Mastering Dizziness & Maintaining
P. Staab, MD, MS
Professor of Psychiatry
Departments of Psychiatry and Otorhinolaryngology
Head and Neck Surgery
The Balance Center
University of Pennsylvania School of Medicine
This chapter is for
people with chronic dizziness, regardless
of the cause. It’s also for their
family members, friends, lovers, coworkers
and employers. No doubt, all of you have
experienced the frustration that comes
with chronic dizziness. Will it ever go
away? What’s causing it? Is it real?
You hope for an answer, but sometimes
find it hard to be optimistic about the
future. Is dizziness your destiny? Not
necessarily. Our understanding about the
causes of chronic dizziness is improving
rapidly and new treatments are available
that are very effective for many individuals.
Of course, these new treatments do not
work for everyone. Some people have to
find a way to cope with their dizziness
over the long term. This chapter will
take you through a process of understanding
chronic dizziness in order to see if some
of our new insights and therapies might
be right for you. If you have chronic
dizziness, you owe it to yourself to learn
as much as you can about mastering your
symptoms. Even if your dizziness cannot
be cured, it doesn’t have to prevent
you from enjoying your life.
Have…Well, I Don’t Know How
to Describe it. I’m Just Dizzy.
People with chronic
dizziness frequently find it difficult
to describe their symptoms. I ask my patients
a lot of questions to help them explain
what they’re feeling:
- Do you have vertigo
- Does it come and
go or is it always present?
- Is it worse when
you move your head, stand up or turn
- Do you feel better
with your eyes open or closed?
- What about grocery
stores, busy malls, wide-open spaces,
riding in a car, or foggy days?
- Is it worse when
- Have you ever
fallen down or fainted?
The answers to these
questions are not always crystal clear,
but that’s okay. Sensations of chronic
dizziness can be confusing and vague.
No need to worry about that. As strange
as it seems, this very quality of vagueness
can be quite helpful from a diagnostic
As you have learned
by now, dizziness and vertigo are not
the same, though many people use the two
words interchangeably. Keep in mind that
vertigo is the sensation that you’re
spinning or the world is turning around
you and it always comes in spells. It
is never a constant symptom. Dizziness
is a sensation of being off balance, off
kilter, unsteady, swaying or rocking.
Some people describe it as a heavy or
foggy feeling in their head. Others say
that they are lightheaded. . .
with chronic dizziness are treated as
if they’re faking. Family members,
employers, insurance companies or doctors
may question their truthfulness. A few
patients have even asked me if their own
symptoms were real! If you have chronic
dizziness that is anything like what was
described above, stick to your guns and
read on. If you’ve never experienced
chronic dizziness, try shaking your head
back and forth 20 times as quickly as
you can or spin around quickly for a whole
minute, then continue reading. This will
give you only an inkling of what it’s
like. . . (and so much more!)