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What is PTSD Hypervigilance or Hyper Alertness?

Updated on February 20, 2010

What is PTSD Hypervigilance or Hyper Alertness?

One of the normal responses to trauma is Post Traumatic Stress Disorder, PTSD. If you are traumatized enough, you may be afflicted with PTSD. As a former Army Officer who is now a theologian, I tend to think of PTSD as Post Terror Soul Disorder. Even our souls can be damaged by PTSD, not just the physical brain structures of the amygdala and the hippocampus. PTSD can change your identity and in my research I study the PTSD-Identity and how to overcome the soul wound of PTSD. One of the most pronounced PTSD symptoms is hypervigilance.

Hypervigilance/Hyper Alertness is a Normal PTSD Symptom

One of the symptoms that are associated with the PTSD-Identity is Hypervigilance, also understood as hyper alertness. Essentially, hypervigilance is being constantly on guard, constantly alert for any stimuli which are associated with your PTSD. These stimuli are frequently termed PTSD Triggers. That is, they are something which triggers further PTSD symptoms or memories.

Hypervigilance may be the result of a PTSD trigger, or

Ingrained hypervigilance may cause more PTSD symptoms.

It can create its own feedback loop that makes my PTSD worse and worse.

Certain memories or stimuli may provoke hyper alertness in me. Or my body may be attuned to always being more alert at a certain time of day as it was in the military.

At the same time, my hypervigilance reminds me of certain horrible times, and that may cause me to have more PTSD symptoms.

Types of PTSD Hypervigilance: Going On Patrol

As a former soldier and security officer I was ordered to go out at two in the morning and make a (very vulnerable) one man patrol of my perimeter. Sometimes this patrol was an exciting event; most times it was a mundane event. One of the things it did was brand into my body and soul the need to get up at or about 2 am and walk my perimeter.

While this vigilance was the right kind of awareness to exercise when I was an Army officer, it did not transfer well to my later civilian life. It disturbed my sleep cycle. This lack of sleep exacerbated some of my physical health concerns that required normal, uninterrupted sleep to heal. For over twenty years after my military service I was usually up several times at night to walk my perimeter. I didn’t need to do it, I had to do it or I could not get back to sleep. Try as some of my doctors might, sleeping pills could not interrupt the requirement to jolt awake and walk my perimeter. I know of this being the case for quite a few vets.

Locking Down the Perimeter & Checking My Equipment

Another feature of my hypervigilance is having to compulsively check windows, doors, gates, etc., to be sure they are locked. I spent a lot of time as a security officer making sure the right locks were properly locked and not tampered with. Many military veterans compulsively check their surroundings and persons to make sure everything is where it is supposed to be. Doors locked, windows closed. I got my wallet, got my keys, got my pen, my notebook, and so forth.

This can be amusing to others as they watch me make sure everything is in its place and then watch me check it every fifteen minutes. When I do it five times, every fifteen minutes, the amusement can turn to annoyance, or perhaps pity. The people who actually care about me will feel compassion.

Why This Hyper Alertness Compulsion?

Why are many veterans with PTSD compelled to be so vigilant? On the one hand we were trained that everything has its place and must be in that place. On the other hand, many of these behaviors that were drilled into us became second nature (actually they became first nature, so to speak) and that meant they saved lives. Hyper alertness on the battlefield, or in a terrorist situation, or patrolling streets in Afghanistan and Iraq saves lives.

Thus, we are PTSD hypervigilant because:

1. Our military training taught us to be hypervigilant.

2. Our brain was trained to expect danger at any moment.

3. Our hypervigilance kept us and other alive, usually.

We experienced danger and lived through it because of our training. Therefore, our body and soul has been conditioned to stay on constant alert, always ready for trouble. This is fine if you are on a patrol or serving in a combat zone, but it does not help when you are trying to live a “normal” life as a civilian.

The problem is that the Army and the Marines never taught us how to turn off our hyper awareness. They discharged us and left us wound up tight inside - without any teaching or warning that we might have PTSD and exhibit hypervigilance as part of the PTSD-Identity.

