Vertigo and PTSD: What’s the Relationship?

I have observed a few different relationships between vertigo and PTSD (Post Traumatic Stress Disorder).

Vertigo can Cause PTSD

First of all, some people have such severe episodes of dizziness and vertigo that they actually get PTSD from the vertigo. They might experience flashbacks of the vertigo episode or have panic attacks worrying about a future vertigo episode.

I’ve had a number of people that say “I have PTSD from my episode of vertigo” and then when I go to try to do my exam or test them, their responses are hyper-vigilant.

They are very tense and highly stressed out throughout my whole exam and treatment because they have been so deeply affected emotionally by what they went through before.

Even if my exam doesn’t provoke severe symptoms, their emotional response is often exaggerated because they are traumatized from what they went through before.

For example, they might yell out, curse aloud or grab onto me during a vertigo presentation that another patient might describe as mild or moderate. I have seen this PTSD-type response to vertigo in even the strongest, toughest individuals and it is certainly not a reflection of character, but reflects the tremendous emotional impact of having severe vertigo on that individual.

I teach all my patients with this type of response some techniques for stress relief that they can use while working with me and if they get vertigo when I am not around.

PTSD can Cause Vertigo

If someone has PTSD, then panic attacks, nightmares or flashbacks they experience can cause them to hold their breath or cause shallow, rapid breathing called hyperventilation.

Holding the breath or hyperventilation due to PTSD can cause lightheadedness, dizziness – or even vertigo – for some people. It can also magnify pre-existing dizziness or vertigo.

Both can be Caused by a Single Traumatic Event

The third way that I have seen PTSD interact with dizziness and vertigo are people who experience a traumatic event causing a new onset of dizziness or vertigo and PTSD at the same time.

One example of this is the military veterans that are coming back home from war zones.

If they have been exposed to a roadside bomb, for example, that is a very traumatic experience, especially if the people they were with got killed or wounded in any way. That blast from the roadside bomb can cause the crystals in the inner ear to break loose, causing them to have true vertigo in their inner ear called BPPV and then also PTSD from the emotional experience, all from one incident or series of incidents that they went through in a war zone.

In that example, the military veteran may also experience a post-concussion brain injury affecting their mental function and/ or ringing in the ears, called tinnitus.

All of the new symptoms that appeared after the traumatic event need to be addressed for the best recovery.

Car accidents, domestic violence or a physical assault are other examples of traumatic events that can cause both PTSD and dizziness or vertigo to show up at the same time.

Those are the three different ways that I have seen PTSD interact with dizziness and vertigo in my clinical practice.

Both physical and mental health needs to be addressed in order for the best outcomes when someone has both dizziness or vertigo and PTSD.

A lot of times, people with PTSD might need mental health support while they are also in Vestibular Rehabilitation for dizziness and vertigo.