Anxiety and Dizziness go Hand in Hand

Any acute or chronic medical condition can create feelings of anxiety, worry, and depression but dizziness is especially attributable to these feelings.  I have many patients who experience distressing anxiety as part of their vestibular dysfunction so if you experience these symptoms too, please know you are not alone.

Dizziness is considered a “reg flag” symptom in the brain and it is treated accordingly.  Dizziness immediately triggers the fight-or-flight response mediated by the sympathetic branch of the autonomic nervous system (ANS).  Sympathetic stimulation symptoms include racing heart, light headedness, sweating, gastrointestinal upset, ringing in the ears, feeling faint or actually fainting, and visual disturbances like blurry vision, tunnel vision, or white-outs.  Other symptoms of sympathetic stimulation can include the feeling of being outside of yourself, feeling that things are not real, and brain fog.  These sensations easily lead to panic and anxiety.  Theoretically this ‘red flag’ response to dizziness makes sense as dizziness can be the harbinger of a stroke, heart attack, or problem with the brain requiring immediate attention.  More frequently however, dizziness is a symptom of less serious conditions that respond well to vestibular rehabilitation by a skilled therapist and do not warrant the excessive ANS response.    

When dizziness becomes more chronic, the feelings can be so distressing that the brain responds by putting extreme importance on the sensation of dizziness.  As a result, the central nervous system (CNS) can become more and more sensitive to vestibular (inner ear balance) stimulation resulting in dizziness with even minimal movements of the head or body.  This effect of increased dizziness with less motion then causes more anxiety to set in creating a snow-ball effect and solidifying the relationship between dizziness and anxiety.

This maladaptive CNS response to vestibular dysfunction and dizziness can happen with any vestibular diagnosis and, in my experience, can happen regardless of if an individual has a history of anxiety or not.  Unfortunately, when anxiety accompanies dizziness it can reduce the brain’s naturally ability to adapt to vestibular dysfunction and lengthen the time it takes to recover.   It is not uncommon for a person to get stuck in a cycle of dizziness and anxiety for years.

The good news is that there is help!  Skilled vestibular rehabilitation, like that provided at Mainstay Physical Therapy, addresses not only the physical causes of dizziness, but also the anxiety and CNS hypersensitivity component of chronic dizziness.  Techniques like skilled relaxation, thought tracking, and patient education are invaluable adjuncts to therapeutic exercises and activities designed to promote adaptation to vestibular dysfunction and resolution of symptoms.   

If you have dizziness, with or without anxiety, please don’t hesitate to get help. 

Contact me today at and feel better!