Chronic Anxiety and the Highly Sensitive Person (HSP)

As a therapist, not all the people I see with chronic anxiety are highly sensitive, but all of the HSPs I’ve worked with have also dealt with anxiety, especially if they learned about the trait later in life.

In my therapy practice, I have found that “anxiety” is a word commonly used for unidentifiable discomfort; it can feel random and mysterious. Being able to identify what we are feeling and why is a step toward shifting the way we relate to anxiety.

Being an HSP and not knowing can contribute to chronic anxiety. Psychologist Elaine Aron began studying the trait of high sensitivity, or “sensory processing sensitivity,” in 1991. In her book The Highly Sensitive Person, she emphasized that the trait wasn't a new discovery, but had often been misunderstood or mislabeled as shyness or introversion.

A quick way to get a sense of what it means to be a Highly Sensitive Person is the acronym DOES, created by Elaine Aron:

D – Depth of Processing
O – Overstimulation
E – Emotional Reactivity/Empathy
S – Sensing Subtleties

All four can contribute to what feels like constant background anxiety.

Depth of Processing

HSPs are thinking and feeling a lot of the time. They typically enjoy deep conversations (with a trusted person), have rich inner lives, take their time making decisions, and tend to be cautious.

Without knowledge of their trait, depth of processing can make HSPs vulnerable to analysis paralysis or circular thinking, both of which can contribute to anxiety.

Overstimulation

Because HSPs are taking in subtleties in their surroundings and processing a lot of information, they are prone to overstimulation. Overstimulation can physically feel like an increased heart rate, a sense of shutting down, or a desire to escape. These experiences will sound familiar to anyone who has dealt with anxiety.

Learning which situations are likely to be overstimulating, and becoming familiar with your own physical warning signs, can be very helpful.

Think of a set of scales. If your scale is tipping into overstimulation, what can you put on the other side? Maybe it's taking a break, leaving a noisy environment, putting on headphones, or doing something that helps you settle.

Emotional Reactivity & Empathy

Too often HSPs are reduced to just this piece: emotional reactivity. HSPs tend to respond strongly to both positive and negative experiences.

As kids, many HSPs heard things like “you’re too sensitive,” “you’re a crybaby,” or “stop crying or I’ll give you something to cry about.” They may also have experienced parents and friends not quite understanding them when they attempted to open up and share their feelings.

HSPs can get the message that feeling deeply and crying are somehow bad: out of control, embarrassing, weak, and to be avoided. When an innate part of us is repeatedly treated as “bad,” shame can develop around it. You start monitoring or hiding a part of yourself that comes naturally to you.

Empathy is another part of high sensitivity. It can be a gift both to the HSP and to the people on the receiving end of their attunement and caring. But HSPs can also benefit from learning to distinguish between noticing what someone else is feeling and taking that feeling on themselves.

Anxiety in particular can be contagious. If you're very attuned to the people around you, sometimes what feels like your own anxiety may have started with someone else.

Sensing Subtleties

HSPs are often very good at sensing subtleties. Elaine Aron makes the distinction that HSPs don't necessarily have “better” senses, but tend to process sensory information more deeply.

Light, noise, temperature, fabric, clutter, texture: HSPs each have their own relationship to sensory input and benefit from knowing specifically what affects them and how.

Once you know what bothers you, you can actually do something about it. Headphones, noise machines, eye masks, comfortable clothing, or simply leaving yourself more recovery time aren't particularly complicated interventions. But first you have to stop assuming you shouldn't be bothered by the thing that's bothering you.

Knowing You're an HSP Can Change Your Relationship With Anxiety

I frequently work with clients who carry shame around sensitivity, emotions, and especially crying.

When HSPs can start to accept the emotional part of themselves, it can be a real turning point. Sometimes HSPs cry because they're overwhelmed. Sometimes they're moved, angry, relieved, embarrassed, or don't entirely know why they're crying yet. Being able to have that experience without immediately judging it can make a difference.

Knowing you're highly sensitive doesn't mean that every experience of anxiety is explained by the trait. But it can give you useful information about yourself. You can start noticing what overwhelms you, what you need more or less of, and which things you've been judging yourself for that may simply be part of how you're wired.

If you think you might be an HSP, Elaine Aron's self-test, books, and website are good places to start.