How to Recover From Vertigo and Inexplicable Dizziness

Susan Gearhart sat up in bed one morning and found the room spinning. “I thought I was having a stroke,” she recalls. Whenever she turned her head, she experienced overwhelming vertigo. “All I could do was cry.”

Gearhart’s doctor diagnosed her with benign paroxysmal positional vertigo, or BPPV, a condition in which crystals in the inner ear migrate to one of the ear’s semicircular canals and trigger a sensation of spinning. (Spinning is the hallmark of vertigo; dizziness is defined by feeling lightheaded or unsteady.) With the help of physical therapy, the BPPV gradually subsided, but an around-the-clock, wobbly sensation plagued her for two years.

“I couldn’t cook dinner or do dishes for more than five minutes before I’d have to sit down. I’d open the refrigerator and feel like I was going to faint. I went to the emergency room three, maybe four times,” she says.

Her symptoms didn’t make sense. Gearhart hadn’t had a stroke, nor did she have an infection or disease. Even though her BPPV had resolved by then, the disorientation persisted and was severe enough to put much of her life on hold.

In search of solutions, Gearhart came across a series of videos by vestibular audiologist Yonit Arthur, AuD. She learned that dizziness without a medical explanation can be a sign that the brain is in a state of hypervigilance — associating countless harmless triggers with danger.

Arthur calls this phenomenon “neuroplastic dizziness” or “neural-circuit dizziness.” She describes it as a programming error affecting the brain’s ability to process information it receives from the body’s sensory systems. Symptoms may begin with a head injury, trauma, infection, or stress, but they persist after the original injury has resolved.

In Gearhart’s case, the trigger was her initial vertigo episode.

Injury, illness, and stress can cause neurological changes, explains functional neurologist Jeremy Schmoe, DC, DACNB. These can affect your brain’s ability to locate your body in space. The resulting dizziness, lightheadedness, motion sickness, or vertigo can, in turn, activate your sympathetic, fight-or-flight nervous system. Soon, your body has entered a self-perpetuating cycle of perceived threat, anxiety, and symptoms.

What Arthur calls neuroplastic dizziness is not a psychosomatic condition. Instead, it’s an indication that your brain’s neuroplasticity — its ability to learn and change — is temporarily working against you. It often means your brain is caught in a pattern of anticipating and experiencing dizziness after the original issue has been resolved.

Fortunately, this is a software, rather than a hardware, problem, says Arthur. That means you can harness your brain’s plasticity to work for you again. One primary way to break free of the cycle, she suggests, is to learn how to react to symptoms in a new way.

Your Body in Balance

Under normal circumstances, your body’s ability to achieve and maintain balance is the result of multiple systems working together to recognize your position in space.

One of these is the vestibular system. Housed in your inner ear, it comprises three semicircular canals that detect whether your head is turning or changing direction. It also includes two small chambers called otolith organs; these detect backward and forward movement, as well as gravitational pull. Incoming information is sent to your brainstem, where a group of nerve cells called vestibular nuclei coordinate reflexes in your eyes and muscles to help stabilize your vision to prevent falling.

Yet balance involves more than the inner ear, explains Schmoe. “The inner ear itself can’t 100 percent detect all of the motion and movement that a complex human being can do.”

The visual system also plays a role in balance. Your eyes send out signals about your environment to different areas of your brain, via the optic nerve, such as whether the ground is level or, if you’re in motion, where you are relative to objects around you.

Finally, there’s the body’s proprioceptive system, composed of receptors in the muscles, joints, tendons, and skin. These provide sensory feedback about gravitational load, how your musculoskeletal system is handling that load, and your body’s position in space. The cervical spine provides input that helps coordinate the movements of your head and body.

[People] may also consciously adapt their behavior, such as by steering clear of crowded places, escalators, or visually busy environments to avoid triggering symptoms. Arthur cautions that extreme avoidance can feed the perceived threat-anxiety-symptom loop. “People become hyperfocused on the symptoms. Their nervous system is sensitized to triggers. These perpetuate the mismatch.”

All three systems — vestibular, visual, and proprioceptive — are integrated in the brainstem and cerebellum. Together they act as your brain’s command center for balance.

Chronic dizziness is a sensory-integration problem in this command center, says Schmoe. When the brainstem and cerebellum start to misinterpret signals from the vestibular, visual, or proprioceptive systems, you get a mismatch between what your brain predicts and what you experience.

We typically find ways to compensate. Someone might rely more on their visual system for balance if their inner ear is offline. Or they may instinctively keep their head still or unconsciously adopt postural or gait changes to find stability.

They may also consciously adapt their behavior, such as by steering clear of crowded places, escalators, or visually busy environments to avoid triggering symptoms. Arthur cautions that extreme avoidance can feed the perceived threat-anxiety-symptom loop. “People become hyperfocused on the symptoms. Their nervous system is sensitized to triggers. These perpetuate the mismatch.”

