What could be causing a psychological imbalance

Soul out of balance

"It is quite normal for mental stress to make you feel dizzy," said Best. They can occur in stressful situations such as exams, the death of loved ones or being in large crowds. But when is dizziness pathological? "When everyday activities are reduced because of him," explained Best.


There are basically two types of somatoform vertigo. The primary somatoform dizziness occurs in about 30 percent of those affected. It is exclusively psychological and is associated with illnesses such as depression, anxiety or panic illness, post-traumatic stress disorder or with social conflicts and high levels of responsibility. The majority of patients, around 70 percent, suffer from secondary somatoform dizziness. With them, the psychological vertigo attacks are the result of an organic vertigo. For example, 50 to 70 percent of patients with dizziness migraines, a special form of migraine, develop somatoform dizziness later on.


The symptoms can be very different. Some patients report vertigo, the illusion of a swaying floor or even vertigo in a lift. The attacks can be long or short - a whole range of complaints is possible.


For the individual patient, dizziness usually has a special function. For example, it can suppress unpleasant situations: You should actually have an unpleasant discussion, but instead the dizziness sets in, so that the discussion is canceled, explained Best. The dizziness can also be an alarm signal, draw attention to certain feelings or cover them up. "When fear occurs in a situation, the dizziness comes and covers the fear, so that one no longer has to deal with this feeling," says Best. The function of the complaints in the respective patient must be found out with the help of a psychotherapist.


Mostly a doctors odyssey


The diagnosis is often made late because organic causes are searched for a long time. Correct diagnosis is actually relatively easy. In the case of vertigo symptoms, patients should first consult a family doctor, as some clinical pictures with organic causes are easy to diagnose and treat. In the case of more complex and long-lasting symptoms and if the general practitioner or ENT doctor cannot find a cause, patients should seek help from a specialized vertigo center. "An interdisciplinary and extensive clarification is possible here," says Best.


Just making the diagnosis and informing the patient about his illness would have a therapeutic effect. Then use multimodal treatment that begins with physiotherapy to restore physical balance and relaxation training. This is followed by a self-exposure in which the patient enters the fear-filled, dizzying situation. An important part of the treatment is psychotherapy, which searches for the causes and triggers of the vertigo symptoms and works on the solution of the internal and external conflicts involved. Somatoform vertigo can usually be treated well with outpatient, once-a-week psychotherapy, Best said. /