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Symptoms of hypervigilence can include sleeplessness, anxiety, panic attacks, and obsessive or obsessive-compulsive behavior. It is important to recognize hypervigilence and to try to channel that energy into constructive activities, and to find a way to rest and relax.
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Hypervigilance
One of the diagnostic criteria for PTSD is hypervigilance. Hypervigilance is watchfulness or checking one's surroundings that is over and above what is normal or reasonable. Hypervigilance takes many forms. It is what makes some of us always choose an aisle seat or one where our back is to a wall. It's what makes some of us carry defensive weapons such as guns, knives, mace or pepper spray, a police whistle or a cell phone set to 911. It makes some of us cross the street to avoid suspicious people. Some of us have alarm systems, multiple locks, window locks, high fences, guard dogs, etc. Another form of hypervigilance is studying people very carefully in an attempt to look deeply into their soul to determine exactly what they are made of. Hypervigilance is included in the cluster of symptoms referred to as "increased arousal". This cluster also includes difficulty sleeping, irritability or outbursts of anger, difficulty concentrating, and exaggerated startle response.
This increased arousal stems directly from our trauma and the form it takes is shaped directly by the nature of our trauma. If we have difficulty sleeping, it may be because we were afraid to go to sleep or stay asleep for fear of an attack of some sort while we were not conscious to repel it or avoid it. If we are irritable, it may be to warn people to keep their distance or to not behave in ways that might trigger us. If we can't concentrate it may be because we are too busy trying to monitor all inputs from possible dangers. If we startle easily it may be because we learned to jump quickly to get out of harm's way. And if we are hypervigilant it is probably because we saw our environment as having multiple and unpredictable dangers that we should be on constant alert for. In fact, much of the time our hypervigilance helps to keep us safe.
However, the "hyper" in hypervigilance suggests that we do more than is normal or reasonable. It is too much because it is an inconvenience or an encumbrance. While it is probably true that we with PTSD are indeed safer because of all the precautions that we take, it is probably also true that our hypervigilance does often get in the way. It may be that we deprive ourselves of going certain places and of partaking in certain events. For example, we don't go to an event because we can't get an aisle seat, or because we don't know what kind of people are going to be there. Sometimes we see people looking at us and we think that they are judging us or are hostile toward us. Sometimes we are afraid to eat certain foods because we are afraid of being poisoned or made ill. And, there are probably numerous other examples of ways in which hypervigilance inconveniences us.
Desired Outcome: Gain an increased understanding of the sources of our hypervigilance, acknowledge its advantages and disadvantages and increase our ability to manage our unwanted behaviors that are driven by our hypervigilance.
Discussion Starters: When, where and how have you been hypervigilant? How have you reacted to your own and others hypervigilance in the past and how do you tend to respond to it now? When do you feel that hypervigilance is bad and when do you feel that it is good? What have you done to try to manage unwanted hypervigilance and what has worked or not worked?
John C Flanagan, LCSW 525 SW Jackson Street Portland, OR 97201-4920 503-228-7574 www.johncflanaganlcsw.com
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Anxiety: A general feeling of being worried. Everyone experiences anxiety from time to time as a result of life experiences, but those with generalized anxiety disorder feel anxious frequently or excessively, not necessarily as a result of a particular situation.
Signs and Symptoms
Muscle tension, trembling Fast heartbeat (tachycardia) Fast or troubled breathing (dyspnea) Dizziness or impaired concentration Palpitations Sweating Fatigue Irritability Sleep disturbances
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What Causes It?
Anxiety can result from many specific causes, such as an underlying medical condition or drugs you are taking. However, there may be no specific cause. Factors such as genetics and early life experiences may play a role.
What to Expect at Your Provider's Office
Your healthcare provider will talk to you about when you feel anxious, what it feels like, and your medical history. He or she will give you a physical examination and may take blood or urine samples for laboratory tests. In some cases, you will have an electrocardiogram (EKG) to rule out heart problems.
Sometimes anxiety has a specific physical cause. A treatment plan can be made once the cause is identified. However, there are a variety of ways to treat anxiety that has no physical cause. Short-term counseling can boost your self-esteem and help you learn coping strategies and problem solving techniques. Your healthcare provider may also suggest trying a method of relaxation such as deep breathing techniques. In some cases, your healthcare provider will prescribe drugs to help you until you have mastered these techniques.
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Benzodiazepines—a group of drugs that help to reduce anxiety and have sedating properties; may cause drowsiness, constipation, or nausea; do not take if you have narrow-angle glaucoma, a psychosis, or are pregnant Antidepressant Medications Tricyclic antidepressants—a group of drugs that relieve depression (which can accompany anxiety); these medications tend to have numerous side effects
Nutrition
Avoid caffeine, alcohol, sugar, refined foods, and cut down on foods that are known to cause allergies (common food allergens are dairy, soy, citrus, peanuts, tree nuts, wheat, fish, wheat, fish, eggs, corn, food colorings, and additives). Fresh vegetables, whole grains, and protein nourish the nervous system, so eat more of these. Calcium (1,000 mg per day), magnesium (400 to 600 mg per day), and B complex (50 to 100 mg per day) help support the nervous system and minimize the effects of stress.
Herbs
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, it is important to work with your provider on getting your problem diagnosed before you start any treatment. Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Tinctures may be used singly or in combination as noted.
A tea (3 to 4 cups per day) or tincture (10 to 20 drops four to six times per day) from the following herbs will help to reduce anxiety and strengthen the nervous system.
Essential oils of lemon balm, bergamot, and jasmine are calming and may be used as aromatherapy. Place several drops in a warm bath or atomizer, or on a cotton ball.
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Homeopathy
Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of anxiety based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
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Acupuncture
Many people report feeling less stressed after receiving acupuncture therapy. This finding has led researchers to speculate that acupuncture may have some beneficial effect when used to treat anxiety directly. In a study of 55 healthy volunteers, acupuncture applied to a "relaxation" point in the ear led to a greater reduction in anxiety than sham acupuncture (needling inactive points). Acupuncturists treat people with anxiety based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In the case of anxiety, a qi deficiency is usually detected in the kidney or spleen meridians. In addition to performing needling techniques, acupuncturists may also employ lifestyle and breathing techniques as well as herbal and dietary therapy.
Massage
Therapeutic massage can be helpful in reducing anxiety and alleviating stress.
Following Up
Follow your health care provider's instructions, and practice relaxation techniques as needed.
Special Considerations
Be sure to tell your health care provider if you are pregnant. Call your provider if you experience any significant side effects from prescribed medications. While the herbal tea suggested above is safe during pregnancy, you should avoid the dried extracts of kava kava and St. John's wort if you are pregnant.
