Can anxiety cause dizziness? Learn why light-headedness, swaying and feeling unsteady on your feet happen, which signs are urgent and what you can do.
As you walk between the long aisles of the supermarket, you suddenly feel the floor shift slightly. The shelves stay where they are, but it is as if you are on the deck of a boat. You grip the shopping trolley tightly and hurry towards the till. Once you are outside the feeling eases, but a question stays in your mind: "What is happening to me?" Whether anxiety can cause dizziness is a question on the minds of many people who go through experiences like this. The answer is yes; but not every dizzy spell comes from anxiety, and some require urgent assessment. In this article I explain why anxiety creates a sense of light-headedness and unsteadiness, how it differs from medical causes, which signs mean you should not wait, and how you can step out of the cycle that makes this feeling grow.
Dizziness Is Not Just One Thing
When we say "I feel dizzy" in everyday language, we may in fact mean very different experiences. This distinction matters both for giving your doctor the right information and for understanding your own experience.
- A spinning sensation: feeling that your surroundings, or you yourself, are spinning. In medicine this is called vertigo and it is often linked to the balance system in the inner ear.
- Light-headedness and lightness: your head feeling empty, feeling as if you are floating, feeling as if you might faint.
- Unsteadiness: not feeling firmly on your feet, feeling as if you are swaying slightly as you walk, the ground seeming soft or moving.
- Fogginess: your vision not being clear, your attention wandering, your surroundings looking distant or strange.
Before seeing a doctor, keeping short notes for a few days makes this distinction easier: when did the dizziness start, how long did it last, did it come with a movement such as turning your head or getting out of bed, was there nausea, ringing in the ears or a change in hearing, and what were you doing and feeling at the time? These notes help your doctor make an accurate assessment and also let you see patterns.
Anxiety-related dizziness mostly falls into the last three groups. A true spinning sensation, on the other hand, more often arises from causes related to the inner ear or the nervous system. The two can also exist together, however; I will come back to this separately below.
Safety First: Which Kinds of Dizziness Are Urgent?
If any of the following accompanies dizziness, call 112 (emergency services) without waiting:
- Drooping of the face, slurred speech or being unable to understand what is said
- Sudden weakness or numbness in an arm or leg
- Double vision or sudden loss of vision
- The most severe headache you have ever had
- Fainting or loss of consciousness
- Marked weakness together with chest pain or palpitations
Apart from these, a medical assessment is needed for dizziness that you are experiencing for the first time, that recurs frequently or that affects your daily life. Your GP and ear, nose and throat and neurology specialists can guide you on this. Changes in blood pressure, anaemia, fluctuations in blood sugar, fluid loss, side effects of some medicines, displacement of the crystals in the inner ear and inner ear infections are among the common physical causes of dizziness.
Can Anxiety Cause Dizziness? What Is Happening in the Body?
Anxiety can lead to a sense of light-headedness and unsteadiness in several different ways.
Changes in Breathing
In anxious moments, breathing speeds up and becomes shallow. This lowers the level of carbon dioxide in the blood and can cause small changes in blood flow to the brain. The result is a light feeling in the head, light-headedness, tingling in the hands and a feeling of being "about to faint". When the person notices this feeling and becomes even more anxious, their breathing speeds up further.
Muscle Tension
Prolonged tension in the neck and shoulders can affect how balance information from the head and neck area is processed. Someone who works at a desk for hours with their shoulders hunched may feel a heaviness in their head and a slight unsteadiness at the end of the day. Looking down at a phone for long periods, clenching the teeth at night and an uncomfortable pillow arrangement can add to this tension. In this case, regular stretches for the neck and shoulders can also ease the sense of light-headedness.
Attention Turning Towards the Body
Balance is a skill we normally maintain without noticing. Information from our eyes, inner ears and the soles of our feet is constantly being combined. When anxiety directs attention to this system, small wobbles that would normally go unnoticed reach awareness and are perceived as dangerous.
Sensitivity to Visual Stimuli
During anxious periods, some people become more sensitive to visual stimuli. Supermarket aisles, the bright and crowded corridors of shopping centres, escalators, patterned carpets, images scrolled quickly on a phone or people streaming along a crowded street can strain the balance system and increase the feeling of light-headedness.
A Sense of Unreality
In moments of intense anxiety, some people describe their surroundings moving away, feeling as if they are in a dream, or feeling as if they are watching themselves from the outside. This experience can also be confused with dizziness. If you would like to know more about this, you can take a look at the article on derealisation and depersonalisation.
When Dizziness Feeds Anxiety and Anxiety Feeds Dizziness
A pattern often seen in the clinic is this: the person first experiences a genuine inner ear problem, for example a short but severe bout of spinning caused by displaced inner ear crystals. This problem resolves with treatment. But the fear of that first experience remains. The person starts avoiding turning their head quickly, bending down and going into crowded places. Weeks or months later, even though the inner ear has fully recovered, a constant sense of swaying and unsteadiness can continue.
In these kinds of persistent unsteadiness, both the balance system and anxiety may need to be addressed together. An assessment by a neurologist or an ear, nose and throat specialist is important for diagnosis and for telling conditions apart; in some cases, balance rehabilitation with a physiotherapist is also recommended.
Balance does its job when you trust it; when you check every step, it starts to falter.
Behaviours that feed this cycle include:
- Holding on to a wall, a shelf or a relative's arm when walking
- Always keeping the head still and avoiding quick turns
- Not going out alone, staying away from crowds and wide-open spaces
- Constantly resting by sitting or lying down
- Checking yourself many times a day: "Am I dizzy now?"
These behaviours give a sense of security in the short term. But the balance system cannot learn to adapt unless it encounters stimuli. The less you move, the more sensitive your balance becomes.
