Increased vigilance: symptoms, causes, diagnosis and treatment


Hypervigilance is a state of constant tension, alertness and special attention to the environment. There are many reasons for increased vigilance, including psychological conditions like anxiety and medical conditions like thyroid disease . Recreational and medicinal drugs can also cause this effect.

The most vigilant diagnosis is based on your medical history and clinical examination. Certain diagnostic tests, such as blood tests and imaging tests, can help determine the cause. Treatment is based on reducing the symptoms of increased alertness and addressing the underlying cause.

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Increased vigilance is an unpleasant sensation. Not only do you notice sensations more easily, but you can't distract your attention from them either.

Most people have experienced brief moments of increased vigilance. For example, people who watch a horror movie or visit a themed "haunted house" are often intimidated by ordinary noises, such as the creaking of a door. And most visitors to the local zoo, after visiting the snake exhibit, stare at the ground in dismay.

Others show increased vigilance when it comes to very specific things, such as high- pitched sounds or physical discomfort. For example, when you hear a beep in another room, you may notice it immediately and be very distracted or worried about it. You may also be overly aware of physical sensations – the pressure of the belt or the rubbing of the fabric against your skin can be distracting.

Increased chronic vigilance

However, excessive surveillance generally goes beyond the simple annoyance, and you may find yourself constantly scanning your environment for threats.

You may be so anxious every time you get on a plane that you can't sit still, eat, or look at a magazine. And if you're overly vigilant in almost any setting, this feeling can get in the way of your life.

People who live with increased vigilance may experience any of the following symptoms :

  • Jumping ability
  • Paranoia
  • Frequent movements of the head and exploration of the environment with the eyes.
  • Distraction from important tasks, conversations with other people, and entertainment.
  • Agitation
  • Anger
  • Depression
  • Isolation
  • Sleep disturbance
  • Feeling helpless
  • Dependence on others
  • Tendency to fight or argue with others.
  • Exhaustion
  • Change in appetite

If you have chronic symptoms of increased alertness, it is vital that you speak with your doctor because the condition can make it difficult for you to maintain your health, your relationships and your work life.


There are a number of risk factors that make you more prone to increased vigilance. Post-traumatic stress disorder (PTSD), fibromyalgia , hyperthyroidism, adrenal disease , poor sleep, anxiety, and schizophrenia are just a few of the medical disorders that increase the likelihood of increased vigilance.

Medical conditions

Medical illnesses can make you more sensitive to your surroundings (you feel things more intensely) or more attentive (you expect negative feelings, experiences, or events), or both.

For example, lack of sleep can make you nervous, anxious, and prone to pain. Endocrine tumors such as pheochromocytoma may have an imminent fate. And drug intoxication or withdrawal often causes extreme paranoia on a temporary basis.

Fibromyalgia is associated with sensory overload , allodynia (a sensation of pain in response to painless touch), and sensitivity to noise and light .

Threat perception

In general, the human brain perceives a lot of information about the environment, including everything that can be seen, smelled, touched, heard, and even tasted. It is impossible to be aware of all these messages and to focus on them.

To effectively manage the input of information, the brain has a filtering process. Sensory messages that are not considered important are silenced.

However, any message that your brain thinks is dangerous receives additional attention. Loud noises, dangerous animals or beetles, threats to people, and painful physical sensations can all be harmful, so react to them.

Hypervigilance identifies a threat. And while your mind knows you don't have to be on the lookout for dangerous animals like wolves or lions in an urban apartment building, you can listen in dismay to any sign of an elevator malfunction while others chat or check their phones without worry. about the elevator.

Hypervigilance is a highly individualized response, depending on what your brain has learned about danger.

Life experience

Life events and experiences can play an important role in improving alertness.

Children who have witnessed parental fights in the home can be made nervous by loud voices. Adults who are bullied may feel nervous about people who have characteristics similar to their former bullies. A person who survived a fire can react sharply to the smell of a fire, to the sound of a smoke alarm.

And when you suffer from increased vigilance, these triggers not only fire you when they arise, but you will unconsciously seek them out, feeling aggressive fights, even when people are joking or noticing the smoke from the candles in the house.


Increased vigilance can affect your peace of mind and can be frustrating for those around you. The first step in relieving your symptoms is recognizing that you can be diagnosed and that treatment can be effective.

Talk to your doctor about your symptoms. Invite a trusted friend or family member if you think they can help you explain your problem to a doctor. Your healthcare provider will ask you questions about your symptoms and your health, and perform a physical exam.

In the context of hypervigilance, one of the most important aspects of your physical exam is measuring your vital signs: temperature, heart rate, breathing rate, and blood pressure. Many illnesses associated with increased alertness can alter your vital signs.

Your healthcare provider may suggest more tests based on your symptoms and the results of the physical exam.

Additional assessments may include:

  • Psychiatrist consultation
  • Blood tests: complete blood count, thyroid and electrolyte tests.
  • General urine analysis and toxicological detection
  • Computed tomography of the brain (CT) or magnetic resonance imaging (MRI)
  • CT scan of the abdomen or neck, MRI or ultrasound

Increased vigilance is seen as an aspect of the disease, not the disease itself. If you suspect that increased vigilance may be a problem for you, talk to your doctor about it. This can help shape the direction of your treatment.

Watch out

The drugs are generally not considered first-line drugs in the treatment of increased surveillance. Counseling and coping methods are often effective, and treating the underlying condition is vital.

Advice and assistance

Your best option is to find a therapist who has an approach that works for you. You may need to talk about certain experiences and events that may have led to your current fears.

Over time, you will learn to be more balanced with your concerns.

Coping techniques that can reduce excessive vigilance include :

  • How to deal with stress
  • Yoga
  • Meditation
  • Attention
  • Deep breathing

Medical administration

If the disease has increased your alertness, treatment can reduce your alertness and improve your overall health.

For example, if you have been diagnosed with an endocrine disorder, you may need medicine or surgery. And there are effective medications that can ease the symptoms of schizophrenia. Sleep deprivation can have many causes, and treatment can include lifestyle management, medication, or sleep apnea treatment.

If you are taking recreational medications or medications that cause increased vigilance as a side effect, it is recommended that you stop taking them.

Keep in mind that you should work with your doctor to plan a schedule to reduce your intake of medications or recreational drugs to avoid withdrawal symptoms.

Get the word of drug information

Some people are so concerned about hypervigilance that they withdraw from situations or environments that increase their alertness. This can be a good approach if there are few situations and they are not important in the overall scheme of your life.

However, if abstaining from triggers leads to isolation or interferes with your productivity, it may be helpful to receive counseling so that you can enjoy life more fully. While you may feel desperate at times, remember that with time and effort, you can overcome excessive vigilance.

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