Hyperarousal and hypoarousal
Hyperarousal and hypoarousal both consist of two cluster symptoms of PTSD.
Hyperarousal presents as a heightened state of anxiety caused by an increase in stress hormones, epinephrine and cortisol. During a panic attack, an individual with PTSD will experience a rapid increase in epinephrine (think: ahh!!) with a low cortisol response (the stress hormone responsible for re-balancing us after a stressful event). During hyperarousal states, the HPA (hypothalamus-pituitary-adrenal) axis, our neurological pathway for stress regulation, becomes over-reactive to triggers, causing this rapid increase in epinephrine (ahh!) which over-stimulates the brain bodily responses. The cluster symptoms typically comprise of anxiousness, difficulty falling/staying asleep, difficulty concentrating, outbursts, irritability, emotional flooding, hypervigilance, excessive startle reflex, and panic attacks.
Hypoarousal then presents as the extreme opposite of an autonomic response, a crash known as a "shutdown" or dissociation characterized by extreme fatigue, flat affect, depression, disconnection, and depressiveness. At this body, the body is craving a break from a sudden surge of chemical reactions that have flooded the body.
Advanced Distress Tolerance Skills
Basic Distress Tolerance Skills
The Stress Response in 6Fs
Window of Tolerance