Hyper-Alert; Heightened State Of Alert

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated August 6, 2021

hyper-alert, hyper-alertness, heightened state of alert

Hyper-alert (a heightened state of alertness) is a common symptom of anxiety disorder and stress. It is caused by the frequent activation of the “fight or flight” system, often by overly anxious behavior or stressful situations and circumstances.

Hyper-alertness is a common symptom of Generalized Anxiety Disorder, Social Anxiety Disorder, Obsessive Compulsive Disorder, and especially anxiety and panic attacks.

This article explains the anxiety symptom “hyper-alert” (hyper-alertness; heightened state of alert), its causes, treatment, prevalence, and frequently asked questions.

Hyper-Alert Common Symptom Descriptions:

Common descriptions of feeling hyper-alert include:

To name a few.

Hyper-alertness can cause most symptoms associated with anxiety. Select any of the links above for more information about that symptom or visit our Anxiety Symptoms article for all anxiety symptoms.

The anxiety symptom hyper-alert can occur rarely, frequently, or persist 24/7 day after day. For example, you can feel on hyper-alert once in a while and not that often, feel on hyper-alert off and on, or feel that way all the time and every day.

Anxiety hyper-alertness can precede, accompany, or follow an escalation of other anxiety symptoms or occur by itself.

It can also precede, accompany, or follow a period of nervousness, anxiety, fear, and stress or occur "out of the blue" and for no reason.

This hyper-alert feeling can range in intensity from slight, to moderate, to severe. It can also come in waves where it’s strong one moment and not the next.

This anxiety symptom can change from day to day and moment to moment.

All of the above combinations and variations are common.

This symptom can feel more disconcerting when undistracted, trying to rest, doing deep relaxation, trying to go to sleep or immediately upon waking up.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including feeling like impending doom symptoms.

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Medical Advisory

We recommend all new, changing, persistent, and returning symptoms be discussed with your doctor as some medical conditions and medications can cause anxiety-like symptoms, including hyper-alertness.

If you've done that and your doctor has attributed your symptoms solely to anxiety or stress, you can be confident there isn't a medical or medication cause.

Anxiety can cause the hyper-alert feeling in many ways. Here are the most common:

1. Stress Response

Anxious behavior, such as worry, activates the stress response. The stress response secretes stress hormones into the bloodstream, where they travel throughout the body and cause many body-wide changes that prepare the body for immediate emergency action – to either fight or flee.

This survival reaction is often referred to as the fight or flight response, fight, flight, or freeze response (since some people freeze like a deer caught in headlines when they are afraid), or the fight, flight, freeze, or faint response (since some people faint when they are afraid).[1][2]

Some of these changes include:

  • Increases blood sugar so that we have an instant boost of energy.
  • Stimulates the nervous system.
  • Stimulates the entire body for action.
  • Shunts blood to the brain so that we are more aware of and reactive to danger.
  • Changes digestive system function so that most of the body’s resources are geared toward fighting or fleeing.
  • Increases activity in the fear center of the brain (amygdala and others) so that we are more sensitive and reactive to danger.
  • Tightens muscles so that the body is more resilient to damage.
  • Puts most of the body’s senses on high alert so that we can more quickly detect and react to danger.

To name a few.

Visit our “Stress Response” article for more information about the many body-wide changes caused by the stress response.

This combination of changes can stimulate the body and make it feel like it is on hyper-alert.

Many anxious people feel a hyper-alertness feeling when anxious.

Acute hyper-alertness is a common symptom of acute anxiety.

2. Hyperstimulation

When stress responses occur too frequently, such as from overly anxious behavior, the body can remain in a state of semi-stress response readiness, which we call “stress-response hyperstimulation” since stress hormones are powerful stimulants.

Hyperstimulation is often referred to as “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation.”[3][4]

Hyperstimulation can cause symptoms of an active stress response even though a stress response hasn’t been activated.

Visit our “Hyperstimulation” article for more information about the many ways hyperstimulation can affect the body and how we feel.