Finding Your Feet

Dizziness and vertigo are among the most common reasons people in the United States visit a healthcare provider, but these visits can be exercises in frustration if providers can’t find a structural explanation.

Chronic dizziness that can’t be explained medically is a prime candidate for a mind-body approach. Depending on the original trigger and what’s perpetuating it, this can involve physical, vestibular, or neurological rehabilitation, as well as coaching or cognitive behavioral approaches. The goal is to dial down the body’s threat response.

“Your body and your mind and your brain are in constant contact, and what affects one is going to affect the other,” Arthur emphasizes.

When Schmoe treats a case of chronic dizziness, he first looks for any potential physiological or neurological root of dysfunction, such as neuroinflammation, imbalances in the gut microbiome, or compensatory strategies that may be making symptoms worse.

Arthur’s treatment approach focuses on vestibular rehabilitation, as well as addressing the psychological and social forces that perpetuate a dizziness cycle. She teaches an exercise called somatic tracking, training her patients to observe sensations with curiosity and without reacting. The goal of this technique is to retrain the brain to recognize safety. This can help reduce the reactivity that can trigger symptoms.

With the help of Arthur’s coaching, Gearhart was able to connect the dots between past trauma, emotions, and dizziness. After about 18 months of work, she was free of dizziness and anxiety. Gearhart now helps others as a mentor in Arthur’s program.

“Knowledge is power,” says Arthur. “Once people understand this is just [their] brain making an error here, they can reduce their fear. Since fear is one of the foundational problems in these cases, that in and of itself can really help with symptoms.”

Supporting Yourself

If you’ve seen a doctor and your chronic dizziness can’t be explained medically, check out the American Institute of Balance and the Vestibular Disorders ­Association to find a vestibular therapist or functional neurologist either near you or who offers telehealth services.

Meanwhile, there are several ways you can support your own healing, including with these expert recommendations:

Learn more. “The No. 1 thing you can do once you’ve got medical clearance is educate yourself on why this is just a software issue in your brain,” says Arthur. With some brain retraining, your neural circuitry can be rebooted.

Engage in gentle movement. Schmoe has designed a neurobic workout that helps activate your cerebellum and rewire neurons. It can also help with balance, coordination, and physical control. (Find Schmoe’s neurobic workout at “The Neurobic Workout.”)

Try somatic tracking. This mindfulness practice teaches your brain that your dizziness is not dangerous to you. Arthur offers guided practices on her YouTube channel, The Steady Coach.

Tend to your stress. Stress can trigger sustained chronic dizziness. To break the cycle, find a practice to ground yourself in the present and create emotional space from your stressors so you can respond more calmly. (For a helpful stress-relief technique, visit “What is EFT and How Does it Work?“)

Reduce brain inflammation. For many of his dizziness patients, Schmoe recommends nutritional supplements to help reduce brain inflammation and improve blood flow to the head. He suggests magnesium L-threonate, glutathione, vinpocetine, fatty acids, and ginkgo, as well as curcumin and resveratrol, which may support blood-brain barrier integrity.

Manage your blood sugar. Your inner ear responds to fluctuations in blood sugar, says Schmoe. Hypo­glycemia (low blood sugar), hyperglycemia (high blood sugar), and insulin resistance are among the most frequent causes of balance disorders.

Get sufficient ­vitamin D. Chronic dizziness is sometimes correlated with vitamin D deficiency. In one study, ­vitamin D–deficient patients with BPPV who received 50,000 IU of weekly supplemental vitamin D3, combined with physical therapy, experienced reduced symptoms that were sustained for at least six months.

Give your eyes a break. Completely avoiding visually stimulating environments can perpetuate the cycle of anxiety and symptoms, but taking occasional breaks from screens and other visually overwhelming stimuli can be helpful.

Try the home Epley maneuver. If you have been diagnosed with BPPV, your practitioner can teach you a method called the Epley maneuver to treat yourself at home. Both Arthur and Schmoe recommend against performing it without a diagnosis and training.

Common Dizziness Disorders

Several conditions can drive maladaptive changes in your brain’s balance and sensory-processing systems. Specific causes, symptoms, and treatments may differ, but they all share a common thread: Your brain is struggling to recalibrate after a destabilizing event. These five conditions can all correspond to chronic dizziness.

Persistent Postural Perceptual Dizziness (PPPD or Triple-PD)

PPPD typically develops after an illness or injury that affects balance. These include vestibular neuritis (inflammation of the vestibulocochlear nerve of the inner ear), concussion, and benign paroxysmal positional vertigo. It can also be triggered by acute stress, a migraine or panic attack, or a fainting episode.

Research suggests that patients with long COVID may be more susceptible. Functional neurologist J­eremy Schmoe, DC, DACNB, often sees patients with PPPD-like symptoms after they’ve experienced immune stressors, including mold exposure, Lyme disease, and chronic gut infections.

