Are HSPs More Likely to Have Chronic Health Issues?

A highly sensitive person suffering from chronic health issues and chronic pain

Does being a highly sensitive person make you more prone to chronic illness and chronic pain? Here’s what the research says.

During my last few years of clinical practice as a physiotherapist and pain consultant, I started to notice how often my highly sensitive clients were struggling with chronic body symptoms or persistent pain. As I saw the pattern over and over again, I decided to get firsthand stories. I began asking my favorite online community of highly sensitive people (HSPs) whether they saw a relationship between being highly sensitive and suffering from chronic health issues, chronic illness, and chronic pain.

The answer was a resounding yes. In fact, I received an overwhelming number of replies, with most stating that there is a correlation. Others argued that previous adverse events, such as childhood trauma, actually have a stronger impact on the development of chronic conditions for HSPs.

Other group members reported that highly sensitive people are more susceptible to stress-related conditions — a claim which is supported by research — which can be a contributing factor to some chronic health conditions, like fibromyalgia. In fact, many HSPs specifically mentioned that they struggle with fibromyalgia, chronic fatigue, and hormonal and psychological issues like chronic anxiety

As a medical professional, however, I knew I had to go beyond firsthand stories. I decided to conduct my own review of the scientific literature. Although there are not many studies that have specifically looked at a link between chronic illness and high sensitivity, the existing data does support a connection. Three studies in particular seem to back up the idea that HSPs are more susceptible to chronic illness or chronic pain — and they reveal some promising ways you can address that. Let’s dig into the research and see how.

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

The first study I looked at examined the relationship between an individual’s sensitivity (known to scientists as environmental sensitivity or sensory processing sensitivity), their self-perceived stress, and their physical symptom complaints. The study assessed 383 undergraduate students in Texas. As a result, the authors reported that sensitivity 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 environmental sensitivity 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 trait of high sensitivity 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 sensitivity 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 seemed to have an opposite conclusion. It investigated the relationship between environmental sensitivity, personality traits, and subjective health complaints in 167 undergraduate students. In this study, the authors identified that neuroticism was a stronger predictor of psychological health complaints than sensitivity itself, as measured by the HSP scale (a psychological test for assessing sensitivity). Neuroticism is considered to be a specific personality trait according to current “Big Five” approach which is dominant in personality science.

At a glance, that would seem to suggest that neuroticism, not sensitivity, is what drives susceptibility to chronic illness. But there’s a catch — actually, two catches:

First, highly sensitive people tend to score higher for the personality trait of neuroticism in the first place. This begs the question of whether the study results do indicate some link with sensitivity after all.

Second, the study only assessed the risk of psychological health complaints — not physical complaints. That means it does not address the connection between high sensitivity and chronic illness or chronic pain, which are largely physiological.

What this study does show is that that psychological vulnerability, rather than the trait of sensitivity itself, can be a stronger predictor for the development of health problems. That’s promising news for HSPs, because we actually have a greater ability to adapt and grow than less-sensitive people, including the ability to better overcome mental health issues as long as we find sources of support to help us. (For more information on this, read about the sensitive “Boost Effect” here, and a fascinating study on how HSP teens were far more able to overcome depression here.)

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 participants with high sensitivity 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 by — 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 appears that high sensitivity does 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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