Risks and Problems of PTSD Hypervigilance

Hyper Alertness Can Damage Family Life

This feature of PTSD can ruin a family life. One veteran required his teenage daughter to be home at 6:30 pm and he locked down the house at 7 pm. You can imagine how happy she must have been with that situation!

The veteran could not think of going to sleep until he knew all of his troops (his family) were indoors and safely locked in. If anyone got up during the night or made sounds, he had to get up and patrol the house and sometimes the yard or the street before he was satisfied that it was safe to go to sleep.

If a person with PTSD has to continually check something to be sure it is as it is suppose to be, he or she may drive people nuts by insisting on getting home to check whatever it is. If part of their military job was to check something every hour, they may feel compelled to check something at home, every hour.

A person with PTSD may become angry if he or she cannot check on something or ensure it is properly locked down. To family and friends, it will seem like he became angry about nothing important. But to the PTSD hyper vigilant individual, the situation will remind them of something that is of life or death importance. To not check on it would be to say he does not care about the safety of his family. The family needs to know that the hyper alertness actually means he wants to keep them safe.

This sort of hypervigilant behavior can be physically exhausting. It can make you physically ill. If you have other disabilities that require sustained rest so you can heal, then that healing will be hindered.

PTSD Hypervigilance, Fatigue, and Stress All Feed On Each Other

A vicious cycle can form. Being physically tired and stressed out will make the PTSD hypervigilance worse. PTSD vulnerabilities will increase the more tired or stressed you are. So hypervigilance can create a vicious circle. You get tired by not properly sleeping because you are up every two hours checking the doors and windows. The memories associated with your hypervigilance can further stress you out, making your PTSD symptoms bubble up. You compensate by becoming more hyper alert. If your family mocks you or criticizes you for being hyper vigilant, then that will also create more stress and the cycle continues.

PTSD Is Not Hopeless

We have examined PTSD hypervigilance in the military veteran. You need to be aware that PTSD is not hopeless. Many of us have healed from the worst of our PTSD symptoms. It is not easy. We remain wounded in our souls from the trauma we experienced. But the PTSD no longer dictates to us how we must live and react to others.

Click on the link if you are interested in how to better understand the PTSD soul wound. You don’t have to give up. It is not hopeless.

Semper Pax, Dr. Z


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      Dr Zemler 3 years ago from United States

      Thank you, Ryan. Transitioning from active duty to civilian life can be a real challenge. Oddly, not everyone appreciates our "get it done no matter what" attitude. Congratulations on your successes!

      Semper Pax, Dr. Z

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      Ryan 3 years ago

      I too had a hard time finding a good job when I first got out of the Service (Navy). It took me a few years to find the potsiion I liked at a company that apreciated my experience and my attitude (get it done no matter what)! Finding a job was the hardest test I ever had! As a veteran and father/stepdad/father in law of four military men, both active and reservist. I salute you and say “Job well done” also I and my family appreciate your hard work in the support of our Freedom!!!

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      Krisalyn 3 years ago

      Great post with lots of imonptart stuff.

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      Dr Zemler 3 years ago from United States

      Hello Bibiana, No, I didn't see the Searching for Private Ryan Film and I was never a girl scout either.. For that matter, neither am I Brian Williams. I honor your service. You've been, as Audie Murphy put it, To Hell and Back.

      You certainly don't have to prove anything to me or to anyone else. The PTSD rules at the VA have changed for the better in the last few years and you may find the app has changed as well.

      Few people have lived through the kind of 24/7 danger you have done.

