Yes, stress can trigger and worsen vertigo associated with anxiety. Vertigo is the sensation that the room is spinning, and is a form of dizziness. Dizziness is where you are off-balance, feel like you are going to faint, or feel light-headed. Vertigo is a symptom of vestibular system dysfunction. The vestibular system is located in the inner ear, and it helps you with balance. If you have vertigo and go to the doctor, and the physical examination and laboratory tests come back as normal, then anxiety may be the problem. The problem is that patients with vertigo or dizziness are often referred to specialists, like ENT doctors or neurologists, and when the medical workup is negative, these patients are not referred back to psychiatry for follow-up. This highlights the lack of multidisciplinary treatment of patients who have psychiatric illness with physical symptoms. This is unfortunate, as anxiety disorder, specifically panic disorder with or without agoraphobia, is highly associated with dizziness (Caliman e Gurgel et al., 2007). Sadly, psychiatry is viewed in the medical community with much stigma, and contributes to psychiatry operating at the fringes of medicine and not being fully integrated within it, contributing to the lack of collaborative treatment.
Another study found that patients with dizziness and panic attacks had higher rates of vertigo and agoraphobia compared to those patients who had either dizziness or panic attacks alone (Yardley et al., 2001). So if you have vertigo or dizziness as a main symptom of panic disorder with or without agoraphobia, this may perpetuate avoidant behaviors, as you would likely have worries that you would get dizzy and receive no help, if you were to leave your home. Vertigo associated with anxiety can have devastating consequences, as you most likely have to quit your job and break-off relationships due to your avoidant behaviors and/or agoraphobia.
So stress can trigger or exacerbate your anxiety, and this may lead to vertigo or dizziness. The treatment for vertigo associated with anxiety is to first have patient education, that the vertigo is an anxiety symptom, rather than a physical symptom of a vestibular disorder or other medical disorder. Then you would have the underlying anxiety disorder treated, with vertigo being most associated with panic disorder. A psychiatric consultation may be warranted here, to consider prescription medication treatment for the panic disorder. Also, cognitive behavior therapy would be helpful to address the avoidant behaviors and the maladaptive thinking and coping style. If you prefer self-help methods, then Anxiety Protocol and/or KalmPro can be helpful to eradicate the anxiety.
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I have bee taking Venlafaxine for depression for about 15 years. About 4 years ago I began having vertigo episodes with nausea. They come on for no particular reason. Sometimes it seems to be due to the position of my head, other time it happens for no apparent reason. An ENT suggested that it was due to swelling in my [middle or inner] ear. I have been taking a diuretic and niacin, and doing a BPPV maneuver. These episodes still happen. Your article communicates to me that I should see a psychologist next. Thank you,
It is possible that anxiety is the culprit- taking the anxiety test (https://anxietyboss.com/test/) can determine how much anxiety you may have.
I have had panic attacks for many years. In some cases they are so severe I pass out and have what I believe are non-epileptic seizures. This has not happened for three years now, I take an antidepressant and Tegretol as the physician is convinced my seizures are epilepsy . I also have a range of physical symptoms prior to panic attacks, most recently severe nausea. I use breathing exercises and my awareness of my disorder is high, so I know how to avoid manage them until they pass. Interestingly all my events tend to begin while I am in a deep sleep. Its as though severe panic attack symptoms wake me up. Is this something you have encountered? Most of my seizures have happened after coming out of a deep sleep as well. Just recently I awoke with severe ‘head spinning’ all the signs of Vertigo. I lie still and normalise, do my breathing and it eventually passes and then once I am up and about it disappears until the next morning. Of course this makes me anxious. Could it just be normal vertigo? Or is it indeed vertigo like symptoms brought on by panic? I know my body very well and am fully functional, but this is a new physical dimension to my panic disorder and frightens me…..
Dear Myles,
Panic attacks often wake people when they are sleeping. And vertigo can be induced by stress and anxiety. You can observe if there is an association between your anxiety and your vertigo, to determine if it is normal vertigo or vertigo induced by anxiety.
Regards,
Dr. Carlo
Omg I’m going threw so much feels like my life is ending I need help I’m probably at the highest level of stress a person can be I’m lost and in desperate need of a way to live atlesst a half normal life again I’m 30 years old and I’m mentally ill and I just wanna be helped on on how to get better
If you have such severe stress, then I would recommend that you see your doctor immediately for help. In the meantime, take the anxiety test on this website to see how much stress and anxiety you have, and what you can do to get started to eradicate your anxiety.
Wow i am 30 too. I thought i wrote that for a second. I have daily panic attacks, depersonalization and now vertigo. I feel your suffering. Its hell. I also have extreme paranoia of someone shooting me or something. I have come out the other side of a lot of it after hospital visits and thinking i was going psychotic. I hope you find hope to enjoy your 30’s
Thank you for your share.
I have vertigo now that is so bad that I have to stay in bed most of the time in fear of falling. I makes me sick to my stomach, if you have never had vertigo then you have no idea what this sickness can do to you. I have blackouts, dizzy spells, bad headaches and sick to stomach. I have just recently had a lot of stress and anxiety added to my life. The last time that I had a bout with vertigo this bad is when the same person who caused it this time caused it in Feb. I have not had vertigo since Feb. of this year.
I’m sorry to hear of your vertigo, anxiety, and stress. If you haven’t already done so, you can see how much anxiety and stress that you have by taking the anxiety test: https://anxietyboss.com/test/. This anxiety test can also tell you how to start decreasing your anxiety and stress, and may thereby help to decrease the vertigo. Please also visit with your doctor for a medical evaluation of your vertigo.
