Part of Dizziness and BPPV
Can vertigo be caused by stress or anxiety?
Warning signs, and when to get help
Can vertigo be caused by stress?
Not on any source we could read. A yes would be easier to read and worth a great deal less to you.
The confusion starts with two words that get used as though they meant the same thing. The NHS describes vertigo as the feeling that you or everything around you is spinning, enough to affect your balance, and says plainly that it is more than just feeling dizzy. Dizziness is the wider word: light-headed, woozy, off balance, about to faint.
Now look at the two lists. For vertigo, the causes the NHS names are BPPV, labyrinthitis, vestibular neuritis, Meniere's disease, migraine, some types of medicine, and sometimes a cause nobody ever identifies. Stress and anxiety appear nowhere on it. On the separate NHS page about dizziness, stress or anxiety is in the list of causes, next to dehydration, heat exhaustion, an ear infection, migraine, iron deficiency anemia, low blood sugar because of diabetes and motion sickness.
So the documented claim is narrower than the one you will have read. Stress and anxiety have a place in dizziness and no established place in the room spinning.
Worth saying this early rather than at the end, because it is where the page finishes. Stress is worth dealing with and a poor place to stop looking, and the symptoms a stressed reader is most likely to wave through, a heart that will not settle, a faint, a dizziness that never lets up, are the ones carrying the shortest deadlines in the warning list at the foot of the page.
Two claims get made confidently online with nothing behind them. One is that stress dislodges the crystals in your inner ear. The other is that stress is the main trigger for migraine-related vertigo. We found no source for either, so neither is repeated here.
What BPPV is, which is short-lived spinning set off by a change of head position, and how it is treated are both on the main page for dizziness and BPPV. The other diagnoses in that list are described on what else vertigo can be, which is the only page here that covers them.
Can anxiety cause dizziness?
This one has a straighter answer: anxiety is on the NHS list of things that cause dizziness, so yes, in that sense.
Read the rest of that list before you settle on it, though, because of what sits beside anxiety on it. Iron deficiency anemia is there. So is low blood sugar in diabetes, dehydration, an ear infection and the side effects of a new prescription. Each of those is found or excluded by something fairly quick: a blood test, a blood pressure reading, a look in your ears, a check of your heart rhythm, a glance down your medicines list.
That is the difference between an explanation and a result. Anybody can offer you an explanation, including you. A result is what lets stress stand as the remaining answer rather than the first one.
If your dizziness also comes with neck pain, read the two artery lines in the warning list at the end of this page before you do anything else, then see neck pain for what that assessment involves.
What stress and anxiety actually do to balance
Here is what a readable national source will support, in the order the evidence gets stronger.
The NHS puts trying to relax in its own self-help list for vertigo, with the reason attached: anxiety can make vertigo worse. That is a statement about severity and not about cause, and holding those two apart is most of what this section is for.
Past that, the Barany Society's criteria for persistent postural-perceptual dizziness are where the measured findings are. That document reports that high anxiety about dizziness during and after a bout of acute vestibular neuritis or BPPV predicted continued dizziness at 3, 6 and 12 months, and that anxiety-related personality traits or an existing anxiety disorder appear to raise the risk of developing the chronic condition it defines. It describes the anxious response to the first attack as possibly an early step in how that condition develops, which is a carefully hedged sentence in the original and stays hedged here (Staab and colleagues, 2017).
What none of that gives you is a mechanism. We are not going to supply one. Nobody we read has shown the chain of events between being under strain and the inner ear misreporting where your head is, and a plausible-sounding chain invented for a web page would be exactly the thing this site exists not to do.
Anxiety after a vertigo attack, which is the commoner direction
Most pages answer the question you typed. This is the one you may actually have.
A first attack of real vertigo is frightening in a way that is hard to convey to anyone who has not had one. The floor stops being reliable. Afterward people do a set of sensible things that quietly become a problem: holding the head rigid, avoiding the side they rolled onto, sleeping propped up, giving up driving before anyone has told them to, checking their balance every few minutes to see whether it is still there.
