The Vicious cycle of anxiety and vertigo

WHY do you feel what you are feeling?

We often experience a heightened response of fear, avoidance, irritability, anxiety when we are dizzy. Why do we feel this way? Let’s dig deep into the science behind it and help our understanding to improve.

We have three primary sensory systems – the Vestibular, Visual and Somatosensory system to help with balance and orient ourselves in space. All these three systems work in sync with each other and brain centres to do their function. 

What happens when one system is injured or impacted by a disease? 

For e.g. vestibular neuritis. There is a decrease in the input going to the brain centres from the side that is affected. This is in turn decreases the signal going to the visual system. The eyes don’t catch the information at the right time and they lag when we turn our head to look at something. This causes retinal slip meaning the image on the retina is not formed well.  There is a mismatch of signal between the vestibular and visual system. This creates an unfocussed/ fuzzy sensation. This we commonly call dizziness. It has a variety of descriptive names but for simplicity, we will keep it as Dizziness. 

Dizziness is perceived by the Limbic system (Amygdala), a centre in the brain as a threat. This centre is a storekeeper of memory and emotions. All negative and positive emotions are stored here. When we get dizzy, the amygdala will send protective impulses throughout the body especially the neck. We often experience neck tightness and body tightness post dizzy spells. This is in response to a threat to protect our body from falling/danger. A lot of people with dizziness will start avoiding to move the neck and walk very slowly and cautiously to prevent the feeling of falling.  These leads to social isolation. 

This reaction from the body causes a decrease in impulse back to the vestibular system. As the vestibular system functions via movements of the head, it stops getting those impulses to orient you. This in turn creates more mismatch, more dizziness and more fear and anxiety.  

Studies have shown that about 1/3rd of the patients with vestibular dysfunction reported anxiety. If you have an underlying anxiety disorder, it can be exacerbated due to vestibular dysfunction. Anxiety is a very big disruptor of the integration of these sensory systems. Therefore, you will feel that the recovery is very slow and arduous. 

How do we break this vicious cycle? 

Vestibular physiotherapist are trained to create a customized program to decrease this anxiety response and improve the function of vestibular system and helping to integrate these system. 

Talk to a Vestibular Therapist.