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June 27 was National PTSD Awareness Day. What does stress have to do with balance and dizziness? It turns out, quite a lot! Personal stress itself has been linked to higher incidence of dizziness[1], but there are also physiological consequences to stress.

Stress and lack of sleep (which can cause extra stress) are risk factors for Benign Paroxysmal Positional Vertigo, or BPPV[2]. BPPV is a condition that causes the world to look like it’s spinning when you change position such as lie down, sit up, or turn your head. Increased stress such as negative life events have been positively correlated with increased incidence of BPPV. In other words, the more stress you have, the more likely you are to have an occurrence or recurrence.

Stress can cause physiological changes akin to the fight or flight response.[3] If an activity, or even thoughts, cause stress, your body may respond by increasing your breathing rate, increasing your heart rate, and tensing your muscles. Increased heart rate and breathing can cause side effects like lightheadedness. Tightened muscles often manifest in the neck and shoulders, which can cause dizziness that stems from the neck. When you’re tense, it’s also difficult to adjust for any deviation from a center position, which makes balance more difficult.

So what can we do to mitigate the effects of stress? There are several options. Studies have shown that Cognitive Behavioral Therapy, or talking to a therapist, can reduce stress and anxiety and improve balance outcomes.

However, if you don’t have access to a therapist, the most accessible thing that you can do for stress management is breathing exercises! When stress and anxiety start to manifest, it often results in breath holding. One effective breathing exercise is called box breathing, we have a video for how to perform that exercise here. If that’s too much coordination or if pausing breathing feels wrong or bad, simply controlling and slowing your breathing can also be effective. Try breathing in for four counts and out for 6 (or in for 3 and out for 5), you can count seconds or footsteps or whatever works best to get an effective rhythm. Give it a try and see what works best for you.

If you’re dealing with dizziness related to stress and anxiety and are struggling to mitigate your symptoms, feel free to come to 360 Balance & Dizziness and a therapist will help tailor the most effective treatment plan to address all the sources of your dizziness or imbalance.


[1] Andersson, G. & Yardley, L. (2000). Time-series analysis of the relationship between dizziness and stress. Scandinavian Journal of Psychology, 41, 49-54

[2] Monzani, D., Genovese, E., Rovatti, V., Malagoli, M. L., Rigatelli, M., & Guidetti, G. (2006). Life events and benign paroxysmal positional vertigo: a case-controlled study. Acta Otolaryngol, 126(9), 987–992. https://doi.org/10.1080/00016480500546383

[3] Chand SP, Marwaha R, Bender RM. Anxiety (Nursing) [Updated 2022 Feb 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK568761/