Ways to Deal With Hyperarousal Symptoms of PTSD

July 29, 2016 Jami DeLoe

The hyperarousal symptoms of PTSD can be frustrating to deal with. Read more to find ways to deal with hyperarousal symptoms in PTSD recovery. Take a look..

For me, dealing with the hyperarousal symptoms of posttraumatic stress disorder (PTSD) is an ongoing thing. I think it's the one group of PTSD symptoms that currently affects me the most, even with all of the therapy I have had and the medication I take. In my last post, I wrote about how the brain functions during trauma and how, for those of us with PTSD, it can get stuck in the reactive state . In this post I want to talk about what it feels like to be in the hyperarousal symptoms of PTSD and how to deal with it.

What Do Hyperarousal Symptoms of PTSD Feel Like?

Have you ever been driving along in your car, looked away from in front of you for a second, and when you look back traffic has stopped and you have to slam on your brakes so you don't rear end the car in front of you? You know that feeling you get--startled, tense, heart pounding, cold sweat? That's what hyperarousal feels like to me, but I don't have to experience a near-miss car accident to feel it. It's a feeling that can come on out of
nowhere, with no real cause, or it can be brought on when I am already feeling anxiety or over-stimulated (Triggers Can Make Anxiety and PTSD Flare Up).

The hyperarousal symptoms of PTSD can be frustrating to deal with. Read more to find ways to deal with hyperarousal symptoms in PTSD recovery. Take a look.. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists the criteria that has to be present for someone to be diagnosed with PTSD. There are several categories, one of which is: alterations in arousal and reactivity. It goes on to say that two of the following have to be present for a PTSD diagnosis:

  1. Irritable or aggressive behavior
  2. Self-destructive or reckless behavior
  3. Hypervigilance
  4. Exaggerated Startle Response
  5. Problems in concentration
  6. Sleep disturbances

At one time or another, since I started experiencing PTSD symptoms, I have felt all of those. The ones that seem to linger though, are the hypervigilance and exaggerated startle response (Combat PTSD Symptoms – Hyperarousal [Being Keyed Up]).

Hypervigilance and the Exaggerated Startle Response: PTSD Symptoms

Hypervigilance is the feeling of constantly being "on alert." I feel this the most when I am somewhere by myself, not necessarily places where there aren't other people around, but places where I don't know anyone, and there is no one with me who makes me feel safe. It's why I don't like to go shopping or to social gatherings by myself.

The exaggerated startle response is irritating at times. It's as unpredictable as the sights and sounds that startle me. It doesn't have to be something loud, or even something that makes noise to make me jump out of my skin. Sometimes it's just seeing something unexpected, like looking up from a book and realizing that my husband has entered the room, or hearing a car honk its horn in the distance.

How I Deal with Hyperarousal Symptoms of PTSD

Just like everything else about PTSD, there are things that work for me when it comes to dealing with hyperarousal symptoms that may not work for everyone. What I have found helpful when it comes to minimizing them are the following:

  • Stop them before they happen--I know that I am more likely to experience hyperarousal symptoms when I am already feeling anxious or overstimulated, so I do my best to address those two things when they come up. When I am feeling anxious, I practice relaxation techniques, close my eyes and breathe deeply, and I tell myself the truth--that everything is okay in that moment (Using Mindfulness in PTSD Recovery). If those things don't work, I take my prescribed anti-anxiety medication (Should I Take Psychiatric Medication for PTSD?).
  • Let others know--For a while at my last job, some coworkers thought that it was funny to sneak up on people and startle them. It is funny to see, but not so much when it happens to me. My fight or flight kicks in, and usually fight wins. So I just let people know that it's not a good idea to do that to me, as well as the fact that I am easily startled by pretty normal things. Just letting people know helps me feel better, and it lowers the chances of startling situations.
  • Don't wallow in the feeling--When symptoms of hyperarousal do come up, I let myself feel the feeling and then I do my best to let it go. It's easy to get caught up in the feelings and stay there or to get frustrated with myself for feeling them in the first place. Neither of those things is productive or healthy. I try to remember that whatever the symptom is, it's just a thing, it doesn't have to ruin my day or make me feel weak.

I would love to hear what works for you when it comes to dealing with the hyperarousal symptoms of PTSD. Please share in the comments below.

Find Jami on Facebook, on Twitter, on Google+, and on her blog, Sober Grace.

