How to Cope with Hyperarousal Symptoms in PTSD

Feeling jumpy and trouble focusing are signs

Veteran Raymond Schwab came to Colorado seeking medical marijuana to treat his PTSD and subsequently had his 6 children taken from him in Denver, Colorado.. Credit: Helen H. Richardson / Contributor / Getty Images

Hyperarousal is a specific cluster of post-traumatic stress disorder (PTSD) symptoms that some people with PTSD experience. As the name implies, hyperarousal is the consequence of heightened (hyper) anxiety and altered arousal responses and includes symptoms such as: 

  • Having a difficult time falling or staying asleep
  • Feeling more irritable or having outbursts of anger
  • Having difficulty concentrating
  • Hypervigilance, feeling constantly "on guard" and ready to act if threatened
  • Being "jumpy" or easily startled

Managing Hyperarousal and PTSD

Like all symptoms of PTSD, hyperarousal symptoms can be difficult to manage. In addition, when these symptoms are not managed effectively, they can lead to unhealthy behaviors such as substance abuse. The following information and resources can help by providing an overview of healthy coping strategies for managing your hyperarousal symptoms.

Coping with Sleeping Difficulties

Difficulty falling and/or staying asleep is one of the hyperarousal symptoms of PTSD. Studies show that sleep problems are one of the most common types of symptoms reported by people with PTSD. It's important to manage sleep difficulties effectively, because poor sleep can lead to a number of other symptoms, such as stress and mood problems. Poor sleep can also have a negative impact on your physical health. Fortunately, you can do a number of things to improve the quality and amount of sleep you get.

If you're having sleep problems, try some of the tips mentioned in "The Best Way for People With PTSD to Cope With Sleep Problems."

Ways of Coping with Anger

People with PTSD experience a great deal of anger, which is one of the hyperarousal symptoms of PTSD. If you have PTSD, you may find that the anger you feel is very intense and also very difficult to manage.

This intense anger can lead to a number of unhealthy behaviors, such as substance abuse, which is why it's important to learn healthy ways of releasing the tension that accompanies intense anger. Some healthy anger management techniques are offered in "Anger Management Techniques for People With PTSD."

Improving Your Memory and Concentration

Many people with PTSD have memory problems and/or difficulty concentrating. These problems can worsen when certain hyperarousal symptoms of PTSD are present. For example, people with PTSD often have trouble sleeping, and poor sleep can affect your ability to concentrate and stay focused during the day.

What can you do to improve your memory and concentration? Check out the resources and information listed in "Ways People With PTSD Can Prevent Memory Loss" for helpful tips.

Managing Impulsive Behaviors

Research shows that of all the symptoms of PTSD, hyperarousal symptoms may be most likely to lead to impulsive behaviors. Why? Because the intense anxiety and discomfort associated with hyperarousal symptoms may lead a person to look for relief by acting impulsively without considering possible negative results.

In addition to learning ways of managing hyperarousal symptoms in PTSD, it can also be important to learn how to prevent impulsive actions. Some healthy strategies for managing impulsive behaviors are discussed in "Managing Impulsive Behaviors."

Interoceptive Exposure to Increase Tolerance of Anxiety

Interoceptive exposure is a specific technique that is often used to treat panic disorder; it may also be useful to increase a person's tolerance of  PTSD-related hyperarousal symptoms. In interoceptive exposure, people are helped to confront, manage, and learn to tolerate feared bodily symptoms like increased heart rate and shortness of breath, which are often associated with anxiety or other intense emotions. 

Interoceptive exposure has been found to be successful in reducing fear of certain bodily symptoms associated with anxiety, as well as increased tolerance of these symptoms. By combining interoceptive exposure with traditional exposure therapy for PTSD, it is thought that people can increase their tolerance of some of the unpleasant symptoms that often occur at the start of exposure therapy for PTSD. In doing so, they may be more likely to stick with treatment for PTSD. 

Progressive Muscle Relaxation

The hyperarousal symptoms of PTSD can lead to increased muscle tension, a common symptom of anxiety. Therefore, certain relaxation exercises that are commonly used to treat panic disorder and other anxiety disorders may be particularly effective for relieving hyperarousal symptoms in PTSD. For one such exercise, called progressive muscle relaxation, a person alternates, pendulum-like, between tensing and relaxing different muscle groups throughout the body. "How to Do the Progressive Muscle Relaxation Exercise" is a primer on how to do this easy but powerful relaxation exercise.

The Bottom Line

Coping with your hyperarousal and PTSD symptoms can be challenging, but with a combination of dedication to learning and using self-help techniques and seeking professional help, you can begin to overcome them.

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