So many people ask me, what causes vertigo and what cures vertigo?
The most common vertigo is benign paroxysmal positional vertigo, also known as BPPV. I’ve actually had this one twice. It’s incredibly common—about one in four people experience BPPV. It’s benign by nature. It’s not a sign of any disease or abnormality. In that regard, it’s just simply calcium particles that belong in the ears. They work in our little balance organs to help us detect movement like full bike acceleration, forward movement, stopping or deceleration, they actually move in little jelly pockets.
If those calcium particles roll out of the jelly and stop moving around the balance canals, it means that as we roll over in bed or look up or bend over into our posture, or put on our shoes with those really strong head gravity movements, the particles are rolling around and sending vertigo signals to our eyes. So the eyes will then flicker, our world spins and we’re like, “Whoa, what’s going on? Am I dying? Is it a stroke? Is it a heart attack?” And we can have this huge anxiety blowout, and there’s your vertigo incident. The good news is, positional vertigo is very brief. It’s generally less than 30 seconds and never longer than 60 seconds. So it’s a brief spinning, a brief vertigo, brief dizziness. It’s often quite strong, and it’s what we call “real vertigo.” And real vertigo includes this movement of the eyes rather than a dizziness sensation that’s just in the head and not necessarily including vision.
BPPV is caused by the moved otoconia calcium particles. To cure it and treat it, as a vestibular audiologist, I would assess my patient’s ears, I would assess which area is affected, I would assess which canal is affected because there’s three balance canals where the particles could be found. And then I would do a very specific maneuver to return those calcium particles from the canal back into those jelly pockets in the otoliths where they belong. Now that treatment, the test and treatment can be done at home using something like the BPPV video kits that I’ve designed. You can learn more about a lot of the causes of vertigo and ways to treat them in my book, Rock Steady. BPPV, I mentioned straight up because it’s the most common. So if you do have vertigo, it’s really important to check that one first because it’s treatable, it’s quick, it’s easy. And in many cases, it’s the best form of vertigo to have because it is so treatable and benign.
Other causes of vertigo can be infections, inflammation around the balance nerves. Another cause of vertigo we hear more about is Meniere’s disease, which is where there’s a buildup of balanced fluid in one usually one ear, but occasionally or rarely in both ears will be bilateral. The Meniere’s, the endolymph fluid of the balance creates too much of this fluid. There’s nowhere for it to go. The inner ear kind of balloons out and swells, which can give a roaring tinnitus sound and some dizziness, vertigo sensations, and can result in really, really strong, severe dizziness from minutes to hours, and then feeling a bit shaky for days or weeks afterwards.
How to cure it? Because it’s a fluid imbalance, the body will naturally reassess and reset its internal fluid. If there’s so much fluid buildup for someone with Meniere’s, it may burst and the body will naturally seep out that fluid to get rid of it to drain it. So it’s a natural process and then it will naturally repair those membranes. The problem is, there could be a good week or month where you’re really not feeling very well and it’s frightening and scary. It requires a little trust in the body to wait through this process. Some people become very reliant on medication because they don’t want it to happen again, they want to eliminate it, they want to get rid of it, when actually, I think it’s very fair to trust that the body will resolve itself. Living with that uncertainty is actually part of the art of healing and recovering from some of the chronic vertigo conditions.
Some other common conditions are vestibular migraine. For vestibular migraine, it’s a migraine issue, so there’s no anatomical damage, but for whatever reason, blood flow and neural messages are not being sent efficiently. They’re being roadblocked, they’re being flooded, they’re not flowing from A to B as would be expected. And that’s why people with migraines often just want a dark, quiet room to recuperate while the brain sorts out that kind of chaos.
For mal de debarquement syndrome, when people have chronic dizziness after a long boat trip or flight or travel of some form, then your messages, for some reason, have not gone back to normal after a lengthy traveling experience. It’s kind of like they’ve gotten so used to being on the boat that the ears adapted to the boat, but then they didn’t adapt back to the land. So again, air signals between the ears, eyes, body, and brain. So the main cause of vertigo is this confusion in the neural signals.
The way to cure it is neuroplasticity. We have to teach those signals how to come back to normal, how to come back to steadiness, calm, peace, quiet. A lot of people get these scary diagnoses of any vestibular condition, and honestly, it doesn’t matter which diagnosis you get given, the way to recover is using neuroplasticity to rebuild healthy, functional, steady neural pathways so you feel normal again, you feel balanced again, you feel centered again. And of course, to be able to address the mental, emotional, spiritual impact of having this uncertainty and of having the attack—it’s overwhelming, it’s isolating, it’s incredibly rare to make anyone with a vertigo vestibular condition without some associated anxiety and depression because of how debilitating and frightening it is.
So part of healing and part of mastering our nervous system and resetting it is having a level of respect and kindness towards our mental, emotional, and spiritual state. How has this affected me as a whole person? How can I support myself as a whole person? How can I regulate my emotions? How can I interrupt anxiety cycles and catastrophe thinking? And how can I believe in myself? That’s the spiritual piece. How can I believe in my body to heal? How can I trust my body again? And how can I allow my body to space its needs to reestablish new neural maps? I’ve literally written a book on how to do this. I mentioned a lot of the common conditions and causes of vertigo. So take a look at my book, Rock Steady.
