Dizziness Anxiety Symptoms

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 19, 2021

anxiety dizziness

Anxiety dizziness, lightheadedness, off-balance, vertigo-like, and woozy feelings are common symptoms of anxiety disorder. Anxiety dizziness can also trigger anxiety, including anxiety attacks and panic attacks.

When this symptom is attributed to anxiety or stress, it’s often referred to as Chronic Subjective Dizziness (CSD) or Persistent Postural-Perceptual Dizziness (PPPD).

This article explains the link between anxiety and dizziness.

Anxiety dizziness lightheaded symptom description:

  • You feel (or suddenly feel) dizzy, lightheaded, faint, off balance, unsteady, that you might faint or pass out, or that you might fall over.
  • It might also feel as though you are walking on a boat on water.
  • It can feel as if the floor beneath you is moving up and down or swaying from side to side.
  • It can also feel like you are so off-balance that your legs may not support you.
  • It can feel like you are unsteady or that it’s hard to keep your balance.
  • You might also have difficulty placing your feet because your perception of the ground or floor may seem wrong or incorrect.
  • In some cases, it may seem that even though you are standing on a firm floor, the floor may be vibrating or moving.
  • It can also feel like the room is trembling, swaying, rocking, or moving.
  • It can also feel like your surroundings are moving, shaking, rocking, or vibrating.
  • While you haven't passed out yet, you think you might. The prospect may frighten you.
  • You might also think, "What if I pass out, what will everyone think of me?" The thought of passing out frightens you, which can cause more symptoms and fear.
  • This symptom can be accompanied by darting eyes.
  • It can also feel like there’s a spinning feeling or pressure in your head.
  • This dizziness lightheaded feeling can also be experienced as a sudden dizzy/lightheaded “spell” that comes out of nowhere and then disappears shortly afterward.

Dizziness anxiety lightheaded symptoms or “spells” can come and go suddenly, come and linger, or persist indefinitely.

They might occur rarely, frequently, or persistently, and might precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by themselves.

Dizziness anxiety lightheaded feelings can precede, accompany, or follow an episode of nervousness, anxiety, fear, and elevated stress, or occur “out of the blue” and for no apparent reason. They can also range in intensity from slight, to moderate, to severe. They can also come in waves, where they are strong one moment and ease off the next.

The anxiety dizziness lightheaded symptoms can change from day to day, and from moment to moment. They can also be strong one week and become significantly less the next.

Anxiety dizziness and lightheadedness can also be characterized as having “episodes” of dizziness or lightheadedness - like you are going to pass out or fall over because of being so dizzy or lightheaded.

Sometimes these dizzy spells come on suddenly, then ease off only slightly. At other times, you can feel dizzy or lightheaded suddenly and then it disappears quickly. Dizziness and lightheadedness can also come on strong and then persist for hours or days at a time.

This dizziness anxiety lightheaded feeling is often described as coming in “waves” where dizzy spells come on quickly and strong, and then slowly ease off throughout the day.

Those who experience this symptom persistently can notice increases and decreases in severity associated with “waves” or “episodes” of intensity. Sometimes the intensity can increase for an extended period, such as days before the intensity decreases again. 

This anxiety dizziness symptom can be more noticeable when undistracted, resting, trying to fall asleep, or when waking up.

All variations and combinations of the above are common.

For some people, episodes of anxiety dizziness and lightheadedness can trigger anxiety, and therefore, be accompanied by an immediate stress response (or panic attack) and its resulting sensations and symptoms, such as nausea, vomiting, sweating, feeling disoriented, rapid heart rate, heart palpitations, having a sudden urge to escape, and so on.

This anxious reaction can occur for many reasons. For example:

  • feeling dizzy can activate the body’s involuntary postural reflex to sensing being off-balance,
  • being surprised by the sudden off-balance feeling, which activates the body’s startle reflex,
  • being alarmed by the sudden dizzy spell, which sets off an episode of anxiety and the accompanying stress response,
  • being afraid of how bad the dizziness can get, which can trigger a stress response alarm,
  • being afraid that you might pass out because of the dizziness, which can trigger a stress response alarm, or
  • by being afraid of the cause of dizziness, which can trigger a stress response alarm (many people fear their dizziness is caused by a serious physical or mental illness).

