Dizziness: psychological causes

Central dizziness

In addition to a disease of the peripheral vestibular system, dizziness can also be triggered by damage to structures in the brain. This form of vertigo is referred to as central vertigo. Possible causes include a stroke, multiple sclerosis, or premature ageing of the cerebellum. Another common form is the so-called vertigo migraine.

“A stroke very often triggers central dizziness. This is an absolute emergency that requires quick action,” emphasizes Strupp. “In addition to acute dizziness, other accompanying symptoms such as swallowing and speech disorders as well as double vision can occur in the event of a stroke.”

Phobic postural vertigo

Dizziness can have not only physical but also psychological causes, as is the case with phobic postural vertigo. In contrast to rotary vertigo, those affected feel the ground shaking under their feet. In addition to dizziness, drowsiness and problems with standing and walking can occur as accompanying symptoms.

“Phobic postural vertigo primarily affects extremely correct and conscientious people,” says Strupp. “It is characteristic that the dizziness worsens in certain situations, such as confined spaces or larger crowds. As a result, those affected deliberately avoid such situations. On the other hand, vertigo improves with exercise or small amounts of alcohol.”

Strupp emphasizes that in the case of phobic postural vertigo, it is essential to explain to the affected patients how their dizziness occurs and thereby also take away their fear of a physical problem. Afterwards, those affected should regularly do light sports and no longer avoid unpleasant situations. In some patients who do not respond to these measures, the vertigo can also be treated with medication.

Chronic dizziness – what are the causes?

Dizziness usually occurs in the form of acute vertigo attacks, but it can also become a constant companion for some sufferers. “The causes that can underlie chronic dizziness include the loss of balance organs on both sides and phobic postural dizziness,” explains Strupp. “In addition, chronic dizziness can also occur in diseases of the cerebellum.”

Damage to the cerebellum can have various causes; for example, it is caused by premature ageing of cells in the cerebellum or by hereditary diseases. Depending on the cause of damage to the cerebellum, other accompanying symptoms, such as eye movement disorders, can occur in addition to dizziness.

A failure of the balance organs can also have different reasons. Typical symptoms of such a failure are vertigo and visual disturbances – those affected have the impression that fixed objects are moving. In addition, patients often state that vertigo and gait disturbances worsen in the dark. This is related to the fact that the patients then lack the information that is perceived through the eyes in the light.

Balance training can sometimes compensate for a failure of both balance organs. Under a physiotherapist’s guidance, using other senses to maintain balance is practised. Nevertheless, the symptoms cannot be eliminated in all patients in this way.