Living with PPPD: How to Cope When Your Body Feels Unsafe

Persistent Postural-Perceptual Dizziness (PPPD) is more than just chronic dizziness. It is a full-body experience that can shake your sense of safety, control, and trust in yourself. For many high-achieving women of colour, it becomes especially disorienting when the medical system cannot provide clear answers, and your body no longer feels like a safe place to live.

This condition does not just affect your balance. It affects your nervous system, your emotional well-being, and your relationship with your own body. If you feel dismissed or unheard by providers and confused by your symptoms, you are not alone. PPPD recovery is possible, and it starts with understanding what is happening beneath the surface.

What Is PPPD and Why Does It Feel So Scary?

PPPD is a functional neurological condition that causes chronic dizziness, imbalance, and visual sensitivity. Symptoms often worsen with motion, standing, scrolling, or being in visually busy environments. Unlike vertigo, PPPD does not involve spinning but creates a sense of motion or unsteadiness that is persistent and distressing (Staab et al. 2017).

It often begins after an illness, a vestibular event, or a period of intense stress. Even after the initial cause resolves, the brain and nervous system can stay on high alert, keeping the dizziness going. This is not imagined. It is a real physiological pattern of dysregulation that affects your sensory and emotional processing (Popkirov et al. 2021).

When Your Nervous System Feels Stuck in Survival Mode

To understand why PPPD feels so overwhelming, we can look at polyvagal theory, developed by Dr. Stephen Porges. This theory explains how the autonomic nervous system responds to perceived safety or danger through three main states:

• Ventral vagal (safe and socially engaged)

• Sympathetic (fight or flight)

• Dorsal vagal (freeze or shut down)

With PPPD, your nervous system can shift rapidly between these states. You may go from calm to overwhelmed just by walking down a crowded hallway or scrolling through your phone. The body interprets visual motion or internal imbalance as a threat, triggering fear, fatigue, or emotional shutdown.

For BIPOC women, who may already live with the effects of racial trauma or chronic stress, this heightened sensitivity can feel even more intense. The body remembers what it is like to be unsafe… physically, emotionally, or culturally… and that memory can shape how symptoms are experienced and processed.

Why PPPD Impacts Self-Trust

When you cannot rely on your own body to feel grounded, it chips away at your sense of control. You may find yourself avoiding places you used to enjoy. You may fear walking alone, attending meetings, or navigating public spaces. The world starts to feel smaller, and shame or self-blame can creep in.

Many women with PPPD are told it is just anxiety or stress. While it is true that stress plays a role, that does not mean your experience is imagined or less valid. A trauma-informed approach recognizes that symptoms like dizziness are real, distressing, and deserve care that honours both the body and the mind.

Tools for Feeling Safer in Your Body

Healing from PPPD involves more than vestibular rehab or medication. It includes building safety into your body and environment. Here are a few approaches that support recovery through a trauma-informed lens:

1. Grounding Through the Senses

Your nervous system responds to cues of safety. Try using sensory grounding techniques like:

• Pressing your feet into the floor and naming five things you can see

• Running warm water over your hands

• Carrying a smooth stone or textured object for tactile grounding

These small tools help bring the brain out of fear mode and into the present moment.

2. Gentle Exposure, Not Avoidance

Avoiding triggers can make symptoms worse over time. Instead, try graded exposure, tiny, manageable doses of movement or stimulation followed by rest. This helps rewire the brain’s response and builds tolerance.

Vestibular therapy may offer support here, but pacing is key. Go slow and celebrate even the smallest wins. Recovery is not linear.

3. Co-Regulation and Social Safety

Being around calm, supportive people can regulate your nervous system, too. This is known as co-regulation. Talking with someone who validates your experience, or even sitting with a pet or therapist, can shift your body toward a state of ease.

Online support groups, therapy, and culturally affirming spaces can provide emotional safety when the medical system has felt invalidating.

4. Self-Compassion Over Self-Criticism

It is easy to fall into thoughts like “I should be over this” or “Why can’t I just push through?” But healing requires kindness. Self-compassion is not indulgence; it is evidence-based and shown to reduce symptoms of anxiety and improve quality of life in chronic illness (Germer & Neff 2013).

Try saying, “This is hard. I am not alone. I am learning to feel safe again.”

Final Thoughts???

Living with PPPD can feel like walking through the world on shaky ground… literally and emotionally. But you are not broken. Your body is not betraying you. It is asking for support.

By understanding how PPPD affects the nervous system and using trauma-informed tools, you can begin to rebuild trust in yourself. Recovery is not just about reducing dizziness. It is about reclaiming your sense of safety and power.

At Balens Therapy, we work with high-achieving BIPOC women navigating chronic symptoms and emotional burnout. You deserve care that sees your full experience and walks with you toward healing, one grounded step at a time.

Works Cited

Germer, Christopher, and Kristin Neff. “Self-Compassion in Clinical Practice.” Journal of Clinical Psychology, vol. 69, no. 8, 2013, pp. 856–867.
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.
Porges, Stephen W. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. W. W. Norton & Company, 2017.