Prescriptions for Life

How to attain your goals, great and small, and create a life you love.

Top 10 Survival Tips for the Highly Sensitive Person (HSP)

Are you easily overwhelmed by noises, crowds, smells and chaos? Have people always told you you're "too sensitive"? You might indeed be a Highly Sensitive Person (HSP). These survival tips from wellness expert Dr. Susan Biali, M.D., can help take the edge off an overly stimulating life. Read More

Exposure Therapy


I enjoyed reading this post on the HSP. And, I agree, it doesn't seem like enough credibility is given to the label.

Currently, I'm seeing a therapist to help me with my sensitivities using exposure therapy. So, I will gradually expose myself to different things that make me anxious or nervous. I would caution HSP's to not create too much of their own quiet worlds, as my therapist said,"you can become like a hot house flower." Needing, things to be "just so" to feel stable. That's what happened to me.

So, yes, no one needs to desensitize themselves to watching horror or war movies or loud concerts and things like that. But, it might be worth exposing ourselves to some things so everything doesn't become an impossible balancing act like it has for me. Just a word of caution from an HSP who has created her own greenhouse and is trying to get back into life a little bit.

Your own greenhouse

Thanks so much for this comment, you raise a very valid point. As with almost anything helpful or "good for you" in this world, this type of coping behavior can become isolating and harmful if taken to extremes. I've found these tips to be helpful in decompressing and maintaining my center in the middle of a busy and quite public life. I enjoy quiet solitary mornings before seeing 35 or more sick patients at the clinic in the afternoon; that balance helps me have more patience with them, rather then becoming irritated by the pace and the pressure (though that still happens occasionally!). I love to retreat with takeout and a good movie on Netflix after speaking to 1000 people in the morning and signing books all afternoon. Each person needs to find the right balance for them and I agree with your therapist that it's not healthy to isolate completely. I've also found that my headphones really help me navigate uncontrollable environments (e.g. hotel rooms) without needing them to be "just so". Also, practices like eating well and sleeping well help one to be more adaptable, relaxed and content in any and all circumstances.
Thank you again!
Susan B.

Hello, I'm afraid of saying

I'm afraid of saying too much. I wanted to ask: is it possible to be both an HSP while having traits of schizoid/attachment disorder
Being emotionally distant towards others and oneself, while still feeling devastated by the perceived insensitivity of others?
Does that even make any sense, or am I just losing it?


... i think it might be a cut of point ... like an overload of HSP ... safety valve? ...
... now you mention it ... i seem to go from one extreme to another sometimes ...
... very confusing to oneself ... who naturally cares about others ... absorbs all their negativity and ... have to recycle it somehow? ... and distancing oneself is almost like self defence ?
... is it something like that or am i losing it?

Something like that

I'm 17 years old and in my junior year. I've been to two psychiatrists, 1 therapist, and 3 doctors. I come by my hypersensitivity from my Dad and possibly my mom (looking into that). Starting from 5 years to 13, I was just like you. I've never heard of someone else having the same sensitivities that I do until last night. I'm sitting in an elective class with tears streaming down my face from the overwhelming relief. I was unfortunate enough to be the neighbor of a girl who emotionally traumatized me from 5 years old. This caused me to escape within myself.
Over the years there have been amazing friends, some I lost, some just didn't work, and the most recent I drifted away from because of drugs and boyfriends. Now I'm focusing on detoxing and graduation.
My advice to you: trust your gut feeling. There are many times that I didn't trust my judgement or wanted to give them a chance, and was sorely mistaken. There is also a difference between self-defense and self-preservation.

ive read abit about this now,

ive read abit about this now, and based on scientific studies it is more so that people around you can percive you with scitzofrenia as dr elaine says for example. and as i have noticed before reading the scientificall studies, just because people percive you in a way, doesnt mean you are it. so give yourself some slack, and even if you were, not a big deal. but as i am reaing further many hsb people go to see doctors, because they Feel they cannot handle sometimes life situations or other people. 2 things are wrong with this 1) the doctors examine them after their current knowledge and say they have an illness they dont really have and the treatment can mak it worse. i coomon thing is often exaity, which hsb people ironically according to themself and scientific research rarly has at all.

