A diagnosis of a vestibular disorder can be particularly troubling for patients because of the profound effects on daily functioning. Vestibular symptoms often impact work and home life in a significant manner. Symptoms can be physical (dizziness, balance issues, vertigo, headaches, nausea, tinnitus, etc.), cognitive (reduced attention or concentration, memory issues) and/or emotional (depression, anxiety, malaise). Vestibular symptoms can be difficult for both patients and their families, because unlike a broken bone, for example, there is often not a definitive timeline as to when a patient will improve.
While many vestibular disorders have an identifiable cause, others do not. Many vestibular symptoms resolve within 6 – 12 weeks, often through complex compensatory mechanisms of the brain and body, or because an underlying condition has improved. However, in many cases, the cause of the symptoms is unknown (even after extensive testing) and vestibular symptoms persist.
One aspect that must be considered in understanding unremitting symptoms is psychological factors. There are two ways in which emotional aspects can affect vestibular symptoms.
Firstly, psychological factors may exacerbate symptoms because of the high levels of stress associated with carrying out daily activities when vestibular symptoms are present. Because vestibular symptoms affect a person’s ability to carry out activities, there is often much anxiety about being able to complete activities of daily living. Because vestibular episodes often appear to be unpredictable and inconsistent in their onset, patients often suffer from a great deal of anticipatory anxiety. This fear and anxiety can often be as disabling as the disorder itself. Many vestibular patients become avoidant of activities, for fear of eliciting symptoms.
Secondly, mind/body processes must be considered as a factor in vestibular symptoms. A tendency to suppress/repress strong negative emotions, high levels of stress and pressure, past loss or trauma and personality types that are conflict-avoidant all serve to enhance vestibular symptoms.