Chronic anxiety can cause a wide range of symptoms, including headaches and dizziness. In fact, dizziness commonly accompanies both acute and chronic anxiety. Additionally, people with inner ear disorders, which can cause dizziness, may be at an increased risk of developing an anxiety disorder.
Anxiety disorders affect over 18 percent of the population, or more than 40 million adults in the United States every year.
In this article, we’ll discuss the connection between anxiety and dizziness, including other possible symptoms, treatments, and when to seek professional help.
Link between anxiety and dizziness
Dizziness is an umbrella term for multiple sensations, such as lightheadedness or vertigo, that cause unsteadiness due to the illusion of movement. Dizziness can be triggered by multiple underlying problems, such as vestibular, neurological, or psychiatric issues.
Anxiety is the natural response to stress that triggers the sympathetic nervous system, allowing the body to prepare to fight, run away, or freeze. Anxiety can be acute, such as the nervousness you feel before a date, or chronic, such as when you have an anxiety disorder.
Fight or flight response
Anxiety and anxiety disorders often cause feelings of dizziness, among other similar symptoms. Sometimes this is due to sudden changes in blood pressure, which can lead to feelings of wooziness or lightheadedness.
More often, it’s simply due to the impact that stress hormones, such as adrenaline and cortisol, can have on the vestibular system of the inner ear.
Inner ear disorders
Vestibular disorders, also known as inner ear disorders, are also linked to increased anxiety, especially in conditions that cause severe disability.
In some cases, having a vestibular disorder that causes chronic episodes of dizziness or vertigo may even increase the risk of developing an anxiety disorder.
For example, in one cohort study from 2016, researchers followed over 15,000 participants for a period of 9 years to determine the risk of developing benign paroxysmal positional vertigo (BPPV).
Between the participants who had anxiety disorders and the participants who didn’t, the researchers found that those with anxiety disorders were more than twice as likely to develop BPPV.
Researchers also observed an increased risk of developing BPPV if the person was female or had cerebrovascular disease.
In a more recent study, researchers investigated the correlation between anxiety, disability, and quality of life in participants with vertigo. Results of the study indicated that almost all participants experienced some level of anxiety, ranging from mild to severe.
However, people whose dizziness was more severe were found to have increased anxiety and disability and lower quality of life.
According to research, stress hormones, which include cortisol, histamines, and other compounds that are released during the stress response, have an impact on vestibular function.
Many of these hormones can influence the homeostatic balance of the inner ear at the cellular level, which can lead to a change in the entire system.
As for the correlation between balance disorders and anxiety, the National Institute of Mental Health (NIMH) explains that having a chronic illness is linked to an increased risk of developing a mental health disorder.
When conditions like BPPV and vestibular migraine make it difficult to function in everyday life, it can cause an increase in symptoms of anxiety and depression.
Dizziness isn’t the only symptom that can be caused by anxiety. In fact, anxiety causes a wide range of symptoms that differ in severity depending on the person. Other symptoms of anxiety may include:
- nervousness, panic, or dread
- rapid heart rate or chest pain
- difficulty breathing or hyperventilation
- chest pain or pressure
- shaking, trembling, or twitches
- cold chills or hot flashes
- numbness or tingling in the extremities
- weakness or fatigue
- nausea, vomiting, or diarrhea
- poor focus or concentration
- sharp or blurred vision
- sense of detachment
When is it an emergency?
Most of the symptoms of anxiety are not dangerous. However, if you are experiencing dizziness and chest pain that is severe and lasts longer than 15 minutes, seek medical help immediately.
Chronic dizziness that is caused by an underlying condition, such as an inner ear disorder, may benefit from the following treatment options:
- Physical therapy. Physical therapy is the standard treatment option for vestibular disorders, such as BPPV, vestibular migraine, and Meniere’s disease. Exercises that focus on the head and eyes, walking, and balance can all be used to help reduce the severity of dizziness and vertigo episodes.