Hello Susan I'm 25 year old

Hello Susan

I'm 25 year old and I'm a highly Sensitive Person. I started a community for people who want to learn about fitness and what it can do for HSP. I don't know how to start it and untill now nobody have signed in. I know I have to give back what I learned. Since I was 6 I was busy with live and death! Check my facebookpage. Thank you very much!

I'm with you...

... try working from home/for yourself with HSP. At my peak I was getting groceries delivered to me and wouldn't leave the house for weeks on end, and if I did, it was midnight-4am to avoid anyone and everyone. I've gotten better, but can still easily go several days without going out.

It's tough, I am scared of everything outside my door. Force yourself, that's all I can offer. It hurts and takes a lot out of you, but don't into a freak like me please.


Hmmmm...this sounds more like agoraphobia, an anxiety disorder, than it sounds like an HSP issue, though perhaps HSP traits may have contributed to your developing it? As I understand it HSP is what is called a trait, not a psychiatric diagnosis or disorder. I'm glad you're seeing a therapist, anxiety is crippling but highly treatable. Good for you for being willing to actively do something about it, many people don't or use medication instead of addressing the underlying issues (nothing wrong with medication in certain cases, of course, but it always worries me if someone wants a quick fix and isn't willing to look at what's going on). Be proud of yourself for your bravery at working to conquer this - and please don't call yourself a freak : ).

I can relate

Personly, I don't think it's agoraphobia, although it does sound a lot like it. I can relate to this story, because something similar has happened to me. Your home can become something of a protective cocoone between you and the overwhelming world. I became overstressed and overwhelmed at university. For a while I had too much going on, including me being part of a board for my program there (something like class president, but we were a group of people). To make the long story short, after I was done, I ended up unemployed. I almost locked myself at home, and avoided many things, because I became overwhelmed too quickly. I preferred to go out at night, and in winter, because there is very few people outside, and the snow muffles sounds. This seems to be a pattern in me, the more stressed and overwhelmed I become during my life, the more I need to isolate myself. But, when you start the isolation, it can become too comfortable and everything too intruding and too difficult to deal with. Even a grocery store could create a feeling of wanting to just run away home and close the door. You need to be "out there" to be able to deal with it.

Unfortunatelly, I'm a person that loves to get engaged in things, and I become overexcited. This year I have managed to push myself almost towards a burnout. Fortunatelly for me, it was cought before it went that far. Right now I go in therapy for it. Instinctively I want to run home and close the door behind me, but I love working too much. During therapy it came up that I might be a HSP. I think because of this knowledge and with her help it will be easier for me to find balance in life.

Is there a difference between

Is there a difference between a HSP and an introvert? If an extrovert can be an HSP, and a HSP is easily overstimulated, then wouldn't that extrovert really be an introvert? Is it the emotional tension that overstimulates the HSP, as opposed to the external stimulation?

I'm curious because I'm unsure if I'm an introvert or an extrovert. I'm easily overwhelmed by chaotic situations, and I'm highly sensitive. I'm more extraverted when I'm in a good mood, and more introverted when I'm overwhelmed. When I'm in a calm setting I tend to be loud and spontaneous (if I have a friend with me), but my energy level can change depending on the environment. An example would be being outside on a windy or cold day, which drains me.

I thought I was going crazy when I noticed that too much light overwhelms me, even natural lighting. I thought that I was taking the whole introvert-overstimulation thing overboard. This might explain why I feel better during the nightime.

I laughed when I read your tip on getting things done in off hours because I've always tried to avoid any situation that could be chaotic. I have never really tried to rationalize my avoidance of chaotic situations, and I never tried to understand why I behaved like this, it just seems to happen automatically. I even park at the back of parking lots to avoid having to deal with congestion near the front.

HSP and Introversion

Thanks so much for your comment, I can relate to much that you wrote. Scott Barry Kaufman, PhD has done some interesting work (that you can find on his PT blog) about how seemingly extraverted people such as rock stars are often actually introverted HSP's. I also wrote a post on my blog called "Why it's hard to be an HSP Introvert".

