What does Hyperarousal Mean?; What is Hyperarousal?

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What is Hyperarousal?

Hyperarousal is when the autonomic nervous system (ANS) is in a constant state of activation. The ANS is made up of two parts, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). As a whole, the ANS works to balance a person’s response to certain stimuli (Rothschild, 1998). When this balance is not kept, a person can experience a persistent state of arousal. In short, hyperarousal is what gives fuel to the “fight or flight reaction” (Wisegeek, 2010); it is the adrenalin rush a person feels when fear or danger is eminent.

When the term hyperarousal is heard, it is usually in its relation to insomnia and post-traumatic stress disorder (PTSD).While a person can experience hyperarousal without having PTSD, a person with PTSD will always show signs of hyperarousal. Others may experience hyperarousal that is caused by extreme stress such as deadlines at work, holiday shopping, financial worries, traffic, or conflicts (Insomnia-free, 2009). In any case, hyperarousal can have a crippling effect on a person’s life, causing them to avoid certain activities that may cause them to feel uneasy.


  • Exaggerated startle reaction
  • Outbursts of anger
  • Extreme vigilance
  • Irritability
  • Feelings of panic and anxiety
  • Insomnia
  • Reduced tolerance for pain
  • Fatigue
  • Difficulty concentrating
  • Constantly being “on guard”

In relation to PTSD, there are three clusters of symptoms. These include:

  • Reliving the traumatic event (memories, nightmares, flashbacks, etc.)
  • Avoiding reminders of the traumatic event (places, people, objects, etc.)
  • Physical symptoms such as the ones listed above


Diagnosis is made when the patient has displayed several of the symptoms noted above. A diagnosis of PTSD may be given if the patient has symptoms from each of the clusters for at least one month. Diagnosis is be made by a qualified physician or mental health care provider that is familiar with hyperarousal and PTSD.


A combination of psychotherapy and medication is the most effective treatment for hyperarousal. The medications that are most commonly used are anti-depressants, mood enhancers or anti-anxiety medication. Cognitive therapy, which is a type of psychotherapy, can be beneficial as it teaches the patient to think about what bothers them in a new way. Retraining the brain in this way makes it easier to cope with the disorder. It is also imperative that there be a strong support system from family and loved ones. With proper treatment, a person can be on the road to recovery and begin to live a normal life again.


Insomnia-free (2009). Hyperarousal and chronic insomnia revisited. Retrieved September 10, 2010, from https://www.insomnia-free.com/hyperarousal.html

Rothschild, B. (1998). A trauma glossary. Retrieved September 10, 2010, from https://home.webuniverse.net/babette/Trauma.html

Wisegeek (2010). What is a fight or flight reaction? Retrieved September 10, 2010, from https://www.wisegeek.com/what-is-a-fight-or-flight-reaction.htm