To name a few.

To see if anxiety might be playing a role in your anxiety symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely it could be contributing to your anxiety symptoms, including dizziness, lightheadedness anxiety symptoms.

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What causes anxiety dizziness symptoms?

Medical Advisory

Causes relating to anxiety include:

Hyper- and hypoventilation[1]

Taking in too much or too little oxygen. Hyper and hypoventilation can change the CO2 level in the blood, which can cause a myriad of anxiety-like symptoms, such as dizziness, lightheadedness, feeling off balance, and feeling like you might pass out.

An active stress response[2]

Behaving in an apprehensive manner activates the stress response. The stress response secretes stress hormones into the bloodstream where they bring about specific physiological, psychological, and emotional changes that enhance the body’s ability to deal with a threat - to either fight with or flee from it - which is the reason the stress response is often referred to as the fight or flight response.

A part of the stress response changes include shunting blood to parts of the body vital for survival, such as the brain, and away from those that aren’t, such as the digestive system. To bring about this shunting action, heart rate and respiration are increased.[2] These blood flow changes alone can cause a person to feel dizzy, lightheaded, off balance, and like you might pass out.

The effects of long term severe stress[3][4][5]

Stress impacts the body’s nervous system. Chronic stress can cause the nervous system to act in odd ways, which can affect our sense of balance. If you’ve been under a lot of stress lately, that stress could be the cause of your dizzy and lightheaded feelings.

Sleep deprivation and fatigue:[6]

Apprehensive behavior stresses the body. A body that’s under sustained stress can become hyperstimulated. Hyperstimulation can cause sleep problems, which can lead to sleep deprivation and fatigue. Sleep deprivation and fatigue are common causes of dizziness, feeling lightheaded, and feeling off balance.

Migraine, Vestibular migraine, or Prodome Migraine symptoms

Migraine headaches, vestibular migraine headaches (migraine headaches that are accompanied by dizziness or exhibit dizziness without the headache), and prodome migraine symptoms (symptoms leading up to a migraine headache) can all cause dizziness.[7][8] Since stress is a common trigger for migraine headaches, and since anxiety stresses the body, many anxiety disorder sufferers experience migraine headaches that are accompanied by dizziness and lightheadedness.

Migraine-related dizziness can come before, during, and after a migraine headache. As well, migraine-related dizziness doesn’t have to be accompanied by the headache itself. Feeling dizzy can be the only symptom of a migraine headache for some people.

Medication

Many prescription medications can cause dizziness as a side effect.[9] Specific to anxiety, many psychotropic medications can cause dizziness and lightheadedness, such as benzodiazepines (Ativan, Xanax, clonazepam, etc.) and antidepressants (Prozac, Zoloft, Trazodone, etc.).

Anticonvulsants, such as Depakote, Neurontin, and Lyrica, which some doctors prescribe for anxiety and depression, can also cause dizziness and lightheadedness.

Many blood pressure and muscle relaxant medications can also cause dizziness and lightheadedness.

Also, taking multiple medications can cause dizziness as a combined side effect.

For more information, talk with your doctor and pharmacist to see if any of the medications you are taking could be causing dizziness or lightheadedness as a side effect.

For more detailed information about anxiety-caused dizziness, our Recovery Support area contains a wealth of detailed information about dizziness, including a more in-depth description of the causes and how to overcome chronic dizziness.

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How to treat dizziness associated with anxiety

Hyper- or Hypoventilation

If your dizziness is caused by hyper or hypoventilation, adopting a natural breathing style – relaxed, slower, and deeper – will correct the CO2 level in the blood, which will eliminate ventilation caused dizziness.

Active Stress Response

If your dizziness is caused by an active stress response, calming yourself down will bring an end to the stress response and its changes. As your body recovers from the changes caused by an active stress response, your body’s functioning will return to normal and your dizziness should subside in time.

Chronic Stress (Hyperstimulation)

If your dizziness is caused by chronic stress (which we call hyperstimulation), reducing your stress and giving your body sufficient time to recover will eliminate this symptom. Keep in mind, however, that it can take a long time for the body to recover once it has become chronically stressed and symptomatic.