I think the difference is that introversion/extraversion specifically relates to how someone relates to people - introverts are drained by social interactions, while extraverts are typically energized by them. HSP goes into a whole other range of responses that pertain to the entire sensory environment.

As I think you alluded to, a percentage of HSPs are actually true extraverts, despite being sensorily sensitive.

It's actually kind of fun to be HSP once you figure out what helps you feel balanced, I love shopping in off hours and get real enjoyment from it instead of it being a stress. Who knew, I actually love to shop! : )


Have you ever heard of High

Have you ever heard of High Sensation Seeker? That might explain your extroversion. But at the same time, you are an introvert. And that's because you are a Highly Sensitive Person too. You are both, a HSP/HSS. You might entertain the term for being both an extrovert and an introvert: Ambivert.

Acknowledging what I am

Hi, A couple of days ago I listened to interview from the EFT World Summit with Rue Hass about sensitive people, thinking it would be good for my wife. After listening a few minutes, I realized that it was actually me that could relate to nearly every point.

I hate noise, busy places, and avoid big cities where possible. I love walking in nature, have a weird love of hills and mountains and take on other peoples issues very easily. For example, a work colleague is going through chemo and explaining some of the things he was experiencing - inside my heart was racing, feeling my eyes filling up and just wanting to help. That happens all the time.

To say I'm struggling at the moment is an understatement, with my family living on the other side of the world for the past 9 months, and me stuck in a concrete box, otherwise known as an apartment, where I can hear everything - driving me crazy.

Also, I don't drink tea or coffee (I can't stand the smell - but that goes for a lot of strong smelling things), eat very healthily (apart from the need for chocolate) and regularly, and avoid milk/cheese/meat and strong spices. I will look into taking some supplements as well.

Thanks for the points you mentioned. They are very helpful, and I can combine my EFT knowledge with the points you mentioned.

Thanks for sharing.

Noisy concrete boxes

Hi P! Thanks to you for sharing as well - as someone who has lived in more noisy concrete boxes than I'd ever care to repeat, get the noise-cancelling headphones. They will change your life! : )

Thank you for the article!

I thoroughly enjoy reading the columns on Psychology Today, in particular the columns on being a Highly Sensitive Person.

I find I react badly to loud environments, loud people (I tend to avoid the Sales/Marketing dept at work :), mess everywhere, brightly lit supermarkets and so on, as you so accurately describe. Even cafés with loud coffee machines are places I avoid.

Music, art and films can affect me very deeply too. I last got rather choked up listening to Philip Glass' Sataygraha at work the other day. :)

Oh, and people often accuse me of being 'too sensitive' (to which I often laugh and reply: 'what, you didn't notice *that*? Tsk, wake up and pay attention!')

What I find though is that instead of feeling stressed or anxious, I tend to get annoyed and irritable, coupled with a burning desire to get out and off to somewhere a bit nicer.

Anyhoo, thanks so much for drawing attention to this phenomenon: I thought it was just me!

I have all of the symptoms of

I have all of the symptoms of HSP and more. However, I put it all down to having PTSD (severe childhood trauma). If I get the PTSD symptoms and triggers under control, then my tolerance for noise and stimulation is much higher. I'm pretty sure that if I didn't have my history of childhood trauma and resulting PTSD, I'd still be an introvert but wouldn't be so damned sensitive to noise and stimulation.

I wonder if at least a few people with supposed HSP aren't misdiagnosed.

PTSD and others

You make a great point, as did Anonymous in the first post. If someone's "HSP" symptoms are extreme and causing extreme distress or incapacity, or severely affecting relationships or other key areas of life, it's a very good idea to go see a professional to discuss what's going on and make sure there isn't some other diagnosis to account for it. It's fairly easy for me to self-diagnose as I've had plenty of counselling and coaching over the years (I love it and seek it out, actually) and am personally a medical and mental health professional.

Re. PTSD, though I had some stresses growing up as most people do, I'm not aware of any severe trauma that might have triggered a PTSD-based source of HSP traits. PTSD is also characterized by other symptoms such as extremely high level anxiety (severely on edge, constantly), flashbacks and nightmares regarding previous traumatic experiences, etc. In that sense the two are quite distinguishable, though I can definitely see that someone struggling with an anxiety disorder (who is made more anxious by caffeine etc.) might misdiagnose themselves as HSP.