      Be Well & Semper Pax, Dr. Z

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      Bibiana 3 years ago

      maybe you saw LOOKING FOR CORPERAL RYAN ! SO MANY BELIEVE THAT WHAT THEY SAW IN THAT MOVIE MUST DESCRIBE HOW PTSD OCCURS!!! Well any soldier with boots on the gorund in Viet Nam anyway will tell you there are a multitude of different incidents ! That progressivly accumulate into the incedent bank while in a combat zone and in Viet Nam that was the whole country; the whole damn war; all the time 24/7! And everyone did their job and everyone was always in DANGER!!! But for the VA PTSD APP you should descibe your incident right here with evidence like witnesses; unit information(whatever that is)sharapnel pieces etc, etc.:________And it should include your charge up Omaha Beach!!!!! Your psycologist probably has never been in any service including the Girl Scouts; onley experienced a country at war on MASH!! and of course will be female and probably has never even left the USA for even a vacation. She probably was first born when you got out or was found dead behind her desk with pencil in hand!!!!! The Veterans should first rate the psycholigists for their experience for relativeness; how applied and salary rating!! THINK? If you can!!! i AM A ONE YEAR VIET NAM VET 1965-1966 I DON'T HAVE TO PROVE ANYTHING TO ANYBODY!!!!

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      Dr Zemler 3 years ago from United States

      Hello Thomas,

      You certainly are living through some hard experiences.

      I think that if I were in your shoes, I would be hyper-vigilant as well. Given the sensitivities to chemicals you described, you have to be vigilant and careful.

      A person does not have to have been a soldier to have PTSD. Chronic illnesses and other health disasters can also traumatize us. How much compassion (or lack thereof) people have for us and our situations can also affect us one way or another.

      I am very pleased for you that you will soon have your service-dog. That's very good news.

      I would suggest you talk with someone face to face who is qualified in listening to people who are chronically ill. It does not have to be a lifetime thing, rather maybe have a couple of visits where you can express how your life affects you and also perhaps be given some good suggestions on how to cope with hyper-vigilance and all of the people who refuse to understand. You are also welcome to come to my main website at

      In the meantime, it is impressive that you are seeking out information about PTSD and your own experiences/symptoms. Most people I encounter lack the courage to take the initiative and seek out knowledge that will help them.

      Semper Pax, Dr. Z

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      Thomas 3 years ago


      Thank you for this article. I suspect myself of ptsd. I can relate to virtually every story that war veterans have. Its a little different for me. I have 3 severe diseases which gradually turned me from little Thomas, that was walking and doing the kind of things that he wanted to do including playing baseball. Into me myself now today, being 20 years old, unable to walk most of the day, and getting paralysed from things as smelling chemical orders, getting cold/warm and getting startled, eating food, to less movement, to much movement, cold/hot air blows against me, and many many more.

      This medical condition, that almost killed me 3 times now, makes me super Hyper vigilant. Since the triggers of the diseases include almost every sensory stimulus and movement. I am always ready to 'run' since i can paralyse from my feet until my nipples (when normal, with full attacks full body )from only smelling chlorine when rolling (with my wheelchair) trough a mall or missing the cleaning lady at the end of a hallway.

      I am so hyper alert on my surroundings that i most of the time cant enjoy even talking with my colleagues on work, since for example i see something going on outside or hear something downstairs in the house. Again, if i startle i can get paralysed or muscle weakness from it. Or i have to *really* concentrate on it, which takes SO much out of me. Also i avoid big public places. I hardly can enjoy being outside, i can enjoy it for like 70 out of 100% if i can say for sure that there is no one around me as far as i can see, not being in between houses. So open grass fields and water. No forest, i don't have overview there.

      And today I actually realized that i have flashbacks big time trough out the day. But not of the actual events (me being paralysed on my bed and not being able to breath any more for more then a minute, not able to say or move. With my mom only a few inches away from me. This gave me a feeling of the worst most pure fear and acceptance of death at the same time. Something that i can not accept myself, as in that i do not understand that acceptance feeling), but i see a static scene of my shopping mall in front of me, with the feeling of pure fear and at the same time feeling of acceptation of dying. Everything else closes of then. Its the 1000 mile stare. I am actually gob-smacked about it, because i literally come to this realizement a few hours back.