The Barany criteria recognize that sequence. They require the chronic condition they define to have been precipitated by something that caused vertigo, unsteadiness, dizziness or balance trouble in the first place, including acute, episodic or chronic vestibular syndromes, other neurologic or medical illnesses, or psychological distress, and they note that most of the conditions that come before it are acute or episodic (Staab and colleagues, 2017). In other words, an attack first, then the trouble that follows it.
The same document is firm about one thing, and it is the sentence to take to your appointment if you have been made to feel you are imagining this. It classifies the condition as a chronic functional vestibular disorder, states that it is not a structural or psychiatric condition, and points out that functional does not mean psychogenic.
Dizziness that stays after the spinning stops
A good number of people get the spinning treated, feel the relief, and then find that something else has stayed behind. Not spinning any more. Swaying, floating, a sense of the ground not quite settling, worse standing than sitting, much worse in a supermarket aisle or a tiled corridor or a long scroll on a phone.
There is a defined diagnosis for that, with criteria that require the symptoms on most days for 3 months or more (Staab and colleagues, 2017). What it is called, what distinguishes it and how a clinician confirms it belong on what else vertigo can be, so there is one proper account of it on this site rather than four partial ones.
What is worth saying here is about your experience rather than the diagnosis. Being told you are fine does not feel like this, and going back to ask again is reasonable. None of it is self-diagnosable either: the criteria end on the requirement that nothing else explains the symptoms better, which is a sentence written for clinicians precisely so that nobody stops at the easy answer.
Is it stress or is it your ear?
That is not a question to settle at home, and there is no test on this page for deciding it. What you can do is turn up with better information than most people manage.
Keep a few days of notes, and record four things. What you were doing in the moment it started, including whether your head or your body moved. How long one episode lasted, measured rather than estimated, because seconds and hours point in very different directions. Whether the room spun or you swayed. Whether anything changed in your hearing, including ringing or a sense of fullness on one side.
Add whether it happens when you are lying completely still, whether it happens on standing up from a chair, and anything new on your prescription list. Clinicians use duration, triggers and hearing symptoms to tell these conditions apart, and the positional tests they do start from your account of it, so the account is worth preparing. How the diagnosis is actually made is set out on dizziness and BPPV.
One pattern deserves its own mention, because readers of this page are the ones most likely to explain it away. If your dizziness is worst in the first minutes of the day, that has several possible causes and a blood pressure reading is one of the cheapest ways to start, which is why why vertigo is worse in the morning treats it as its own question.
What helps when both are going on
Start these exercises only after a doctor or vestibular physio has found the cause of your dizziness. New dizziness, or dizziness that has changed, needs checking first.
With that in place, the order of work is not complicated. Get the ear question settled, because an untreated positional vertigo keeps producing the attacks that are feeding the worry, and no amount of calm will stop the room spinning when you roll over. If a repositioning treatment is what you need, that is done or taught by a clinician who knows which ear and which canal are involved, and this site deliberately publishes no steps for it.
For unsteadiness that lingers afterward, there is a graded program of gaze, balance and walking work, built on the principle that the system retrains through movement rather than through rest (Hall and colleagues, 2022). Its stages, doses and stop rules sit on dizziness and BPPV, and your own physio decides what you do and how much of it. The point relevant to this page is that the movements you have stopped making are usually the ones a vestibular physio will want back, in their order rather than yours.
This site does not deliver breathing routines, relaxation protocols or psychological treatment, and a page about anxiety is exactly where somebody would be tempted to improvise one. So we will not. If the distress is significant, or it is shaping your days, tell your doctor about that part as plainly as you told them about the spinning. Where unsteadiness is the main problem, balance and falls prevention is the wider plan, and balance and dizziness lists the rest of what is here. One plain instruction belongs with all of it, whatever the cause turns out to be: do not drive, climb ladders or use machinery while you feel dizzy (NHS dizziness). Exhaustion with all of this is common enough to have its own page in vertigo, tiredness and brain fog.
