Hyperarousal and hypoarousal
Hyperarousal is a state of too much activation: tense, alert, irritable, unable to settle. Hypoarousal is too little: flat, foggy, slowed, disconnected.
What drives it
Both are the threat system's responses when demand exceeds capacity: one mobilises, the other shuts down to conserve. Recognising which is happening shows what someone needs: settling, or bringing back online.
How it shows
Work
Hyper: rapid speech, irritability, startle, can't sit still, sleeping badly, overreacting to messages. Hypo: monotone, staring, 'I don't really have an opinion', missing deadlines from inertia, slow reaction to urgent problems.
Relationships
Hyper: snapping at kids, flaring at small things, lying awake. Hypo: going blank in arguments, sitting on the sofa unreachable, 'I don't feel anything'.
Self
Hyper: heart racing, mind racing, jaw tight. Hypo: heaviness, numbness, fog, voice feels far away, hard to move.
What tells it apart
Major depression: Hypoarousal is a state that can switch on and off within minutes in response to triggers; depression is a sustained mood lasting weeks.
Hypomanic (manic) character: Hyperarousal feels driven by threat and is tense and unpleasant; hypomanic energy feels expansive, confident and pleasurable.
Dissociation (including depersonalisation and derealisation): Hypoarousal is low energy and flatness; dissociation is an alteration of awareness or identity, such as feeling unreal or losing time, and can occur in either state.
A test
Note what preceded the change and how fast it came on; a shift within minutes after a reminder of threat points to arousal states, not mood disorder.
Questions to carry
- What came right before the change, and how many minutes did it take to set in?
- Under too much pressure, which way do I go, wound up or flat, and what brings me back?
How strong the research is
moderate. Hyperarousal is a well-measured PTSD symptom cluster; hypoarousal as a distinct shutdown state is less well specified, though research on the dissociative subtype of PTSD supports it.
Where it comes from
DSM-III, 1980 (hyperarousal in PTSD); Pat Ogden and colleagues, 2006 (hypoarousal); Ruth Lanius and colleagues, 2010 (dissociative subtype)
Sources
- Stephen W. Porges, Orienting in a Defensive World: Mammalian Modifications of Our Evolutionary Heritage. A Polyvagal Theory (1995)
- Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (2014)