Complex PTSD Symptoms:

Hypervigilance

Trauma survivors need to feel safe and secure in spite of what their awareness is telling them.
Sections:

  • Behaviors of Hypervigilance

  • The Four F’s

  • Anxiety from CPTSD Isn’t General Anxiety

  • How to Cope

COMPLEX PTSD - SHAME - AVOIDANCE - DYSREGULATION - INTERPERSONAL DIFFICULTIES - DISSOCIATION - IMPULSIVITY - OBSESSIVE THOUGHTS - DEPRESSION - TRIGGERS - PHYSICAL - PERSONAL EXAMPLES - TREATMENT

Behaviors of Hypervigilance


Hypervigilance refers to the experience of being in a state of high alert, constantly tense and 'on guard' and always on the lookout for hidden dangers, both real and presumed– it's stressful and exhausting to maintain.


This state of increased awareness, anxiety, and sensitivity to the environment around you often manifests as a need to always scan your surroundings for potential threats. 

With the brain’s resources on constant alert, the results can be inappropriate or even aggressive reactions in everyday situations.

This constant scanning and rescanning of their environment can make people with hypervigilance ignore their family and friends around them. Often, they will overreact to loud sounds and bangs, unexpected noises, smells, etc. They can get really agitated and/or frightened, (especially when in a crowded or noisy area as there is too much to 'analyze').

Hypervigilance can make safe situations, people and places feel threatening. Even familiar surroundings and people can be an issue as hypervigilance can make people acutely aware of subtle details normally ignored – body language, a person's voice and tone, their mood, their expressions – all things which are continually assessed.

Some common behaviors of hypervigilance are:

  • Lack of objectivity – reading too much into situations 
     
  • An over awareness of what people see or think about us
     
  • Perpetually scanning your environment to find threats (this can cause 'Darting eyes')
     
  • Looking for others to betray constantly
     
  • Not being aware of what is obvious to others
     
  • Appearing jumpy, jittery, and unable to sit still
     
  • A reluctance to try new things or meet new people
     
  • Unable to have conversations sometimes because you are distracted and unable to focus
     
  • The creation of obsessive patterns or obsessive avoidance of perceived threats (in extreme cases, a person may develop agoraphobia)
     
  • Constantly concerned about others
     
  • The mind tell us partial truths that we latch onto
     
  • Adrenaline-induced physiological symptoms:(dilated pupils, an increased heart rate, and elevated blood pressure)
     
  • Over scrutiny/analyzing behavior of situations
     

Many people with hypervigilance may feel their actions are necessary to maintain safety and security in the aftermath of a trauma 

– but when hypervigilance is getting in the way of them being able to do day-to-day activities, and live their life as they want to, it's something that needs to be addressed as part of their PTSD.


SLEEP DISTURBANCES

Often, hypervigilance affects sleep: someone may be too afraid to fall asleep, the smallest noise can fully wake them up, and the surge of adrenaline can make it very difficult for them to get back to sleep.

This change in sleep can also exacerbate other PTSD symptoms and can further intensify feelings of paranoia, fueling more hypervigilant behaviors.
 

SUSPICIOUSNESS

Hypervigilance from PTSD can result in being suspicious of people and their motives. This can result in feelings of paranoia around others: 'What are they really thinking about us?' 'What are they planning to do to us?', 'Why are they with me?'.

It can feel like you're waiting for the betrayal, watching the other person looking for clues in order to prepare for it. However, some people are not prepared to 'wait' for the betrayal and may end an otherwise healthy relationship.
  

PARANOIA

'When someone is paranoid, they have high levels of fear and anxiety. They are suspicious of other people and may believe that others are out to "get them". They may believe in conspiracies or feel that others are threatening them. 

When left untreated, paranoia can progress into delusions.' Hypervigilance from PTSD can often be mistaken for paranoia as it tends to over-estimate the potential for danger at any given moment. 

However, unlike someone suffering with paranoia, a hypervigilant person is usually aware of their symptoms. 

It can be a vicious cycle however, as a they may be so aware of their fears and hypersensitivity that they then think of themselves as paranoid – but it's important to make the distinction.

'Hypervigilance causes someone to be on guard and high alert. When someone is paranoid, they tend to have delusional beliefs that aren't based on anything real. When someone has hypervigilance, they aren't delusional.'
 

CATASTROPHIZING

PTSD panic can often cause our minds to take a current situation and give it an extremely negative spin– allowing it to take us down all sorts of roads of worry and 'what ifs'. 

It can often produce a self-fulfilling prophecy of failure – we believe something will fail so we unconsciously create a situation that ensures failure.

Of course, this can create many more negative situations, which can lead to a spiral of doubt, failure and so worsening PTSD symptoms.

