Anxiety and Dizziness: What's the Connection?

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.

BPPV

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.

Vertigo

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:
  • diuretics
  • antidepressants
  • beta-blockers
  • 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.

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.

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.