Chapter 12
Mastering Dizziness & Maintaining Balance

Jeffrey P. Staab, MD, MS

Assistant Professor of Psychiatry
Departments of Psychiatry and Otorhinolaryngology
Head and Neck Surgery
The Balance Center
University of Pennsylvania School of Medicine
Philadelphia, PA

Is Dizziness My Destiny?

This chapter is for people with chronic dizziness, regardless of the cause. It’s also for their family members, friends, lovers, coworkers and employers. No doubt, all of you have experienced the frustration that comes with chronic dizziness. Will it ever go away? What’s causing it? Is it real? You hope for an answer, but sometimes find it hard to be optimistic about the future. Is dizziness your destiny? Not necessarily. Our understanding about the causes of chronic dizziness is improving rapidly and new treatments are available that are very effective for many individuals. Of course, these new treatments do not work for everyone. Some people have to find a way to cope with their dizziness over the long term. This chapter will take you through a process of understanding chronic dizziness in order to see if some of our new insights and therapies might be right for you. If you have chronic dizziness, you owe it to yourself to learn as much as you can about mastering your symptoms. Even if your dizziness cannot be cured, it doesn’t have to prevent you from enjoying your life.

I Have…Well, I Don’t Know How to Describe it. I’m Just Dizzy.

People with chronic dizziness frequently find it difficult to describe their symptoms. I ask my patients a lot of questions to help them explain what they’re feeling:

• Do you have vertigo
• Lightheadedness
• heavy-headedness
• imbalance?
• Does it come and go or is it always present?
• Is it worse when you move your head, stand up or turn around?
• Do you feel better with your eyes open or closed?
• What about grocery stores, busy malls, wide-open spaces, riding in a car, or foggy days?
• Is it worse when you’re tired?
• Have you ever fallen down or fainted?

The answers to these questions are not always crystal clear, but that’s okay. Sensations of chronic dizziness can be confusing and vague. No need to worry about that. As strange as it seems, this very quality of vagueness can be quite helpful from a diagnostic standpoint.

As you have learned by now, dizziness and vertigo are not the same, though many people use the two words interchangeably. Keep in mind that vertigo is the sensation that you’re spinning or the world is turning around you and it always comes in spells. It is never a constant symptom. Dizziness is a sensation of being off balance, off kilter, unsteady, swaying or rocking. Some people describe it as a heavy or foggy feeling in their head. Others say that they are lightheaded. . .

Occasionally, people with chronic dizziness are treated as if they’re faking. Family members, employers, insurance companies or doctors may question their truthfulness. A few patients have even asked me if their own symptoms were real! If you have chronic dizziness that is anything like what was described above, stick to your guns and read on. If you’ve never experienced chronic dizziness, try shaking your head back and forth 20 times as quickly as you can or spin around quickly for a whole minute, then continue reading. This will give you only an inkling of what it’s like. . . (and so much more!)