What exactly is PPPD?
Persistent Postural-Perceptual Dizziness (PPPD) is a long-term condition where people feel dizzy, unsteady, or like they’re swaying even when they’re not actually moving. These symptoms last for three months or more and often feel worse when standing up, walking around, or looking at busy or moving things (like crowds, traffic, or screens).
PPPD usually starts after something messes with your balance, like an inner ear problem, a bad virus, or even a very stressful event. Even though the original issue might have healed, the brain gets stuck in “alert mode,” which makes it hard to feel balanced again.
What’s tricky is that PPPD doesn’t show up on standard medical tests, so diagnosis is based on your symptoms and how they show up in everyday life. Experts agree that PPPD isn’t caused by a damaged balance system, but by how the brain and body are responding after that system was shaken up.
People with PPPD often rely too much on their vision to stay balanced, become extra alert to body sensations, and may feel more anxious or cautious. This can create a cycle that keeps the dizziness going.
The good news? PPPD is treatable. A mix of vestibular rehab (balance exercises), therapy (like CBT), and sometimes medication can help retrain the brain, calm the nervous system, and get you back to feeling steady again.
How can Balens Therapy help with PPPD?
At Balens Therapy, we understand that Persistent Postural-Perceptual Dizziness (PPPD) is more than just feeling off balance; it’s a whole-body experience that can disrupt your daily life, make you anxious about moving, and leave you feeling stuck in survival mode. But you don’t have to navigate it alone.
Our approach is rooted in a compassionate, evidence-based approach. We offer psychotherapy that integrates cognitive behavioural therapy (CBT), a proven treatment for PPPD, especially when anxiety, hypervigilance, or stress are making symptoms worse. Through CBT, we’ll help you recognize and shift thought patterns that keep your nervous system on high alert, gently reframe your relationship with your symptoms, and build new coping tools that support healing.
We also recognize the deep mind-body connection in PPPD. Many of our clients benefit from our holistic, trauma-informed style, which creates space for nervous system regulation and body awareness. We may incorporate nature-based strategies (like grounding practices with plants or mindfulness inspired by natural cycles) to help you feel calmer and more connected during the healing process.
While we don’t offer vestibular rehab directly, we often collaborate with other healthcare providers, like physiotherapists who specialize in VRT, to ensure you’re getting a comprehensive, team-based approach. And if medication is part of your plan, we can support you in advocating for that with your physician, while helping you manage any emotional or physical responses.
Above all, we tailor care to you. Every brain and body is different, and healing from PPPD is not one-size-fits-all. Whether you're newly diagnosed or have been living with symptoms for a while, our goal is to help you move from simply coping to feeling steady, safe, and empowered again.