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Is there a link between stress and vertigo?

Out of every 10 patients I treat, about 3 have experienced sudden dizziness or vertigo in their lives. Often mistaken as a condition, vertigo is a symptom that’s characterised by the sensation that you or the environment around you is spinning. This feeling may be mild, but for others it can be so severe that they find it hard to keep their balance and continue their tasks. Many even get sick as well due to the spinning sensation. Some patients liken this feeling to motion sickness.

Vertigo attacks can come very randomly — more so during periods of stress, at least from anecdotal evidence. These attacks may last for a few seconds or several days. But does stress really trigger vertigo? I’ll explain more about the causes of vertigo later below.

But first, if you get a vertigo attack in the middle of doing something, I advise that you please rest for a while to allow the dizziness to settle. It is dangerous to get about with a loss of balance as you might fall and hurt yourself. Later in this article, I will teach you some tips on how to alleviate your vertigo.

Causes of vertigo

Vertigo can be caused by a myriad of things, but some common causes among patients include:

Benign paroxysmal positional vertigo (BPPV)
To date, BPPV seems to be the most common cause of vertigo. It might sound complicated, but it basically means a rapid change in head movement that causes an intense, brief spinning sensation. This rapid change could be a blow to the head or even something as simple as getting out of bed too soon. For patients who regularly experience vertigo —especially older patients—, try to be mindful about your movements.

Infection
Vestibular neuritis, a viral infection of the vestibular nerve which runs along the inner ear, can cause intense and constant vertigo. Our vestibular nerve sends information to our brain regarding balance. When it is inflamed or infected, this information isn’t communicated properly, causing you to feel disoriented. While vestibular neuritis improves after a few days, symptoms can take about three weeks to subside.

Meniere’s disease
Meniere’s disease is a disorder of the inner ear that’s triggered when excessive fluid accumulates in the inner ear. Apart from experiencing vertigo, patients usually also get ringing in their ears or hearing loss that comes and goes.

Migraine
Vestibular migraine, or migraine-related dizziness is a type of migraine where patients experience a combination of balance problems, vertigo and dizziness together with other migraine symptoms. About 30-50% of migraine patients experience vertigo.

Is there a link between stress, anxiety and vertigo?

The short answer to this is no — stress and feelings of anxiety do not directly cause vertigo. But why do people experience vertigo when they are stressed or anxious? That’s because our cortisol levels and other stress hormones increase, which negatively impacts the transmission of information from your vestibular system to your brain. This itself contributes to dysfunction in the vestibular system.

Studies show that those with anxiety disorders are two times more likely to develop BPPV. When triggered with anxiety, they may experience sudden vertigo. For example, someone with social anxiety may feel dizzy when left in a crowded room.

In the same vein, vertigo can induce anxiety too i.e. when a patient worries about experiencing vertigo, it stimulates the vestibular system and causes anxiety.

When to see a doctor for vertigo

You should see a doctor or ENT specialist if you have recurring signs of vertigo or if your vertigo is accompanied by fainting, seizures, chest pain or difficulty breathing. Treatment options will depend on your symptoms as well as results from a simple examination your provider carries out. You might be prescribed medication as well. If your vertigo is stress-induced, psychotherapy might be a better treatment option.

How to manage vertigo

There are some things you can do on your own to avoid the onset or relieve your symptoms of vertigo. I recommend to:

  • Do simple exercises like the Epley manoeuvre to correct your symptoms
  • Sleep with your head slightly elevated
  • Get out of bed slowly and sit on the bed for awhile before standing
  • Avoid bending down and getting up too soon
  • Avoid any neck movements
  • Move your head slowly and carefully during daily activities

If your vertigo is stress-induced, the best way of course is to try and minimise stress in your life. It will be a good idea to minimise your caffeine and alcohol intake and stay adequately hydrated too. Don’t ignore your stressors; address them as soon as possible before your symptoms get worse. I suggest doing some meditation and exercise to help clear your mind, but a therapist might be able to help better.

References

  1. Chen, Z. J., Chang, C. H., Hu, L. Y., Tu, M. S., Lu, T., Chen, P. M., & Shen, C. C. (2016). Increased risk of benign paroxysmal positional vertigo in patients with anxiety disorders: a nationwide population-based retrospective cohort study. BMC psychiatry, 16, 238. https://doi.org/10.1186/s12888-016-0950-2
  2. Karatas M. (2008). Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. The neurologist, 14(6), 355–364. https://doi.org/10.1097/NRL.0b013e31817533a3
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