Medical News Today: Hyperarousal: Symptoms and treatment

Hyperarousal is a group of symptoms that people with post-traumatic stress disorder may experience. What are the key signs of hyperarousal and how can people manage their symptoms?

Some people with post-traumatic stress disorder (PTSD) experience heightened anxiety. This may make them more sensitive and overly responsive to stimuli and events in the world around them. This state of increased sensitivity is called hyperarousal.

In this article, we look at the symptoms and causes of hyperarousal, as well as how a person can manage it. We also look at how people can help loved ones experiencing hyperarousal better cope with their condition.

Symptoms of hyperarousal

Hyperarousal is one symptom of PTSD. A person experiencing hyperarousal may:

senior man suffering from hyperarousal
Symptoms of hyperarousal include feeling jumpy, finding it hard to concentrate, and being impulsive.
  • find it hard to go to sleep or stay asleep
  • feel irritable and quickly lose their temper
  • find it hard to concentrate
  • constantly feel on-guard (hypervigilance)
  • be more impulsive than usual
  • feel like their muscles are more tense than usual
  • feel pain more easily
  • feel their heart beating faster than usual
  • feel jumpy and be startled easily
  • breathe more quickly or less deeply than usual
  • have flashbacks about a traumatic event

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Causes of hyperarousal

The main cause of hyperarousal is PTSD. It is less commonly caused by alcohol withdrawal.

PTSD is a mental health condition brought on by a traumatic event. The sorts of events that might cause PTSD include:

  • a robbery
  • a car crash
  • a sexual assault
  • military experiences
  • childhood abuse
  • domestic abuse
  • a fire
  • a terrorist attack
  • a natural disaster

There are many other events that can increase the risk of developing PTSD. However, not everyone who has experienced a traumatic event will experience PTSD or hyperarousal.

How to cope with hyperarousal

Experiencing the symptoms of hyperarousal and other PTSD symptoms can be distressing. If a person notices these symptoms in themselves or someone else, it is a good idea for them to speak to a doctor.

Sometimes, a person experiencing hyperarousal might behave in a way that is self-destructive. This can include driving recklessly or drinking excessively. Ensuring their safety and the safety of others means it is important for people affected by hyperarousal to get treatment.

Alongside treatments the doctor may recommend, there are several coping strategies that a person experiencing hyperarousal can try. Strategies to manage different symptoms of hyperarousal are listed below:

Sleeping difficulties

People with hyperarousal who find it hard to sleep may try:

  • sticking to regular bedtime and waking times
  • exercising during the day
  • avoiding caffeine after midday
  • not consuming alcohol in the 6 hours before bed
  • avoiding naps during the day
  • getting up to do something relaxing when unable to sleep for more than 30 minutes, then returning to bed once drowsy
  • reducing screen time, such as watching TV or using a laptop, in the bedroom
  • creating a calm atmosphere in the bedroom
  • wearing an eye mask and earplugs to block out light and sound
  • practicing deep breathing before bed
  • practicing mindfulness, meditation, or yoga


People with hyperarousal may find it difficult to control their temper. The following coping strategies may help:

Lady with a single tear on her face
Crying as a release may help to cope with anger.
  • crying as a release instead of shouting
  • doing vigorous exercise or dancing
  • punching a pillow or something else soft
  • talking to an empathetic friend or family member
  • writing things down
  • creating expressive artwork
  • practicing deep breathing
  • practicing mindfulness, meditation, or yoga

Trouble concentrating

People with hyperarousal who experience difficulties concentrating may find that the following strategies help:

  • trying to improve sleep quality
  • practicing mindfulness exercises
  • removing or turning off distractions, such as their mobile phone
  • improving concentration by working in short bursts and gradually increasing these periods by 5 minutes at a time
  • focusing on one task at a time

Impulsive behavior

People with hyperarousal who are acting impulsively can try:

  • practicing mindfulness exercises
  • finding a positive task or activity to replace the impulsive or destructive behavior
  • speaking to a friend or sending them a message
  • writing about how they are feeling
  • identifying the negative consequences of impulsive behavior
  • practicing deep breathing

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How to help a loved one with hyperarousal

Support for a loved one with hyperarousal
A person can support a loved one with hyperarousal by listening and not overreacting to their symptoms.

One way to support a loved one who is experiencing hyperarousal is to make them aware of the above coping mechanisms.

Offering to try some of these things, such as mindfulness, deep breathing, or meditation, with them may also help.

It is important not to overreact to any behaviors associated with hyperarousal. Being there to listen in a non-judgmental, empathetic way can also help.

Above all, the most important way to help a loved one experiencing hyperarousal is to ensure they have spoken to a doctor and received a proper diagnosis. This will ensure they get access to the right treatment.


There is a range of treatments available for hyperarousal that can help people to manage their symptoms:

  • Exposure therapy: This type of therapy helps a person with PTSD experience traumatic situations and memories in a safe environment to help reduce fear and anxiety.
  • Eye movement desensitization and reprocessing (EMDR): This works alongside exposure therapy and includes eye exercises that alter the way a person reacts to a particular memory.
  • Cognitive behavioral therapy (CBT): This gives a person practical ways to cope with negative thought patterns and behaviors that result from their PTSD.

In addition to these therapies, the doctor may prescribe the following medications to help manage hyperarousal and other PTSD symptoms:

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PTSD can be a long-term condition and hyperarousal is a common symptom. However, there are many coping strategies that people can use to reduce the impact hyperarousal may have on their daily activities.

PTSD can be well managed with the right therapies, medications, and ongoing support. If a person is experiencing symptoms of hyperarousal or PTSD, they should speak to a doctor for a proper diagnosis and treatment plan.

Similarly, if a person is concerned about a colleague, friend, or relative who may be experiencing hyperarousal or PTSD, they should encourage the person to speak with a doctor or even offer to accompany them.

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