Sleep Deprivation and Fatigue

If your dizziness is caused by sleep deprivation and fatigue, increasing your sleep, rest, and giving your body sufficient time to regain its normal energy will eliminate fatigue-caused dizziness.

Migraine Headaches

If your dizziness is caused by migraine headaches, there are many ways to reduce migraine headaches, including reducing stress and avoiding your migraine headache triggers. Addressing your anxiety issues can also be helpful as anxiety stresses the body and can contribute to triggering migraine headaches.

Medication

If your dizziness is caused by medication, talk with your doctor about reducing your dosage, switching to a different medication, or stopping altogether, if possible. NEVER stop a medication without first talking with your doctor or pharmacist. Stopping some types of medications abruptly can cause significant harm.

Play the clip below for Jim Folk's commentary about the dizziness anxiety symptoms. Jim Folk is the president of anxietycentre.com.


Dizziness is a common symptom of elevated stress, including the stress anxiety can cause. Jim Folk experienced profound dizziness during his 12 year struggle with anxiety disorder.

Can anxiety dizziness last all day?

Dizziness due to an episode of anxiety generally doesn’t last all day. It can last a little longer than the anxiety episode itself. Dizziness due to chronic worry or stress (hyperstimulation) can last all day or longer. This type of anxiety dizziness can last as long as the body is chronically stressed.

Is dizziness from anxiety dangerous?

As a symptom, no, dizziness from anxiety isn’t dangerous. However, you might want to be extra cautious when doing certain activities, such as driving, operating heavy machinery, getting up from a lying or sitting position too quickly, or while using the stairs.

You might also want to avoid turning your head too quickly or being in environments with a lot of motion, such as crowds or where there is heavy traffic.

So again, while anxiety dizziness itself isn’t dangerous, feeling dizzy, lightheaded, and off balance can cause problems when doing certain activities.

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Can dizziness cause anxiety?

Anxiety is caused by apprehensive behavior. So, no, dizziness doesn’t cause anxiety. But dizziness can cause involuntary startle, postural reflex, and stress responses that can produce similar symptoms to anxiety. If a person doesn’t like feeling dizzy and becomes afraid of it, she might worry about feeling dizzy, which does create anxiety.

If you have become afraid of the dizziness anxiety symptom, you might want to connect with one of our recommended anxiety disorder therapists to help you overcome this fear. Since fear drives anxiety, and anxiety stresses the body, which is a common cause of anxiety dizziness, overcoming your fear of dizziness can eliminate anxiety-caused dizziness.

Working with an experienced anxiety disorder therapist is the most effective way to overcome anxiety disorder, including the many fears anxiety disorder often establishes.

For a more detailed explanation about anxiety symptoms including this one, why symptoms can persist long after the stress response has ended, common barriers to recovery and symptom elimination, and more recovery strategies and tips, we have many chapters that address this information in the Recovery Support area of our website.

NOTE: Anxiety, stress, and hyperstimulation-caused dizziness is often misdiagnosed as vertigo, benign positional vertigo (BPV), Meniere’s Disease, Labrynthitis, and vestibular neuritis. If you’ve tried the treatments associated with each condition, yet your dizziness and lightheadedness persist, your dizziness and lightheadedness may be caused by stress, including anxiety-caused stress. Therefore, you may want to seek out a medical professional who understands the connection between dizziness/lightheadedness and stress. For instance, it’s reported that psychiatric disorders appear to be the second most common cause of chronic dizziness.[10]

It’s been long known that anxiety and stress cause an increase in activity in the fear center of the brain (the amygdala and other parts of the brain) and a decrease in activity in the executive function parts of the brain (the prefrontal cortex and others).

However, this is the first time brain scans have been used to examine how emotion-regulation circuits are changed by anxiety and chronic stress in children.

The takeaway, however, is not that the brain is malfunctioning or damaged in some way due to anxiety, but that the brain is responding the way it’s supposed to when we think we are in danger. This change in brain function is an integral part of the body’s survival mechanism.

We explain this change in brain function in more detail in our “Stress Response” article.

