Dizziness

Definition

Dizziness is a broad word for several related sensations: lightheadedness, unsteadiness, a floating or spaced-out feeling, or a sense that you might faint.

Anxiety is a common cause. When the stress response switches on, breathing speeds up, and over-breathing lowers the carbon dioxide in the blood, which produces lightheadedness, tingling, and a spacey feeling. Anxiety also raises attention to body sensations, so a small wobble gets noticed and amplified.

Dizziness can also come from the inner ear, blood pressure, dehydration, low blood sugar, medication, and other medical causes. As with chest symptoms, anxiety is a reasonable explanation only after a clinician has considered the others.

Symptoms and key features

Dizziness linked to anxiety tends to involve:

• a lightheaded, floaty, or "not quite here" feeling, rather than the room spinning
• it often arrives with other anxiety signs: fast breathing, a racing heart, tingling
• it tends to rise and fall with the level of anxiety
• it's often worse when attention locks onto it, and eases with distraction
• it usually doesn't cause an actual faint, even though it can feel like it might

True vertigo, a sense that the room itself is spinning, more often points to the inner ear than to anxiety, and is worth describing precisely to a doctor.

What it looks like

• Mid-conversation, the floor feels slightly unreliable, and you grip the edge of the table without quite deciding to.
• During a panic attack, a wave of lightheadedness arrives and the fear of fainting makes the panic spike.
• You stand up, feel briefly swimmy, and then spend the next hour braced for it to happen again.
• A long, stressful day leaves you feeling vaguely floaty and half a step removed from things.

What people often confuse this with

A sign you're about to faint. Anxiety dizziness rarely leads to an actual faint. Fainting usually involves a drop in blood pressure, while anxiety tends to raise it. The feeling is convincing; the outcome usually isn't.

Vertigo. Vertigo is a specific spinning sensation, more often linked to the inner ear. Anxiety dizziness is usually more of a lightheaded, floaty feeling. The distinction helps a doctor point in the right direction.

A serious neurological problem. That's a common fear, and far more often the cause is anxiety, over-breathing, or being run down. New or persistent dizziness still deserves a medical check, both for reassurance and to rule other causes out.

What research says

Dizziness and lightheadedness are well-recognized features of anxiety and panic, and the main mechanisms are understood: over-breathing, which changes blood chemistry, and a heightened, anxious focus on body sensations. The evidence here is rated mixed because dizziness is a broad symptom with many possible causes, and the research specific to anxiety-related dizziness is smaller than for some other symptoms.

The clinical order is the same as for any physical symptom: a medical evaluation comes first, to consider inner-ear, cardiovascular, and other causes. When anxiety is the cause, the treatments that help anxiety, including cognitive behavioral therapy and breathing retraining, tend to reduce the dizziness as well.