Chronic hyper-alertness is a common symptom of hyperstimulation caused by chronic anxiety due to how hyperstimulation affects the body, especially the nervous system.

Many anxious people experience chronic hyper-alertness due to hyperstimulation.

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3. Behavior

Anxious behavior triggers stress responses every time we’re anxious. As such, anxious behavior is a common cause of acute hyper-alertness (every time a stress response is activated) and chronic hyper-alertness (due to anxiety-caused hyperstimulation).

For instance, many behaviors associated with anxiety issues can cause and contribute to a hyper-alert feeling, such as:

  • All of nothing thinking
  • Catastrophizing
  • Imagining and dwelling on the worst (worry)
  • Fear of health and medical matters (health and medical sensitivities)
  • Fear of having a serious mental health problem
  • Feeling overwhelmed
  • Fear of the strong feelings of anxiety and panic
  • Crisis living
  • Perfectionism
  • Unhealthy boundaries

And so on.

Anxious behavior is a common cause of acute and chronic hyper-alertness.

4. Other Factors

Other factors can cause anxiety-like symptoms, aggravate existing anxiety symptoms, and contribute to hyperstimulation and its symptoms, including:


Side effects of prescription and over-the-counter (OTC) medications can mimic, cause, and aggravate anxiety symptoms.

Talk with your doctor and pharmacist if you are unsure if your medication is playing a role in your symptoms, including feeling hyper-alert.

Visit our Medication article for more information.

Recreational Drugs

Many recreational drugs can cause and aggravate anxiety symptoms.

Many recreational drugs can also profoundly affect the nervous system, which can aggravate existing anxiety symptoms since anxiety also affects the nervous system.

Visit our Recreational Drugs article for more information.


Stimulants bring about their stimulating effect by causing the secretion of stress hormones and other chemicals into the bloodstream, stimulating the body.

Increasing the body’s stimulation can cause and aggravate existing anxiety symptoms.

Visit our Stimulants article for more information.

Sleep Deprivation

Going without adequate sleep can affect the body in many ways, such as:

  • Prevents the body from sufficiently refreshing itself
  • Stresses the nervous system
  • Impairs brain function
  • Increases blood pressure
  • Increases blood sugar
  • Increases moodiness
  • Increases cortisol secretion to compensate for feeling tired (cortisol is a powerful stress hormone)

These effects can cause and aggravate anxiety symptoms.

Visit our Sleep Deprivation article for more information.


Fatigue can cause many anxiety-like symptoms and aggravate existing anxiety symptoms, such as difficulty thinking, foggy head, lightheadedness, dizziness, unsteadiness, pain, heart palpitations, trembling, memory loss, muscle weakness, and shortness of breath, to name a few.

Visit our Fatigue article for more information.

Hyper and Hypoventilation

Over breathing (hyperventilation) and under breathing (hypoventilation) can also cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Hyper And Hypoventilation article for more information.

Low Blood Sugar

Even if blood sugar is low within the normal range, it can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Low Blood Sugar article for more information.

Nutritional Deficiency

Nutritional deficiencies, such as low vitamin B and D, to name two, can cause anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Nutritional Deficiencies article for more information.


Dehydration can also cause anxiety-like symptoms and aggravate existing anxiety symptoms, such as concentration problems, lightheadedness, dizziness, fatigue, headache, involuntary panic attacks, muscle twitching, and heart palpitations.

Visit our Dehydration article for more information.

Hormone Changes

Hormones affect the body in many ways and can affect each other. A change in hormones can cause many anxiety-like symptoms and aggravate existing anxiety symptoms.

Visit our Hormone Changes article for more information.


Pain stresses the body, especially chronic pain. As such, pain can stress the body sufficiently to cause hyperstimulation and its symptoms and aggravate existing hyperstimulation and symptoms.

If you are anxious, hyperstimulated, and symptomatic, pain, especially chronic pain, can aggravate all of them.

Visit our Pain article for more information.