Thank you for pointing this out!

The trait of high sensitivity and Highly Sensitive People and my website

I invite you to visit my website:
and I'd love to get your feed back and any commnts that you may have.
All the best, Jim Hallowes

Holy cow - I just realized

Holy cow - I just realized something! (Was a total DUH! moment!) I've often wondered how I went from being an ENFP as a child to an INFP as an adult. I thought that was definitely weird, but, I've always been weird, so I guessed that is just what happened. But no, my HSP traits are what make me think I'm an introvert. I'm really still an extrovert. And I can look back at childhood and see some of those HSP traits even then. It all makes sense now. Even though I ran across Dr. Aron a few years ago and immediately realized I was, in fact, HSP. Funny that it took me so long to see.

your aha moment

Hi! Glad to see that you posted here, I always enjoy hearing from you on Twitter : ). I find it fascinating that your HSP traits made you an introverted extravert...a coach colleague of mine shared this post to her community and EVERYONE there is talking about this simultaneous extravert/intravert HSP phenomenon. Seems there are a lot of us out there, some very interesting research could be done here.


Might I suggest another way of looking at what has been expressed as a "simultanious" trait? I think some people are actually "highly social introverts." The introversion/extroversion has to do with how you renew your energies. Introverts recoup with long walks, nature, mustic and art--quiet sorts of activities.

A highly social person will look like an extrovert, but watch how they renew their energies. I have two daughters; one I pegged as introvert, like her mom! The other was an outgoing extrovert like her dad. As an adult she corrected me and insisted she was an introvert and pointed to how she renewed her energies: with music, nature (especially enjoying sunsets!), reading, leisurely bath with candles...I had to admit, she was right!

Did you download my brain?

Did you download my brain?

Autism Spectrum?

I find myself wondering if HSP is at the very low-end of the Autism Spectrum umbrella. The reason why I say this is because people with these issues have a very difficult time with stimuli. Noise in particular, but social interactions and other stimuli are also difficult and/or stressful.

What I wonder is if what is today called "Autism Spectrum Conditions" will be discovered to be the extreme end of what is in actuality an every day issue for many people.

I have many similarities with what you are describing as HSP (this is the first that I've heard of it), and I have sometimes wondered if I have some minute connection with autism spectrum conditions.

Autism - very interesting

Thanks so much for sharing your thoughts Stephen, I think you might be on to something. On another post I wrote on HSP a while ago, a woman with Asperger's posted a similar comment.

Your post made me think of when I was little - I don't know much about Autism but as you mention the pattern of social interaction (or lack thereof) is quite distinctive. I remember when I was young my mother used to urge me to spend time with other kids e.g. at their houses, and I did not like it AT ALL. I usually couldn't wait to leave (sometimes got actually panicky if left to stay overnight) and found them incredibly boring, I would much rather be in my own world.

I remember that other kids seemed to like me and would frequently invite me over to their houses, but I would rarely initiate an invitation to my home unless I felt pressure to do so to appear "normal". There were neighborhood kids on my street I enjoyed playing with (we had great adventures in the woods, loved to dress up and have dance contests, so they were more my species!), but that was the exception not the rule.

I also really related to James Durbin on American Idol (who has Asperger's).

As an adult I do deeply enjoy social interactions with interesting people, and have some wonderful very close friends, I'm much better adapted. But wouldn't be if I didn't have a lot of down time on my own! I spend TONS of time alone and like it that way. Wow, this has been long, but you really hit on something...
Thanks for your comment!

Hey Susan. :-) I was the same

Hey Susan. :-)

I was the same way as a kid, although my parents eventually let me do my own thing. There was one guy who I hung out with on a regular basis, but when he and others got together for parties I'd always politely excuse myself and walk home. They also never understood why I never wanted to go play pool or such with them. It's just too darn noisy with too many people.

Strangely, I was pretty popular for awhile, too, as a kid.

These days I'm still quite the loner, but I've been attending classes at a university for about four years now. It's been a great tool to slowly expose myself to social interaction and groups of people, but I did join later than most so the age difference makes it difficult to relate with most of the other students.

