The Link Between Being an HSP and Chronic Health Issues, According to Science

A highly sensitive person clutches her stomach in pain

Does being a highly sensitive person make someone more prone to health issues, like chronic illnesses? Here’s what the research says.

During my last few years of clinical practice as a specialist physiotherapist and pain coach, I started to notice how often my highly sensitive clients were struggling with chronic body symptoms or persistent pain. As I’d see this recurrent pattern over and over again, I decided to dig a little bit into this topic and asked on the social media — within a group for highly sensitive people (HSPs) — people’s opinions on whether they perceived a relationship between being highly sensitive and the higher chance to develop a chronic health problem.

Interestingly, I received an overwhelming number of replies, where most stated that, yes, there is a correlation. Meanwhile, others argued that previous difficult life events, such as childhood trauma, actually have a stronger impact on the development of chronic conditions. 

Other group members reported that highly sensitive people are more susceptible to stress-related conditions, and that in case of difficult past events, HSPs tend to cope worse than non-HSPs. In addition, many people of that group mentioned that they struggle with chronic health conditions, such as fibromyalgia, chronic fatigue, and hormonal and psychological issues, like chronic anxiety.   

Although people’s answers were quite straightforward and clear to me, as I have a background in research, I decided to conduct my own review of the scientific literature (although not comprehensive). Unfortunately, I could not find the same certainty in my findings, mainly due to the low number of papers available on this topic. However, although not exhaustive, I found some similarities between people’s perceptions and the results identified in three studies that I am going to talk about below.

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Study #1: The Higher the Sensitivity, the More Stress and Health Complaints You May Have

The first study I looked at examined the relationship between an individual’s sensory processing sensitivity (SPS, the scientific term that identifies an HSP), self-perceived stress, and physical symptom complaints in 383 undergraduate students in Texas. As a result, the authors reported that SPS was positively correlated with levels of stress and health symptoms, including a racing heart, heartburn, and sore throat. 

This means that the higher level of sensitivity you have, the more stress and number of health complaints you tend to report. These results seemed to be in line with people’s perception from the social media group.  

However, the study also reported that the relationship between SPS and health complaints was not moderated by the level of self-reported stress. This means that the adverse effects of stress on health did not amplify health complaints reported in HSPs. Therefore, the level/amount of stress for HSPs was not conditional for the relationship between the SPS trait and health. 

This likely means that being a highly sensitive person appears to be a better predictor for illness than self-perceived stress. In addition, with equal levels of stress between HSPs and non-HSPs, HSPs have a higher probability of developing health problems. Thus, it is possible that SPS may influence physical health outcomes. 

It is important to note, though, that the authors did not assess (or control) for psychological vulnerability, such as the presence of neuroticism, anxiety, or depression, factors that might have influenced the conclusions. Moreover, it is worth noting that, as the authors stated in their article, “as with all studies based on correlational data, a causal relationship between measures of sensory-processing sensitivity and health cannot be established.”

Study #2: Psychological Vulnerability Can Be a Stronger Predictor for Developing Health Problems Instead of the HSP Trait

Another study had an opposite conclusion. It investigated the relationship between SPS, personality traits, and subjective health complaints in 167 undergraduate students. In this study, the authors identified that neuroticism (considered a specific personality trait according to the Big Five approach) was a stronger predictor of psychological health complaints (but not physical complaints) compared with the factors of the SPS scale. 

These results support the idea that psychological vulnerability, rather than the HSP trait itself, can be a stronger predictor for the development of health problems in this population.

Study #3: Being an HSP Might Play a Significant Role When It Comes to Chronic Physical Illnesses 

A third study investigated the relationship between sensory processing sensitivity and lifestyle with stress in 170 patients with irritable bowel syndrome (IBS). The findings seemed to highlight how HSPs are highly correlated with very common chronic conditions, such as gastrointestinal issues.

In the results, the authors reported that patients with SPS were not prone to experience higher amounts of stress, per se, unless in the presence of a chronic illness. Therefore, they concluded that, similarly to the first study above, indirect effects of temperamental variables (like being a highly sensitive person) might play a significant role when it comes to chronic physical illnesses. Therefore, causing more stress once a stressful factor or event (in this case, a disease) develops in life. 

