Why do vestibular disorders trigger anxiety, and how do you break the dizziness-anxiety loop?

Is my dizziness causing my anxiety, or my anxiety causing my dizziness?

It can go either way, and often both. Vestibular disorders commonly lead to anxiety, and people with anxiety are more likely to develop persistent dizziness after an inner ear problem. That is not all in your head: it reflects real connections between the vestibular nuclei and the brain areas that control fear and autonomic responses¹.

How does the dizziness-anxiety loop keep symptoms going?

After a frightening episode, the brain stays on guard. You stiffen your neck and body, watch your feet, avoid stores and driving, and notice every small sensation. Those protective habits reduce the chances for the balance system to recalibrate and can turn a healed inner ear problem into persistent dizziness such as PPPD².

How does therapy calm the nervous system?

• Finding and treating any remaining inner ear problem first
• A clear explanation of your symptoms, drawing on Dr. Patel's pain neuroscience training as a Therapeutic Pain Specialist
• Breathing and relaxed posture practice during balance tasks
• Graded exposure to avoided movements and places
• Coordination with your physician or a counselor when anxiety needs its own treatment

Where can I get help for dizziness and anxiety in Alpharetta or Cumming?

We see patients from Alpharetta, Johns Creek, Milton, Cumming and Suwanee whose dizziness and anxiety feed each other. Visits are 60 minutes and one-on-one, so there is time to explain, practice and adjust. Call 911 for chest pain or other emergency symptoms.

Where can I get help in Alpharetta, Cumming and nearby?

Dr. Manan Patel, PT, DPT, TPS and our team of physical therapists see patients from Alpharetta, Johns Creek, Milton, Roswell, Cumming, Suwanee, Sugar Hill, Buford, Duluth and Forsyth County at two North Atlanta clinics. Every visit is 60 minutes, one-on-one, and urgent appointments are available within 48 hours. We are in-network with Traditional Medicare, BCBS / Anthem and Tricare, and offer a $129 rate per visit for self-pay and out-of-network plans. Not sure where to start? Take the free symptom self-check, or visit our Alpharetta clinic or Cumming clinic page.

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References

1. Balaban CD, Thayer JF. Neurological bases for balance-anxiety links. Journal of Anxiety Disorders. 2001.
2. Staab JP, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD). Journal of Vestibular Research. 2017.

Answered by Dr. Manan Patel, PT, DPT, TPSDoctor of Physical Therapy, Certified Vestibular Specialist and one of the few certified Therapeutic Pain Specialists in North Atlanta, with 15+ years of outpatient care. About Dr. Patel

This answer is general education, not a diagnosis or a substitute for an examination. If you have new or worsening symptoms, contact your doctor. Call 911 for sudden severe dizziness with trouble speaking, weakness, numbness, double vision or a severe headache.