The Four F’s


Fight, Flight, Freeze and Fawn

The fight/flight response is an innate automatic response to danger in all human beings. A more complete and accurate description of this instinct is the fight/flight/freeze/fawn response.

The complex nervous system wiring of this response allows a person in danger to react in four different ways.
 
FIGHT RESPONSE 
is triggered when a person suddenly responds aggressively to something threatening.

FLIGHT RESPONSE 
is triggered when a person responds to a perceived threat by fleeing, or symbolically, by launching into hyperactivity.

FREEZE RESPONSE 
is triggered when a person, realizing resistance is futile, gives up, numbs out into dissociation and/or collapses as if accepting the inevitability of being hurt. 
 
FAWN RESPONSE 
is triggered when a person responds to threat by trying to be pleasing or helpful in order to appease and forestall an attacker.
 

Traumatized children often over-gravitate to one of these response patterns to survive, and as time passes these four modes become elaborated into entrenched defensive structures that are similar to narcissistic [fight], obsessive/compulsive [flight], dissociative [freeze] or codependent [fawn] defenses.

These structures help children survive their horrific childhoods, but leave them very limited and narrow in how they respond to life. Even worse, they remain locked in these patterns in adulthood when they no longer need to rely so heavily on one primary response pattern.

It is important to understand that variances in the childhood abuse/neglect patterns, birth order, and genetic predispositions result in people polarizing to their particular 4F type.

Fight -    Narcissistic
Flight -   Obsessive/Compulsive
Freeze - Dissociative
Fawn -   Codependent

 Anxiety from CPSTD Isn’t General Anxiety

Written by Vicki Peterson
 

Regardless of the difference, no condition should ever be minimized. If you are feeling anxious or depressed, it's important and urgent to find the right support for you.

No one gets a prize for "worst" depression, anxiety, trauma or any other combination of terrible things to deal with, and no one should suffer alone.

With that in mind, there is a difference between what someone who has Complex PTSD feels and what someone with generalized anxiety or mild to moderate depression feels. 

For someone dealing with complex trauma, the anxiety they feel does not come from some mysterious unknown source or obsessing about what could happen. 

For many, the anxiety they feel is not rational. General anxiety can often be calmed with grounding techniques and reminders of what is real and true. Mindfulness techniques can help.

Even when they feel disconnected, anxious people can often acknowledge they are loved and supported by others.

—For those who have experienced trauma, anxiety comes from an automatic physiological response to what has actually, already happened.  

The brain and body have already lived through "worst case scenario" situations, know what it feels like and are hell-bent on never going back there again.  

The fight/flight/freeze response goes into overdrive. 

It’s like living with a fire alarm that goes off at random intervals 24 hours a day.

It is extremely difficult for the rational brain to be convinced "that won't happen," because it already knows that it has happened, and it was horrific.

Those living with generalized anxiety often live in fear of the future. Those with complex trauma fear the future because of the past. The remedy for both anxiety and trauma is to pull one's awareness back into the present. 

For a traumatized person who has experienced abuse, there are a variety of factors that make this difficult. 

First and foremost, a traumatized person must be living in a situation which is 100 percent safe before they can even begin to process the tsunami of anger, grief and despair that has been locked inside of them, causing their hypervigilance and other anxious symptoms.

That usually means no one who abused them or enabled abuse in the past can be allowed to take up space in their life. It also means eliminating any other people who mirror the same abusive or enabling patterns.

Unfortunately for many, creating a 100 percent abuser-free environment is not possible, even for those who set up good boundaries and are wary of the signs. 

That means that being present in the moment for a complex trauma survivor is not fail-proof, especially in a stressful event. They can be triggered into an emotional flashback by anything in their present environment.

It is possible (and likely) that someone suffering from the effects of complex trauma is also feeling anxious and depressed, but there is a difference to the root cause.

Many effective strategies that treat anxiety and depression don't work for trauma survivors. Meditation and mindfulness techniques that make one more aware of their environment sometimes can produce an opposite effect on a trauma survivor. 

At the first sign of anxiety or depression, traumatized people will spiral into toxic shame. 

Depending on the wounding messages they received from their abusers, they will not only feel the effects of anxiety and depression, but also a deep shame for being "defective" or "not good enough."

Many survivors were emotionally and/or physically abandoned, and have a deep rooted knowledge of the fact that they were insufficiently loved. 

They live with a constant reminder that their brains and bodies were deprived of a basic human right. Even present-day situations where they are receiving love from a safe person can trigger the awareness and subsequent grief of knowing how unloved they were by comparison.

Anxiety and depression are considered commonplace, but I suspect many of those who consider themselves anxious or depressed are actually experiencing the fallout of trauma.

