Medicine

Dizzy spells often a mental rather than a physical issue

For some people the problem of dizzy spells or lightheadedness is caused by a psychological condition that over time can become unbearable. File Photo  

How often have you said that you were “feeling quite lightheaded” without giving it a further thought? Well, for some people the problem of dizzy spells or lightheadedness is caused by a psychological condition that over time can become unbearable.

To experience constant lightheadedness from first thing in the morning until last thing at night is akin to suffering one of the symptoms of seasickness on a permanent basis.

Not surprisingly, the condition is a heavy burden to carry and, to make matters worse, thousands of patients have to live with the problem because their general practitioner is unable to find anything physically wrong.

This is because, in many causes, lightheadedness can be caused by psychological rather than physical problems.

“In Germany, approximately the same number of people suffer from dizzy spells as headaches,” says Professor Annegret Eckhardt-Henn, medical director of Stuttgart’s Clinic for Psychosomatic Medicine and Psychotherapy.

According to Eckhardt-Henn, around 12 per cent of all Germans will suffer from lightheadedness and its consequences at least once in their lives. “Around 30 per cent of these incidents can be put down to psychological problems,” she explains.

In most cases, many years pass before the person receives the correct diagnosis of their condition. Sometimes a problem with the spinal chord is suggested while on other occasions heart circulation problems or blood supply issues are considered the cause of the lightheadedness.

“Most patients with the somatic form run from suspicion to suspicion, undergo superfluous therapy after superfluous therapy and take a lot of unnecessary medication,” says Mark Obermann from the Department of Neurology in the University of Duisburg-Essen.

However, nothing ever seems to help alleviate the symptoms. “The fear that something really bad will happens grows uncontrollably,” he says.

The dizzy spells can also get so strong that some sufferers barely trust themselves to leave home. “At the beginning, issues such as phobias and depressive or dissociative problems occur,” explains Eckhardt-Henn.

The most common affliction for sufferers is a fear of public places like railway stations, market squares or shopping centres.

“Fear of an escalator or a visit to the cinema can also be the trigger for the onset of a dizzy spell,” she adds.

While some phobia sufferers begin to sweat more profusely or shiver in such situations, patients with lightheadedness feel a rolling unsteadiness. “The lightheadedness is then thought to be the main problem and not the fear that lies behind it,” says Eckhardt-Hann.

Professor Michael Strupp of the Klinikum Grosshadern of Munich’s Ludwig Maximilians University notices similar traits in many of the patients he treats for dizziness. “There are people who are aware of their duties and intent on keeping them under control,” he says.

Following the negative experience of the first spell of lightheadedness, many begin to suppress the problem. “Those affected have a very intensive self-perception about their sense of balance,” he explains.

In reality, all people swing slightly when standing as it is impossible to remain 100 per cent straight and immobile. However, phobia sufferers pay so much attention to their own sense of balance that they notice every small movement and value it negatively.

“In this way, a self-observation spiral develops, which increases the lightheadedness and produces it again and again,” says Strupp.

The lightheadedness takes on a momentum of its own and only begins to abate when the patient concentrates or is distracted by something else. Accordingly, the first step in any therapy is enlightenment, says Obermann.

“Once patients understand what is going on, for many of them the situation improves.” The fundamental phobia triggers can then be targeted so that, step by step, the spiral of fear can be dissipated.

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Printable version | Feb 26, 2021 11:27:27 PM | https://www.thehindu.com/sci-tech/health/medicine-and-research/Dizzy-spells-often-a-mental-rather-than-a-physical-issue/article15791943.ece

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