Stress can be responsible for a number of ailments and physical conditions within the body, and you might have heard it can cause vertigo, too. Many people tend to link stress to mental health rather than physical health, but it is clear from many studies that the body can suffer when the mind is unsettled. 

If you have been suffering from vertigo, or you are worried about symptoms of vertigo returning due to heightened stress, we are taking a look at what vertigo is, whether or not excessive stress can lead to this, what else could be causing vertigo, how to diagnose and treat stress-related vertigo, and where to get support for stress and anxiety if you need it. 

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about stress or anxiety causing vertigo, we can help. 

Remember, according to the NHS you should go to A&E if you have vertigo and: 

• A severe headache 
• A very high temperature or feel hot and shivery
• Have been sick or feel very sick

What is vertigo?

Vertigo is a strange sensation. It can feel like a particular kind of dizziness that gives the person suffering the feeling of the world around them spinning, tilting or swaying while they are not moving. It may feel like an intense type of motion sickness similar to the feeling one might get during and after time on a boat, but vertigo can occur without the person being in motion. 

Vertigo is often a symptom of an underlying condition rather than being a condition itself, and it can be caused by an injury, a migraine, an infection, or something else. There are two types of vertigo; peripheral vertigo and central vertigo.

Peripheral vertigo – This is the most common kind of vertigo, making up around 80% of vertigo cases, and it is caused by an issue with the inner ear, or the vestibular nerve. This nerve is responsible for our balance, so when something affects it, it can cause lots of strange feelings of being off-kilter or unbalanced.

Central vertigo – This is a less common kind of vertigo which comes about as a result of an issue in the brain. This type may be caused by conditions such as a stroke, severe migraines, brain injuries, infections, conditions like multiple sclerosis (MS), and more. 

Studies have found that in the general population, dizziness and vertigo affect 20-56% of people in their lifetime. Some of the most common symptoms of vertigo include: 

• Severe dizziness that gets worse when moving the head
• Loss of balance 
• A spinning sensation that feels like the room is moving 
• Feeling nauseous or vomiting 
• Headaches or migraines 
• Involuntary eye movements 
• A ringing or buzzing sound in the ear 
• Increased sweating
• Hearing loss 

What causes vertigo? 

The most common type of vertigo is Benign Paroxysmal Positional Vertigo (BPPV), which is caused when minuscule calcium crystals (known as otoconia) detach from their typical place on the sensory organ inside the ear (known as the utricle) and move around the inner ear. The semicircular canals help to sense the rotation of the head, so when the crystals reach the semicircular canal and the person moves their head to a new position, this can cause vertigo. 

A number of conditions can disrupt balance of the inner ear, such as: 

• Ménière disease: This is an inner ear disorder causing symptoms like vertigo, hearing loss or tinnitus, and sometimes a sensation of pressure in the ear.
• Vestibular neuritis and ear infections: This is an inflammation of the vestibular nerve inside the ear which most often occurs due to a viral infection. Conditions such as labyrinthitis can lead to sudden vertigo, feelings of nausea and balance issues. In about 85% of dizziness cases, the vestibular system is the problem. 
• Medications: Some medications affect the inner ear or the central nervous system and can cause side effects like vertigo.
• Vestibular migraines: Those who suffer from migraines may experience vertigo as a symptom, as well as severe headaches. 
• Pregnancy: A 2020 study found vertigo was the most commonly reported vestibular symptom in the first trimester of pregnancy. 

Issues with the brain can also cause vertigo, such as:

• A head injury that causes damage to the brain and impacts the inner ear
• A tumour in the brain or near the inner ear that negatively affects the balance centre
• A stroke or similar condition that causes reduced blood flow to the brain

The above are only a few examples of the symptoms that might cause vertigo, so it is important to remember if you experience this or other symptoms you should see a medical professional to rule out anything that may require treatment.

How do I know if it’s dizziness or vertigo? 

If you have never experienced vertigo or dizziness in the past, it may be difficult to tell the two apart when both involve feeling off balance. While they are two distinctly different sensations, telling them apart can be tricky without a frame of reference. To differentiate between the two, try to remember:

Dizziness = A sensation of light-headedness, being slightly unsteady on your feet, disoriented, nauseous and/or feeling faint. 

Vertigo = A sensation of the world around you spinning and moving, and nausea, which is triggered by certain head movements. 

Both vertigo and dizziness can be caused by a number of conditions, so if you experience either you may wish to consult a medical professional who can check for other typical underlying problems such as inner ear disorders or neurological issues.

It's important to note that both dizziness and vertigo can be symptoms of various underlying conditions, including inner ear disorders, neurological issues, or other medical problems. 

Is there a link between stress or anxiety and vertigo or dizziness? 

