Can Vertigo Be Caused by Stress or Anxiety?

What is Vertigo?

Vertigo is a symptom of vestibular dysfunction.⁷ It refers to the sensation that you or your environment are spinning or moving.

Vertigo can be described as extreme dizziness. It can last for a few seconds or a few hours. In severe cases, it can be persistent for weeks or even months.⁵

Some people might not notice they have vertigo. For others, it can be so severe that it affects their balance and prevents them from doing everyday tasks.

Symptoms of Vertigo

Vertigo can feel like everything is moving around you. A common symptom of vertigo is trouble balancing.

The following symptoms may also accompany vertigo:

• Nausea
• Vomiting
• Tinnitus (ringing in the ears)
• A feeling of fullness in the ears
• Headaches
• Motion sickness
• Nystagmus (when the eyes uncontrollably move side to side)

Can Stress and Anxiety Cause Vertigo?

Stress and anxiety can indirectly cause vertigo. About five percent of American adults experience vertigo, particularly when they’re feeling stressed.

While stress can’t cause vertigo directly, it might contribute to health problems that do. For example, stress can contribute to inner ear problems that lead to dizziness.^{3, 9}

Stress produces adrenaline, which can reduce or stop blood circulation in the inner ear. This damages hearing and may result in vertigo.

Anxiety can cause hyperventilation, especially when panic attacks occur, sometimes leading to vertigo. Hyperventilation refers to rapid or deep breathing, which causes your blood's carbon dioxide (CO2) to drop quickly. 

Other Causes of Vertigo

Getting vertigo attacks can be a symptom of many different health conditions and circumstances. Here are some examples:⁶

• Benign paroxysmal positional vertigo (a change in the head position)
• Low blood pressure, such as from standing up too quickly (as with benign paroxysmal positional vertigo)¹
• Hyperventilation
• Migraine headaches
• Muscle weakness
• Perilymphatic fistula (a tear in the ear’s membrane, causing leakage of the inner ear fluid)
• Meniere’s disease (fluid backup in the inner ear)
• Labyrinthitis (inflammation or infection of the inner ear labyrinth)
• Vestibular neuritis (inflammation of the vestibular nerve)
• Cholesteatoma (noncancerous skin growths in the middle ear from repeated ear infections)
• Diabetes
• Arrhythmia
• Physical trauma, like head injuries
• Ear surgery
• Shingles near the ears
• Being bedridden for a prolonged period
• Syphilis
• Otosclerosis
• Brain disease
• Multiple sclerosis (MS)
• Acoustic neuroma
• Viral infections

Tips for Preventing and Managing Vertigo

Some tips for preventing and managing vertigo symptoms include:⁸

• Don’t stand up or change head positions too quickly 
• Take over-the-counter (OTC) pain relief medications to reduce migraines
• Maintain a healthy lifestyle with a balanced diet and regular exercise
• Practice breathwork to steady rapid breathing
• Incorporate self-care activities into your day that alleviate stress and anxiety 

When to See a Doctor

If you regularly experience unexplained vertigo, talk to your doctor. 

If you are taking medication to treat vertigo and it is not getting better, consult your doctor. You should also reach out to your doctor if your vertigo is getting worse over time. 

Anyone who is experiencing inner ear dysfunction that is causing vertigo should consult a doctor right away. Because stress and anxiety can ultimately lead to vertigo, talking to a mental health doctor can also help.

Diagnosis

Vertigo symptoms can be diagnosed in a few ways:

• Fukuda-Unterberger’s test. During this test, you will march in place for 30 seconds while keeping your eyes closed. Rotating or leaning to one side could indicate an issue with the inner ear labyrinth.
• Romberg’s test. During this test, you will also close your eyes. This time, you will stand still with your arms to your side and your feet together. Feeling unsteady could suggest an issue with the central nervous system (CNS).
• Head impulse test. During a head pulse test, your doctor will move your head to each side while you keep your eyes focused on a nonmoving target. They will check how well your inner ear’s balance system controls eye movements. You could have an inner ear problem if it's not working well.
• Vestibular test battery. A vestibular test battery is a series of tests that look for inner ear issues. Your doctor will place goggles over your eyes to monitor your eye movement while you follow a target. They may also place warm and cool water in your ear canal.

Your doctor may run several tests to find the root cause of vertigo.

Depending on your health history, current state of health, and other factors, your doctor can also narrow down common causes of it.

If you think stress and anxiety are causing vertigo, your doctor can examine your mental health and test for an anxiety disorder. They may also test your stress hormones.

Treatment

Treatment for vertigo symptoms varies depending on the underlying causes. You cannot treat vertigo directly. Instead, the condition responsible for causing vertigo must be treated:

• If you have diabetes, treatments may include shots of insulin, nutrition plans, and lifestyle changes. 
• If you have Meniere’s disease, treatment may consist of medications like prochlorperazine and betahistine. These help to relieve nausea and reduce vomiting.
• Physical trauma-induced vertigo may need to be treated with surgery.
• If anxiety or stress are causing vertigo, treatment can include finding healthy ways of managing stress. Some doctors recommend physical therapy for stress-induced vertigo.⁴

Cognitive-behavioral therapy (CBT) and holistic healing problems can help you deal with emotional triggers that contribute to stress or anxiety disorders.

Outlook

The outlook for vertigo depends on the underlying cause. Because vertigo is a symptom of a health condition, not a condition itself, it can’t be resolved without determining and treating the underlying problem.

Some conditions that trigger vertigo are more severe than others. Brain disease and multiple sclerosis have a much worse outlook than if you have an ear dysfunction, low blood sugar, or a viral infection.

Stress is currently considered a major problem around the world. American adults report feeling more stressed out than ever before.²

Summary

If you are experiencing vertigo, you’re not alone. Vertigo is a common health concern, but it’s not always a cause for worry.

Talk to your doctor if you find yourself getting dizzy often. Depending on your diagnosis, there are treatments available to help reduce vertigo.

If you are wondering if stress can cause vertigo symptoms, remember that your mental health is essential for overall health, not just for keeping vertigo attacks at bay.