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Im A 45 Year Old Male With A Long History
Question: im a 45 year old male with a long history of health anxiety and acid reflux, both for 15+ years. I've had weird dizziness off and on over the years, the last of which was this last march. I got a dropping sort of feeling which lasted maybe 1-2 seconds which happened a few times but stopped.
I immediatly went to the ER.
The doctor did some exam tests on me and said it was likely benign vertigo.
He said though it can feel uncomfortable, it wasn't serious. He gave me some exercises to do but said he thought it was stress/ anxiety.
It seemed to go away from that point forward.
I didn't have any dizziness for 6 months but I recently had a very major prolonged stressful time in my life and after a few months i got dizziness again.
I went back to the ER and surprisingly saw the same exact doctor. He evaluated me again and said the same thing.
Anyway, the doctor told me that I tested normal and only had the same slight eye responses to his exam as i did the first time I was there. not sure what he saw but He said when mild and hard to invoke its likely not a true showing of anything. He also said that the drugs I take can cause patients eyes to respond a bit different.
He followed by saying that given 6 months had passed and my symptoms were the same without added symptoms or incident that he felt confident it was anxiety related. He said there was a possibility that it could be crystals in my inner ear or irritation of my inner ear from reflux. He reccomended I should start anxiety therapy and encouraged doing the exercises as they wouldnt hurt to do if it ended up proving to be fixed by anxiety therapy.
I saw my GP since then and he wasn't really concerned either.
Is this common and can anxiety/ stress really cause issues like this?
this dizziness only adds to my stress.
by the way, I've not fallen, lost my balance, thrown up or had a headache or anything like that.
I immediatly went to the ER.
The doctor did some exam tests on me and said it was likely benign vertigo.
He said though it can feel uncomfortable, it wasn't serious. He gave me some exercises to do but said he thought it was stress/ anxiety.
It seemed to go away from that point forward.
I didn't have any dizziness for 6 months but I recently had a very major prolonged stressful time in my life and after a few months i got dizziness again.
I went back to the ER and surprisingly saw the same exact doctor. He evaluated me again and said the same thing.
Anyway, the doctor told me that I tested normal and only had the same slight eye responses to his exam as i did the first time I was there. not sure what he saw but He said when mild and hard to invoke its likely not a true showing of anything. He also said that the drugs I take can cause patients eyes to respond a bit different.
He followed by saying that given 6 months had passed and my symptoms were the same without added symptoms or incident that he felt confident it was anxiety related. He said there was a possibility that it could be crystals in my inner ear or irritation of my inner ear from reflux. He reccomended I should start anxiety therapy and encouraged doing the exercises as they wouldnt hurt to do if it ended up proving to be fixed by anxiety therapy.
I saw my GP since then and he wasn't really concerned either.
Is this common and can anxiety/ stress really cause issues like this?
this dizziness only adds to my stress.
by the way, I've not fallen, lost my balance, thrown up or had a headache or anything like that.
Brief Answer:
Anxiety may cause similar symptoms to those that you are experiencing. I think you have a combination of anxiety and BPPV (details below).
Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,
I carefully read your query and understand your concern.
I think you have a combination of both BPPV (benign paroxysmal positional vertigo) and anxiety.
BPPV is a condition that is caused due to some crystals that precipitate in the ear (the area that is responsible for the balance). Certain movements trigger movements of these crystals which cause a false sense of movement to the patient and intense dizziness that comes abruptly and lasts shortly. It may be triggered by consecutive movements as well.
This is generally diagnosed with a maneuver in the office (Dix-Hallpike), which consists of certain movement of your head while the doctor watches your eyes' movements.
With a similar maneuver (probably the exercises the doctor gave you home) these crystals are relocated to an area that is not so sensitive to movement and this causes the dizziness to cease.
In the case of anxiety, the dizziness can be mild continuous or it may also come in short stronger waves of dizziness or it can be a combination of both. Generally, dizziness from anxiety is not triggered by movements, it happens unpredictably.
I would recommend you to follow the instructions of your doctor when it comes to treatment. You will need to do the Epley maneuver (as the doctor explained to you) if you get these strong waves of dizziness that are aggravated by certain movements.
As for the treatment of anxiety, you may benefit from a combination of psychotherapy (Cognitive Behavioral Therapy) and medications (SSRI drugs such as sertraline, escitalopram, etc).
This combination is found to be very effective in treating anxiety.
I would recommend you to have a TSH and FT3 check to rule out thyroid problems as the thyroid gland may affect the way we handle stress.
To conclude:
- Anxiety may cause similar symptoms to what you are experiencing
- I think you have a combination of both BPPV and anxiety causing you dizziness
- The dizziness in BPPV is episodic, strong and triggered by certain head movements
- The dizziness in anxiety can be episodic, continuous or a combination of these
- Treatment for anxiety with CBT and SSRI drugs is recommended and is quite effective. Epley maneuvers are needed for BPPV (medications do not help with BPPV)
- Ruling out thyroid problems is advisable (TSH and FT3 blood tests)
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Anxiety may cause similar symptoms to those that you are experiencing. I think you have a combination of anxiety and BPPV (details below).
Detailed Answer:
Hello and welcome to 'Ask A Doctor' service,
I carefully read your query and understand your concern.
I think you have a combination of both BPPV (benign paroxysmal positional vertigo) and anxiety.
BPPV is a condition that is caused due to some crystals that precipitate in the ear (the area that is responsible for the balance). Certain movements trigger movements of these crystals which cause a false sense of movement to the patient and intense dizziness that comes abruptly and lasts shortly. It may be triggered by consecutive movements as well.
This is generally diagnosed with a maneuver in the office (Dix-Hallpike), which consists of certain movement of your head while the doctor watches your eyes' movements.
With a similar maneuver (probably the exercises the doctor gave you home) these crystals are relocated to an area that is not so sensitive to movement and this causes the dizziness to cease.
In the case of anxiety, the dizziness can be mild continuous or it may also come in short stronger waves of dizziness or it can be a combination of both. Generally, dizziness from anxiety is not triggered by movements, it happens unpredictably.
I would recommend you to follow the instructions of your doctor when it comes to treatment. You will need to do the Epley maneuver (as the doctor explained to you) if you get these strong waves of dizziness that are aggravated by certain movements.
As for the treatment of anxiety, you may benefit from a combination of psychotherapy (Cognitive Behavioral Therapy) and medications (SSRI drugs such as sertraline, escitalopram, etc).
This combination is found to be very effective in treating anxiety.
I would recommend you to have a TSH and FT3 check to rule out thyroid problems as the thyroid gland may affect the way we handle stress.
To conclude:
- Anxiety may cause similar symptoms to what you are experiencing
- I think you have a combination of both BPPV and anxiety causing you dizziness
- The dizziness in BPPV is episodic, strong and triggered by certain head movements
- The dizziness in anxiety can be episodic, continuous or a combination of these
- Treatment for anxiety with CBT and SSRI drugs is recommended and is quite effective. Epley maneuvers are needed for BPPV (medications do not help with BPPV)
- Ruling out thyroid problems is advisable (TSH and FT3 blood tests)
I hope this answers your query.
I remain at your disposal for further medical assistance.
Regards,
Dr. Antoneta Zotaj
General and Family Physician
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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