The head is spinning: what to do if you feel vertigo symptoms?

If you feel dizzy, it can be caused not only by “harmless” reasons, but also by serious diseases affecting the many vital systems. What are these, and what can be done to prevent or treat these presentations? Read to find the answer in the article.

Causes of dizziness

Vertigo presents with dizziness feeling with a sensation that the whole world is spinning around you. It can occur due to a variety of reasons, like vascular issues, brain dysfunction, or an eye disorder. Provocative factors could be:

• High blood pressure: High blood pressure is related to the inner ear (vestibular) impairments.¹ Higher blood pressure can lead to inner ear haemorrhage and tissue hypoxia, resulting in compromised cochleovestibular function, presenting as vertigo and/or hearing loss in patients.²
• Orthostatic hypotension: Also called postural hypotension, results from a lowering of blood pressure due to a sudden change in posture, such as moving to a vertical position from sitting or lying down. The drop in blood pressure reduces blood flow in the inner ear, compromising the autoregulatory capacity of the choleovestibular circulation in patients. This can result in dizziness, fainting, and other symptoms associated with vertigo.^1,3
• Anemia: In case of anemia, the patient has low hemoglobin levels in the blood. Iron deficiency anemia is the most common type of anemia that results in reduced oxygen-carrying capacity in blood. It can make one feel dizzy or lightheaded in addition to causing a faster heartbeat and shortness of breath.⁴ Iron-deficiency anemia shows a positive correlation with vertigo. Anaemic patients are at high risk of vertigo recurrence, and the rate of vertigo increases with higher severity of anaemia.⁵
• Anxiety: Patients with anxiety often complain of dizziness as a co-occurring symptom. Some feel dizzy due to their anxiety, while others may report getting dizzy first and then feeling anxiety symptoms. Higher stress and anxiety can elevate the levels of hormones like cortisol, which can negatively impact the vestibular system. The frequency of anxiety or depression in patients with dizziness is reported to be very high (>45%).^6,7
• Pregnancy: Pregnancy is marked by hormonal, physical and psychological changes. All these can impact balance, leading to symptoms such as vertigo and unsteadiness. Pregnancy can exacerbate the existing vestibular diseases such as vestibular migraine, Meniere’s disease.⁸

Diagnosis of a general sense of well-being disturbance

To establish the cause of vision dimout and vertigo, it is necessary to visit a primary care provider or ear-nose-throat (ENT) specialist. For diagnosis, your doctor may perform different types of tests, see details in Diagnosing vertigo: which tests will your doctor use?, including the following:^9,10

• Eye and head movement testing: The doctor will establish whether there is a problem associated with the visual organs or with the inner ear using a variety of tests.
• Scans and imaging: Imaging tests like MRI (Magnetic Resonance Imaging) or CT (computed tomography) scans can help to detect problems in the inner ear or brain.
• Posture and balance testing: These tests help to understand problems, if any, with your balancing systems and posture.
• Other examinations like blood tests to check for infection, and tests to check the heart and blood vessels.

Treatment

Treatment of vertigo should be carried out under the monitoring of a medical specialist. Therapy should not be aimed at the consequence – dizziness and lightheadedness, but at the root cause of this condition. Based on the provocative factor of the disease, appropriate medicines are necessary:

• Medications: Medicines that can relieve dizziness and an upset stomach can provide fast relief for vertigo. In case of underlying conditions, such as arterial hypertension or anaemia, appropriate medicines to resolve these issues can relieve the vertigo symptoms. Additionally, anti-anxiety or migraine-preventive medicines are also prescribed to alleviate the stress- and headache-related dizziness symptoms.^2,5,10

• Head position movements: Also known as Epley manuever, involves a series of head movements which is especially useful in benign paroxysmal positional vertigo.¹⁰
• Balancing movements: Small exercises that help your balance system become less sensitive to motion. These are physical therapies aimed for equilibrium training. Another method is use of voluntary eye movements and fixation to improve visual fixation.¹⁰
• Psychotherapy: Behavior therapy and psychoeducational therapy that helps in understanding the precipitating factors of vertigo and behavior change is also indicated in patients to help improve symptoms.^10,11
• Surgical therapies: Although rare, certain surgical procedures related to inner ear are performed for refractive cases where other treatment options may not yield desired results.^10,11

What could you do when your head is spinning?

Do not panic and calm down, understanding that vertigo is not a serious condition can help reduce anxiety. In order to administer first aid to yourself when you feel unwell, you need to do the following:¹²

• Move away to a safe space away from roads or other obstacles
• Walk slowly and take the help of rails or walk near walls
• Sit or lie down until the condition returns to normal;
• Practice slow and deep breathing
• Focus on a spot in front of you
• Find a quiet, dark place. Close your eyes if you need to and use earplugs to block noise.

If the condition worsens, call an ambulance. Do not take any measures without the advice of a medical practitioner

Avoid or reduce triggers to lower the vertigo episodes:¹²

• Decrease alcohol, caffeine, and tobacco intake
• Reduce salt intake
• Avoid situations and activities that cause stress
• Adhere to the prescribed medications for the underlying condition to keep them under control, such as blood pressure or blood sugar
• Reduce the movements or activities that trigger vertigo
• Keep your medications and aids near you all the time. Keep your medical ID with you in case of emergencies
• Be open about your condition with your family or friends so that they can help you in the case of an emergency.

When it is necessary to visit a doctor

In case of vertigo, it is important to understand when it is necessary to visit a doctor, and when you do not need to become anxious about vertigo. It is necessary to seek medical attention if you cannot cope with vertigo at home on your own. Seek the help of a medical specialist in case of the following symptoms:¹³

• It disrupts your daily life.
• The condition persists or returns.
• Has no clear cause
• Hear ringing in your ears or other sounds.
• You see double or other vision changes.
• You have other symptoms such as fainting, headaches, and nausea.
• Chest pain or difficulty breathing
• Ongoing vomiting
• Confusion or slurred speech

In the meantime, apply self-care tips listed above.