Understanding how stress and anxiety can cause vertigo — and vice versa — can be crucial in treating symptoms of these conditions.

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Fast breathing, churning stomach, a racing heartbeat — these are only a few of the most common physical signs of stress and anxiety. But another symptom can crop up when we feel worried, and it’s much less talked about: vertigo.

Vertigo, which can present as dizziness and being off-balance, can lead to other symptoms.

The condition is often associated with heights — such as looking down from the top of the Empire State Building. But being up high is a vastly different scenario from feeling stressed, which can occur anytime, anywhere.

“Vertigo is actually a symptom, not a diagnosis, and therefore the causes are wide and varied,” explains Dr. Zoë Watson, a general practitioner in London.

But “the source of ‘true’ vertigo is usually vestibular in origin, or relating to the inner ear and other systems within the brain which control sense of balance and spatial orientation,” Watson adds.

Sometimes, vertigo can be caused by:

Vertigo symptoms

Dizziness is the most common marker associated with vertigo. But you might also experience:

  • light-headedness
  • feeling unbalanced
  • nausea and vomiting
  • headaches
  • sweating
  • ringing in the ears

Possible causes

Several causes can contribute to dizziness, including:

  • substance use
  • certain medications
  • anxiety
  • low blood sugar

How long does vertigo last?

Vertigo can disappear as soon as it appears. “Vertigo is never permanent,” says Julian Lagoy, MD, a psychiatrist at Mindpath Health. “An episode can last seconds, hours, or days, depending on the underlying pathophysiology.”

Studies have shown that stress can influence conditions that can cause vertigo. For instance, Japanese research from 2016 found that vertigo symptoms in those with Ménière’s disease decreased significantly when their bodies’ production of the stress hormone vasopressin was reduced.

But stress can also encourage vertigo-like symptoms. “The most common type of dizziness which tends to be associated with stress is either light-headedness or presyncope, or the sensation of feeling faint,” says Watson.

Stress, hormones, and the vestibular system

Stress and the vestibular system — the part of the inner ear that helps modulate balance and provides the brain with information about movements — are interlinked.

“It is thought that the ‘fight or flight’ hormones released when we are anxious, cortisol and adrenaline, can have a direct impact on the vestibular system and further add to the dizzy sensation,” Watson explains.

A 2012 review suggests these hormones may impede the functioning of this system and influence the messages it sends to the brain.

These hormones can also impact other aspects of the body. According to Lagoy, adrenaline can stimulate the autonomic nervous system. During the fight, flight, or freeze response, adrenaline can cause you to experience:

  • increased heart rate
  • elevated respiratory rate
  • feeling on “high alert”

Adrenaline release can also induce narrowing of blood vessels. Combined with an increased heart rate, blood is pumped less efficiently — leading to sensations associated with vertigo, such as dizziness and light-headedness.

Although similar, stress and anxiety are different concerns. According to the American Psychological Association, stress is typically linked to external factors, while anxiety involves worries that persist even when there are no outside stressors.

But it’s possible to experience vertigo-like symptoms with stress and anxiety. As with stress, anxiety also prompts the release of cortisol and adrenaline, which can trigger dizzy spells.

The relationship between anxiety and vertigo can seem like a “chicken and egg” situation.

“People who have chronic dizziness due to various causes can experience anxiety and low mood due to the impact of living day to day with [it],” says Watson.

In a 2009 analysis in Germany, almost one-third of participants who reported experiencing dizziness also had at least one anxiety disorder. And in a 2018 Chinese study of 127 participants experiencing benign paroxysmal positional vertigo, half had symptoms of anxiety, depression, or both.

Panic attacks

Many people with anxiety also experience panic attacks, which can generate sensations of light-headedness and dizziness.

Hyperventilation can primarily cause dizziness with panic attacks, Watson says.

Breathing quickly during a panic attack can cause you to breathe in too much oxygen and breathe out too much carbon dioxide. This can temporarily constrict the blood vessels’ blood supply to the brain and cause the light-headed sensation connected to vertigo.

To address the symptoms, a doctor can help you understand them and ensure there are no underlying physical causes.

Recording symptoms

Keeping a diary to record your vertigo symptoms and instances of stress or anxiety might also help you recognize a connection.

When stress or anxiety cause vertigo spells, treatment options typically involve addressing these conditions to resolve symptoms.

Self-care

Lifestyle changes can help reduce stress and anxiety. Self-care to reduce cortisol and possibly even alter areas of the brain linked to stress include:

Psychotherapy

One of the most effective approaches for managing stress and anxiety is cognitive behavioral therapy (CBT).

In a 2014 study of generalized anxiety disorder, CBT was an effective treatment for 75% of the participants. Researchers in 2011 also found that CBT significantly reduced anxiety caused by vertigo and dizziness.

If your vertigo symptoms are particularly severe, you could speak with a doctor or psychiatrist about medication to treat stress and anxiety, Lagoy says.

Anxiety medication

Doctor-prescribed medications can often be an effective tool for managing anxiety causing vertigo symptoms.

There are many types of anxiety medications, including:

  • selective serotonin reuptake inhibitors (SSRIs)
  • serotonin-norepinephrine reuptake inhibitors (SNRIs)
  • tricyclics
  • benzodiazepines
  • buspirone
  • beta-blockers
  • monoamine oxidase inhibitors (MAOIs)

If you feel anxiety medication could be beneficial, a doctor or psychiatrist can prescribe the right one for you.

Dizzy spells, faintness, and other vertigo symptoms can be unsettling and distressing. Many circumstances can cause vertigo-like symptoms, including stress and anxiety.

If you’re experiencing vertigo and stress or anxiety, you’re not alone.

Consider talking with a doctor about your symptoms to rule out any health conditions as a first step. Journaling your symptoms in a diary can also help you record your experiences to understand potential causes.

Treating vertigo often depends on addressing underlying causes. Vertigo symptoms related to stress and anxiety can be reduced through:

  • self-care and lifestyle changes
  • therapy
  • medication

Podcasts like “The Anxiety Coaches” can also be a resource for learning about the relationship between stress and vertigo symptoms and tips for coping.

If you’re ready to get help from a therapist, consider Psych Central’s guide to finding mental health support.

Stress and anxiety can create various psychological and physiological reactions. Recognizing this with hope can be a vital step to wellness.