APA Reference
DeLoe, J. (2016, July 29). Ways to Deal With Hyperarousal Symptoms of PTSD, HealthyPlace. Retrieved on 2024, June 16 from

Author: Jami DeLoe

Jami DeLoe is a freelance writer and addiction blogger. She is an advocate for mental health awareness and addiction recovery and is a recovering alcoholic herself. Find Jami DeLoe on her blog, Sober GraceTwitter, and Facebook.

Frustuck Wreden
December, 6 2017 at 11:09 am

I appreciate the blog, but I need some acknowledgment that sometimes all the thinking and preparation in the world will not prevent bad days. The other thing I hope to get some support around is the fact that other people can be just horrific when dealing with my being startled. It's nice to move on from being startled, but even more difficult to move on from people who vilify a person for something they cannot help--most especially in the workplace. So much so that I wonder if there is a workplace for me at all....

In reply to by Anonymous (not verified)

December, 12 2017 at 7:32 pm

The potential for difficult days is always there. When we think about all of the planning and preparation we do in recovery and symptom management, part of that is planning for those bad days as well. It's easy to become discouraged and expect to be judged when our PTSD brings out trigger responses. One thing to think about is how our own expectations of stigma impact how we present ourselves. Dealing with PTSD symptoms in the workplace is something that looks different for everyone.I find it extremely helpful to explain my PTSD by its symptoms. As you can see, I too have experienced many issues around PTSD in the workplace! I hope some of my insights can be of use. Please let me know if you want to discuss anything else.

August, 22 2017 at 8:27 pm

I found this blog to be very helpful. I have PTSD from being raped and kidnapped. I've had a tough time of it. It's very shameful and even telling the counselor was hard to do. I ended up leaving counseling I was so embarassed.
I have good days and bad days.
Thank you for writing this blog. I wanted to read this because I battle with hypervigelence every day. It's no fun.
I have to watch for triggers.
I agree letting bad feelings associated with a trigger go sooner than later is very helpful. I've gotten into the habit of doing it.
I get back to feeling calmer sooner.
But I don't always win. Sometimes I get irrirtated.

In reply to by Anonymous (not verified)

August, 22 2017 at 9:07 pm

Brian, I'm sorry to hear you left counseling feeling embarrassed. Please remember it's your abuser who should feel shame, not you. I know exactly how difficult it is to tell one's story. I hope you get counseling again. Even if you work on ways to manage your hypervigelence. I spent a great deal of time in counseling working on symptoms without having to talk about my trauma directly.

Yvonne France
August, 2 2016 at 10:32 pm

I have worked with combat solders returning from oversea who have PTSD. I have seen how they have reacted if there is a loud noise in their vicinity. I'm currently furthering my education and working on a research paper. I'm going on blogs and researching how I can better the treatment of veterans in my clinical area. I would appreciate some insight back from you on how to care for veterans with PTSD.

In reply to by Anonymous (not verified)

August, 6 2016 at 11:15 am

as a military caregiver to a combat-veteran with multiple injuries, I would suggest an approach that includes the spouse/caregiver and the veteran's input. One of the greatest concerns caregivers have is the prevalent use of medication for every symptom of PTSD. On the other hand, if you will be dealing with rural veterans, it can get a bit tricky; as the distance they often have to drive to receive treatment through the VA (given that you will be working for the VA) could potentially increase the anxiety and hyper-vigilance symptoms. This can make it extremely difficult to reach the veteran once he/she is in your office. From personal experience, for instance, my husband gets really anxious and irritable when he has to ride in a vehicle for longer than 15 minutes and further than the two closest towns from our home.
By the time we get to his appointment, his anxiety level is sometimes so high that I have to take over most of the conversation with his providers. At times, he will completely shut down, others he will do nothing but talk about his frustrations with the VA. This can make it really difficult for the provider to even suggest a treatment plan, although we always work it out and he adheres to the suggested treatment plans. I have found that he will open up more to the providers who will involve my husband and myself in this process.
I find this particular blog to be quite helpful in finding information from a less traditional point of view. I have noticed through my own studies, that while textbooks and classroom instructions are very informative in terms of learning and understanding the concepts, it is far different actually being exposed to these conditions and aiming for treatment.
If there is anything else I can help you with, or if there is any more insight you'd like to receive, please feel free to contact me:

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