Can anxiety cause dizziness? Why you feel light-headed, and what helps

The room feels like it’s tilting. Your head goes light, your legs feel wobbly, and you grab onto something to steady yourself. Then comes the fear: Am I going to faint? Is something wrong with my brain?

Dizziness is one of the most common physical symptoms of anxiety. Here’s why it happens, how to tell when it might be something else, and what helps.

If dizziness comes on suddenly with weakness or numbness on one side, a drooping face, slurred speech, a severe headache, chest pain, or you faint, call 911 (or your local emergency number) now.

Can anxiety cause dizziness?

Yes. Dizziness and light-headedness are listed symptoms of both panic attacks and generalised anxiety. People describe it as:

• light-headed or woozy
• floaty, as if walking on a boat or a soft mattress
• unsteady on your feet
• feeling like you might faint
• a sense of motion, or the room shifting, though usually not true spinning

Why anxiety makes you dizzy

• Overbreathing. When you’re anxious, you often breathe faster or more deeply than your body needs. That lowers the carbon dioxide in your blood, which narrows blood vessels in the brain a little and causes light-headedness, tingling and a spacey feeling.
• Adrenaline. Your heart races, your blood pressure shifts, and blood is sent to your muscles. That can leave you feeling wobbly.
• Tense neck and shoulder muscles, which can contribute to an unsteady, heavy-headed feeling.
• Watching for danger. Anxiety makes you hyper-aware of body sensations. Small, normal wobbles feel much bigger when your brain is on high alert.
• Not eating or drinking enough, which is easy to do when you’re anxious.

Dizziness during a panic attack

Dizziness is one of the recognised symptoms of a panic attack, and it’s often one of the most frightening, because it brings a fear of fainting or losing control. During a panic attack:

• Overbreathing peaks. Breathing fast lowers carbon dioxide, causing light-headedness, tingling and a spacey feeling within a minute or two.
• Your heart races and your blood pressure usually rises, which is why fainting during a panic attack is uncommon.
• Fear feeds the feeling. Noticing the dizziness, and fearing what it means, keeps the panic going.

If it happens:

1. Sit down, or stop what you’re doing. If you’re driving, keep breathing slowly and pull over when it’s safe.
2. Look at one still point, like a door frame or a sign.
3. Make your breathing gentle, not deep. Small, slow breaths through your nose, with a long, slow breath out. Don’t gulp air.
4. Ground yourself while seated: feel your feet on the floor and your back against the chair.
5. Remind yourself: “This is panic. Panic makes me dizzy, but it doesn’t usually make people faint. It will pass.”

The exception: some people with a fear of blood, needles or injury do faint, because their blood pressure drops suddenly. If that’s you, lie down with your legs raised when you feel faint. And if you actually faint, or feel faint without panic, see a doctor.

When dizziness and anxiety feed each other

Dizziness is frightening, so it causes anxiety. Anxiety then causes more dizziness. This loop is very common.

Sometimes it carries on after the original cause has gone. For example, after a bout of an inner ear infection, vertigo or a panic attack, some people are left with dizziness or unsteadiness on most days for months. It’s often worse when standing or walking, in busy places like supermarkets, or when watching moving things. This is called persistent postural-perceptual dizziness (PPPD). It’s a recognised condition, and it responds to treatment like vestibular rehabilitation (balance exercises with a physical therapist), CBT and sometimes medicine.

Other causes of dizziness

Dizziness has many causes, and it’s worth getting checked, especially the first time. Common ones include:

• Inner ear problems. Benign paroxysmal positional vertigo (BPPV) causes brief spinning when you turn your head, roll over in bed or look up. Infections and Ménière’s disease can cause vertigo with hearing changes or ringing in the ears.
• Low blood pressure when you stand up, making you light-headed for a few seconds
• Dehydration, especially in hot weather, after exercise or illness
• Low blood sugar, particularly if you have diabetes or have skipped meals
• Medicines, including some blood pressure tablets, antidepressants, sleeping tablets and pain medicines
• Migraine, which can cause dizziness with or without a headache
• Anaemia, heart rhythm problems and other medical conditions
• Alcohol and other drugs

When to get help

Call 911 (or your local emergency number) if dizziness comes with:

• sudden weakness or numbness, especially on one side of your body
• a drooping face, slurred speech or confusion
• a sudden, severe headache
• sudden loss of vision or double vision
• chest pain, a very fast or irregular heartbeat, or breathlessness
• fainting

See a doctor soon if:

• dizziness keeps coming back, or you’re not sure what’s causing it
• you have spinning vertigo, especially with hearing loss or ringing in your ears
• it started after a head injury
• it started after a new medicine
• it’s affecting your daily life, or you’re avoiding going out

What helps in the moment

1. Sit or lie down if you feel faint, and wait until it passes before getting up slowly.
2. Fix your eyes on a still point, like a door frame or a spot on the wall.
3. Slow your breathing down. Breathe in gently through your nose for 4 and out for 6. Avoid big gulps of air, which feed overbreathing.
4. Ground yourself. Press your feet into the floor and notice the solid surface under you.
5. Sip some water, and eat something if you haven’t for a while.
6. Name it. “This is anxiety dizziness. It feels strange, but I’m safe, and it will settle.”

What helps over time

• Practise slow breathing daily, so you’re less likely to overbreathe when anxious.
• Stand up slowly, especially after sitting or lying down for a while.
• Stay hydrated and eat regularly.
• Keep moving. Avoiding walking, busy places or turning your head can make dizziness and fear worse. Gently doing more helps your balance system and your brain recalibrate.
• Treat the anxiety. CBT helps with the fear of dizziness and with panic. If dizziness has lasted months, ask about vestibular rehabilitation.

Frequently asked questions

Why do I feel dizzy during a panic attack?

Mostly because of overbreathing: breathing faster than your body needs lowers the carbon dioxide in your blood, which causes light-headedness and tingling. Adrenaline and fear of the sensation add to it. Slow, gentle breathing usually eases it within minutes.

Can anxiety make you dizzy all day?

Yes, especially if you’re anxious most of the day and breathing fast and shallowly without noticing. But dizziness all day should be checked by a doctor to rule out other causes, like an inner ear problem, low blood pressure or a medicine side effect.

Can anxiety cause vertigo?

Anxiety usually causes light-headedness or unsteadiness rather than true spinning vertigo. If the room is spinning, especially when you move your head, it’s more likely to be an inner ear problem, which is very treatable. The two often happen together, though.

Will I faint from anxiety dizziness?

It’s uncommon. During a panic attack, your blood pressure usually goes up, not down, which makes fainting less likely. Some people with a fear of blood or needles do faint, because their blood pressure drops suddenly. If you’ve actually fainted, see a doctor.

How long does anxiety dizziness last?

During a panic attack, it usually eases within minutes as the panic settles. With ongoing anxiety, it can come and go for hours or days. Dizziness that lasts months may be PPPD, which is treatable.

How Breatheasy can help

Breatheasy can help you slow down the overbreathing behind anxious dizziness. Its breathing exercises pulse your phone as you breathe in, so you can sit with your eyes fixed on one spot and just follow the rhythm. If dizziness turns into panic, tap “I’m feeling anxious” and Luma walks you through it, step by step. Breatheasy is coming soon to iPhone and Android.

Sources

• Dizziness, NHS
• Vertigo, NHS
• Low blood pressure, NHS
• Diagnostic criteria for persistent postural-perceptual dizziness (PPPD), Staab and others, Journal of Vestibular Research, 2017
• Symptoms of a stroke, NHS
• Panic disorder, NHS