Dizziness and anxiety - causes and treatment

What can cause dizziness? Could it be something physical?

One of the first things we do when a client comes to us with dizziness as their main problem is that we ask if they have seen a doctor to be examined.

A doctor's examination is important to rule out physical problems that can, or should, be treated. But rather often the doctor can’t find a clear cause for the symptoms.

The fact that the doctor does not find anything underlying can create frustration and anxiety. Fortunately many find it comforting to know that dizziness is a rather common symptom that often just passes. To be clear, dizziness can have physical causes, but it can also occur for no apparent reason. Healthy people can be dizzy, even over time. And for most, these symptoms don’t become a major problem.

Dizziness and anxiety

Although dizziness and visual disturbances have sometimes been triggered by a physical condition, anxiety can cause the symptoms to intensify and persist for years after the physical condition, or the disease that triggered the symptoms is over.

Let us illustrate with an example to see how dizziness can create problems for one person and not for another:

Two women have a dizzy spell at work after a busy period. For several days afterwards, they feel more dizzy than usual. They both go to the doctor who examines and informs them that there is nothing to worry about. They give it a while and come back if it gets worse.

One woman reassures herself that the dizziness is bothersome, but not dangerous. She therefore stops paying so much attention to the symptoms, and notices that she can function well, and do everything she usually does, despite the fact that she is dizzy.

She continues her everyday life as before, and after a while completely stops thinking about the dizziness. It's just a symptom that pops up every now and then without it being an issue. Eventually, the symptom may disappear completely.

The other woman continues to monitor for symptoms. She thinks it can’t be normal to feel so dizzy and feels that she can’t settle down until she knows the cause. She spends a lot of time analyzing the dizziness and keeps an eye on when it improves and what makes it worse.

She is also very careful when she moves. When she gets up, she does it slowly, and she constantly watches if she is dizzy. If she forgets it for a moment, it feels weird. She then usually checks to see if the feeling is still there. Sometimes she can test if she is dizzy by moving abruptly or looking up and down quickly. Then she always gets dizzier.

Over the course of time, she has googled and read a lot, and sought out several specialists. Despite this, she doesn’t get a clear answer as to what the cause of the symptoms is, or what she should do to get better.

The dizziness gradually becomes more and more bothersome and present. It especially shows up in situations where she thinks it should definitely not. She begins to avoid a number of things. For example, driving a car, going to a cafe with friends, malls and shops, and walking in the woods.

Metacognitive treatment for anxiety and dizziness

In metacognitive therapy, we believe that why you are dizzy is less important . Of course you should see a doctor to get an examination and rule out that the cause of the dizziness is something dangerous. But once you have done that, you can safely choose to focus less on being dizzy.

Even if the symptoms have a physical cause, focusing a lot on them does not make you feel better. On the contrary, it can make the symptoms more prominent and bothersome. Just as a wound can hurt more when you focus on it, you can forget about it when you have your attention focused on something else.

When you pay attention to the symptoms, it becomes difficult to be present in what you do.

In addition, you become mindful of any hint of dizziness, which can lead to anxiety, and thus escalate the symptoms by activating the sympathetic nervous system. It is also difficult to forget the problem as long as you keep an eye on it.

In order to avoid thinking so much about being dizzy, and to avoid provoking dizziness, many people use coping strategies such as avoidance and securing. You may:

• Bring something with you for support
• Analyze changes in symptoms
• Take it easy and rest a lot
• Look down as you walk
• Be careful and avoid a lot of things - e.g. driving, stores, malls and having visitors or visiting
• Seek medical advice and various specialists
• Google and read a lot about possible causes of the symptoms
• Ruminate - what are the symptoms of and what can you do to get better?
• Checking - is the feeling of dizziness still there?

Most people who visit us have many concerns related to dizziness. Often they’ve had other forms of anxiety or a tendency to worry a lot, even before dizziness became a problem. Health anxiety and dizziness is a common combination, and so is dizziness and social anxiety, panic disorder, or generalized anxiety disorder.

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Common assumptions associated with dizziness are:

• I can’t focus on anything else as long as I am dizzy.
• I can’t stop thinking about it until I know what causes the symptoms.
• If I don’t keep an eye on it, I may lose control.
• When I’m dizzy, I have no control over what I say and do.

These assumptions are understandable, but must be challenged. Because it is possible to be dizzy and not focus on it all day. It is possible to be dizzy without thinking about it all the time. And most people can function well in everyday life despite dizziness.

Dizziness and blurred vision do not automatically lead to loss of control, not being able to behave normally, nor does it necessarily mean that we can’t drive a car. It’s possible to drive a car, be social, and go to the store with dizziness. In fact, if you don’t focus on the dizziness when doing these things, it doesn’t have to be that distracting either.

Do you feel better or worse when you monitor your dizziness and worry a lot?

If there’s a physical reason behind it, worrying won’t help. Many people still feel that they can’t let go of monitoring and looking for solutions. In that case, I usually ask how much time is appropriate to set aside per day to think about and look for symptoms.

Maybe you can try reducing that time to 10 minutes a day where you check-in on the dizziness, looking for solutions and worrying? Or maybe you can set aside an hour a week to google for causes and solutions?

Challenging yourself to get back to life and start doing more of the things you have avoided is also important. Avoidance makes you feel more fragile and insecure, and as long as you keep avoiding, you will not have the opportunity to discover that you can handle many of the things you avoid - even without coping strategies. Taking back everyday life and letting go of coping strategies becomes important if you are to be able to live well with dizziness. And also if you want to get less dizzy in the long run.

Because dizziness is not lessened by you monitoring it and thinking about it. On the contrary.

Would it make a difference if you could spend less time focusing on the dizziness? Managing your focus and choosing what you want to spend time thinking about is a matter of practice. If you have the right tools, it doesn’t have to be that difficult.

If you are struggling with dizziness, and find that you spend an exhausting amount of time worrying, ruminating, avoiding, controlling, and monitoring your dizziness, metacognitive therapy can help you. You can easily book an appointment in our calendar. You can also benefit from our workshop on dealing with anxiety and worry - especially if you generally tend to worry. You can find more information about the workshop here!