We can remedy this change by behaving calmly instead of anxiously. As we use calming behavior, the executive function parts of the brain increase in activity, and the fear center decreases. Thus, restoring our ability to regulate our emotions.

So, it’s not that we can’t regulate our emotions when we’re anxious, but a matter of learning how so that we can gain more control over our emotions when we are anxious.

Recovery Support members can read the articles “Hyperstimulation And Its Effects,” “The Rational Brain And The Emotional Brain,” and the “Natural Ways To Shift The Body Out Of ‘Emergency Mode’” in chapter 14 for more information about how anxiety changes brain function and how to regain emotional control.

You can read the press release about this research below:

Stanford study finds stronger one-way fear signals in brains of anxious kids

Signals from the brain’s fear center make it more difficult for anxious and stressed children to regulate their emotions, a first-of-its-kind brain scanning study from Stanford shows.

In chronically stressed or anxious children, the brain’s fear center sends signals to the decision-making part of the brain that make it harder to regulate negative emotions, according to new research from the Stanford University School of Medicine.

The findings, which was published April 21 in Biological Psychiatry, come from the first study to use brain scans to examine how emotion-regulation circuits are changed by anxiety and chronic stress in children. The children studied were 10 or 11 years old, a developmental stage when vulnerability to mood-regulation disorders, such as anxiety and depression, becomes entrenched.

The study used functional magnetic resonance imaging to examine the nature of the signals between two parts of the brain: the amygdalae, almond-shaped nerve clusters on the right and left sides of the brain that function as its fear centers; and the dorsolateral prefrontal cortex, a brain region involved in executive functions such as decision making and emotion regulation.



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“The more anxious or stress-reactive an individual is, the stronger the bottom-up signal we observed from the amygdala to the dorsolateral prefrontal cortex,” said the study’s senior author, Vinod Menon, PhD, the Rachael L. and Walter F. Nichols, MD, Professor and professor of psychiatry and behavioral sciences. “This indicates that the circuit is being hijacked in more anxious children, and it suggests a common marker underlying these two clinical measures, anxiety and stress reactivity.”

Victor Carrion, MD, a co-author of the study and professor of child and adolescent psychiatry, said, “This study shows that the communication between our emotional centers and our thinking centers becomes less fluid when there is significant stress. You want that connection to be strongly signaling back and forth. But stress and anxiety of a certain level seem to interrupt that process.”

Carrion is the director of the Stanford Early Life Stress and Pediatric Anxiety Program, and is the John A. Turner, MD, Endowed Professor for Child and Adolescent Psychiatry. Lead authorship of the paper is shared by researcher Stacie Warren, PhD, and postdoctoral scholar Yuan Zhang, PhD.

Kids react to images

The study included 45 students in a California community with predominantly low-income residents who often face high levels of adversity. All 45 children had their anxiety levels and stress responses measured using standard behavioral questionnaires. Although their exposure to stress was potentially high, none were diagnosed with mood disorders.

To test how the children’s brains responded as they were trying to regulate negative emotions, the scientists conducted functional MRI scans while the study participants looked at two types of images, neutral and aversive. Neutral images showed pleasant scenes, such as someone taking a walk, whereas aversive images showed potentially distressing scenes, such as a car crash.

The children received instructions about responding to each image. For all the neutral images and half the aversive images, they were asked to look at them and respond to them naturally, rating their emotional state on a numerical scale after seeing each one. They were asked to look at the other half of the aversive images and try to reduce any negative reactions they had by telling themselves a story to make the pictures seem less upsetting — a story such as, “This car crash looks bad, but the people in the vehicles weren’t hurt.” After the kids tried to modify their emotional reaction, they again rated their emotional state on the numerical scale.

As the researchers expected, the children reported less negative emotions after being asked to reappraise their reactions to aversive images.

Using the brain-scan data, the researchers tested the strength and direction of interactions between the amygdala, the fear center, and the dorsolateral prefrontal cortex, the reasoning center, while the children viewed the images. Although the children with different levels of anxiety and stress reactivity reported similar reductions in their negative emotions when asked to reappraise the aversive images, their brains were doing different things.

