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Anxiety Can Cause Chronic Dizziness

Living with chronic dizziness can be a taxing and exasperating endeavor as medical cures are often few and far between. However, discerning the source of the dizziness can give clinicians a ‘heads up’ toward development of abatement strategies.

New research finds that chronic dizziness can stem from many different causes including anxiety disorders, migraine, and traumatic brain injury in the part of the nervous system governing involuntary activities.

One particular type of chronic dizziness not related to vertigo (a feeling of turning or whirling usually associated with inner ear problems) has long vexed physicians, according to background information in the article.

“Patients with this syndrome have chronic nonspecific dizziness, subjective imbalance and hypersensitivity to motion stimuli, which are exacerbated in complex visual environments (e.g., walking in a busy store, driving in the rain),” the authors write. Some researchers have proposed the term chronic subjective dizziness for this condition.

Jeffrey P. Staab, M.D., M.S., and colleagues at the University of Pennsylvania Health System, Philadelphia, studied 345 men and women age 15 to 89 (average age 43.5) who had dizziness for three months or longer due to unknown causes. From 1998 to 2004, the patients were tracked from their referral to a balance center through multiple specialty examinations until they were given a diagnosis.

“All but six patients were diagnosed as having psychiatric or neurologic conditions, including primary or secondary anxiety disorders, migraine, traumatic brain injury and neurally mediated dysautonomias,” or abnormal functioning of the autonomic nervous system, which controls involuntary actions.

Anxiety disorders were associated with 60 percent of the chronic dizziness cases and central nervous system conditions (including migraine, brain injuries and autonomic nervous system disorders) with 38.6 percent. Six patients (1.7 percent) had irregular heartbeats.

“The results of this investigation provide some insight into pathophysiologic mechanisms that may precipitate and perpetuate chronic dizziness,” the authors write. “Two-thirds of patients had medical conditions associated with the onset of dizziness, whereas one-third had anxiety disorders as the initial cause. Therefore, chronic subjective dizziness may be triggered by either neurotologic [ear-related] or psychiatric conditions.”

“Key diagnostic features were identified in the clinical history for each illness,” they continue. For example, those with migraines often had nausea or vomiting, anxiety disorders were associated with fear and worry, and those with autonomic nervous system disorders tended to become dizzy when they exerted themselves.

“Careful inquiry about these key features during otologic evaluations may increase diagnostic precision and lead to more specific treatment recommendations for these perplexing patients.”

The report was published in the February 2007 issue of Archives of Otolaryngology – Head & Neck Surgery, one of the JAMA/Archives journals.

Source: JAMA/Archives of Otolaryngology – Head & Neck Surgery

Anxiety Can Cause Chronic Dizziness

This article has been updated from the original version, which was originally published here on February 20, 2007.

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2019). Anxiety Can Cause Chronic Dizziness. Psych Central. Retrieved on September 26, 2020, from
Scientifically Reviewed
Last updated: 3 May 2019 (Originally: 20 Feb 2017)
Last reviewed: By a member of our scientific advisory board on 3 May 2019
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