[Source] Hi everyone. I will be sharing with us about Hypervigilance using as a case study, a counseling/amateur shrink session I had recently with a sweet young lady (with her permission). For confidentiality’s sake though, I will call her Cathy. I met Cathy through a mutual friend. She was convinced she had a bad case of OCD (Obsessive Compulsive Disorder) and was seeking the help of a Psychologist. Our mutual friend referred her to me and we scheduled a session together. For the records, I am a Psychologist whose specialization is Human Resources and Organizational Behavior. However, I know the rudiments on Behavioral Psychology and Psychotherapy and I was willing to help Cathy in any way I could. After getting Cathy’s bio-data for appropriate profiling, I asked her to tell me why she thought she had OCD and here is what she told me in her own words. “Ok…So there was a time thieves came to our house but then that was a long time ago and I already got over that. Last year, I heard some houses in our area were robbed again, at that point i became very scared that they might come to our house, each time I was home alone, I was always too paranoid, checking around if someone had jumped over the fence or something. By the time I went back to school, my mind was off it already. Recently, been at home alone and then I find myself imagining things like what if the thieves come to our house again etc. The thoughts are always so real, I’m so scared I’m not even able to get myself busy to as to put my mind off those thoughts. I keep checking whether the doors are properly locked, there was a time I realized I left the room to go to the sitting room to check if I locked the door well like 4 times in less than 10 minutes. The fear and paranoia is so bad, like really bad.”
[Source] “Now, why I said I think I have OCD is because I find myself very restless if I don’t go to check the door when the thought to go and check it comes to my mind and the thought comes so frequently. Another one is this, one day, we saw a scorpion at home and then my father was like we should always be careful around. It’s normal to be conscious of the environment after, after some time, took my mind off it. Now all of a sudden, I feel the urge to check everywhere I want to sit or lie down, extra conscious. Days and weeks after we saw the scorpion, I wasn’t even so extra conscious about checking everywhere like that. The scorpion issue was last year I think, recently, even when I want to sleep, I always check under my bed, the edges of the bed cos I am scared that a scorpion is probably there, and then it’s weird because I don’t feel comfortable if I go to bed without checking. And now someone stayed in the room with me for some time and she was always asking what was I looking for under the bed, I would say nothing, it’s awkward saying I’m scared there could be a Scorpion there. And then those thoughts just started like a month or two ago, don’t know why. I’m always so scared and paranoid when they come up. If I’m home alone, no matter how hot the weather may be, I pull down all the curtains, I am scared of seeing outside cos I have the fear that a thief or something might be there. Even with that, if I am in the sitting room, I get up nothing less than 10 times in an hour to check if I locked the door, if I left something on fire, if I turned the gas off properly, Even when going out, after locking the door, there’s still the feeling it’s not properly locked. So I go back, unlock and lock it again like twice and then try so hard to take my mind off it when the thought comes up again that it’s not properly locked. I don’t use my phone freely even inside the house cos I think someone would just walk in OR something and snatch it from me. If I was around someone, and they act the way I do, I think I would be scared of them. Reason being that I would be like, why would someone be so scared and acting like they have a mental problem?”
I could feel how scared she had been and how her fears were beginning to subtly interfere with her interpersonal relationships and this made me even more determined to help her as best as I could. I asked Cathy to think deeply about the two obviously traumatic occurrences that obviously brought on her paranoia and to share every single detail of both events with me. She did, telling me about the day armed robbers came to their home. They had all been at home and relaxed when they heard their dog barking. Her mum got up to check and opened the door. The armed robbers came inside and she was the first person faced with a pointed gun. We identified that scare as a very traumatic experience for Cathy. The family moved out of the house and supposedly got over the incidence but she obviously had a dormant case of PTSD (Post Traumatic Stress Disorder) . In a more recent occurrence her dad killed a scorpion under the chairs were they all usually sat to relax and she got scared yet again. This new fear triggered the dormant PTSD and her old fears and paranoia became very active and evident as she began to exhibit all the traits/symptoms described above. All of these brought me to this diagnosis;
Cathy has been a victim of severe trauma and she is suffering from Hypervigilance as a result of unresolved Post Traumatic Stress Disorder.
Hypervigilance is a state of increased alertness. If you’re in a state of hypervigilance, you’re extremely sensitive to your surroundings. It can make you feel like you’re alert to any hidden dangers, whether from other people or the environment. Often, though, these dangers are not real. Hypervigilance can be a symptom of mental health conditions, including: post-traumatic stress disorder (PTSD), anxiety disorders and schizophrenia. These can all cause your brain and your body to constantly be on high alert. Hypervigilance can have a negative effect on your life. It can affect how you interact with and view others, or it may encourage paranoia. Healthline.com
Identifying the problem was a major step for her. Managing it and getting over it will be the next step. I have shared with her the basic steps necessary to help her and will be monitoring her progress for about a month. If there are however no tangible changes after 1 month, I would recommend a visit to a Specialist Psychiatrist who would be in a better position to put her through a PTSD therapy and prescribe the standard medication to aid the therapy.
- Consciously try to calm down by breathing in and out slowly, repeatedly.
- Think objectively about realities of the current situation before reacting.
- Wait to calm down before reacting to any urges to check around.
- Learn to recognize your fears and do your best to avoid them taking over your rationality.
- Be careful and set boundaries for yourselves and people around you.
- Share your fears with those close to you. They’ll go a long way to help you calm down whenever you begin to exhibit tendencies.
These are simple ways to deal with the fear and although it may not generate immediate results, it would definitely help to gradually reduce the intensity of the occurrences or episodes until the paranoia is eventually dispelled. In a case where all of the above steps are practiced and nothing changes within a month, there would be a need to visit a Psychiatrist. Cathy has begun to apply this therapeutic steps and is gradually beginning to see positive results. She no longer checks under her bed for lurking scorpions and this is a huge step forward. She still keeps checking if the door is locked repeatedly and is yet to begin opening her windows. I was just telling her today to take a recording of her own voice when she checks on the door, telling herself she has checked and all is well. When she feels the urge to check again, if she would just calm down and play the recording to remind herself that she checked already, she’ll slowly begin to get over that too. I am very optimistic that she’ll get better with time and care.