- Medications. When physical therapy is not enough to alleviate the dizziness, medication may be used to help relieve symptoms. Medications that are commonly prescribed for vestibular disorders include:
- calcium channel blockers
Dizziness that is caused by an underlying anxiety disorder should improve with anxiety treatments, such as:
- Psychotherapy. Psychotherapy techniques such as cognitive behavioral therapy (CBT) have a long history of success in treating anxiety disorders. Increasing self-awareness of anxiety and learning coping skills can help reduce some of the symptoms of chronic anxiety.
- Medications. Antidepressants are the most commonly prescribed medication for both depression and anxiety disorders. Most times, medications are used in combination with psychotherapy to produce long-term reductions in anxious feelings and symptoms.
- Lifestyle changes. In addition to therapy and medications, relaxation techniques can be an essential part of managing daily stress levels. Meditation, yoga, and gentle exercise are just a few ways to reduce the everyday symptoms of anxiety and stress.
Frequent dizziness tends to lead to increased anxiety, while chronic anxiety often causes chronic dizziness. Sometimes, this relationship can create a vicious circle that is hard to break without taking steps to relieve symptoms.
Making lifestyle changes, such as eating a well-rounded diet, practicing relaxation techniques, and getting professional help can help improve quality of life in people with both anxiety and vestibular disorders.
When to talk with a professional
If you have been experiencing dizziness that does not go away or has begun to interfere with your ability to function, talk with a medical professional. In most cases, testing will reveal the underlying reason behind these episodes, and treatment can help reduce — or even stop — the symptoms.
Sometimes, there is no visible cause for frequent dizziness. This may indicate an underlying condition such as anxiety. If this is the case, you may be referred to a therapist or other mental health professional for treatment.
The bottom line
Anxiety and dizziness have a reciprocal relationship in which anxiety can cause dizziness, and dizziness can cause anxiety. Research has shown that in many cases, dizziness and anxiety go hand-in-hand, which can sometimes create a loop of chronic symptoms.
By treating the underlying cause — whether physical or psychological — you can relieve the symptoms of dizziness and improve your overall quality of life.
For some people, dizziness can get so bad it causes fainting, which increases the chances of injury. Fainting might be a result of blood pressure dropping, which can come from experiencing something fearful like intense pain, the sight of blood, or when the body undergoes physical stress.
Interestingly, people who suffer from anxiety are more likely to experience dizziness. A study of 1,287 participants¹ in Germany found that of the 15.8% of the group who experienced dizziness, over one-quarter of them had symptoms of at least one type of anxiety.
While everyone experiences dizziness differently, it generally describes the feeling when you’re unsteady on your feet, feeling faint or woozy, or feeling as though the world is spinning around you.
Dizziness is commonly experienced by everyone worldwide. You might remember feeling it for the first time as a child after being spun around too fast on a merry-go-round. You could also experience dizziness after standing up too fast.
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If you have a diagnosed anxiety disorder where you experience panic attacks (feelings of severe anxiety) that are over quickly, your experience of dizziness may be quite different from someone with persistent chronic anxiety who may be more likely to suffer chronic subjective dizziness accompanied by anxiety.
You can breathe a deep sigh of relief knowing that dizziness symptoms are not always caused by a significant illness. Often, some form of a balance problem is involved, which may require the intervention⁵ of a neurologist, ear nose and throat specialist, audiologist, physiotherapist, or psychologist.
The duration and severity of your dizziness depend on how bad the initial imbalance of chemicals in the system is and how severe its related to anxiety.
The central vestibular system is a part of your brain and brain stem that’s responsible for balance. Research suggests that a connection exists⁴ between the central vestibular system and the pathways for triggering anxiety and fear.
Dizziness on its own can cause anxiety with people feeling insecure on their feet, being afraid of falling or causing general concern about their health.
Hyperventilation is associated with anxiety disorders and often causes lightheadedness, one of the main categories of dizziness. In other cases, a person may have some form of injury or head trauma³ that impacts the brain, spinal cord, and/or nerves of the brain and body, causing dizziness.
