Hyperarousal Symptoms, Causes & Treatments. Learn more About Hyperarousal Definition.

Hyperarousal is a state of increased physiological and psychological activation observed in conditions such as Attention Deficit Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD). Hyperarousal refers to activating the sympathetic nervous system, which leads to increased heart rate, rapid breathing, sweating, and muscle tension. Hyperarousal is often triggered by stress, anxiety, or trauma and can negatively affect an individual’s quality of life.


What Is Hyperarousal?

Hyperarousal is a psychophysiological condition commonly observed in individuals with post-traumatic stress disorder (PTSD). As its name implies, hyperarousal symptoms can be characterized by excessive psychological and physical alertness that can disrupt daily functioning and sleep patterns. Traumatic incidents that trigger the development of hyperarousal Symptoms in individuals with PTSD can encompass:

  • Accidents
  • Combat experiences.
  • Natural disasters.
  • Incidents of sexual violence.

This heightened alertness effectively keeps both the body and mind in a perpetual state of vigilance, making it challenging to engage in routine activities. This persistent state of heightened arousal is primarily driven by the “fight-or-flight” response within the autonomic nervous system.

We will explore the origins, symptoms, and potential treatments for hyperarousal as it manifests in PTSD.

What are the Hyperarousal Symptoms?

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is used to identify mental health problems. It lists six different groups of symptoms, or “clusters,” connected to hyperarousal in PTSD. These clusters are made up of:

  1. Anger or Angry Outbursts: Chronic hyperarousal often manifests as difficulty controlling anger or engaging in aggressive verbal or physical behavior without apparent provocation.
  2. Impulsivity: One of the primary risks associated with hyperarousal is the tendency to act impulsively, which may involve engaging in reckless or self-destructive behaviors like dangerous driving, excessive alcohol or drug use, or self-injurious actions.
  3. Hypervigilance: Those experiencing hyperarousal tend to exhibit heightened sensitivity to perceived threats, living in a perpetual state of alertness, which can be mentally and physically draining.
  4. Excessive Startle Reflex: An increased startle response is expected, causing individuals to react strongly to loud noises or unexpected movements, such as jumping in response to a ringing telephone.
  5. Attention Issues: Problems with concentration, focus, and memory can disrupt daily life and work performance.
  6. Sleep Disruption and Insomnia: Elevated states of arousal, coupled with recurring nightmares, often interfere with the ability to obtain sufficient sleep and adhere to healthy sleep patterns (e.g., sleep hygiene).

In addition to these six subtypes, anxiety disorders, irritability, and panic episodes are often linked to hyperarousal in people with PTSD.

What are the Causes of Hyperarousal?

People who have PTSD can be affected by many different things that can bring up memories of stressful events and cause symptoms. Here are some examples of these kinds of triggers:

  • Scent of Diesel Fuel: The mere whiff of diesel fuel can ignite flashbacks to life-threatening situations, particularly if that odor is associated with the time and place of the traumatic incident.
  • Weather Forecasts: An impending forecast of freezing rain, linked to a past automobile accident on black ice, can send stress levels soaring before one’s morning commute.
  • Familiar Tunes: Hearing an old song while waiting in the checkout line at a store can unleash a rush of vivid memories tied to a traumatic experience.

When these things happen, they can quickly make you feel very alert inside. These are some of the physical signs of autonomic hyperarousal:

  • Accelerated heart rate.
  • Elevated blood pressure.
  • Sweaty palms.
  • Shortness of breath.

Psychologically, hyperarousal is upsetting and can make you feel panicked and anxious even when there is no real threat or danger. The body and mind stay on high alert in this constant heightened awareness.

People with hyperarousal often have anxiety and find it hard to relax. Being on high alert can be too much for some people, making it hard to go about their daily lives.

Over time, the things that cause PTSD symptoms can make the body’s stress reaction less effective at controlling it. Stress reactions that are built into the body are always on, which can lead to chronic hyperarousal. This is spurred by surges of epinephrine (adrenaline) and norepinephrine, both neurochemical messengers in the brain, which rapidly activate the body’s fight-or-flight response—typically a protective mechanism in the face of danger. But when someone has PTSD, long-term high amounts of these chemicals can alert them.

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Tips and Strategies for Managing Your Hyperarousal PTSD

✅ Practice slow breathing to keep your body from reacting too strongly when hyperaroused. Taking slow, deep breaths can help calm your body and make your feelings less severe.

✅ Grounding activities, like writing down what you can feel or describing your surroundings, can help you focus on the present and take your mind off upsetting memories or thoughts.

✅ Adding awareness and meditation to your daily life can help you relax, feel less anxious, and handle your emotions better.

