- Psychological dizziness, vertigo, and imbalance refer to psychological factors associated with various balance disorders.
- The most common psychological factors related to vertigo are anxiety, fear, hypervigilance, and depression.
- Significant psychological factors can intensify and prolong symptoms or impede recovery.
Psychological Factors Related to Dizziness, Vertigo, and Imbalance
Physical and mental functions related to balance are closely intertwined in the brain, as many neural networks involved in balance systems also serve other functions. As a result, various mental and psychological functions, such as cognition, emotions, needs (motivation), interaction (sociality), and character traits (personality), affect balance, imbalance, and symptoms of dizziness and vice versa. Psychological factors and concurrent mental health disorders rarely cause or solely explain dizziness, but they can intensify and prolong symptoms. Functional magnetic resonance imaging (MRI) has helped clarify the role of the neural networks; for example, in persistent positional postural dizziness (PPPD), changes in the functioning of brain areas and neural networks associated with anxiety are detectable.
Psychological Factors of Vertigo and Their Effects on Symptoms
Of the psychological factors, emotions and information processing are the most influential in the onset, intensification, and prolongation of balance disorders. In general, psychological factors are more closely associated with prolonged rocking vertigo and a feeling of imbalance than with rotational vertigo. The natural and inevitable counterpart to dizziness is a certain degree of anxiety, which is defined as a feeling of restlessness, hypervigilance, and fear. If the anxiety intensifies and persists for a long time, it can lead to fear-avoidant behaviour. In this case, one might think, for example, that the activity and exercise will inevitably exacerbate symptoms, so it is better to wait and see. However, in reality, daily activities and exercises can actually alleviate symptoms and serve as a form of therapy.
Anxiety and fear are generally associated with dizziness, but psychological factors can even make the condition long-lasting and debilitating. In such cases, the effects of psychological distress can extend to all areas of life.
Factors Leading to and Exacerbating Psychological Dizziness
- Anxiety disorder or history of depression
- Previous panic attacks
- Post-traumatic stress disorder (PTSD)
- Manifestation of psychological symptoms as symptoms of dizziness (somatisation)
- Previous concussion and/or whiplash injuries
- Central sensitisation of the nervous system
- Insufficient relaxation and persistent sleep problems
- Psychiatric disorders that affect emotional regulation and cognitive functions
Treatment and Rehabilitation of Psychological Balance Disorders
In my practice, I have noticed that the best way to calm the mind and reduce anxiety related to dizziness is to alleviate the symptoms as quickly as possible with vestibular rehabilitation. This reduces patients’ fears of serious or incurable conditions and encourages them to actively participate in managing their symptoms and improving their functional capacity. Additionally, sleep quality is crucial to assess because it is often one of the underlying factors in persistent balance disorders, regardless of whether obvious psychological symptoms are identified.
In general, psychological factors are best assessed and treated by psychologists, neuropsychologists, psychotherapists, and psychiatrists. It is common for patients to have a previous diagnosis and a possible history of therapy or medication, for example, for the treatment of anxiety disorders. Because the physical and psychological factors related to balance are practically inseparable at the brain level, improved standing balance, eye-head coordination, and more stable walking, for example, often also treat the psychological factors associated with dizziness.
Read more
What causes vertigo, dizziness and imbalance?
Read more about common causes of dizziness and imbalance
PPPD (Persistent Postural-Perceptual Dizziness)
Concussion (Post-Concussion Syndrome)
Read more about common causes of vertigo and imbalance
Benign Paroxysmal Positional Vertigo (BPPV)
