Stress and vertigo: what to know

Vertigo is a false feeling that you or your surroundings are moving, often spinning or tilting. Stress and rapid breathing can make balance symptoms feel stronger, while worry may follow an episode and reinforce avoidance. Stress alone cannot identify the cause. Brief attacks brought on by turning in bed can occur with benign paroxysmal positional vertigo; hearing changes or ringing may point towards another inner-ear problem such as [Meniere's Disease](/conditions/menieres-disease/). Infection and [Migraine](/conditions/migraine/) can also affect balance. Read about [Vertigo](/symptoms/vertigo/).

Sit or lie somewhere safe, keep your head still, and avoid driving, heights or machinery until the sensation settles. Breathe slowly and regularly rather than taking rapid breaths. Move from lying to sitting and standing gradually, and keep pathways clear to reduce falls. Note what happened immediately beforehand, how long it lasted, hearing symptoms, headache, nausea and whether head movement triggered it. If positional vertigo is diagnosed, a clinician may recommend the [Epley Manoeuvre](/treatments/minor-procedures/epley-manoeuvre/); do not perform it without appropriate instruction.

Seek urgent help for vertigo with new weakness, facial drooping, trouble speaking, severe headache, fainting, chest pain, inability to walk or sudden hearing loss. Arrange assessment for a first episode, repeated attacks, persistent imbalance, ear pain or symptoms after an injury. Stress should not be used to explain away a new neurological symptom.

Does the timing or movement trigger suggest an inner-ear cause? Do I need hearing or balance tests? Is a repositioning manoeuvre suitable, and how should I reduce fall risk?