Hyperarousal Facts

Hyperarousal Definition

Hyperarousal is a state of increased physiological and psychological activation observed in various conditions such as ADHD, PTSD, anxiety disorders, and chronic pain. This heightened activation can lead to anxiety, irritability, and difficulty sleeping. This condition can be triggered by stress, anxiety, or trauma and can negatively affect an individual’s quality of life.


Hyperarousal Treatments

The treatment for this condition typically involves a combination of psychotherapy, medication, and lifestyle changes. Psychotherapy, such as cognitive-behavioral therapy, can help individuals learn coping skills to manage hyperarousal symptoms. Medications, such as anti-anxiety or sleep aids, may also be prescribed. Lifestyle changes like exercise, relaxation techniques, and healthy sleep habits can also help reduce hyperarousal. Treatment plans are tailored to the individual’s specific needs and underlying condition.

Hyperarousal Symptoms

  • Anxiety and nervousness.
  • Restlessness and agitation.
  • Insomnia or difficulty falling and staying asleep.
  • Irritability and easily triggered anger.
  • Increased heart rate and sweating.
  • Hypervigilance and heightened sensitivity to environmental stimuli.
  • Racing thoughts and difficulty focusing.
  • Fatigue and exhaustion.
  • Increased muscle tension and physical discomfort.
  • Impulsivity and risk-taking behavior.

These symptoms can be present in various conditions, such as PTSD, ADHD, anxiety disorders, and chronic pain. If you are experiencing symptoms of this condition, seeking professional help to identify the underlying cause and develop a treatment plan is important.

Hyperarousal Statistics

Hyperarousal is a common symptom in various conditions, such as PTSD, ADHD, anxiety disorders, and chronic pain. As such, it is a significant public health concern that affects individuals of all ages and backgrounds. Understanding the prevalence of this condition in different populations can provide insights into the scope of the problem and guide the development of effective interventions. This section will explore statistics about this condition, including prevalence rates, risk factors, and demographic patterns.


Approximately 8 million adults in the U.S. experience PTSD in a given year, and an estimated 7-8% of the population will develop PTSD at some point.

Source: The National Center for PTSD

The prevalence of ADHD among adults is estimated to be around 4%. Hyperarousal is a key feature of ADHD and can lead to attention, impulsivity, and behavior control difficulties.

Source: CDC

Anxiety disorders are also prevalent in the U.S. and often involve hyperarousal symptoms. Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults.

Source: Anxiety and Depression Association of America


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Hyperarousal symptoms can be present in various conditions, such as PTSD, ADHD, anxiety disorders, and chronic pain.
Hyperarousal symptoms can be present in various conditions, such as PTSD, ADHD, anxiety disorders, and chronic pain.

Why is Hyperarousal a Problem for People With PTSD?

Hyperarousal is a terrible sign of PTSD, a disease that can make your life different. You live in constant tension because your fight-or-flight reaction is always on.

This can make people feel suspicious and scared all the time. Fast, paranoia, anger, and inability to fall asleep can occur. When you have hyperarousal, it can affect your whole life, depending on how bad it is.

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What Are The Causes of This Condition?

Hyperarousal can have a variety of causes, including:

  • Trauma: A history of physical, emotional, or sexual abuse can lead to hyperarousal, particularly in conditions like PTSD.
  • Chronic stress: Exposure to chronic stressors, such as a demanding job or relationship problems, can lead to persistent hyperarousal.
  • Substance use: Drugs or alcohol can interfere with the body’s stress response system and contribute to hyperarousal.
  • Medical conditions: Certain conditions, such as chronic pain or heart disease, can cause hyperarousal due to the body’s response to physical stress.
 Certain conditions, such as chronic pain or heart disease, can cause hyperarousal due to the body's response to physical stress.
Certain conditions, such as chronic pain or heart disease, can cause hyperarousal due to the body’s response to physical stress.
  • Neurological conditions: Certain neurological conditions, such as ADHD or epilepsy, can lead to hyperarousal due to altered brain functioning.
  • Genetics: Hyperarousal may have a genetic component, as some individuals may be more susceptible to experiencing an overactive stress response.

Hyperarousal PTSD Treatment


Available Treatments for PTSD Post-traumatic stress disorder (PTSD) is often a lifelong condition that cannot be entirely eradicated. Still, it can be effectively managed to minimize symptoms, including hyperarousal, enabling individuals to lead fulfilling lives. The primary approach to treating PTSD involves psychotherapy, which can be conducted in an individual, group, or combined setting. In some cases, mental health professionals may also prescribe medication. These treatments work to alleviate symptoms by:

  1. Boosting Self-Confidence: Therapy helps individuals rebuild their self-esteem and develop a positive outlook.
  2. Teaching Coping Strategies: Psychotherapy equips patients with effective coping mechanisms to manage PTSD symptoms when they arise.
  3. Addressing Related Issues: Therapy can also manage other concerns stemming from the traumatic experience, such as co-occurring mental health disorders or substance abuse.

