Why anxiety often accompanies vertigo and other balance disorders

When you live with a health condition that affects your balance, you likely know what it’s like to live with anxiety—possibly even panic attacks, too.

Inner ear disorders and anxiety often co-occur

Chronic vertigo, dizziness, and disequilibrium are often caused by inner ear problems and tend to go hand in hand with anxiety, making an already challenging health problem much more difficult to endure.

In fact, for most sufferers, the only thing worse than vertigo or dizziness is having a panic attack at the same time.

But there is a reason that balance disorders cause this type of intense anxiety and panic. And once you understand what’s going on, you can manage it more effectively and improve your quality of life in a meaningful way.

Vertigo sufferers predisposed to anxiety

Unfortunately, almost everything about the experience of vertigo, dizziness, or general disequilibrium predisposes a sufferer to also experience intense anxiety and panic.

Take vertigo for example—when you experience it for the first time, it’s absolutely terrifying because you don’t know what it is or why it’s happening.

Imagine walking along, enjoying your day, when all of sudden the world starts to violently spin around you. You fall to the ground immediately, panicking and holding on for dear life, unable to stand or move to safety.

The waves of intensifying nausea hit next. Your brain, suddenly in shock, thinks you might have been poisoned and wants you to vomit to get the poison out. But there is no poison, so the vomiting brings no relief.

Minutes turn to hours, and when the horror show finally ends, you are left with no answers, exhausted and afraid.

You think it must have been food poisoning. You tell your friends to avoid the restaurant where you ate lunch. But then it happens again.

Related: Is your dizziness from labyrinthitis, BPPV or Meniere's? How to know

Subsequent dizziness episodes unleash vicious cycle

Once is scary enough, but for many vestibular patients it starts to happen more and more frequently, and it often strikes at random. Anxiety increases and the fear makes it hard to leave the house. What if it happens again while you’re out? What if it happens while you’re driving?

Of course, you go to the doctor, but there is a fair chance that your doctor won’t know what’s wrong with you either. The average vestibular patient sees 5 to 7 doctors before getting an accurate diagnosis, potentially suffering for years before getting any kind of helpful answer.

To make matters worse, your symptoms are invisible. You don’t look sick, so everyone assumes you’re fine, but they’re wrong. You’re suffering on every level—physically, emotionally, psychologically—and nobody really understands what you’re going through. You worry that people will think you are exaggerating, or worse, that you’re just lazy. Many do.

When you finally get a diagnosis, you take to the internet to learn more, but a lot of what you find conflicts with everything else you find, and it’s all terrifying.

The worst-case scenario becomes fixed in your mind, further amplifying your fear and anxiety. And all the while you are suffering. The vertigo and dizziness are getting worse, your quality of life is in shambles, and other symptoms are popping up as well.

There is an unbelievable amount of uncertainty and fear at every step of a vestibular patient’s journey.

Under these circumstances, anxiety and panic are not only rational, but the proper emotional response of a sane person experiencing this kind of difficulty.

The equilibrium–anxiety connection

Fear may be the primary driver of anxiety and panic for most vestibular patients, but there are also other factors at play, which can be even harder to control.

At a deeper level, dizziness and vertigo are so scary because they dislocate your sense of space.

Most of us take our sense of balance for granted because we really don’t ever have to think about it until something goes wrong. But at all times, our inner ear, joints and muscles, and eyes, are all continuously feeding our brain the information it needs to maintain equilibrium.

At a deeper level, dizziness and vertigo are so scary because they dislocate your sense of space.

Dizziness and vertigo not only disrupt this important flow of information, but distort it with incorrect data, making it impossible for sufferers to make decisions about their environment with any degree of confidence.

Anxiety and panic are the emotional outcomes of this type of uncertainty as well.

It’s both an acute and chronic problem

Perhaps the biggest issue of all is that the anxiety creates a negative feedback loop.

The dizziness and vertigo cause the initial feeling of panic and anxiety, which in turn causes the vertigo and dizziness to worsen and happen more frequently. This only causes more anxiety, at which point the vicious cycle repeats.

In a lot of ways, the panic and anxiety experienced during acute vertigo or dizziness is like throwing gasoline on a fire. It multiplies your suffering at the height of an already horrible experience, while also worsening your symptoms on an ongoing basis.

Fortunately, it’s not all bad news.

