Sometimes I hear from people who are experiencing hyperarousal symptoms. Naturally they want immediate, effective relief, preferably in the form of a magic pill. And I’m not laughing because I’ve been there and I know what it feels like.
So of course they ask me, do I have any ideas? So then I have to break the bad news. I don’t have any immediately-effective remedies to offer. All I have is relaxation, mindfulness and CBT, none of which give them the instantaneous relief they want and need so badly.
They might give these activities a try. When they don’t work the hyperarousal symptoms seem worse than ever. Then panic creeps up. What is happening? Am I going crazy? Is this normal? Do I have something physically wrong? What should I do?
Telling people in this state of mind and body that they need to sit quietly, become mindful of all the chaos inside of them, and deliberately breathe more slowly is like telling someone on a runaway train to just relax and read a book until the train stops on its own. It sounds utterly absurd. Nonetheless, it is the only solution I know of (in the case of hyperarousal, not the runaway train).
I hope this article will show you how to approach this seemingly difficult task so it works a little faster, and doesn’t seem so impossible. And I will also point out why drugs are not the best solution in spite of their being the closest we get to a magic pill.
Note: None of the statements in this article should be considered medical or psychological advice. This is an opinion-based article, meaning no medical or scientific sources were researched or cited. Please consult a professional if you want or need professional help.
What Is This Thing Called Hyperarousal
Briefly, it is the state of being seriously “wired up,” physically and mentally. In a previous article I have connected it to the fight or flight instinct. And in a later article, I mentioned a few tips on how to deal with it. Now it is time to go a little deeper into the root causes of this condition. And then maybe some possible ways to finally flip that annoying little switch from “very much on” to “blissfully, peacefully off.” OK, maybe just dimmed a little will be a good start.
What It Feels Like
Physical symptoms may include an increased heart rate and pulse, faster breathing, feeling “on edge” with faster reflexes, heightened alertness, heightened sensitivity to stimuli (jumping at sudden noises). Sometimes there is sweating and a feeling of warmth all over or just in the head and neck. Sometimes there’s also a feeling of coldness especially in the hands and feet.
Sometimes you’ll feel a bit of lightheadedness due to breathing too fast. Sometimes you’ll experience muscular tension and contraction of various muscles throughout the body, especially around the face, neck, shoulders.
Mental symptoms may include feelings of fear, excitement or anxiety—or all of the above, either all jumbled together or alternating from one to another. On the other hand, mental symptoms may be mild or nonexistent in the beginning, especially when the initial cause is physical rather than mental.
Efforts to calm oneself seem futile. Sleep feels far off in another galaxy. Sometimes if you do sleep, it is restless and you wake up with a jolt of anxiety, heart pounding and renewed symptoms
Like insomnia and anxiety, there is profoundly paradoxical aspect to hyperarousal. Those who are dealing with it, especially during chronic insomnia, find themselves sucked into a vortex of anxiety that can reach panic stage.
People who have had anxiety or panic attacks are already familiar with these symptoms. Those who don’t have an anxiety background may become quite alarmed, which of course, magnifies the symptoms (the snowball effect in action).
There is an intense desire to force some calmness into the situation by any means possible. But how can you force calmness? The simple reality is, you can’t. But that’s a hard realization, so you keep trying anyway. This leads to a desperate attempt at relaxation exercises, a frantic shot at meditation, a last-ditch effort at slow breathing… no luck.
Finally a doctor usually gets involved – because for desperate people, sleeping pills are the only thing that comes close to flipping that miserable switch. Unfortunately, the pills often don’t work. And in some cases they make the situation worse than before.
In previous articles I have referred to hyperarousal as a cause of insomnia. Well, it does prevent sleep, so in that way it could be considered a cause. But to be truly accurate, we’d have to admit that hyperarousal is not really a cause of insomnia. It is not a cause of anxiety. It is not a cause of anything.
It is a symptom.
“Something” is causing the uncomfortably heightened state of mind and body. And since the basis of analysis and problem solving is identifying the root cause of the problem, this is the best place to start.
Here are the most common causes:
- Anxiety of all types. Yes, that includes sleep anxiety.
- Excitement/ over-stimulation. This is different from anxiety because positive stimuli from good things happening can be a trigger, such as starting a great new job or a relationship or even watching an exciting movie.
- Caffeine and other dietary stimulants (even sugar for some people).