A Common Experience in Turkey: "It Feels Like an Earthquake"
After the 6 February 2023 earthquakes, many people described starting to feel as if the ground were shaking even when it was not. This was seen not only among people living in the earthquake zone, but also among many who followed the news intensively or who lost loved ones.
Let us say an engineer in his forties, who lived through the earthquake in Kahramanmaraş and then moved to Ankara, sometimes feels the floor sway slightly while sitting at his desk on the twelfth floor of the office tower where he works. He immediately looks at the chandelier and the glass of water on his desk; nothing is moving. Even so, his heart speeds up and he glances towards the stairs. This experience may reflect the body continuing to keep its alarm system on high after a major danger. A sense of swaying like this can also appear as part of post-traumatic experiences, and it is important to address it within that framework.
When you experience this kind of swaying, looking at a hanging object in the room, such as a lamp or a curtain, is a calm way of finding out whether there really is a tremor. But if you have started doing this check every minute, the checking itself may have turned into a habit that keeps the anxiety alive. For many people who came from the earthquake zone, even knowing that they are sitting in a safe building does not immediately change the body's state of alertness; the body is persuaded more slowly than the mind. This slowness is not a weakness but a natural trace of the danger that was lived through.
What Can You Do About Anxiety-Related Dizziness?
The suggestions below are for people who have had a medical assessment and whose dizziness is thought to be related to anxiety. If you are receiving treatment for a balance problem, give priority to the recommendations of your doctor and physiotherapist.
- Name the sensation. Instead of "I'm dizzy", use descriptive language such as "Right now there's a lightness in my head and the floor feels a bit soft." This stops the sensation being a sign of catastrophe.
- Calm your breathing. Breathe quietly and slowly through your nose rather than your mouth. Trying to breathe quickly and deeply can increase light-headedness.
- Fix your eyes on a still point. Looking at a fixed object in the distance, such as a door or the horizon, steadies visual information.
- Hold on less. When the urge to hold on to a wall or shelf comes while you are walking, try taking a few steps without holding on. It is important to experience that your body can carry you.
- Bring movement back. Daily walks, slowly turning the head from side to side and gentle stretches help the balance system to adapt again. Do these with your doctor's approval and gradually.
- Return to challenging settings step by step. If you have been avoiding settings such as supermarket aisles or shopping centres, start with short visits and gradually extend the time.
- Do not neglect basic needs. Drinking enough water, not skipping meals, sleeping regularly and reducing caffeine reduce the physical factors that increase light-headedness.
If a feeling of being about to faint often accompanies your dizziness, the article on feeling faint may also feel familiar.
When Should You Seek Professional Support?
If your medical assessment was clear but one of the following describes you, talking to a mental health professional may be useful:
- You avoid going out alone, public transport or crowds for fear of dizziness
- You constantly check your balance and think about it all day long
- Dizziness comes with panic attacks or an intense fear of dying or fainting
- Although your inner ear problem has resolved, the sense of unsteadiness has lasted for months
- You started to feel swaying after an earthquake, an accident or another difficult event
These signs do not amount to a diagnosis on their own. If the symptoms are intense, an assessment by a psychiatrist can also be part of the process.
How Is Anxiety Dizziness Approached in Therapy?
Cognitive Behavioural Therapy (CBT) is one of the research-supported approaches for working with the fear that accompanies bodily sensations. For anxiety about dizziness, the therapy process usually includes the following steps:
Developing a shared understanding. The medical and psychological dimensions of dizziness are discussed together. How anxiety affects balance and how checking behaviours keep the feeling going are explained.
Examining catastrophic thoughts. Thoughts such as "I'm going to fall and faint", "There's something wrong with my brain" or "I'll make a fool of myself in front of everyone" are compared with the person's own experiences and the medical information.
Facing the sensations. With the therapist, sensations similar to dizziness are produced in a controlled way; for example, turning slowly on a chair or shaking the head quickly for a set time. The person experiences these sensations passing on their own.
Returning gradually to avoided settings. Places such as supermarkets, shopping centres, public transport or tall buildings are approached again within a plan that suits the person's pace.
Working with trauma and stress. If the dizziness started after an earthquake or an accident, the traumatic experience itself also comes onto the therapy agenda. Long-term stress, workload and responsibilities within the family can also be addressed.
For more information on how the bodily symptoms of anxiety are worked with, you can take a look at the anxiety and panic page.
Frequently Asked Questions
Can dizziness caused by anxiety make me fall?
Although the light-headedness linked to anxiety can be intense, the great majority of people do not fall during it, because the balance system actually keeps working. Even so, if you have fallen, fainted or been injured, this must be assessed by a doctor.
My dizziness is worse in the mornings; is that normal?
In the mornings, changes in blood pressure, an empty stomach, lack of fluids and anticipatory anxiety about the day can increase light-headedness. Getting out of bed slowly, not skipping breakfast and drinking water can help. If morning dizziness has started recently, consult your doctor.
I get dizzy after looking at my phone for a long time; is that related to anxiety?
Looking at a screen up close for a long time, rapidly scrolling images and sitting still can increase light-headedness, especially during sensitive periods. Taking breaks, looking into the distance and going for short walks helps. If this feeling comes with intense fear, it is possible to get support from a professional to address it together with the anxiety.
Which doctor should I see about dizziness?
As a first step, your GP can carry out a general assessment and refer you on if necessary. If there is a spinning sensation, ringing in the ears or a change in hearing, an ear, nose and throat specialist comes to the fore; if there is numbness, weakness or problems with vision, a neurologist. In the case of urgent signs, 112 should be called directly.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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