      I am not to stoked to go to speak to someone since my diseases are commonly get diagnosed as being psychological. I know ptsd is, but my other diseases are cell defect related.

      I am sooo lucky to get my service dog next week. I have experience with dogs for 20 years, and one service dog before for two days. The service dog calmed me down and kept me relatively calm even in foreign areas. At least to a level were i could have a conversation on the side with somebody while walking. I still make sure i have 360 far as you can call it security.

      Can you please give me your thoughts?

      Thanks again,


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      Dr Zemler 4 years ago from United States

      Hello PFC Grampy, The label of "peacetime vet" can be used against us. Since we did not fight at Iwo Jima or Okinawa people will act as if they don't have to care about our suffering. One of the Big Lies about PTSD is that you have to be a combat vet to get PTSD. While combat vets have certainly been through hell, others can also get PTSD, both in and out of the military.

      Take a look at "An Operator's Manual to Combat PTSD" and don't let the title throw you. That small book is very useful for anyone recovering from trauma, regardless of cause. I recommend it to anyone grappling with PTSD, intrusive memories, and dumb people who ignore us left and right because they don't want to display compassion. I also recommend you continue to trying to write about these experiences, maybe only in small doses at first, as that is one of the ways to bleed off some of the toxicity of PTSD. Semper Pax, Dr. Z

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      PFC Grampy 4 years ago

      My PTSD came not from Viet Nam but the Cold War error. Most people don't understand that after Nam there was a new war going on here in the U.S.A. I was targeted by local law inforcement aand wrongfully arrested, persecuted "not prosecuted" and thrown into a dorm setting with 14 rival gang members. Unfortunatly Marine training did not cover 14 to 1 odds. I had to endure constant beatings, rape and sodomey on me, which ccaused the on set of my Ptsd and anger issues. The Sherifs watched this over jail cameras and did nothing. And when that didn't break me provided my enemy enough drugs to lace my coffee and kill me 6 times over. When that didn't work they transferred me to a one man cell where I tried to burn myself to death due to the anger, and degredation I felt. It has now been over 35 years and I have to face this tramas daily. Worse than that they branded me a sex offender to a crime that never even happened. So can you tell me how do you come to terms with issues when most people don't hear or even try to understand once they hear the brand? And they say Im a peace time VET yea right?

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      Dr Zemler 5 years ago from United States

      Thank you for taking the time to read and comment. While it is important that the VA (or somebody in the medical field) treat your son's symptoms, he (and you) can hope for more than just that. You are right that he needs to deal with the underlying issues if he is to have any lasting healing. Some folks will start that healing sooner than others. It is good he is doing the college work. That will help. I also recommend people begin to write a notebook of their thoughts that no one else has to read. That, over time, will help with getting to the underlying causes. Do not give up hope. Keep loving him. Take a look at the books War & the Soul, and also An Operator's Manual to Combat PTSD. Both are excellent for understanding - and coping/healing - PTSD. He is lucky to have a mom like you. Semper Pax, Dr. Z

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      SickMOM 5 years ago

      My son returned about 1 year ago from Afghanistan and while he seems to be coping to most. I know better. He is not sleeping and has sought help for that but they just give him sleeping pills. Exercise helps but I think his exercise is becoming excessive. He has started college work because it gives him something to do all night while others sleep. He sleeps better at home. I fear that unless he deals with the underlying issue - instead of the symptoms - he is going to come unglued. Is the best he can hope for coping with the symptoms?

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      Dr Zemler 6 years ago from United States

      Dear Adrian, You are not being “controlling,” you just know better than most what an absence or failure to be on time can really mean. Part of this journey is dealing with so many people who either don’t understand or don’t want to understand. And, unfortunately, some people become toxic.

      There are a few things I would recommend, but please be mindful that I am “only” a doctor of theology, and not a medical doctor. If possible, see a therapist or counselor. They can often be of some help. Beyond that I am a big believer in the therapeutic value of writing and any sort of art or craft. They don’t have to be submitted to anyone, they are for you. It is amazing what we can learn through the process of creation. Prayer is also useful. Don’t expect God to wave a magic wand and make it all better. Rather, tell God how much this hurts and how much you miss your friend. Share your sorrow with God. My main website at may be of some use to you.

