alertness.

Behaviors: What hypervigilance looks like in others

You might notice that a friend, partner, or family member seems constantly on edge. Here are some behaviors that can be common in people who are hypervigilant:

  • jumpiness
  • knee-jerk responses to noises or sudden movements
  • overreaction to loud noises or conversations
  • a tendency toward defensiveness and hostility

Emotional symptoms: How hypervigilance feels

Hypervigilance is not pleasant. It feels a whole lot like bad anxiety or even paranoia from schizophrenia or severe bipolar disorder — and yep, sometimes it’s a symptom of those conditions.

Here are some of the emotional symptoms:

Mental: What’s going on in your head

Hypervigilance can seem, look, and act a whole lot like paranoia. You might find yourself thinking up ways to justify your fear of hidden dangers:

  • Maybe you’re hooked on true crime.
  • Maybe you doomscroll.
  • Maybe you fixate on news articles or recent events that help rationalize your fears.

Being on high alert gets exhausting. Peeps experiencing hypervigilance might have trouble sleeping even though they feel worn out. It’s a vicious cycle.

Any long-term effects?

Yep. And they’re not ideal.

Deteriorating relationships

When you’re constantly in defense mode, you might find yourself making snap judgments of others because it feels like a way to protect yourself. Living in your head and centering your life around your fears might fray your connections.


Fear of hidden dangers might tempt you to spend all your nights chilling on the couch instead of interacting with your social circle because it feels safer to avoid those situations.

The spiral

A 2014 study suggests that hypervigilance can create a feedback loop:

  1. High sensitivity to danger makes you notice things that trigger anxiety.
  2. These triggers convince you to be *even more* vigilant.
  3. This feeds your anxiety again…

You get the picture.

So, what’s the difference between hypervigilance and paranoia?

Someone who has a mental condition with paranoia as a symptom, such as paranoid personality disorder, may be hypervigilant.

But experiencing hypervigilance does *not* always = paranoid personality disorder or another mental health condition.

Delusions: You have hyperspecific, untrue beliefs about others.

For instance, you might believe that your bae is cheating on you (with no proof) or that your boss is out to get you.
High alert: You don’t have a specific, fixed fear — you’re just on guard for any danger that might come your way.
Lack of self-awareness: If you have paranoia, you won’t know you have it.Awareness: You struggle to relax *despite* knowing you’re unjustifiably on edge.
Present-focused: You think someone is trying to harm you *now.* Future-focused: You’re probably anxious about what *could* happen in the future.

So many possibilities.

Maybe you’ve got anxiety

Anxiety is a leading cause of hypervigilance.

It makes sense that generalized anxiety disorder or social anxiety disorder could make you hyperaware of your surroundings. That’s especially true when you’re in a new place or meeting new people.

Maybe you’re dealing with PTSD

Not everyone experiencing hypervigilance has PTSD.

But many people with PTSD feel tense and on high alert in crowded, noisy, or unfamiliar places.

Signs you may be experiencing PTSD

Only a mental health professional can diagnose PTSD. If you experience several of these symptoms for longer than a month, contact a doctor or a mental health pro:

  • flashbacks or bad dreams about a traumatic event
  • a strong urge to avoid places and people associated with the traumatic event
  • a constant on-edge feeling
  • trouble sleeping
  • difficulty remembering the specifics of the traumatic event
  • feelings of guilt without explanation
  • feelings of detachment from loved ones and disinterest in activities you used to enjoy
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Maybe it’s schizophrenia

First things first: Schizophrenia is a rare but serious and potentially disabling mental illness. But feeling hyperalert ≠ schizophrenia.

Folks with schizophrenia may experience episodes of hypervigilance, which makes hallucinations and paranoia worse. But schizophrenia also comes with other symptoms.

Don’t try to self-diagnose schizophrenia. If you’re concerned about your own or a friend’s mental health, contact a doctor.

The following factors and events may trigger or worsen episodes of hypervigilance:

  • loud noises
  • small or crowded spaces
  • feelings of abandonment
  • the feeling of being judged or being an outsider
  • physical pain
  • emotional turmoil
  • chaotic environments with unpredictable people
  • people or places that trigger memories of past trauma

If you’ve ever had a panic attack, you know taking deep breaths and regularly practicing meditation can help.

But hypervigilance can suggest a deeper-rooted mental health issue. If you pick up on signs of hypervigilance, it’s best to talk with a doctor or a mental health professional.

7 coping mechanisms to try

Therapists often start by teaching you these skills to calm and center yourself:

  • Practice pausing before reacting. Even counting to 10 can help.
  • Take slow, deep breaths while holding your body still.
  • Slowly scan for objective evidence of danger before reacting.
  • Remember that feelings aren’t facts: Acknowledge your fears, but don’t let them control your actions.
  • Try mindfulness apps or meditation.
  • Set boundaries for yourself.
  • Exercise! Sometimes going for a run or lifting all the heavy things is enough to release adrenaline and boost endorphins so you can feel calmer.

Try therapy

A few types of therapy may be helpful for hypervigilance.

Cognitive behavioral therapy (CBT)

CBT is a type of talk therapy. Your therapist will walk you through experiences you’ve had and the ways they’re causing stresses and fears today.

CBT prepares you to cope with moments of anxiety and process emotions differently. It can help you understand how you’re thinking about things, determine whether the thoughts are accurate or helpful, and come up with alternative ways to see things.

Exposure therapy

This type of therapy gives you a safe place to face your fears and memories head-on. Your therapist will introduce exposure gradually while teaching you ways to relax so you can cope with the feelings this treatment will stir up.

This can help you practice managing anxiety and flashbacks. Exposure therapies are backed by research as treatments for PTSD.

Eye movement desensitization and reprocessing (EMDR)

This therapy style combines exposure therapy and specific eye movements.

Sounds a little woo-woo, we know — but research totally has its back.

Talk with your doc about meds

Your brain is an organ. Just as you might for your heart, lungs, or skin, you sometimes need medications to treat problems or conditions that affect it.

Doctors might prescribe these meds for PTSD, severe anxiety, or schizophrenia:

  • antidepressants
  • anti-anxiety medications
  • mood stabilizers, also called atypical antipsychotic medications

Using medication can be an important part of managing hypervigilance caused by an underlying mental health condition, especially if therapy isn’t working.

If your doctor suggests medication, be sure to ask about side effects. Some of these meds can have pretty significant ones. It’s also best to ask about how to stop taking them, since stopping them abruptly can cause withdrawal symptoms.

How to get a diagnosis

  • Talk with a doctor about your hypervigilance.
  • If you already see a therapist, tell them about your latest episodes of hypervigilance. They’ll know whether to teach you more coping skills or refer you to a psychiatrist to talk about meds.
  • If you already have a mental health diagnosis, look for a therapist or psychiatrist who specializes in your condition.
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Hypervigilance is a chronic state of heightened awareness or alertness. It can be overwhelming, terrifying, and exhausting.

Experiencing hypervigilance *could* mean that you’re dealing with an underlying health condition like anxiety, PTSD, or schizophrenia.

Deep breathing, exercise, and meditation can be helpful when you’re experiencing hypervigilance. If you’re feeling on edge all the time or avoiding loved ones because you don’t want to be in public places, it’s time to talk with a doctor.