Hypervigilance in Fibromyalgia. What is it?

By Adrienne Dellwo.

Hypervigilance is a state of being constantly tense, on guard, and exceptionally aware of your environment.

A small but growing body of research suggests that hypervigilance is a feature of fibromyalgia and may contribute to the common symptom of sensory overload.

The idea is that our brains become overly aware of things, which can include painful stimuli, noises, bright lights, and general activity.

That could explain why our bodies react so painfully to a sensation that most people wouldn’t experience as painful (called allodynia), as well as why we’re sensitive to noise, light, chaotic environments and more.

With hypervigilance, not only do you notice things more readily, you’re likely to be unable to divert your attention from them. When something is beeping in the other room, you’ll notice it right away, be highly distracted by it, and probably become agitated if it doesn’t go away.

The same goes for feeling the pressure of a waistband or how a fabric rubs across your skin. Our brains perceive it as a threat, our brains fixate on it, and our physiological response is far more extreme than it should be.

In many conditions, hypervigilance is tied to anxiety. One fibromyalgia study, however, suggested that we can be hypervigilant with or without anxiety.

The human brain perceives a lot of information about our environments that we’re never consciously aware of.

There are too many signals bombarding our brains at any one time, so there’s a filtering process – things considered unimportant are filtered out and we’re never cognizant of them.

Anything that your brain considers a threat, however, gets extra attention. This can be a highly personalized response, depending on what your brain has learned is a danger.

For example, take people with arachnophobia (fear of spiders.) Because of it, they’re almost assuredly the first person in the room who will notice a bug on the wall or something small moving on the carpet across the room. Their brains are constantly on alert, especially in places where they’ve frequently seen spiders.

When they see a spider, they may panic, may want to run away, may want curl up in a safe place and cry. With fibromyalgia, the response to over-stimulating environments can be similar.

I have personal experience with that. One time, I was standing in line to buy something in a small, chaotic store in which an employee had turned on loud, thrashy music with an extremely rapid beat. Fortunately, I was with my husband and when I handed him my items and told him I had to get out of there, he understood.

Outside, I sat down against a wall, closed my eyes, and breathed deeply until I was no longer in danger of a full-blown anxiety attack. As an arachnophobe, I can see the similarities between that and what happens when I see a spider.

Most parents experience a certain amount of hypervigilance when it comes to our children. When you have a new baby, the tiniest whimper can bring you flying out of bed. You notice small hazards that other people don’t, such as an exposed power outlet or a glass on the edge of a table.

So while hypervigilance is normal in certain situations, It’s not healthy to spend too long in a hypervigilant state. Police officers and soldiers in combat zones often do, which is what puts them at risk for PTSD.

Hypervigilance can disrupt sleep, cause avoidance behaviors, and make you jumpy and anxious. Being on alert all the time is exhausting. It can make you irritable and prone to outbursts. Panic attacks are definitely possible.

Hypervigilance is an aspect of illness and not an illness itself. If you believe hypervigilance is a problem for you, talk to your doctor about it. That may help shape the direction of your treatment.

Drugs aren’t generally used to treat hypervigilance. Instead, coping techniques and treatment for the illness that caused it are recommended.

Coping techniques can include:

It’s a good idea to remove yourself from situations or environments that ramp up your hypervigilance. However, if this leads to isolation or avoidance behaviors, you may benefit from counseling.

While you may feel hopeless at times, remember that, with time and effort, hypervigilance can be overcome.

Gonzalez JL, et al. J