It’s no secret that severe stress and anxiety in our minds can lead to a number of physical symptoms in our bodies, and an estimated 5% of adults in the US have reported experiencing vertigo as a symptom of stress or anxiety. This can happen for a number of reasons, since stress may not directly cause vertigo but could affect the vestibular system which can impact the inner ear area and disrupt things like balance and coordination. For example: 

• Hypoarousal – Seen in cases of post-traumatic stress disorder, hypoarousal is an overwhelming amount of stress that can cause the body to shut down. When this happens we can feel a strong rush of the stress hormone cortisol followed by a quick drop in cortisol, which can lead to dizziness, lightheadedness, or even vertigo. 
• Physical pain or tension – Stress can also cause a number of physical reactions that can lead to vertigo, such as muscle tension in the neck that affects blood flow.
• Breathing changes – Stress and anxiety can adapt our breathing patterns to make them more shallow or rapid (hyperventilation) which can impact the levels of oxygen and carbon dioxide within our bodies. This can affect our balance and lead to vertigo.
• Migraines – Stress can trigger migraines, and vertigo can be a symptom of vestibular migraines. 

One study found those with anxiety disorders were 2.17 times more likely to develop Benign Paroxysmal Positional Vertigo (BPPV) than those without, so if you suffer from anxiety this could be linked to vertigo symptoms if you experience them. 

Stress-related vertigo may indicate that your stress levels are critically elevated, and other underlying conditions could also be causing your vertigo, so it is important to see a medical professional about any vertigo symptoms no matter what you think the underlying cause may be so they can rule out anything that requires treatment. 

How do I diagnose stress-related vertigo?

You may be able to ascertain whether or not your vertigo is caused by a specific medical condition or if it has come on due to stress or anxiety. Any type of vertigo – whether stress-induced or not – can last anywhere from a few seconds to a few days or longer, so it can be difficult to determine if stress is the cause based on the length of the symptom. 

No matter the cause, you should visit your doctor to get a proper diagnosis. They will normally do some assessments and ask questions. They might:

• Ask you about your medical history 
• Ask you about any medications you are taking
• Ask about any other symptoms you have as well as vertigo
• Do a stress assessment which involves talking about your lifestyle
• Do a physical examination to check for any inner ear problems, neurological issues, and more 
• Assess your eye movements, coordination and balance to check how your vestibular system is responding 
• Do blood tests to rule out any other suspected medical conditions or infections 
• Perform a Dix-Hallpike test, which is when you are put in a position to trigger your vertigo so a doctor can examine your eyes and symptoms 

If stress or anxiety are thought to be the cause, your doctor may request a psychological evaluation to see if this could be causing symptoms.

How do I treat stress-related vertigo?

When you are having an attack of vertigo, it is often best to lie very still in a quiet, dark room to help alleviate feelings of nausea, spinning or stress. You may also want to avoid anxiety-inducing situations so stress does not continue to lead to vertigo.

As soon as a medical professional has been able to diagnose stress-related vertigo, they may refer you to a specialist such as an ENT doctor (ear, nose and throat) to discuss possible interventions, and you can begin to look for treatments to help ease the sensation of vertigo. These may include medications to tackle anxiety or vertigo itself, or vestibular rehabilitation exercises to improve balance by helping the brain compensate for inner ear issues.

While you can attempt to deal with the symptoms of vertigo alone, it is vital to tackle stress-induced vertigo by dealing with the underlying stress issues as these can start to manifest in other ways throughout your life. Often this means lifestyle modifications are required to manage stress symptoms. 

You can try to incorporate things like: 

• Mindfulness exercises such as breathwork or meditation 
• Progressive muscle relaxation 
• Improving your sleep schedule 
• Eating a balanced, healthy diet 
• Maintaining an exercise routine with stress-relieving activities like yoga or jogging 
• Avoid stressful events 
• Making time for things that relax you and make you happy 
• Keeping a stress diary to figure out what your triggers are 
• Setting boundaries with family or friends that may be causing your stress 
• Use biofeedback techniques to learn how to control physiological functions like muscle tension or rapid heart rate in order to reduce stress 
• Pursuing psychotherapy (such as cognitive behavioural therapy) to help explore the source of anxiety and manage stress symptoms 

Should I see a doctor about vertigo?

Vertigo can certainly be caused by stress, but in any case you should speak to a doctor if you are experiencing vertigo. This is because your vertigo could be an indication of another underlying health condition, or it could be a sign of severe stress which your doctor may be able to help with. 

If you experience severe or prolonged symptoms of stress or vertigo, associated symptoms like headaches or vision problems, experienced an injury or head trauma, are experiencing vertigo for the first time in your life, think a medication you take could be causing your vertigo, or you are elderly and more at risk of falls, you should seek a proper diagnosis from your doctor so they can help you alleviate vertigo and other symptoms, and address any root causes. 

Where can I get help to manage stress? 

Stress can cause a bespoke combination of symptoms for each person, so effectively managing stress looks different for everyone. This means some trial and error is needed to find the techniques that suit you best. You might find some useful tips from the list above. 

Social support is incredibly important for those suffering with anxiety or stress, so speak to friends or family members if you feel comfortable doing so. You could also reach out to support groups or communities, or seek therapy from a qualified mental health professional (like a psychologist or psychiatrist) who can provide coping strategies for managing stress.

If you have a question about stress and anxiety, such as wondering if stress can cause diarrhoea, we’re here to assist on your journey. Our free 15 minute consultation can guide you to the most relevant specialists to answer your questions and discuss next steps.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader private mental health care.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.