Because the balance issues and anxiety are so closely intertwined, if you work to get your anxiety under control, the severity of your dizziness, vertigo, and other symptoms should improve as well. At the very least, you will be able to cope a lot more effectively.

The best strategy is to immediately start taking steps to reduce your anxiety.

So to help you get started, I’ve put together a list of strategies that have helped me manage my own anxiety-related Meniere’s disease, a vestibular disorder I’ve lived with for nearly a decade.

Some of the strategies are best used during acute episodes of dizziness or vertigo, while others are meant to bring overall stress and anxiety levels down throughout your life.

Anxiety management strategies for inner ear problems

Counseling/therapy

Counseling, psychotherapy, or “talk therapy” is a fantastic resource that can help you reduce your anxiety by addressing the underlying issues that are causing it in the first place. It’s also a great way to learn other healthy coping strategies to better deal with the adversity of living with a vestibular disorder. At its best, therapy can be an overwhelmingly positive and cathartic experience. But it’s important to find the right therapist and a therapeutic style that matches your personality and situation. Not all therapists are created equal, so you may need to see more than one to find the one that best fits your needs.

Meditation

In the early days of my Meniere’s disease diagnosis, adopting a daily meditation practice did more to reduce my anxiety than anything else I tried by far. It dramatically lowered my stress and anxiety levels, helped me find lasting relief from tinnitus, and had a profoundly positive effect on my quality of life at every level. There are many styles of meditation and many simple ways to get started, but I find that meditation apps are a great way to learn. Here is a list of exceptional meditation apps, some of which are free, some of which not, all of which are excellent:

• Waking Up: A Mindfulness Meditation Course by Sam Harris (My personal favorite)
• 10% Happier: learn to Meditate from the World’s Top Mindfulness Experts
• Calm: the #1 App for Meditation and Sleep
• Headspace: Live a healthier, happier, more rested life
• Insight Timer: The Best Free App for Meditation and Sleep

Relaxation techniques

There are many different relaxation techniques that can help to both deal with acute anxiety and panic in the middle of a difficult moment, as well as reduce anxiety levels overall. From muscle relaxation to breathing techniques and more, it’s worthwhile to learn as many relaxation techniques as you can.

Utilize better strategy for planning activities 

When you live with a vestibular disorder, there is so much health-related uncertainty surrounding every one of your decisions. And that fear starts to affect almost all of the choices you make on a regular basis. But if you spend some time thinking through every possible outcome and planning for every contingency, fear doesn’t have to be the deciding factor in your decisions. I made a free worksheet you can download today to help you start doing more of the activities you want to be doing but find yourself avoiding out of fear.

Anxiety medication

In certain situations, your doctor may decide to prescribe one of many possible medications to help reduce either acute or chronic anxiety. There are risks associated with some of these medications, but in the face of debilitating anxiety or panic attacks, these medications might just be the best course of action and can provide a lifeline to sufferer in need.

Exercise

Exercise is another powerful way to help manage your anxiety and it doesn’t have to be intense to give you the benefits. Even a little bit of walking is enough to release the anti-stress feel-good chemicals in your brain, like dopamine and endorphins. The caveat here is that it can be difficult to start exercising, especially when you are actively experiencing vertigo or dizziness on an ongoing basis. Stationary bicycles, treadmills, and elliptical machines are a great choice, as you can hold on to the railings for balance while you exercise. Specific activities like yoga and tai chi are also excellent options for vestibular patients. There are even forms of yoga that can be done sitting down in a chair.

Improve sleep

A good night of sleep can go a long way toward reducing overall anxiety levels. It’s also an important piece of the puzzle when managing a vestibular disorders or other chronic illness. Getting enough high-quality sleep is utmost importance.

Brainwave entrainment

Brainwave entrainment is a powerful audio technology that can cause very specific changes in your mental state using nothing but sound. By synchronizing your brainwave frequencies to the frequencies that correspond with deep relaxation, you will start to feel deeply relaxed and sedated in a matter of minutes. All you have to do is press play.

Final thoughts

Managing anxiety in the face of a difficult diagnosis that causes vertigo or dizziness is never easy. But it’s always worth the effort.

It won’t cure your condition or solve all of your problems, but it can trigger a cascade of positive changes that can improve the severity of your vertigo, dizziness, other vestibular symptoms, and overall health.

At the very least, it can help you raise your quality of life in a significant way, and that’s what matters most.

More from Glenn: My top stress management products for tinnitus sufferers