Most therapists are not well trained to handle trauma, especially the complex kind that stems from prolonged exposure to abuse. Unless they are specially certified, they might have had a few hours in graduate school on Cluster B personality disorders, and even fewer hours on helping their survivors. 

Many survivors of complex trauma are often misdiagnosed as having borderline personality disorder (BPD) or bipolar disorder.

Anyone who has sought treatment for generalized anxiety or depression owes themselves a deeper look at whether trauma plays a role.

How to Cope with Hypervigilance


The first thing to establish is that it's very important to get treatment for PTSD. If you have PTSD symptoms after experiencing a traumatic event, whether it was a few days ago or years ago, it's important to get the help that you need.

There are some things however, that can help reduce hypervigilance in the meantime, but be mindful that reducing your symptoms of hypervigilance requires a lot of self-control and a conscious effort to identify things or incidences that provoke anxiety, and shift your focus away from such anxiety cues.

  • Try to 'catch yourself out' when you sense yourself spiraling down your own personal hypervigilant thought patterns.
     
  • It can also help to be "in the moment" for a few minutes – perhaps focusing on your breathing in and out slowly, focus on your connection to the earth (your feet on the floor, your bottom on the chair) – this will give your mind time to calm itself.
     
  • Writing down your negative thoughts can also help to see patterns on when your hypervigilance and help control your mind a little more. To see why writing can help PTSD in general, you can read our blog post here.
     
  • Another helpful tactic comes from 'Into the Light': 'instead of thinking "My partner is late again…it's the third time this week…..perhaps he is losing interest me or doesn't care about me anymore… I wonder if he's having an affair … why was he checking his phone last night? This relationship is almost certainly over.", perhaps try something along the lines of "My partner is late again … it's the third time this week and I'm finding this difficult. We need to sit down together and work out a good communication plan when he's going to be late so I can still relax and enjoy my evening."'
     
  • 'For people with hypervigilance, home can feel like the safest spot to be, but getting outside of your comfort zone is essential. Exposure to the outside world is necessary to keep pushing back against the restrictions of hypervigilance.'
     
  • 'While hypervigilance can stem from several sources, anxiety, stress, and worry all play a central role. Because of this, deep breathing, autogenic training, progressive muscle relaxation, and guided imagery are all great habits to practice.
     

Hypervigilance can be a frightening and frustrating emotional state that makes you feel stressed and fearful in many situations. Remember, it produces flawed and distorted thoughts, and although they are convincing, they are wrong. By believing in yourself and committing to professional mental health treatment, you can overcome hypervigilance and the associated psychological disorders.

SOURCES:

CPTSD Workbook, Arielle Schwartz PhD/ CPTSD Treatment Manual__CPTSD: From Surviving to Thriving, Pete Walker__www.verywellmind.com/what-is-complex-ptsd__psychcentral.com/ptsd/complex-posttraumatic-stress-disorder-symptoms#common-triggers__goodtherapy.org/dissociation-c-ptsd-role-of-detachment-in-complex-trauma___crappychilhoodfairy.com/cptsd-behaviors-like-narcissism__Crittenden, P. M., Heller, M. B. (2017). The roots of chronic posttraumatic stress disorder: Childhood trauma, information processing, and self-protective strategies. Chronic Stress, 1, 1-13 https://journals.sagepub.com/doi/10.1177/2470547016682965__Kessler, R. C., & Bromet, E. J. (2013). The epidemiology of depression across cultures. Annual Review of Public Health, 34, 119–138. https://www.annualreviews.org/doi/10.1146/annurev-publhealth-031912-114409__Lawson, D. M. Treating adults with complex trauma: An evidence-based case study. Journal of Counseling and Development, https://onlinelibrary.wiley.com/doi/abs/10.1002/jcad.12143 Sar, V. (2011, March 7)__Developmental trauma, complex PTSD, and the current proposal of DSM-5__European Journal of Psychotraumatology, https://www.tandfonline.com/doi/full/10.3402/ejpt.v2i0.5622__Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. Therapeutic assessment of complex trauma: A single-case time-series study. Clinical Case Studies, 12, 228–245. https://journals.sagepub.com/doi/10.1177/1534650113479442__https://www.verywellmind.com/agoraphobia-101-2584235__Avoidance Behavior, Written by Silvi Saxena MBA, MSW, LSW, CCTP, OSW-C/Reviewed by Raiy Abulhosn MD__ https://psychcentral.com/pro/complex-ptsd-and-the-realm-of-dissociation

Treatment

COMPLEX PTSD - SHAME - AVOIDANCE - DYSREGULATION - INTERPERSONAL DIFFICULTIES - DISSOCIATION - IMPULSIVITY - OBSESSIVE THOUGHTS - DEPRESSION - TRIGGERS - PHYSICAL - PERSONAL EXAMPLES - TREATMENT