- Mild mind-affecting drugs (both prescription and non-prescriptions) and withdrawal from these drugs.
- Jet lag and other circadian rhythm imbalances.
- Mild to moderate hormonal imbalances (such as what occurs close to or during menopause).
Here are some less common and more serious causes:
- Post Traumatic Stress Disorder (PTSD).
- Serious mental illness (bipolar disorder, schizophrenia, paranoid delusions).
- Endocrine disorders (including thyroid and adrenal imbalances).
- Serious drug addiction, substance abuse and withdrawal.
- Allergic reactions (these can become medical emergencies, seek help immediately in that case).
Obviously, all suspected medical or serious causes of hyperarousal, including mental illness, drug addiction. allergies and PTSD, should be treated by qualified professionals.
Who Gets This the Most?
A certain percentage of people have a greater tendency toward nervous system instability and over-stimulation. In simple terms, they are sensitive. This doesn’t mean they cry easily or take things too seriously or are always offended or more sympathetic than average. It just means that their nervous systems respond quicker and more strongly to external and internal stimuli, and also take longer to return to a normal resting state. Senses may be more acute as well, though that’s not as noticeable as people age. There are lots of us hanging out in insomnia-land as well.
Distinguishing Hyperarousal from Anxiety
Since these two states have so much in common, why not just say hyperarousal and anxiety are one and the same? Because despite many similarities, they are not quite the same. Anxiety can certainly be a root cause of hyperarousal. And the reverse is also true—hyperarousal symptoms can increase anxiety in the typical feedback mechanism. One can easily blend into and even turn into the other. So what is the real difference?
Anxiety can be traced to specific thoughts. “What if I never sleep again?” “What if something terrible happens?”
Hyperarousal might be traceable to an identifiable thought, but usually it is more difficult to figure out. The cause-effect relationship between thinking and feeling is less clear, more vague, less specific, more mysterious. The trigger may be physical rather than emotional in nature, external rather than internal. The emotions involved are not limited to anxiety–as mentioned above, excitement or even happiness might be triggers.
Hyperarousal and Insomnia Connection
This is one of those peculiar, paradoxical, viciously cyclical, cause-effect-cause, chicken-and-egg situations.
Hyperarousal does cause insomnia in the sense that it prevents sleep. Who can sleep in this state? As mentioned, sometimes when we get exhausted enough, a few restless hours of poor-quality sleep may come to us, but then we wake up again with the pounding heart and fun stuff.
Then the vicious cycle makes its slow, vicious turn. Insomnia then causes hyperarousal… mainly for two reasons:
- Insomnia tends to end up as sleep anxiety, which contributes to the overstimulated nervous state, and
- Sleep deprivation combined with anxiety magnifies hyperarousal symptoms.
Apparently, the body’s normal instinctual response to anxiety-based insomnia is something like this:
“Uh-oh, something’s up, I’d better keep all systems switched “on” in case there’s some sort of emergency.”
Yeah, that’s the part of your brain that doesn’t do any actual thinking or reasoning or rational problem solving—it just reacts. Maybe it’s in the lower part of the brain. Maybe it’s in some other area. Unfortunately I don’t know any neuroscientists to ring up and ask about this.
Now we’re in full paradoxical panic mode, where what we want most (calm and quiet) is what drifts further and further away from us.
What To Do About It…
No doubt about it, the hyperarousal state is tough to figure out. Fortunately it responds reasonably well to the following 5 action steps, presented in logical order.
This means sitting and observing the physical tension and chaos in your body and the frantic thoughts in your head without trying to fight them off, change them, or escape from them. You do this for 1-5 minutes at a time.
It is well known among therapists who treat panic disorder that FEELING your panic rather than trying to fight with it or run away from it, is a profound step toward getting over it. It also works with hyperarousal symptoms when you are stuck in a paradoxical snowball.
Just sit quietly and really focus on FEELING your discomfort, agitation and anxiety/excitement. See if you can encompass this discomfort and agitation in your mind’s eye. You can visualize containing it with your arms, holding it, embracing it, hugging it. Then try to make this feeling even more concentrated, more acute, and more clear. Try hard to make it feel even worse! I know, it sounds weird, but I have used this technique to self-treat panic feelings and for some reason, it helps.
Work toward tiny achievable goals of relaxation or calming
When I say tiny, I mean it. How about just 30 seconds of physical relaxation? Once you get to stay calm for just one minute, two minutes possibly 5 minutes at a time, you realize that more is possible. But expecting too much will just give you disappointment. Tiny incremental improvement is all you need and all you should expect at first.
