Why Won’t the Dizziness Go Away? Understanding the Anxiety–PPPD Cycle
If you have been feeling dizzy for weeks or months without a clear medical explanation, you are not alone, and you are not imagining it.
Many high-achieving women, especially women of colour, end up in a loop of specialist appointments, normal test results, and vague reassurances. If you have heard, “It is just anxiety,” and walked away feeling dismissed, this post is for you.
There is a growing body of research around a condition called Persistent Postural-Perceptual Dizziness (PPPD), which often develops after a period of acute dizziness, a stressful life event, or both. While the name may sound clinical or complicated, the experience is deeply personal. It affects your ability to work, socialize, move, and even trust your own body.
Let’s break down what PPPD is, why it becomes chronic, and how anxiety plays a key role in the cycle.
What Is PPPD?
PPPD is a chronic vestibular condition that causes non-spinning dizziness, imbalance, and a sense of motion that does not match your environment. Symptoms often worsen with standing, walking, scrolling, or exposure to busy visual environments like grocery stores or traffic.
According to the Bárány Society, PPPD is considered a functional neurological disorder that disrupts how your brain and body process sensory information, not because of damage, but because of dysregulation (Staab et al. 2017).
This means the brain is receiving real signals from the body but interpreting them in a way that keeps it in a state of perceived threat. It is like a faulty alarm system: nothing is wrong, but your body keeps ringing the alarm anyway.
The Anxiety–Dizziness Feedback Loop
One of the hardest parts of PPPD is the way anxiety and dizziness reinforce each other. Many people experience an inner dialogue like this:
I feel dizzy
That makes me anxious
The anxiety increases my dizziness
Now I feel even more out of control
This cycle has a neurobiological explanation. Research shows that individuals with PPPD have increased activation in the insula, a brain region that processes internal sensations and threat perception (Indovina et al. 2015). This heightened awareness of bodily sensations, paired with chronic stress or trauma, can create central sensitization, a state where the nervous system becomes hyper-reactive to input.
If your body has learned that dizziness is dangerous, even minor motion can trigger a fear response. And if you are someone who tends to push through symptoms… something many professionals and caregivers are conditioned to do… the cycle can worsen until burnout or panic sets in.
The Role of the Mind–Body Connection
There is a deep mind–body connection in PPPD. It does not mean the dizziness is “all in your head.” It means your nervous system is involved.
This is where polyvagal theory can help explain what is happening. When your body feels unsafe, whether due to illness, stress, or trauma, your nervous system shifts into survival mode. This might show up as anxiety (fight or flight) or fatigue and disconnection (freeze or shutdown).
Because PPPD disrupts your sense of balance and movement, your nervous system stays on high alert. It is trying to protect you, but it ends up amplifying symptoms.
Trauma-informed care recognizes that chronic health conditions can be both a medical issue and an emotional wound. The body remembers what it means to feel unsafe, especially if you have navigated racism, medical gaslighting, or ongoing stress.
Why High-Achieving Women Are Often Overlooked
BIPOC women are often praised for their resilience, but this expectation can become a burden. If you are used to managing a full workload, caregiving, or being “the strong one,” it can feel almost impossible to slow down or ask for help.
Many clients with PPPD are perfectionists, high-functioning professionals, or caretakers. They may not appear distressed on the outside, but inside they feel unsteady, exhausted, and overwhelmed.
A 2021 study found that people with PPPD often experience significant distress and functional impairment, yet their suffering is frequently dismissed due to normal imaging and test results (Popkirov et al. 2021).
Validation is part of healing. You are not overreacting. Your symptoms are real. And you deserve support.
What Can Help?
Recovery from PPPD is possible, but it takes a multidisciplinary approach that targets both the brain and body. Treatment may include:
Vestibular rehabilitation therapy to retrain the brain’s balance system
Cognitive Behavioural Therapy (CBT) to challenge fear-based thoughts and reduce avoidance
Somatic or trauma-informed therapy to help regulate the nervous system
Pacing strategies to avoid boom-and-bust cycles of pushing through, then crashing
Mindfulness and grounding tools to reconnect with safety in the body
Therapy tailored to BIPOC experiences can be especially helpful when medical systems have felt invalidating or alienating.
Final Thoughts???
If your dizziness just will not go away, and you are tired of being told it is nothing, know that PPPD is real and treatable.
You are not fragile. You are not imagining things. Your body is trying to protect you. With the right support, you can retrain your brain, calm your nervous system, and rebuild trust with your body.
At Balens Therapy, we support women of colour navigating the complexity of chronic symptoms, stress, and neurodivergence. Your healing is possible, and it starts with being seen.
Works Cited
Indovina, I., et al. “Pathophysiology of functional dizziness: implications for treatment.” Current Opinion in Neurology, vol. 28, no. 1, 2015, pp. 61–68.
Popkirov, S., Staab, J. P., & Stone, J. “Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness.” Practical Neurology, vol. 20, no. 1, 2021, pp. 13–21.
Staab, J. P., Eckhardt-Henn, A., Horii, A., Jacob, R., Strupp, M., Brandt, T., & Bronstein, A. M. “Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the Committee for the Classification of Vestibular Disorders of the Bárány Society.” Journal of Vestibular Research, vol. 27, no. 4, 2017, pp. 191–208.
