Can Anxiety Cause Dizziness?

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When Can Anxiety Cause Dizziness?

When anxiety is intense and long-lasting it can become one of a number of recognised mental disorders that produce unpleasant symptoms in the mind and body. Dizziness is one such symptom. Substance misuse often exacerbates the condition.  Proper diagnosis is essential so that suitable treatment can be provided.

What Is Anxiety?

Anxiety is usually a response based on fear, at the prospect of a perceived challenge to a person’s future physical or emotional state. It brings a sense of foreboding and unease that can sometimes become acute or can lead to a state of chronic anxiety, if not treated. There are a number of conditions that can be considered anxiety disorders and together with depression, they make up the most common type of psychological condition in the UK (around 8% of people affected). All can be treated with a good likelihood of improvement.

Types of Anxiety Disorder

Diagnostic manuals such as the DSM 5 1 in the USA and the ICD 112 produced by the World Health Organisation, specify various types of anxiety disorder:

1. Generalised Anxiety Disorder (GAD) typically occurs with feelings of depression and can last for months or sometimes years. The worrying is often persistent and extreme, to the extent that a person finds most aspects of life hard to deal with.
2. Panic Disorder (often called panic attacks) occurs suddenly and may not persist long but can bring extreme feelings of fear and loss of control. They can occur for no apparent reason although they can be triggered by substance misuse.
3. Social Anxiety Disorder manifests in a fear of being judged or watched and can be sometimes so extreme that sufferers are reluctant to attend any social grouping such as school or workplace and may not wish to leave the home (agoraphobia).
4. Post-Traumatic Stress Disorder(PTSD) can happen as the result of traumatic events that people have experienced or witnessed such as death, violence, or sexual abuse. Sufferers often feel disassociated as well as anxious and can be triggered into panic by loud noises or other reminders of past happenings.
5. Separation Anxiety Disorder, more common in children than adults, occurs as a result of separation or fear of separation from people who are important in their lives.
6. Obsessive Compulsive Disorder(OCD) sufferers typically have obsessions based on anxiety about specific things, that they try to relieve through compulsive, repetitive behaviour (such as hand washing through fear of infections).

Effects of Anxiety on the Body 

Any type of intense anxiety can produce unpleasant physical effects on the body, including dizziness. Here are some common anxiety symptoms:

• palpitations pounding heart, or accelerated heart rate
• sweating
• trembling or shaking
• dry mouth (not caused by medication or dehydration)
• difficulty breathing
• feeling of choking
• chest pain or discomfort
• headaches
• nausea or abdominal distress
• dizziness, feeling unsteady, faint, or light-headed
• hot flushes or cold chills
• numbness or tingling sensations
• muscle tension and aches
• difficulty swallowing

In addition, persons affected often feel unable to relax, detached from reality, irritable, unable to concentrate, and have difficulty sleeping.

What Causes Dizziness Symptoms?

A high state of anxiety can upset your normal body functions, including balance because your brain is receiving abnormal messages in two ways:

1. Blood supply: when anxiety becomes stressful, your breathing changes – you start taking in short quick deep breaths – this is known as hyperventilation. It means the air you take in is now different, and the level of carbon dioxide in your bloodstream is reduced. This in turn affects your brain, producing feelings of dizziness and general weakness.
2. Brain chemicals: the amygdala – the part of the brain that controls ‘fight, flight or freeze’ impulses, is central to processing anxiety and originating the body’s responses. When anxiety levels are high, this can put the body into a state of arousal which increases the production of adrenalin, cortisol, and other chemicals. This sudden surge, often called the ‘adrenalin rush’ can upset the brain’s control functions such as balance, leading to a feeling of dizziness.

Inner Ear Disorders and Anxiety

Vestibular disorders, as inner ear disorders are known, can be caused by anxiety and can also be the cause of anxiety. This reciprocal relationship can sometimes create a repetitive pattern that increases the discomfort, producing chronic subjective dizziness. The inner ear is crucial to the body’s balance function and one way that it can be upset is when anxiety levels are abnormally high.

There are however, other ways in which vestibular disorders can occur such as from infections of the inner ear (labyrinthitis), poor blood circulation, as a side effect of certain medicines, or brain injury such as concussion. Certain diseases such as Meniere’s disease can also cause balance problems. In all cases where balance disorders are observed and inner ear disorders are likely, a proper diagnosis is the first step.

Vertigo Sufferers and Anxiety

Vertigo is the sensation that the world around you is moving or spinning. It tends to be more intense than dizziness. It is accompanied by a loss of balance and often by nausea too. When the vestibular system is compromised due to intense anxiety, panic attacks, or chronic anxiety symptoms, then vertigo can occur. As with most vestibular disorders, vertigo itself can generate feelings of anxiety and those affected should seek medical treatment as soon as possible. 

Treatment for Anxiety and Vertigo

Treatment for most kinds of anxiety disorders will generally consist of medication or psychotherapy and often, both will be employed.

• Medication: drugs used are often powerful and should always be taken with proper medical supervision. They may include antidepressants, tranquillisers such as benzodiazepines, or more specialist anti-anxiety drugs such as Pregabalin. Since many of these substances are addictive, their long-term use should be avoided.
• Psychotherapy: the two main types of talking therapy that are recommended are cognitive behavioural therapy (CBT) and relaxation therapy. However, acute anxiety conditions such as PTSD may require more specialised treatment, for example, EMDR (eye movement desensitisation and reprocessing). CBT is designed to help a person come to terms with their problems by changing the way they think about them whereas relaxation therapy teaches practical techniques for helping the mind and body to relax. Generally speaking, all kinds of person-centred therapy are likely to be helpful when dealing with anxiety disorders because they enable a person to talk through their fears and concerns and be listened to. That in itself is usually a calming process.

It is said that depression is looking at the past and anxiety is looking at the future so the fundamental message behind the psychology of treatment for anxiety sufferers is to aim to live in the here and now. Mindfulness, relaxation and other complementary therapies – massage, and acupuncture, for example, can all help too.

Anxiety Disorders and Substance Addiction

People with anxiety disorders often turn to alcohol and drugs to help them manage the problem but substance misuse can make anxiety worse – alcohol, for example, damages the central nervous system leading to tremors, acute unease, and even paranoia. This self-defeating relationship can have serious physical and psychological effects. At Castle Craig Hospital we will always address anxiety issues of any kind as a part of our addiction recovery programme.

If your anxiety is becoming a problem and you feel that you may be turning to unhealthy remedies such as alcohol and other addictive substances, please don’t hesitate to call us on 01721 546 263. We are always ready to listen and advise on the best treatment options.

References

1. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)
2. International Classification of Diseases 11th Revision