These findings fit well with the concept of differential susceptibility, which states that HSPs are deeply affected — and more susceptible — to both negative and positive experiences compared to non-HSPs. 

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The Correlation Between HSPs and Chronic Health Issues

So going back to the main question at the beginning of this article, which is whether there is a correlation between highly sensitive people and the incidence of health problems, the answers appear to be affirmative. It seems the SPS trait does seem to play a role as a vulnerability factor in the development and maintenance of a health complaint. However, we’ll keep in mind that some researchers have argued that other psychological elements, such as neuroticism, may need to be present to predict a health issue.

Therefore, the interaction between the highly sensitive trait, stress, or psychological vulnerability may increase the likelihood to develop health complaints (no matter how much stress or how many stressors). What is also worth adding here is that there is a good level of evidence — as seen in systematic reviews and meta-analyses — that demonstrates that trauma-related symptoms, and lifetime stressors, play an important role as a risk factor for chronic pain conditions, too. These include research regarding IBS, as well as fibromyalgia in the general population. 

Therefore, it is very possible that these findings are even truer for HSPs. One can assess that trauma treatment, healing of old wounds, stress management, and stress prevention are essential elements to consider when treating pain or chronic health problems.   

Looking at the Link Between Stress and the Nervous System

From what we have learned from the above studies, it appears that the high sensitivity trait, per se, most likely is not enough to develop health problems in life. This is very good news! 

However, from my work experience, I can confidently say that stress is a big factor in most HSPs’ lives. But let’s spend a few words on what exactly happens to the nervous system when stress increases extensively in our body following traumatic or stressful events. This topic can be quite extensive, but I will try to be concise. 

When we experience continuous childhood challenges (i.e., we live in a chaotic family or have abusive caregivers), for example, our nervous system switches into “protective-alert” mode. This is a survival mechanism that makes us more vigilant toward external stimuli. Over time, in order to cope with the external stressors, we develop coping strategies to help us in certain types of environment. For example, we become people-pleasers toward adults/caregivers or we always try to be quiet in order to avoid conflict

When we are growing up, these coping mechanisms seem to work in order for us to be loved and accepted by those within our inner circle. However, in the long term, they can cause some changes in the nervous system, such as increased neural activity of the emotional brain (the limbic system), which becomes “overactive.”

Imagine that, on top of this overactive nervous system, when you grow up, you then experience further stressors. These could include important life events — changing homes, jobs, or getting divorced — over your life as an adult. It is then that the nervous system starts to detect danger more often than before, even in the body, most likely in the form of pain, even when there is no actual tissue damage or an injury. 

Also, if we are in pain for a long time, our own internal pain relief systems start to fade and reduce the production of important hormones that work as “internal pain-killers,” like serotonin, endorphins, and oxytocin. Instead, our body will produce more cortisol (“the stress hormone”) and adrenaline, which, in turn, create a vicious cycle of an internal perception of danger.

How to Get Out of The Vicious Stress-Pain-Stress Cycle

At this point, you’re probably wondering, “How can we get out of this vicious cycle?” Well, the answer is not simple, as chronic symptoms and persistent pain are complex. 

However, according to the latest scientific understanding of pain, stress, and trauma, we know that it is possible to retrain our nervous system, by using techniques such as “Top-Down and Bottom-Up”. For example, body practices that aim to tune into your body needs — including yoga, dance, breathwork, or gentle movements — are all considered Bottom-Up techniques. And Top-Down approaches, on the other hand, use cognitive-behavioral techniques that aim to manage your pattern of thinking, negative self-talk, and consequent behaviors. (These can also all greatly benefit HSPs regardless of symptoms or pain.)

In addition, learning what increases your level of arousal (internal and external stimuli), working around your emotions, and finding out what soothes your nervous system can help to rebalance your physiology. This can help you live in a calmer and healthier physiological state overall.

And, finally, we can be certain that, thanks to what we know from neuroscientific studies, our nervous system is plastic. In other words, it’s modifiable. So with the right inputs, training, and understanding, we can change — and prevent or even treat — chronic symptoms, which is imperative for highly sensitive people. 

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