Can Anxiety Cause Dizziness? Why It Happens and When to Worry

Yes. Feeling light-headed or dizzy is a recognised physical symptom of anxiety, and feeling faint, dizzy or light-headed can be part of a panic attack, according to the NHS. Over-breathing and the body’s stress response can both bring it on. But dizziness has many other causes, so spinning, fainting or dizziness that keeps coming back needs a doctor’s check.

This is general information, not a diagnosis. For other body symptoms, see Can anxiety cause…? 12 physical symptoms explained; for anxiety itself, start with our anxiety guide.

Is dizziness a recognised symptom of anxiety?

Yes. The NHS page on anxiety, fear and panic lists feeling light-headed and dizzy among the physical symptoms of anxiety, and feeling faint, dizzy or light-headed among the symptoms of a panic attack. Mind, the mental health charity, lists the same feelings as panic attack symptoms, along with breathing in too much or too quickly. The NHS dizziness page also names stress or anxiety as one of the things that can make you dizzy.

Dizziness that comes on during a panic attack usually eases as the attack passes. The NHS says a panic attack usually lasts 5 to 20 minutes and, although frightening, is not dangerous. See panic attack vs anxiety attack for the difference.

Why does anxiety make you feel dizzy?

Several things can play a part: breathing too much, stress hormones, and changes in how you hold yourself and watch your balance.

Over-breathing (hyperventilation)

When you are anxious you may breathe faster and deeper than your body needs, often without noticing. MedlinePlus, the US National Library of Medicine’s health encyclopedia, explains that over-breathing lowers the carbon dioxide in your blood, which causes many of the symptoms: feeling light-headed, dizzy or weak, a pounding heartbeat, and numbness or tingling in the arms or around the mouth. It lists anxiety, panic and stress among the emotional causes.

Fast breathing also has medical causes, such as heart and lung problems. MedlinePlus says rapid breathing for the first time may be a medical emergency, so do not assume it is anxiety unless a doctor has told you so.

The stress response

When you feel anxious or scared, your body releases stress hormones such as adrenaline and cortisol, which can raise your heart rate and make you sweat, the NHS explains. In some people this sets off a panic attack. A pounding heart, sweating and breathlessness can all arrive together with the dizzy feeling.

Tense muscles and a stiff way of standing

Anxiety can also change how you stand. In research on phobic postural vertigo, an older diagnosis that fed into PPPD (below), people stood with their lower-leg muscles tensed against each other, causing small, rapid sway. Healthy people normally stand like this only in hard balance situations, such as at a height, according to the Bárány Society criteria paper. Researchers think this stiff, closely watched balance may help keep dizziness going, but it is not proven.

What is PPPD, and how is it linked to anxiety?

Persistent postural-perceptual dizziness (PPPD) is a long-term condition in which dizziness, unsteadiness or a non-spinning sense of movement is present on most days for 3 months or more. It is defined in diagnostic criteria from a committee of the Bárány Society, which classes it as a chronic functional vestibular (balance) disorder. The paper is clear that it is “not a structural or psychiatric condition”.

Symptoms can wax and wane but last for hours, and get worse with:

• being upright, standing or walking
• moving, or being moved, for example riding in a car or a lift (elevator in the US)
• looking at moving or busy visual scenes, such as passing traffic or crowds

Anxiety links to PPPD in more than one way. PPPD usually starts after something that upsets balance, and the criteria paper lists panic attacks and anxiety that cause prominent dizziness among the most common triggers, at about 15% of cases each, behind inner-ear or brain balance disorders (25 to 30%) and vestibular migraine (15 to 20%). The paper also names high anxiety and close watchfulness about symptoms during that first episode as possible early steps towards PPPD. PPPD can exist alongside an anxiety disorder or another illness, so having anxiety does not rule it out.

Dizziness, vertigo or feeling faint: what’s the difference?

“Dizzy” covers several feelings, and the type can point to the cause. The NHS says dizziness can mean feeling off-balance, giddy, light-headed or faint, or feeling that you or things around you are spinning, which is vertigo.

Feeling	What it is like	Possible causes
Light-headed	Woozy or swimmy, as if you might pass out	Stress or anxiety, standing up suddenly (a drop in blood pressure called postural hypotension), dehydration or heat, low blood sugar in diabetes, iron deficiency anaemia, a new prescription medicine (NHS)
Spinning (vertigo)	You or the room seem to move or spin, enough to affect your balance; you may feel or be sick	Mostly inner-ear problems such as BPPV, labyrinthitis, vestibular neuronitis and Ménière’s disease; also migraine and PPPD; less commonly a stroke or multiple sclerosis (NHS inform)
Feeling faint	Dizziness, sweating, feeling hot or sick, or changes to your vision just before passing out	Standing up too quickly, not eating or drinking enough, being too hot, being very upset or in severe pain, heart problems (NHS)
Unsteady most days for months	Off-balance or rocking rather than spinning, worse when upright, moving or in busy places	PPPD, often after an inner-ear problem, migraine, panic or anxiety (Bárány Society)

NHS inform notes that anxiety can make vertigo worse, but that does not mean anxiety caused the spinning. BPPV, where certain head movements trigger vertigo, is one of the common causes, which is why spinning is worth getting checked.

