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Highly Sensitive Person

Are Highly Sensitive People More Prone to Illness?

Are HSPs more prone to illness or stress?

I understand that on social media the question keeps arising about various health issues to which HSPs might be more prone—illnesses such as fibromyalgia, chronic fatigue, and migraines. But there is no clear research evidence for any illness being caused by being an HSP. Here are the studies done so far on physical problems and SPS (sensory processing sensitivity, another term for the trait). I have tried to give you enough information that you can look them up on Google Scholar if you want to:

  1. In 2006 Benham found an association between SPS and physical symptoms—including back pain, diarrhea, heartburn, and sore throat—in American university students.
  2. In contrast, Grimen and Diseth in 2016 found in a study of Norwegian university students that there was no clear correlation between SPS and “subjective health complaints.” The personality trait of neuroticism was a better predictor of having such complaints.
  3. Takahashi and others, in a 2020 study of SPS and “dispositional mindfulness” (the personality trait of being less reactive or judging of emotions, being able to describe feelings, and acting with awareness in the present) found SPS was correlated with physical symptoms, but HSPs who also had this trait of mindfulness reported fewer physical symptoms.
  4. Imura and Tagasugi (2022) used a large adult sample and tried to control for more socioeconomic variables (but not degree of stress) and found a low but statistically significant correlation between SPS and gastrointestinal symptoms, and then speculated about a cause.
  5. These four studies only used symptom checklists (a problem in that HSPs may notice more symptoms than others would, due to their greater sensitivity to all stimuli, without having more illnesses). But a 2017 study by Goldberg and colleagues found a correlation between SPS and an actual illness, Type I diabetes in adolescence. However, this type of diabetes often begins when a youth is under stress.
  6. Finally, Benham (who did the first study above, in 2006) and his colleagues got it right when they published in 2023 “The pathway from sensory processing sensitivity to physical health: Stress as a mediator.” Looking for and finding a mediator is how you try to get at the causation—the source of a correlation between two things—in this case between SPS and health. Stress was the clear mediator.

Given Benham’s study, we can look back and see in all of these studies the potential role of stress. For example, in one study, health problems in HSPs were related to neuroticism (depression, anxiety, etc.). In another, they were reduced by emotional regulation (“mindfulness”). In the study involving an actual illness, the illness itself was stress-related.

In fact, medical research is very clear that for everyone, stress is the biggest contributor to all health problems. Because HSPs are affected more by their environment than others, including stressful situations, HSPs are definitely more prone to any health problem that is increased by stress. But stress is the problem, not being highly sensitive. So if SPS is not about being more vulnerable to illness, what is it, really?

What Is SPS, Really?


SPS is one of two largely invisible survival strategies found in many species. One strategy, employed by the majority, involves not paying attention to the details of situations; and they do fine as long as these details do not matter very much, which is true most of the time. They dash into situations or ignore them, without a great deal of consideration.

A substantial minority, in humans we call highly sensitive, use a different survival strategy. They do pay attention to the details, and sometimes that pays off. There is not much to see when people are just paying attention and thinking about what they are observing. HSPs simply soak up their environments and adapt. Fit in. That is why the trait is almost invisible.

Differential Susceptibility Determines Our Visibility

HSPs are not always invisible, however. By noticing so much more in every situation, we are more affected than others by our childhood. This is called “differential susceptibility,” the part of the trait well researched by Jay Belsky and Michael Pluess. All children tend to stick to what they learned in childhood, as if that is the best predictor of the future. But HSPs learn even more during childhood, and that gives them a huge advantage if the people around them loved them, made them feel secure, were reasonable when conflicts arose, and generally taught behaviors that would help them in adulthood.

If their childhood was difficult, HSPs absorb that too. As kids, maybe they felt threatened by the people around them, or mistrustful. As a result, even as adults they may doubt that people really care about them. They tend to be anxious, shy, or crazy overachievers. Or maybe they were harshly punished or bullied, so even now they are always watching out for trouble. Or they just expect to be defeated and feel hopeless. All this makes them more visible. Others notice their anxiety, depression, defensiveness, fear of defeat or rejection, or their feeling of being victimized—even for being HSPs. Plus, all this expecting the worst means even ordinary interactions can feel stressful. Most often, HSPs are just noticed for being more stressed than other people. Hence people begin to see SPS as being about having more mental or physical problems than other people or having some kind of disorder. They never notice the HSPs doing well.

It's Not That We Must Have Good Childhoods. It’s That Our Sensitivity Prepares Us for What It Expects in the Future

What most fascinates me, however, is that the trait is not about needing to have a good childhood in order to be healthy and happy, but it is, again, about learning from what we observe. In particular it is about learning from our childhood environment what we need in order to survive in the assumed-to-be-the-same environment as an adult. So if ever in doubt about what SPS refers to, remember this research result:

In a study titled “Role of childhood adversities and environmental sensitivity in the development of post-traumatic stress disorder in war-exposed Syrian refugee children and adolescents,” data was collected from 549 Syrian refugee children in Lebanon—data on childhood adversities (neglect, abuse, fighting in the family, etc.) plus their exposure to war traumas (being unable to leave home due to bullets and bombs, seeing people die or be tortured, etc.), the Highly Sensitive Child Scale, and an assessment of their degree of PTSD.

Although childhood adversities, war events, and sensitivity were all significantly related to PTSD, previous childhood adversities before the war were the most important variable in predicting PTSD. But look at this: HSCs who had experienced lower childhood adversities had the highest level of PTSD. Those HSCs with high childhood adversity experienced the least PTSD given their war exposure. Here is the essence of SPS. It seems that high childhood adversity prepared sensitive children in particular for the adversities of war, while a “good” childhood least prepared them. So it was not having a good upbringing, but the match between earlier childhood and later events that led to the least stress and the best outcome, if we can call it that. The trait does not make us fragile, but is designed to prepare us for the life we will live in the future.

Bottom Line: A huge amount of research indicates that the key to good health for everyone is reducing stress as much as possible. That means that you as an HSP, by giving stress reduction your attention, can be healthier than others. Yes, you get stressed by being overstimulated. But you can figure out how to avoid that. You can meditate, make rest a priority, eat right, exercise, and set boundaries. Change jobs if you have to. Hire help. Find a way.

If something is stopping you from reducing your stress level, it is probably that you had a difficult childhood. So do what you have to do to heal that. Are you thinking of those Syrian refugees and that any adversity you suffered as a child should only make it easier to handle stress in adulthood? But who wants to grow up prepared to deal with living in a war zone? Most of us live in a very mixed world in which there is very little violence and ample opportunity to find meaning and some happiness if we can stay rested.

You cannot eliminate stress. It is part of life. But look around you at what stresses other people, and what stresses you in particular. As an HSP, it is your nature to observe your world and then use what you have seen to find a better way. You can do that!

More from Elaine N. Aron Ph.D.
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