Why "it is just stress" is the wrong place to stop
Because of what stress shares a list with, and because of how dizziness announces the things that matter.
Stress sits on a list of causes of dizziness that also holds anemia, low blood sugar and the effects of medicines, all of which are found quickly and treated easily once somebody looks. Leaving them unlooked-for costs months of feeling terrible for no reason. Tiredness goes the same way, and it has its own line in the list below: tiredness that has run on for weeks, that you cannot account for, or that is getting in the way of your daily life is a question for your doctor rather than something to file under being stretched too thin. And dizziness is also the first symptom of a stroke, of a tear in an artery in the neck, of a heart rhythm that is not holding, and of a blood pressure that drops when you stand. Those are the reason this page carries the warning list it does.
Notice how the two fit together. A reader who has settled on stress is the reader least likely to act on a racing heartbeat, because a racing heartbeat is also what anxiety feels like. That is the most dangerous thing about the explanation that brought you here.
None of which means you are not under strain. You probably are. It means stress is a reasonable thing to deal with and a poor thing to conclude.
When dizziness with anxiety needs checking rather than calming
Call emergency services straight away for any sign of a stroke, even if it goes away: sudden dizziness with unsteadiness or falling over, a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack).
Read the warning list at the end of this page once, now, while nothing is happening. The lines are not interchangeable: each one has its own timing, from calling emergency services to an appointment within a few days, and the last of them is the appointment that gets the cause of your spinning confirmed and treated. For most people reading a page like this, that appointment is still ahead of them.
Three of those lines are on this page for its particular reader. A racing, pounding, fluttering or irregular heartbeat with dizziness or faintness carries an emergency route, and it is the line most likely to be mistaken for a panic symptom. Blacking out or fainting, even briefly, carries a same-day route and is not a thing to absorb into a story about stress. And dizziness that has been there all the time for a day or more, rather than in short spells when you move your head, is not behaving like a positional vertigo at all, which is why it carries its own same-day line.
Go and get it looked at. Then deal with the stress, which will still be there, and which deserves better than being used as the reason to leave a symptom unexplained.
Related exercise programs
Warning signs
Get emergency help now
- Emergency: call emergency services straight away for any sign of a stroke, even if it goes away: sudden dizziness with unsteadiness or falling over, a face that droops on one side, an arm you cannot lift or keep up, slurred or muddled speech, weakness or numbness on one side of your body or face, sudden blurred vision, double vision or loss of sight, trouble swallowing, a sudden severe headache, or a sudden fall where your legs give way but you do not black out (a drop attack).
- Emergency: vertigo or dizziness together with new hearing loss, double vision or loss of vision, trouble speaking, or weakness, numbness or tingling in an arm or leg. Call emergency services or go to an emergency department straight away.
- Emergency: dizziness with a new, severe headache, or a sudden, severe headache that feels unlike anything you have had before. Call emergency services straight away.
- Emergency: a new headache or neck pain, or both, that does not feel like ordinary neck pain. If this is your first bout, judge it by how it behaves rather than by how it compares. Either of the next two is enough on its own. One, it came on suddenly, in a single moment, even if it is not severe and even if it has eased since. Sudden onset counts on its own. Two, nothing you do changes it much: no position or rest makes a real difference, and after the first day or two it has not started to settle. It counts even if you have none of the other emergency signs above, and it matters more if it started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated. Go to an emergency department straight away, or call emergency services if you cannot get there safely, and do not drive yourself. Do not start these exercises, and do not have any hands-on treatment to your neck, until your neck has been checked. A tear in an artery in the neck can start as pain alone, often on one side, with nothing else to find. If you can find a position that eases it, follow the same day warning sign for this below instead.
- If chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
- Emergency: a racing, pounding, fluttering or irregular heartbeat that does not settle when you rest, or that comes with dizziness, feeling faint or fainting, chest pain or shortness of breath. Call emergency services straight away. If it has already stopped, get medical advice the same day.
