Can Stress Cause Vertigo? 3 Strong Reasons the Answer is Yes
Vertigo is a symptom and not a diagnosis. Some people equate vertigo to a room-spinning sensation, but that isn’t the only way that vertigo can present. In simple terms, vertigo can be defined as a false sense of movement of the environment or oneself when in reality there is none. There are generally two classes of vestibular disorders: central and peripheral.
Peripheral is referring to dysfunction of the inner ear and conditions can include:
- Benign paroxysmal positional vertigo (BPPV)
- Meniere’s disease
- Labyrinthitis
- Vestibular neuritis
- Acoustic neuroma
Central disorders, on the other hand, reflect a brain that is not processing sensory information correctly, leading to dizziness and vertigo. Conditions include:
- Vestibular Migraine
- Persistent Perceptual Postural Disorder
- Mild Benign Paroxysmal Positional Vertigo
- Stroke-related dizziness
- Post-concussion syndrome.
Anxiety & Dizziness Share Overlapping Brain Pathways
The Dizzy Anxious Cycle is a well-known phenomenon for people living with vestibular disorders. Vertigo, especially when uncontrolled, is highly distressing and can lead to feelings of nervousness and fear. The anxiety can then feed into the dizziness, effectively creating a vicious cycle.
This relationship is intuitive to understand but researchers have gone deeper to show that there is a neural and physiological basis for the dizzy-anxious cycle. A 2011 paper published in the Expert Review of Neurotherapeutics goes over the extensive overlap between neural networks associated with anxiety and dizziness.
The paper mentions various complex networks such as the vestibulo-parabrachial nucleus, cerebral cortical networks, raphe-nuclear vestibular network and more. It goes into detail on how these networks interact but the main takeaway is that vestibular pathways overlap extensively with those implicated in the regulation of emotions and affective states. While we often compartmentalize symptoms of anxiety and dizziness, pathologically they could just be two sides of a single coin.
Stress and How Cortisol can Disrupt Balance Processing
Cortisol is the hormone largely responsible for the fight or flight response with stress. It’s a useful response for high-stakes emergencies, such as having to run away from a tiger. However when stress is constant and cortisol levels remain elevated, it can lead to maladaptive symptoms such as dizziness and vertigo.
This is because cortisol influences the ion channels and biochemical neurotransmissions of the brain. Not only that, they can also regulate the function and physiological processes of the inner ear. Therefore, stress management remains an integral part of effectively treating or managing dizziness and vertigo.
Stressful Life Events can Trigger Vestibular Disorders
While most stress-induced dizziness or vertigo is transient, the unfortunate reality is that some will end up with permanent symptoms. Stressful life events such as work pressure, loss, or trauma can all precede the development of a vestibular disorder. We don’t have enough data to definitively draw a causal relationship between the two. Not to mention that dizziness and vertigo are multifactorial. But suffice it to say, adverse life events do increase risk of vestibular dysfunction.
Anecdotally, I have seen many cases where a patient’s dizziness started around a stressful life event. Mostly associated with central vestibular disorders such as vestibular migraine or PPPD. I’ve also seen patients with disabling anxiety develop more persistent symptoms after an inner ear insult that typically recovers fully. The sudden change and unpredictability in day-to-day function naturally feeds into stress and anxiety, further reinforcing the dizzy-anxious cycle
So can Stress Cause Vertigo? And what do we do about it?
The answer is a resounding yes. Stress typically exacerbates an existing vestibular disorder but in some instances it can even be the original cause, largely a product of neurological brain maladaptation.
The good news is that even though the brain has maladapted, it can also be retrained for better function. Often through exercises that involve recalibrating eye, neck, and head movements in a process known as vestibular rehabilitation. With a skilled practitioner, recovery is possible.
If you’re having difficulty getting a handle on your vertigo, you’re not alone.
When stress, migraine, or metabolic factors are involved, dizziness often requires a more individualized approach. A personalized plan can help clarify what’s contributing to your symptoms and outline next steps. Get your FREE treatment plan here.