It doesn’t matter what you choose to practice for these quickie sessions. It doesn’t matter if you lie down or sit in a chair. Personally, I like to lie down and try “letting go” techniques, which work quickly. You don’t have to do a full body scan. Simply sit quietly and focus on some part of the body that feels very tense. It could be the head, neck, chest, stomach or lower back. Take one breath in, hold it for a few seconds, then let it out slowly and as you do so, visualize the tension leaving that area in a slow trail of smoke or steam. Watch the smoke dissipate as it flows upward. Repeating this once or twice should take about 30 seconds.
Then evaluate. Did your pulse slow slightly for a tiny bit? Did you feel a little bit less tense for a few seconds? If so, consider this a smashing success. Even if it starts right back up again, this is an important milestone. It means that more is possible.
Start a habit of positive self-talk
Interrupt your frantic self-talk with a few reassuring, calming, encouraging phrases. “This will pass.” “I will be OK.” “This is just a temporary thing and I will feel better soon.” “This is a problem that can be solved.” “I know I can do this.” Those are just a few examples.
Now you begin to make a gentle yet persistent effort to let go of the tension for longer periods of time. Check out these relaxation techniques here. Or make up your own, using these as a guide.
Investigate the root cause
Once you have achieved a little more equilibrium, you can begin to first investigate the root cause of this state of mind-body.
If you have been suffering from sleep anxiety for a while, you really don’t need to look further. This is probably your root cause. But is there more? Quite possibly. What started the insomnia in the first place? What was that trigger? Was it stress? Was it excitement? Was it a life change? Did you resolve this problem effectively or did you just put it out of your mind so you didn’t have to deal with it? Might there be some practical steps you can take to address this root cause?
CBT for Anxiety
If you have determined that anxiety, including sleep anxiety, is the root cause of your hyperarousal symptoms, you can begin a more comprehensive CBT inner dialogue. Go here to get started. Also check this CBT article, and this one, for more ideas.
Drugs and caffeine addiction
If you are experiencing these symptoms after taking medication for a period of time (longer than a week or two), there may be a cause-effect here.
Tapering off prescription drugs is not an easy task, and if the drugs are treating a physical condition or serious depressive or bipolar or other mental conditions, you should not taper off without discussing it with your prescribing doctor.
If you have been taking benzodiazepine drugs and want to start tapering off, you might refer to the links in this article for assistance. Caffeine addiction needs to be approached in a similar way. Taper off to avoid miserable withdrawal symptoms. Remember that some soft drinks contain more caffeine than a cup of plain coffee.
What NOT to do when you are experiencing hyperarousal symptoms:
- Try to “force” yourself to sleep. Does this help? No, it doesn’t. So why continue to do it?
- Beat yourself up about your lack of control. Does this help? No, it never does. So give it up already.
- Try to stay relaxed for long periods of time. If you can stay relaxed for a long time, that’s great. If you can’t, try 30 seconds of relaxation and then build up to one minute, two, three, four and five. And give yourself lots of encouragment and support while you’re doing it.
- Try to “shut up your brain.” Yeah, like that really works?
- Increase the dosage and/or frequency of your medication. If you are on medication and having hyperarousal symptoms, increasing your dosage will probably not help. Even if it gives you temporary relief, you are simply postponing your suffering. Begin tapering off mild benzos, and discuss stronger meds with your doctor.
- Try to solve hyperarousal symptoms by going on the internet… and reading about endocrine disorders, heart arrhythmias and who-knows-what-other-really-scary-awful-illness. It’s up to a real doctor with diagnostic tests to determine if you’re suffering from a life threatening condition. Use electronic devices to help yourself heal, not to scare yourself silly.
Obviously, there is no magic pill for hyperarousal symptoms. You must find the root cause of them, whether from anxiety, excessive stimuli, dietary sensitivities, medications, life problems, challenges and changes, PTSD, or most likely (since you’re on this site) the paradoxical vicious cycle feedback mechanism from insomnia, sleep anxiety and whatever else has been thrown into the mix. Then take proactive steps to solve these root causes using methods that make sense given the identified causes.
Yes, you will feel calmer… soon. Give yourself the support you need and the tools you can use to feel better in small increments, over time. Treat yourself as you would your best friend.