With PPPD, the brain is stuck in a heightened state of vigilance, misinterpreting normal movement and visual input as a threat. You may feel unsteadiness, motion sensitivity, lightheadedness, or nonspinning dizziness. Symptoms often get worse when standing or walking. Visually busy environments, like grocery stores or crowded places, can also be a trigger.

Treatment may include vestibular ­rehabilitation therapy, which is ­designed to help you regain control of gaze stability, physical stability, and balance. Cognitive behavioral therapy can retrain your brain and reduce symptoms. Medication may also be beneficial.

Schmoe often recommends an anti-inflammatory diet to support treatment. “If you’re doing these things and you’re still not feeling well, there could be something underlying going on that’s causing inflammation in the nervous system,” he says.

Benign Paroxysmal Positional Vertigo (BPPV)

BPPV occurs when calcium crystals called otoconia become dislodged from their usual location in your inner ear and move into the semicircular canals that help control balance. When you move your head, the dislodged crystals shift, sending signals to your brain that trigger sudden, intense vertigo. You may also feel nausea, unsteadiness, or a sense that the room is spinning.

BPPV is more common in older adults, people with head injuries, and people with a history of inner-ear infections.

BPPV itself is not chronic: It can be treated using physical therapy techniques, including the Epley maneuver, to return the crystals to the otolith organs in your inner ear. Sometimes it even resolves on its own.

But because it can cause hypervigilance and a sensitization to triggers, BPPV can lead to PPPD. “In that case, it’s not the physical problem that’s making dizziness chronic. It’s because the brain has taken over,” says vestibular audiologist Yonit Arthur, AuD.

Post-Concussion Syndrome (PCS)

Up to 80 percent of mild traumatic brain injuries lead to post-concussion syndrome, which can involve head­aches, brain fog, fatigue, and dizziness. Persistent PCS is diagnosed when post-concussion symptoms persist for more than three months after an initial concussion.

People with PCS may rely more on their vision than their vestibular and proprioceptive systems. Such reliance can overstimulate their nervous system, says Schmoe. “You may also have a sensation called vection, when you feel like you’re moving but you’re not.”

Anyone can develop PCS after a concussion, but it’s more common in those who have had multiple concussions, a history of migraine, or previous neurological conditions. “The concussion research is clear that psychosocial factors, including preexisting anxiety, are major risk factors for people developing chronic symptoms,” adds Arthur.

Recovery is typically nonlinear and takes time. Treatment may include physical therapy, vestibular therapy, cognitive therapy, or life­­style adjustments.

Visually Induced Dizziness (VID)

Rather than a diagnosis itself, VID is a constellation of symptoms caused by dysfunction in the vestibular system and triggered when your brain struggles to process complex visual environments. Sometimes called visual vertigo, VID can be caused by a range of conditions, including head injury, BPPV, and vestibular migraine. It’s often a symptom of PPPD.

The mismatch between what you’re seeing and your body’s sense of movement and balance can make you feel dizzy, lightheaded, or unsteady. It can also cause nausea, headaches, brain fog, and a feeling of being “off” even when you’re sitting still. Common triggers include grocery-store aisles, busy or moving patterns, fluorescent lighting, and scrolling on your phone. Hypervigilance and anxiety perpetuate symptoms.

VID is more common in people with vestibular disorders, like vestibular ­migraine, or a history of concussions. If you are prone to motion sickness or spend extended time on digital screens, you may also be more vulnerable.

Treatment may include vestibular rehabilitation therapy and exposure training. Schmoe has found virtual reality can help desensitize some people.

Vestibular Migraine

Vestibular migraine can cause dizziness symptoms with or without a headache. Rather than reflecting a problem with the vestibular system, it affects the vestibular-associated processing systems in the brain, says Arthur.

Symptoms may include sudden or prolonged dizziness, vertigo, an off-balance feeling, or unsteady walking. You may also have other migraine symptoms, including nausea and vomiting, light sensitivity, and sound sensitivity. Symptoms can last minutes to days and occur with or without pain.

Anyone can suffer vestibular migraine, though people with a history of migraine headaches, motion sensitivity, or inner-ear disorders are most susceptible, says Arthur. It often runs in families and can be triggered by hormonal shifts, bright lights, and disrupted sleep. Stress is a big factor, as well.

Treatment may include vestibular therapy, medication, and migraine-management strategies. “With vestibular migraine, there’s a change in blood flow into the neurological ­circuitry of the brain as well as changes in inflammatory mediators, so people respond well to anti-inflammatory dietary approaches,” says Schmoe.

Unlike many practitioners, Arthur doesn’t recommend migraine diets and trigger diaries, which she has found cause people to focus too much on their symptoms.

“Having a healthy diet overall is important,” she says, “but people don’t need to be sitting around being vigilant. What they need is to stop being as afraid of their symptoms.”

This article originally appeared as “Restore Your Balance” in the September/October 2025 issue of Experience Life.