More stress leads to less control of emotional reaction

The more anxious or stressed the child, the stronger the directional signals from the right amygdala to the dorsolateral prefrontal cortex. No such effects were seen in the reverse direction — that is, there was no increase in signaling from the dorsolateral prefrontal cortex to the amygdala. Higher levels of anxiety were associated with less positive initial reactions to aversive images, less ability to regulate emotional reaction in response to aversive images, and more impulsive reactions during reappraisal of aversive images. Higher stress reactivity was linked with less controlled, more impulsive reactions when reappraising aversive images, suggesting that the dorsolateral prefrontal cortex is less able to carry out its job.

Not only do the findings reveal how the brain can be changed by anxiety, they also act as a baseline for future studies to test interventions that may help children manage their anxiety and stress responses, the scientists said.

“We need to be more mindful about intervening,” Menon said. “These results show that the brain is not self-correcting in anxious children.”

“Thinking positively is not something that happens automatically,” Carrion said. “In fact, automatically we think negatively. That, evolutionarily, is what produced results. Negative thoughts are automatic thoughts, and positive thoughts need to be practiced and learned.”

The paper’s other Stanford co-authors are former research assistants Katherine Duberg and Sarah-Nicole Bostan; postdoctoral scholar Percy Mistry, PhD; Weidong Cai, PhD, clinical assistant professor of psychiatry and behavioral sciences; former postdoctoral scholar Shaozheng Qin, PhD; and former staff researcher Aarthi Padmanabhan, PhD.

This work was completed in partnership with the Ravenswood City, Alum Rock and Orchard school districts and Pure Edge Inc., which provides mindfulness curricula for children, and supported by the Lucile Packard Foundation for Children’s Health, the National Institutes of Health (grants EB022907, NS086085 and MH121069), the Stanford Maternal Child Health Research Institute and the Stanford Institute for Computational & Mathematical Engineering.

Media Contacts

ERIN DIGITALE
Tel 650-724-9175
digitale@stanford.edu

MARGARITA GALLARDO
Tel 650-723-7897
mjgallardo@stanford.edu

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders and symptoms page.

anxietycentre.com: Information, support, and therapy for anxiety disorder and its symptoms, including the anxiety symptom back pain.

References

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  1. Lahmann, Claas, et al. “Psychiatric Comorbidity and Psychosocial Impairment among Patients with Vertigo and Dizziness.” Journal of Neurology, Neurosurgery & Psychiatry, BMJ Publishing Group Ltd, 24 June 2014, jnnp.bmj.com/content/early/2014/06/24/jnnp-2014-307601.short.
  1. “Dizziness.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Sept. 2018, www.mayoclinic.org/diseases-conditions/dizziness/symptoms-causes/syc-20371787.
  1. Staab, J P, and M J Ruckenstein. “Autonomic Nervous System Function in Chronic Dizziness.” NCBI PubMed, U.S. National Library of Medicine, Sept. 2007, www.ncbi.nlm.nih.gov/pubmed/17514065.
  1. Ludman, Harold. “Vertigo and Imbalance.” The BMJ, British Medical Journal Publishing Group, 22 Jan. 2014, www.bmj.com/content/348/bmj.g283.
  1. 11. Kim, Sung Kyun, et al. “Relationship between Sleep Quality and Dizziness.” PLOS ONE, Public Library of Science, 2018, journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0192705.
  1. Cha, Yoon-Hee. "Migraine-Associated Vertigo: Diagnosis and Treatment." Seminars in Neurology, 29, Mar. 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682200/
  1. Baloh, Robert, et al. "Migraine Associated Vertigo." Journal of Clinical Neurology, 20 Sep. 2007. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686840/
  1. Gill, Lisa. “Drugs That Might Be the Cause of Your Dizziness.” Consumer Reports, 2019, www.consumerreports.org/drug-safety/drugs-that-might-be-the-cause-of-your-dizziness/.
  1. Pederson, Traci. “Chronic Dizziness May Be Tied to Psychiatric Disorder.” Psych Central, 1 May 2018, psychcentral.com/news/2018/05/01/chronic-dizziness-may-be-tied-to-psychiatric-disorder/135036.html.