Hypervigilance is a state of heightened alertness in which a person is constantly and often exhaustingly on the lookout for signs of danger or threat. In the context of cardiac arrest survival, hypervigilance is one of the most commonly reported psychological symptoms and can significantly affect daily life, relationships, and wellbeing.
**What it feels like**
A survivor experiencing hypervigilance may be constantly monitoring their own heartbeat, acutely aware of any chest sensation, and unable to relax or feel safe. They may startle easily, struggle to sleep, or find it difficult to concentrate on anything other than physical symptoms. Family members or carers can also develop hypervigilance, monitoring the survivor closely and feeling persistent anxiety when they are apart.
**Why it happens**
Cardiac arrest is a profoundly traumatic event. The body and mind have experienced a life-threatening situation and the survival instinct can remain in a state of high alert long after the physical danger has passed. The brain essentially stays switched on to scan for the threat recurring. This is a normal trauma response, but when it persists it becomes distressing and disabling.
**Connection to PTSD**
Hypervigilance is one of the core symptoms of [post-traumatic stress disorder](/glossary/post-traumatic-stress-disorder/), alongside [intrusive memories](/glossary/intrusive-memories/), nightmares, avoidance behaviours, and emotional numbing. Not all survivors who experience hypervigilance have a full PTSD diagnosis, but the underlying mechanism is similar.
**Management**
Hypervigilance does not usually resolve by itself if left unaddressed. Effective approaches include trauma-focused [cognitive behavioural therapy](/glossary/cognitive-behavioural-therapy/), eye movement desensitisation and reprocessing (EMDR), mindfulness-based techniques, and in some cases medication. Speaking to a GP is the first step; referral to a psychologist or counsellor with experience in trauma is often appropriate for survivors whose symptoms are persistent.
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