Imagine that on most days you feel like the floor is moving. At other times, you feel far away from your physical environment. These are some of the common symptoms of chronic dizziness. Some cases might be caused by migraines or other physical conditions. For others, a psychiatric condition might be to blame.
What is Chronic Dizziness?
Someone can experience dizziness in one or more ways. Vertigo is the most common type and it feels like spinning or being in motion. Presyncope includes fainting, lightheadedness, “blacking out,” and blurry vision. Disequilibrium often occurs while walking and feels like a loss of balance. It can be a symptom of Parkinson’s disease, musculoskeletal disorders, or certain medications.
Chronic subjective dizziness (CSD) is when patients feel dizzy almost daily for more than three months. About twice as many women as men suffer from CSD, and anxiety is a common cause. CSD sufferers frequently feel out of balance, heavy-headed, or light-headed. Many cases may be the outcome of cardiac disease, neurological disorders, or diabetes. In other cases, psychiatric disorders might be the underlying cause.
The Link with Psychiatric Disorders
According to a 2018 study in The Journal of the American Osteopathic Association, psychiatric conditions that are mostly anxiety-related affect about 15 percent of sufferers. Both neurological conditions and psychiatric conditions can play a part. Dr. Jeffrey Staub, a researcher at The Balance Center at the University of Pennsylvania in Philadelphia, says that both the CSD and psychiatric condition can affect each other, making both of them worse.
There is Hope
In spite of recent findings, many patients still suffer in silence. Unfortunately, some physicians overlook the link between chronic dizziness and a possible psychiatric disorder in a patient. This is often the case when a physician is hesitant to suggest to the patient that there is an underlining psychiatric issue.
Nevertheless, greater awareness and effective treatment are possible. Therapy relies a great deal on patient education. A physician who detects an underlying psychiatric issue, such as stress, should discuss this with the patient. Because talking about stress and other psychological issues can be sensitive, physicians might start with an open-ended question such as, “Many of my patients go through a lot of stress. How has stress affected your life recently?” These conversations can make discussing treatment a little easier and open the door to a psychiatric referral.
Patients may get relief from cognitive behavioral therapy (CBT). Others might benefit from prescription medications. About 50 percent of patients who go on selective serotonin reuptake inhibitors (SSRIs) are likely to see complete relief, while 70 percent experience a significant decrease in dizziness symptoms.
Back to Equilibrium
Patients should not have to put up with dizziness, no matter the underlying cause. Seeking help can mean getting one’s life back in balance. Patient education and attention to both physical and mental health is the key to relief and the path to feeling back to normal again.