The "interesting people" part is the key, for me. I have a significant dislike of small talk, but actual, interesting, one-on-one conversation is something that I very much enjoy, even if it does require that I "plug in" for a day or so. :)

I don't watch a lot of TV, but I just watched some videos on YouTube of James Durbin. He's a very talented person. That would have been a good season to watch.

Possible Connection Between Autism and HSP

I'm a psychology student, and I believe that the field of Evolutionary Psychology can offer a possible connection between Autism and HSP. It seems that people with Autism Spectrum disorders and Highly Sensitive People share a profound hypersensitivity to their environment, this is obvious after reading all of the comments on this page and also thinking back to my own childhood as an HSP. I don't believe that a significant trait like this would exist for no reason, ultimately this is conjecture, but I believe that one possible explanation is that what these two groups share is
the activation of a certain set of epigenetic traits. Epigenetics is defined by Wikipedia as "the study of heritable changes in gene expression or cellular phenotype caused by mechanisms other than changes in the underlying DNA sequence... It refers to functionally relevant modifications to the genome that do not involve a change in the nucleotide sequence."

There would appear to be countless variables involved in Autism Spectrum Disorders, so I should be careful not to overgeneralize- but I hypothesize that HS People carry genetics which came about because they allowed people better survival rates in relatively quiet environments which existed everywhere before the industrial revolution, but especially even further back perhaps 3,000 years or more. I personally hear every seemingly insignificant noise around me in a radius which varies, but one might say it to be about 60 or more feet. In a modern city this is very stressful, and can probably cause a myriad of psychological issues, but in the wilderness one's survival can easily depend upon hearing the snap of a small branch.

The most simple way to explain epigenetics which I've come across:
"Although identical in genetic sequence, queen bees and worker bees are entirely different in terms of their behavior, physiology, and appearance; phenotypic differences between queen bees and worker bees abound. For example, queen bees can produce as many as 2,000 eggs in a single day, whereas worker bees are sterile. Worker bees spend their days foraging for food, collecting pollen, maintaining the hive, and fighting off invaders, while queen bees spend their days having food delivered to them and laying eggs to keep the hive populated with enough workers. Queen bees are 5 times larger than worker bees. Not surprisingly, the life span of queen bees is typically 20 times longer than that of worker bees.

What is responsible for these dramatic differences? In this case, the phrase "you are what you eat" comes to mind. Both queen and worker bee larvae are initially fed a diet of royal jelly, which is provided by nurse bees. However, the worker bee larvae are rapidly weaned and fed a diet of nectar and pollen. In stark contrast, the queen bees are bathed in royal jelly throughout larval development, and they continue to feast on the royal-jelly diet as adults."

— Heidi Chial, PhD and Jennifer Akst, MS

Autism & HSP

Very interesting! My gut feeling is that there is some kind of a link, though I'm not specialized enough in this area to be able to formally comment. What fascinating information you've posted here Heidi and Jennifer, thank you!

Name Correction

I probably didn't format that post as good as I could have and also used a nickname which made it even more confusing. I have a Bachelor's in Psychology as of now- the uppermost two paragraphs I posted were mine while the lower two paragraphs were a quote I found in an investigating study of bees and epigenetic inheritance. The quote explaining epigenetics was from Dr. Heidi Chial, PhD and Jennifer Akst, MS.


That is an interesting observation that should be studied more, I think you may be on the right track though. Before I knew that I was HSP, I found myself relating to portrayals of people with aspergers (it is on the autism spectrum) because of their need for structure, issues with social interaction and and sensitivity to noise/light.

Post new comment

The content of this field is kept private and will not be shown publicly.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Allowed HTML tags: <a> <em> <strong> <cite> <code> <ul> <ol> <li> <dl> <dt> <dd>
  • Lines and paragraphs break automatically.
  • You may quote other posts using [quote] tags.

More information about formatting options

Susan Biali, M.D., researches health and happiness. She is also a professional flamenco dancer and author.


Subscribe to Prescriptions for Life

Current Issue

Let It Go!

It can take a radical reboot to get past old hurts and injustices.