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What helps when anxiety makes you dizzy?

Get safe first, then slow your breathing. These steps are for dizziness you know is linked to anxiety; if it is new, different or comes with a warning sign below, get medical help instead.

1. Sit or lie down. The NHS advises lying down until the dizziness passes, then getting up slowly; NHS inform says to sit down straight away. Do not drive, climb a ladder or use heavy machinery while you are dizzy.
2. Slow your breathing. Mind suggests concentrating on breathing slowly in and out while counting to 5. MedlinePlus describes pursed-lip breathing: pucker your lips as if blowing out a candle, then breathe out slowly through them. Our guided breathing exercise can pace you.
3. Ground yourself. Mind says grounding techniques can help you feel more in control. The 5-4-3-2-1 grounding technique walks you through what you can see, feel, hear, smell and taste.
4. Use the ABC. Mind sums it up as ABC: accept that it is a panic attack, breathe, and connect yourself to your senses.
5. Have some water. The NHS suggests plenty of fluids and avoiding coffee, cigarettes and alcohol while dizzy.

What helps in the longer term?

Longer-term help means treating the anxiety and, if the dizziness persists, getting your balance checked.

• Talking therapy. The NHS says you can see a GP or, if you are 18 or over (16 or over in some areas), refer yourself to an NHS talking therapies service. It also points to self-help CBT (cognitive behavioural therapy) techniques, and advises slowly building up time in worrying situations rather than avoiding them.
• Early, dizziness-focused CBT. The Bárány Society paper reports that people with early signs of chronic dizziness who had three sessions of CBT, started within 8 weeks of the triggering event, had marked reductions in dizziness and avoidance that lasted to a six-month follow-up.
• Vestibular rehabilitation. The same paper says treatment studies in PPPD showed significant improvement with balance (vestibular habituation) exercises or with serotonergic antidepressants (SSRIs). NHS inform says gentle movement helps the balance system reset, and that if vertigo or balance problems last more than 6 weeks you may be referred to a vestibular (balance) physiotherapist.
• Medicine. Whether medicine is right for you is a decision for you and your doctor. Do not start, stop or change any medicine without advice.

What else can cause dizziness?

Many things, so dizziness that keeps coming back should be checked, not put down to anxiety. The NHS lists these causes:

• Low blood pressure on standing. Dizziness when you stand or sit up suddenly can be postural hypotension.
• Ear problems. Feeling off-balance with some hearing loss or ringing in the ears (tinnitus) can mean an inner-ear problem; spinning after a cold or flu can be labyrinthitis. NHS inform adds BPPV and Ménière’s disease.
• Low blood sugar. Hypoglycaemia in people with diabetes.
• Medicines. Dizziness after starting a new prescription medicine can be a side effect; ask your pharmacist.
• Anaemia and more. Iron deficiency anaemia, an ear infection, migraine, dehydration or heat exhaustion, and motion sickness.

When to see a doctor

See a GP (family doctor) if you are worried about your dizziness, if it will not go away or keeps coming back, or if it comes with changes to your pulse, fainting or collapsing, headaches, or feeling or being sick, the NHS advises. The NHS says to see a GP if you have fainted, to find out what caused it. Also see a GP if anxiety is hard to cope with or self-help is not working.

Ask for an urgent GP appointment or contact NHS 111 if you have vertigo with a severe headache, feel or are being sick, or have a high temperature and feel shivery (NHS inform).

Call emergency services or go to A&E (the emergency room) straight away if dizziness comes with:

• signs of a stroke, remembered as FAST: face drooping on one side, arm weakness or numbness, speech problems such as slurred words, and time to call 999. Other stroke symptoms include feeling dizzy or falling over, a severe headache and blurred vision (NHS).
• double vision or loss of vision, hearing loss, difficulty speaking or slurred speech, or weakness, numbness or tingling in the arms or legs (NHS inform).
• fainting with chest pain or a pounding, fluttering or irregular heartbeat, fainting during exercise or while lying down, not waking within 1 minute, a seizure, or not fully recovering (NHS).

If stroke symptoms stop, the NHS says to get help straight away anyway. Never put chest pain with dizziness down to anxiety without a check; our guide to anxiety’s physical symptoms lists the heart attack warning signs. Do not drive yourself to A&E. In an emergency call 911 (US), 999 (UK) or 112 (EU). If anxiety comes with thoughts of harming yourself, our Get help now page lists crisis lines.