Are you highly sensitive?
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Many of my patients report that they are highly sensitive to medications—they may experience many of the side effect listed on the package insert (and some effects not listed). They may also be sensitive to certain foods, noise, and other things in the environment. Unfortunately, I’ve found that these folks often feel overlooked and dismissed by the conventional healthcare system. The thinking is, since there’s not an easy explanation for how they feel, it must be “psychogenic” or “somatoform”. What these labels really mean, in the eyes of the conventional system, is “difficult.”
This isn’t helpful for anyone. It leaves practitioners feeling frustrated and patients feeling unseen and unheard.
I’ve found that they are several helpful ways to think about sensitivity. The first, and perhaps most useful, is concept of the “highly sensitive person”, or “HSP”.
The concept of high sensitivity was popularized by Dr. Elaine Aron, a psychologist who has written extensively about the topic since the ‘90s. Her first book, “The Highly Sensitive Person: How to Thrive When the World Overwhelms You”, was initially published in 1996. Aron, who herself identifies as an HSP, describes sensitivity as an innate personality trait characterized by heightened sensitivity to stimuli in one’s environment, including emotional, sensory, and social cues. HSPs tend to process information more deeply than individuals who do not possess this trait. And while sensitivity may sometimes be perceived as a bad thing in our society, it brings a lot of intriguing qualities (and in other cultures is perceived very favorably). Aron writes that the trait is not inherently good or bad, but is instead neutral—it just is, in the same way that eye color or hair color just are. The trait is actually quite common and is present in 15-20% of the population, and Aron uses a simple questionnaire to assess it (you can take it yourself here). Despite being well-described, I still find there is a lack of awareness of the concept.
Here are a few of key characteristics associated with HSPs:
Heightened sensory processing – HSPs have a more sensitive nervous system, which can make them more aware of subtle details in the surrounding. This is not a sensory processing disorder—it is a sensory processing sensitivity. With this sensitivity comes great depth. HSPs tend to process information more deeply and exhibit greater emotional responsiveness than individuals without the trait.
Emotional intensity – HSPs tend to experience emotions more intensely and often have a rich and complex inner emotional life. They may be deeply affected by both positive and negative emotions, and display high levels of empathy and compassion.
Overstimulation - HSPs can become easily overwhelmed in environments with high levels of stimulation, such as crowded places or noisy gatherings. They often need more time to recharge and recover after exposure to such situation. Yet the trait is not the same as introversion; HSPs may be either introverts or extroverts.
Deep processing – HSPs process information deeply and reflect extensively on their experiences. They analyze situations thoroughly, consider multiple perspectives, and make decisions cautiously. Aron describes this as a strong “pause to check” system (which is counterbalanced by a “go for it” system).
Aversion to conflict – HSPs may go to great lengths to avoid conflict and may feel deeply affected by criticism or negative feedback.
Empathy and compassion – As noted above, HSPs often have a strong sense of empathy and are carefully attuned to the emotions and needs of others. They may excel in roles that require understanding and supporting others, such as caregiving, counseling, or creative fields. Aron notes that, traditionally, those drawn to healthcare are more often HSPs (though notes that this is changing as the field changes).
Creativity and insight – HSPs often have a high degree of creativity, imagination, and insight. This allows them to process deeply and develop unique and innovative perspectives.
While high sensitivity is quite prevalent, I don’t think it’s a single trait. Instead, I imagine it emerges from a combination of genetic and environmental factors that may be different for everyone. This is not to say, though, that it can’t be understood and described in detail. I find that nutrigenomics can be quite helpful in understanding the genetic and molecular basis of an individual person’s sensitivity (for more information about nutrigenomics, read my blog post here). In one person, for example, a particular combination of SNPs involved in inflammatory pathways (like APOE, IL-6, CRP, FOXO3, etc) might lead to high inflammatory sensitivity. In another patient, SNPs involved in detoxification (like GSTP1, CYP1B1, MNSOD, NAT2, etc) might lead to detoxification sensitivity. In yet another patient, SNPs involved in oxidative stress (like GSTO2, UCP1, PPARG, CAT, etc) might lead to sensitivity to oxidative stress. This is another tool in the systems medicine approach to thinking about sensitivity, using a biomedical framework, and I often consider testing large panels of low penetrance SNPs for patients using tools like 3x4 Genetics.
It’s worth noting that other healing systems have different, and quite sophisticated, ways of thinking about sensitivity. In Chinese medicine, for example, sensitivity might most often be demonstrated in the spleen. The spleen is not just a physical organ in Chinese medicine—it represents a complex system of functions that include physiological and energetic aspects. It is responsible for many interactions with the outer world—digesting food, processing thoughts and emotions, and generating immunity.
While largely misunderstood, sensitivity is quite common, and is in fact normal. It may come with challenges (like easy overstimulation), but it also can bring unique and intriguing gifts (like creativity and insight).