Regards,
Dr. Carlo
I had Bells Palsy in February and was in high care for a week
Since this i have recovered my speech and facial movements. I have seen the neoroligist that perscribed a antidepressant and 5mg tab for stress. It is now four months since Bells. I battle to regain consentration and since i am providing for myself have been out of a job. I have severe vertigo and the moment i stop medication it comes back. How long do i have to take the meds. I have never been on medication and this is so frustrating. The Bells started in my ear. Thank you for advising.
If you are prescribed medication for anxiety, then you may have to take it for several months to get symptom-relief. In the meantime, while you are on medications, you should look into counseling or self-help methods to see how you can reduce your anxiety naturally. You can begin by taking the anxiety test here: https://anxietyboss.com/test/
I’ve had severe anxiety and stress for 8 months now. I suffered from panic attacks at the start, now they are gone. I feel woozy, off balance, unsteady everyday. When I sit or lie down, I feel like I’m floating or rocking. My symptoms got worse, all I did was cry for 8 months straight. My neck is so stiff, could it be my neck muscles or stress? I’ve done every test, all came back normal thank god. Confused!!!
I’m sorry to hear of your distress. If your doctor has not found a physical illness causing your symptoms, then all you describe can be attributed to anxiety and stress. As the article states, dizziness can be associated with anxiety. Stiff muscles can also be a symptom of anxiety, as when you are stressed, you get muscular tension, as your body is preparing either to fight, run, or freeze (the fight, flight, or freeze response). If you are crying, this indicates low moods which may be associated with depression, in addition to anxiety. May I suggest you take the anxiety test to see how severe your anxiety is, and then it will give you an indication of where to start to get better and to get help. However, you may still need to see a psychiatrist to help with diagnosing and treating any anxiety and depression you may have.
Six weeks ago I had two days of extreme vertigo;, bed ridden. I made it to the doctor the third day and the head moves relieved it about 90 %. Yet after that for about five weeks each morning started out with manageable vertigo until about 1:00. This was tiring and effected my work performance. My work was very high stress for everyday last two years, no time off. I was let go last week and to the day of my stress work departure I have had no vertigo whatsoever. My balance is clear and perfect. I can position my head anyway, quick side to side, whip back, upsidedown, no vertigo. I am convinced the extreme stress of my former work, over time, caused the vertigo. I will not go back to fhat work ever. Just an FYI.
Travis, thank you for your share, and that could be a case of vertigo anxiety. For the future, if you find yourself in high-stress situations and the vertigo returns, I recommend that you utilize the methods in AnxietyBoss.com to eradicate anxiety and stress.
I would just like to share a few things. I’ve been troubled greatly with anxiety, fear of the unknown, depression, vertigo, physical ailments…..the list goes on and on. I have gone through a divorce and the loss of a dear friend in 6 months time and have skipped the steps of grief and anger suppression. These two steps are paramount even before anxiety begins it’s grip on you. Take the steps while you feel that first moment of relief. Don’t just into anything too fast and put yourself first.
First off, your anxiety and depression is not life threatening. Second, it will go away. Third, you must work very hard and motivate your mind to clear the clamoring that is the voice inside of your head. You are the source of your own wellness and you will be fine once you control the chatterbox.
Recognize and accept that you have anxiety.
Learn to float with your panic attacks instead of running and tucking yourself away. This only makes things worse. I have had multiple panic attacks, feeling like I am about to fall around because of the dizziness during meetings and have slowly learned to adjust when it happens and fight through. Doing this a number of times builds confidence and sooner or later you will begin to get back to your old self.
Invest heavily in meditation practices.
Invest heavily in exercise.
No Alcohol/No Caffeine
No bad relationships
Your ailments will not be cured by drugs. Your head fog will not go ahead unless you research the steps and motivate yourself.
Your comments are presumptuous and judgmental. How do you know people who suffer from anxiety and depression are not thinking about taking their life or that their illness is not life-threatening? Please keep your judgmental and amateur recommendations to yourself.
We forget an extremely important aspect of our lives quite often, mental health. Thanks Dr Carlo , here’s a very informative post relating how stress affects physical health and causes vertigo or disequilibrium. It is indeed important to seek medical intervention as early as possible to reduce the damage to oneself.
Thanks Dr. Anita!
Hi, I believe I have vertigo anxiety stress, I’m on medication for my anxiety but the last few days iv been having vertigo symptoms, dizzy , head spins just feel like shit, hot and cold flushes and headaches
Sorry to hear that- make sure to see your family doctor to rule out any medical problems causing the vertigo symptoms.
I have needle phobia. Having had so many cannulas put in every month and in between for two years now. It’s so bad that I know feel sick and off balance. I have vertigo tablets prescribed. I have only just realised that having a cannula put in on Friday for 10 hours, I now have vertigo. Could this be stress related.
It can be stress-related, but please check it out with your doctor first, in case there is a medical problem causing it.
Hello Doctor I read your great article and wanted to ask you if you have heard of PPPD. I don’t have vertigo but just feel dizzy and I received the PPPD diagnosis. It is highly related to panic attacks and anxiety which I have and the only treatment options for it are SSRI. I was prescribed Lexapro for it but am scared to take it because of side effects. Have you heard of this new syndrome or have you treated any patients with it? Thank you for your time.
Persistent Postural-Perceptual Dizziness? Vestibular rehab and CBT are the treatments for this. Not aware of SSRIs helping this.