Standard psychotherapy approaches include:

  • Cognitive Behavioral Therapy (CBT): CBT helps patients identify and modify thinking patterns contributing to their PTSD symptoms, such as negative self-perception and the anticipation of recurring traumatic events. It is often used in conjunction with exposure therapy.
  • Exposure Therapy: This behavioral therapy enables patients to confront traumatic situations and memories in a controlled, safe manner, facilitating better-coping strategies. Virtual reality programs are frequently employed in this process.
  • Eye Movement Desensitization and Reprocessing (EMDR): EMDR combines exposure therapy with a guided series of eye movements to help patients work through traumatic memories and alter their reactions.

Medications can also play a role in PTSD treatment. However, these drugs may have significant side effects, necessitating close collaboration with a mental health care provider to assess their effectiveness. The goal is to determine the most suitable medication or combination of medicines for an individual’s unique situation. It’s important to note that these drugs may take several weeks to take effect.

Commonly prescribed medications for individuals with PTSD include:

  • Antidepressants: These drugs alleviate symptoms of depression and anxiety that often accompany PTSD, potentially improving sleep and concentration.
  • Anti-Anxiety Medications: These are used to alleviate severe anxiety. Due to potential abuse, they are generally prescribed for short periods.
  • Prazosin (Minipress): This medication can help reduce or eliminate nightmares in people with PTSD.

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We Level Up Hyperarousal Dual Diagnosis Treatment

The definition of dual diagnosis (also referred to as co-occurring disorders) can differ between institutions. However, it is generally described as the specific treatment of someone diagnosed with a substance use disorder and a mental health disorder simultaneously. Treating dual-diagnosis clients is a critical aspect of our inpatient treatment experience because co-occurring disorders are strongly correlated with instances of substance abuse.

Creating a treatment plan that addresses the physical aspects of withdrawal, the psychological connection with drug use, and managing underlying mental health disorders is part of setting clients up for success.  A thorough mental health analysis identifies possibilities for treatment.  Meeting with mental health counselors and medical care providers means access to behavioral therapy and medication treatment. At our dual diagnosis treatment center, We Level Up can implement the highest quality of care. 

We recognize the fragile complexities of how mental and substance abuse disorders can influence others and sometimes result in a vicious cycle of addiction.  That’s why we offer specialized treatment in dual-diagnosis cases to provide the most excellent chance of true healing and long-lasting recovery.

Accepting that you may be living with a mental illness can be challenging. However, treating the presenting substance abuse case can be magnitudes easier once correctly diagnosed and treated. Only a properly trained medical professional can diagnose these underlying conditions.  If you believe you are suffering from a disorder alongside addiction, we urge you to seek a qualified treatment center to begin your journey to recovery. Call We Level Up today.

  1. What is Chronic Limbic Hyperarousal?

    Chronic Limbic Hyperarousal (CLHA) is characterized by a persistent state of increased limbic system activation, which regulates emotions and memory. This condition can lead to anxiety, depression, irritability, and difficulty sleeping. CLHA is often associated with traumatic experiences or chronic stress and can be treated with psychotherapy, medication, and lifestyle changes.

  2. What is Hyperarousal Insomnia?

    Hyperarousal Insomnia is a type of sleep disorder characterized by difficulty falling or staying asleep due to a persistent state of increased physiological and psychological activation. This condition can lead to racing thoughts, restlessness, and increased heart rate. Hyperarousal Insomnia is often associated with conditions such as anxiety, PTSD, or chronic pain, and it can be treated with a combination of cognitive-behavioral therapy, relaxation techniques, and medication.

  3. What are Hyperarousal Examples?

    PTSD hyperarousal symptoms such as hypervigilance, irritability, and difficulty sleeping. Or ADHD hyperarousal symptoms such as restlessness, fidgeting, and difficulty focusing.

  4. What is Autonomic Hyperarousal?

    Autonomic hyperarousal is a state of overactivity in the autonomic nervous system, which regulates unconscious bodily functions such as heart rate, breathing, and digestion.

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Sources
  1. National Institute of Mental Health – Hyperarousal Symptoms in PTSD: https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml#part_155672
  2. Department of Veterans Affairs – Understanding PTSD: Hyperarousal: https://www.ptsd.va.gov/understand/types/hyperarousal.asp
  3. Department of Defense – Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury: Hyperarousal: https://www.dcoe.mil/conditions/Hyperarousal
  4. National Center for Posttraumatic Stress Disorder – Hyperarousal: https://www.ptsd.va.gov/professional/treat/essentials/hyperarousal.asp
  5. Office of Minority Health – Posttraumatic Stress Disorder: https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=32
  6. National Alliance on Mental Illness – PTSD: https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Posttraumatic-Stress-Disorder