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A year ago I started a thread on the TMSHelp forum about dizziness. To spread the knowledge that helped me and others recover, I have decided to post the initial post on this forum too. The post is based on an article by Sarah Edelman that is no longer available on the internet sadly. The list of accompanying symptoms and her explanation of the mindbody process that is behind it could help others here to become more convinced that their problems are the result of a mindbody issue too. I have tried to make an abstract of the original article and added a few things myself [...in brackets...]. If someone knows a good link to the Sarah Edelman article, please post it here.

The original thread: http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=8397 (TMSHelp Forum - Psycho-Physiological Dizziness Syndrome)

Admin edit: We received permission from Dr. Edelman to post the PDF, here:
https://www.tmswiki.org/forum/attachments/2019-information-flyer-pdf.1218/
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Psycho-physiological dizziness syndrome
PPDS refers to a cluster of symptoms that arises for some people in the period following either:

1. a vestibular event (such as vestibular migraine, labyrinthitis, inner ear trauma) OR
2. a period of stress (with or without panic attacks)
The syndrome is characterized by episodic dizziness or light-headedness (not spinning), in addition to other symptoms. These vary between individuals and may include:

• Periods of unsteadiness or a feeling of the ground being unstable. [I personally describe this as a sensation of the floor moving below you or as walking on a waterbed].
  
• A feeling of rocking or swaying, or feeling like you are veering to the side when walking.
  
• A feeling of ‘fullness’, ‘cloudiness’, ‘fogginess’, or ‘heaviness’ of the head.
  
• Dizziness in response to particular movements, such as turning head from side to side, getting up from a chair, looking up, bending over, lying down etc..
  
• Tinnitus (ringing, buzzing or hissing sound on one or both ears)
  
• Visual disturbances (sensitivity to bright light or to motion stimuli; episodically out of focus)
  
• Numbness, tingling or ‘electrical’ sensations in hands, feet, face or scalp (often one-sided)
  
• Momentary dizziness or internal ‘shift’ sensations that last for a couple of seconds.
  
• Nausea
  
• Headaches
  
• Feeling hot or flushed
  
• Wobbly legs
  
• Tightness or clenching of the jaw.
  
• Heart palpitations or missed heart beats
  
• Body or situations may at times feel different or unreal
  
• Frequent fatigue
  
• [pain and tightness in the neck, shoulders and/or upper back]...

As you can see, these are all physical symptoms, the factors that maintain them are primarily psychological. People who visit their doctor with these symptoms are often sent home without a good diagnosis although the symptoms are very real.

PPDS is caused by a combination of perception (perception of threat), hyper vigilance (selective attention to perceived threat) and autonomic arousal (the body’s biological response to perceived threat).

Once dizziness is triggered, people enter a self-perpetuating anxiety cycle. The symptoms from autonomic arousal are perceived as a threat, which in turn maintains hyper vigilance, which in turn maintains autonomic arousal, and so causes the symptoms to keep occurring.

As the syndrome is maintained by a perception of threat, it is more likely to arise among people who score high on the ‘anxiety trait’, although some people are not aware of this aspect of their personality until they develop the syndrome.

Dizziness can be triggered by situations (social events, busy environments, certain locations like supermarkets or class rooms) or can come up spontaneous (recognition of a threat on an unconscious level).

Being tired, unwell or in pain usually increases symptoms, because in general it makes people feel more vulnerable.

The paradox in this syndrome is that trying to control the symptoms simply reinforces the perception that they are a threat and therefore the anxiety cycle is maintained. The key to recovery lies in doing the opposite – learning to perceive the symptoms as harmless and not worthy of any special attention. Once you stop trying to control the symptoms, they lose their power and gradually fizzle out.

The way to overcome the fear is to deliberately face it. Target the situations that are most likely to trigger symptoms. The goal is NOT to try to avoid the symptoms but to experience the symptoms without the emotional response that they usually evoke. Let the body experience the symptoms without resistance or fear. Better said: surf the symptoms. In time this will slow down the anxiety cycle and often the symptoms will completely disappear.

It is important therefore to stop avoiding any situations or activities because of dizziness, but the same goes for safety behaviors (lying down when symptoms appear, holding on to things to keep yourself stable, relying on others company when you go to certain places).