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Treatment: how to get rid of hyper-alertness

When hyper-alertness is caused or aggravated by other factors, such as the other factors mentioned above, addressing the offending factor(s) can reduce and eliminate episodes of feeling hyper-alert.

When acute hyper-alertness is caused by an active stress response, calming yourself down will end the stress response and its changes. As your body recovers from the active stress response, this anxiety symptom should subside.

Keep in mind it can take up to 20 minutes or more for the body to recover from a major stress response. But this is normal and needn’t be a cause for concern.

When chronic hyper-alertness is caused by hyperstimulation, reducing and eliminating hyperstimulation will reduce and eliminate this symptom.

As your body recovers from hyperstimulation, it stops exhibiting symptoms, including hyper-alertness.

However, eliminating hyperstimulation can take much longer than most people think. It’s common for hyperstimulation symptoms, such as hyper-alertness, to linger as long as the body is hyperstimulated.

But as with all symptoms of hyperstimulation, this symptom will subside when the body has returned to normal, non-hyperstimulated health.

Because this symptom is just a symptom of hyperstimulation (chronic stress), it’s harmless and needn’t be a cause for concern.

Lingering anxiety symptoms are an indication that:

  • You are continuing to trigger stress responses (from stressful circumstances or from anxious behavior).
  • The body’s stress level hasn’t been sufficiently reduced.
  • The body hasn’t completed its recovery work.

Lingering anxiety symptoms ONLY remain because of the above reasons. They AREN’T an indication of a more serious medical problem.

Anxiety symptoms will subside when hyperstimulation has been eliminated, and the body has had sufficient time to recover and stabilize.

Since worrying, fretting, and becoming emotionally upset about anxiety symptoms stress the body, these behaviors aren’t helpful to recovery and symptom elimination.

Passively accepting your symptoms in the short-term — allowing them to persist without reacting to, resisting, worrying about, or fighting them — while faithfully practicing your recovery strategies will bring about their cessation in time. Acceptance, practice, and patience are key to recovery.

Keep in mind that it can take a long time for the body to recover from hyperstimulation's adverse effects. Despite the lack of apparent progress, we have to persevere with our recovery efforts and remain patient as the body recovers.

We also have to do our recovery work FIRST before the body can recover. It’s the cumulative effects of our recovery work that produces results down the road. And, the body’s stimulation has to diminish FIRST before symptoms can subside.

Nevertheless, faithfully practicing your recovery strategies, passively accepting your symptoms, containing your anxious behavior, and being patient will bring results.

When we do the right work, the body has no choice but to recover.

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Short-term remedies:

Even though eliminating hyperstimulation will eliminate chronic anxiety symptoms, including feeling hyper-alert, some people have found the following strategies helpful.

However, keep in mind that each person can have a unique symptom experience since each person is somewhat physically, chemically, psychologically, and emotionally unique. What might work for one person might not for another.

Reduce stress – Since stress, including anxiety-caused stress, is a common cause of feeling hyper-alert, reducing stress can reduce episodes of this symptom.

Any stress reduction strategy can help improve this symptom. Visit our article “60 Ways To Reduce Stress And Anxiety” for natural stress reduction strategies.

Recovery Support members can read chapters 4 and 14 for many natural ways to reduce stress and anxiety.

Regular good sleep – Regular good sleep can reduce stress, cortisol, and the body’s overall level of stimulation. Their reduction can reduce and eliminate anxiety symptoms, including this one.

Regular deep relaxation – Deep relaxation can also reduce the body’s overall level of stimulation and stress, leading to a reduction in anxiety symptoms, including hyper-alertness.

Contain your anxiousness – Since anxiety activates the stress response, which causes anxiety and hyperstimulation symptoms, containing your anxiousness about this anxiety symptom can help reduce and eliminate it.

The more successful you are in containing your anxiousness, the more opportunity your body has to reduce stress and stimulation. A reduction in stress and stimulation can reduce episodes of feeling hyper-alert.