In some cases, it’s believed anxiety is the main cause of dizziness². When people feel anxious, they can hyperventilate. This type of breathing changes the balance of gases in the blood and causes the brain to feel weak and faint.
What can you do to reduce dizziness caused by anxiety?
When you first feel a wave of dizziness coming on, you can do a few things to help keep you safe.
Sit down as soon as you start feeling dizzy to reduce your risk of falling over and injuring yourself.
If sitting down doesn’t reduce feelings of dizziness, try lying flat to allow oxygen to reach your brain.
Hold on to the furniture or use a walking stick if you have one to provide additional support.
If you’re driving, protect yourself and others by pulling over as soon as it’s safe to do so.
Avoid coffee or tobacco.
Keeping a diary of your activities, when and how frequently symptoms occur, and how (if at all) you manage your symptoms can be a good way to build awareness around your triggers to dizziness and anxiety, and where they come from.
When you work with a health professional, you can learn various techniques to help reduce your anxiety.
When you’ve been feeling dizzy or anxious, it is tempting to want to sit or lie down and wait for the feeling to go away. Exercise, however, can be a highly valuable part of dealing with dizziness. It helps the body correct for the feeling of imbalance and alleviates the symptoms.
Exercise also releases endorphins and other feel-good hormones⁶, which help the brain deal with stress. When you’re moving your body, your mind tends to move away from whatever might be causing your anxiety.
To make it easier to get out the door, choose an exercise that you enjoy doing. Go out and enjoy nature to help build the feeling of connectedness.
If getting active on your own feels overwhelming, have a chat with your doctor and see if they can refer you to a vestibular physiotherapist.
If you experience dizziness related to anxiety, working with a physical therapist (physio) can be helpful. Physical therapists target the central vestibular system with various exercises to get it working as effectively as possible.
In addition, they can discuss with you the situations when you feel more frequent dizziness related to anxiety.
Often, this might be environments such as shopping malls, grocery stores, or even wide-open spaces. By understanding the potential triggers of your dizziness, your physical therapist can determine the best treatment approaches.
Working with a physical therapist doesn’t need to be a big step. They will work with you at your own pace and gradually increase activity levels.
Many breathing techniques are available to provide relaxation and manage stress and symptoms of dizziness.
One strategy is diaphragmatic breathing, also known as belly breathing, where you use your entire stomach, abdominal muscles, and diaphragm. This technique is designed to help slow your breathing when you’re feeling anxious.
You might have also heard of people breathing in and out of brown paper bags, which is another way to help control breathing.
Another technique is called progressive muscle relaxation, which helps you relax in a two-step process. First, you tense different muscle groups in your body, then you release the tension and take notice of how you feel once the muscles relax.
Coping with anxiety
People deal with anxiety differently. Reading a book, particularly fiction, can be a good way to unwind and free the mind from whatever may be causing your stress. The same enjoyment can be found in music, podcasts, drawing, and other artistic crafts.
Animals can also be highly therapeutic, particularly cats and dogs. They provide a sense of companionship, encourage owners to be playful and active, help reduce stress and anxiety, and lift low moods.
Talking with a friend or family member whom you feel safe confiding in can be helpful to reduce the load of whatever stress may be driving your anxiety. If you prefer to keep your worries confidential, write them down in a journal or somewhere private.
Visualizations are another tool that can be used to help manage stress and its associated dizziness. Visualizations are when you imagine something that’s enjoyable for several minutes so you feel better afterward. An example might be your favorite holiday destination.
When thinking about these pleasing scenarios, the body and brain are more prone to relaxation and calmness.
You can also choose to participate in talk therapy to work through your anxiety, stress, or depression. There are different types of talk therapies available to choose from. It might be done in a group setting, one-on-one with a mental health professional, or you can seek the support of a loved one.
Cognitive behavioral therapy is commonly used to treat anxiety. It involves exploring how you view things and then challenging you with tasks to break free from unhelpful thoughts. The focus is to train your brain to stop thinking negatively by replacing those thoughts with positive alternatives.