      But, know that this new hypervigilance and fear does not have to become your permanent “new normal.” We can achieve much healing. Don’t give up. Semper Pax, Dr. Z

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      Adrian 6 years ago

      Thank you for this article...I recently found my best friends wife murdered and the coward that kill her, he committed suicide....this has affected me greatly and affecting my loved ones - they don't understand, nor can I expect them to - I am scared all the time and always looking over my shoulder and very very aware of my surroundings....I get upset when I don't hear back from people in a certain timeframe - I am being viewed as controlling, they just don't understand....I can't sleep if everything or everyone isn't where I know they are and having trouble believing people telling me where they are.....this is killing me...

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      Dr Zemler 7 years ago from United States

      Hello Chris, Thank you for your service and welcome back home. Having your bags packed and everything ready to go reminds me of when I was in the service. Periodically our battalion would be part of the “window brigade.” That brigade had to be ready to deploy at a moment’s notice. We had to ensure we were always ready to move out. We got conditioned that every phone call or knock on the door was a deployment order. We got a bit jumpy.

      After we came out of the window we still were on edge, ready to deploy, expecting any phone call to send us out. Our bodies and souls were still in the window, still ready to jump. Anxiety had been carved into all of our responses.

      I can tell you that I have known many veterans who respond like you do in having gear packed and weapons handy. We learned to be prepared in an unsafe environment. The military failed to re-tool us to live in a safer environment back home. Sounds like you are experiencing that.

      We acquire an anxiety that tells us we are never safe; we have to be hyper vigilant and hyper alert. This wears us down and causes us not to trust others. This in turn breaks down relationships and serves to isolate us. This isolation then alienates us further. In cases of PTSD, we end up all alone and in despair, hiding with our gear and our weapons.

      Don’t give up hope. You don’t have to live in fear. Take a look at Ed Tick’s book, War and the Soul, or the book, An Operator’s Manual to Combat PTSD. You are welcome to visit my main site, just google the two words PTSD and Spirituality, you’ll find my site.

      I will keep your peace of mind in prayer. Welcome Home.

      Semper Pax, Dr. Z

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      Chris 7 years ago

      I am a combat Infantry Soldier in the Army. I did two tours in Iraq and I have been back from the last tour for over a year now. It is difficult for me to be anywhere that there are large groups of people like malls and airports because I keep thinking this is where a suicide bomber is going to show up. In addition to this I think I have hyper alertness because I keep an emergency survival bag in my vehicle and one in my home. Both of these survival bags are complete with food and water and I repack them every week so the water is fresh and so I can accurately remember what is in the bags, this is something I also did on both tours in Iraq. I keep a loaded pistol in the closet near the front door of my apartment, another one under my living room couch and another one under my pillow in my bed. Right now I'm still convinced that I'm just being safe in being prepared for whatever but after reading this article I'm wondering if it's talking about me.

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      Dr Zemler 7 years ago from United States

      Hello Sarah, It took some bravery on your part to write what you wrote. That is certainly admirable.

      While your situation is certainly challenging, the upside is that you can identify some of the causes and are able to articulate them. Many people go their entire lives not being able to even write down or say to themselves what gave them PTSD or how it makes them feel. I am glad that you are able to at least do that – it is not easy. It is hard journey we are on without PTSD, but know that we have value and that you worth. Semper Pax, Dr. Z

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      Sarah 7 years ago

      I grew up with PTSD my entire life from my parents abusing and neglecting me emotionally from infancy onwards-- and other people constantly bullying and persecutime me as well; and now I'm terrified of people being hurtful to me or better than me, and I can't go anywhere or do anything in life because I'm constantly afraid of that; and no matter how well I do, it's not good enough, I feel continually threatened and compared and inferior.