Recovery Support members can read more about containment, what it is, and how to apply it in chapter 6

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Therapy is the most effective way to eliminate anxiety symptoms since unidentified and unaddressed underlying factors that cause anxiety and stress issues are the number one reason why anxiety disorder and its symptoms persist. [5][6][7]

Dealing with your anxiety issues (Level Two recovery) is the most important work overall if you desire lasting success.

If you have difficulty containing, becoming unafraid of your symptoms, becoming unafraid of the feelings of anxiety, eliminating your symptoms, overcoming your anxiety issues, or have what seems like out-of-control worry, consider connecting with one of our recommended anxiety disorder therapists.

All of our recommended therapists have personally experienced anxiety disorder and have overcome it. Their personal experience with anxiety disorder combined with their Master's Degree and above professional training makes them a good choice for achieving lasting success over anxiety disorder, its symptoms, and worry.

Working with an experienced anxiety disorder therapist is the best way to attain Level Two recovery success. In many cases, working with an experienced therapist is the only way to overcome stubborn anxiety.


How common is the hyper-alertness anxiety symptom? Approximately 70 percent of anxious people experience this symptom. As you can see, hyper-alertness is a common anxiety symptom.

Additional Comments

While some people might not like this symptom, and some might distress about it, many go to great lengths to feel hyper-alert.

For instance, many people take stimulants, such as caffeinated coffee and “uppers,” to feel hyper-alert.

Others, such as “adrenaline junkies,” engage in stimulating and risky behavior to feel “pumped up,” “on-the-edge,” and “alive.”

If you are worried about this anxiety symptom, I encourage you to view it for what it is: the consequences of elevated stress and stimulation, and nothing more.

As you reduce stress, rest, get good sleep, and regularly deeply relax, the body’s overall level of stimulation will diminish. As it does, feeling hyper-alert subsides.

Again, this symptom needn’t be a cause for concern. It is common and harmless.

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Hyper-alertness Frequent Questions

Is feeling hyper-alert dangerous?

No. Hyper-alertness is not dangerous. It’s an indication that the body is overly stimulated. That overstimulation often comes from stress, such as stressful circumstances or anxiety, since anxiety stresses the body. It can be eliminated by reducing stress, increasing rest, and not worrying about this common anxiety symptom.

Can hyper-alertness be caused by a medical condition?

It can be, which is why we recommend discussing all new, changing, persistent, and returning symptoms with your doctor. If your doctor attributes hyper-alertness to anxiety, yes, anxiety is a common cause of feeling overly alert.

Can ingesting stimulants increase hyper-alertness?

Yes! Since hyper-alertness is caused by elevated stimulation, such as from stress and anxiety, ingesting stimulants will aggravate hyper-alertness. If you want to eliminate this symptom, you’ll need to reduce the body’s overall stimulation level, not increase it.

If I reduce stress, will that alone eliminate hyper-alertness?

Reducing stress is an important part of recovering from hyperstimulation-caused hyper-alertness. However, you’ll also need to contain anxious behavior if anxiety has caused or contributed to the development of hyperstimulation.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including hyper-alert anxiety symptoms.


  1. "The Physiology of Stress: Cortisol and the Hypothalamic-Pituitary-Adrenal Axis." DUJS Online. N.p., 03 Feb. 2011. Web. 19 May 2016.
  2. Godoy, Livea, et al. "A Comprehensive Overview on Stress Neurobiology: Basic Concepts and Clinical Implications." Frontiers In Behavioral Neuroscience, 3, July 2018.
  3. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018.
  4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015.
  5. Hofmann, Stefan G., et al. “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-Analyses.” Cognitive Therapy and Research, U.S. National Library of Medicine, 1 Oct. 2012.
  6. Leichsenring, Falk. “Is Cognitive Behavioral Therapy the Gold Standard for Psychotherapy?” JAMA, American Medical Association, 10 Oct. 2017.
  7. DISCLAIMER: Because each body is somewhat chemically unique, and because each person will have a unique mix of symptoms and underlying factors, recovery results may vary. Variances can occur for many reasons, including due to the severity of the condition, the ability of the person to apply the recovery concepts, and the commitment to making behavioral change.