- Emergency: if you faint while exercising, call emergency services, even if you feel fine again quickly.
- Emergency: you have just fallen and cannot get up, or you think you may have hurt your head, neck, back or hip. Stay where you are, keep warm and call emergency services, or get someone to call for you. If you got up and walked without trouble and only notice pain later, use the same-day lines in this list instead.
- Emergency: you fell and cannot remember the fall or how it happened. Go to an emergency department straight away, and do not drive yourself. You may have blacked out or hit your head without knowing it.
Get help today
- Same day: a new headache or neck pain, or both, that does not feel like ordinary neck pain, that started after a neck injury or strain, even a minor one, a bout of heavy coughing, or having your neck manipulated, but that does ease when you change position or rest. Get checked the same day before you start these exercises or have any hands-on treatment to your neck. If nothing you do changes it much any more, or it has not started to settle after a day or two, follow the emergency warning sign for this above.
- Same day: you blacked out or fainted, even for a moment. Get medical advice the same day. Call emergency services instead if the person is not breathing, cannot be woken within 1 minute, has not fully recovered or has trouble speaking or moving, has chest pain or a pounding, fluttering or irregular heartbeat, fainted while exercising or lying down, is shaking or jerking, or was badly hurt.
- Same day: dizziness, lightheadedness, blurred vision or feeling faint when you stand up that is new for you, does not pass within a minute or two, keeps happening, or has made you fall. Sit or lie down, and get medical advice the same day. This can be a drop in blood pressure on standing (postural hypotension), a type of low blood pressure, which the NHS lists among the causes of falls, and your doctor can check it. Tell them about your medicines, because some can cause it. If it does not settle within a few minutes of sitting or lying still, call emergency services. If you faint, use the fainting line above.
- Same day: sudden new dizziness, or feeling faint or unsteady, without any of the stroke signs above. Stop, sit down and get medical advice the same day. If you faint, it does not settle within a few minutes of sitting still, or you cannot stand or walk steadily, call emergency services.
- Same day: dizziness or spinning that has been there all the time for a day or more, rather than coming in short spells when you move your head, without any of the emergency signs above. Get medical advice the same day. If you cannot stand or walk steadily, call emergency services.
- Same day: vertigo with being sick or feeling very sick, a very high temperature, or feeling hot, cold or shivery, without any of the emergency signs above. Get medical advice the same day.
- Same day: you are more short of breath than usual, or short of breath while you are resting or lying down, without any of the emergency signs above. Get medical advice the same day. Call emergency services if you have severe difficulty breathing, are gasping, choking or cannot get your words out, or your lips or skin turn very pale, blue or gray. Breathlessness is not a symptom of the inner ear: the NHS names heart failure and lung conditions among the causes, and it is easy to put down to being run down.
- Same day: after a fall, you are in pain, have hurt yourself or feel unwell, or you were on the floor for an hour or more, without any of the emergency signs above. Get medical advice the same day, even if you managed to get up.
Book an appointment
- Within a few days: short spells of spinning when you lie down, roll over in bed or look up, or dizziness that keeps coming back, without any of the signs above. See your GP or a physio within a few days so the cause can be confirmed and treated.
- Within a few days: you have had a fall, even if you were not hurt, or you keep tripping, stumbling or feeling that your legs might give way. Book an appointment with your doctor within a few days and ask about a falls assessment. Tell them about every fall, even the ones where you were not hurt.
- Routine: you have been tired for a few weeks and you are not sure why, your tiredness is getting in the way of your daily life, or you are tired along with other symptoms such as losing weight without meaning to or a change in your mood. Book an appointment with your doctor about the tiredness itself, say how long it has been there and what else has changed, and let them decide what to test. Tiredness is not a symptom of the inner ear: the NHS names sleep apnea, iron deficiency anemia, diabetes, an overactive thyroid and ME or chronic fatigue syndrome among the conditions behind it, and a blood test settles several of them. Tell your doctor as well if anyone has said you gasp, snort or choke in your sleep. If the tiredness comes with chest pain, feeling faint, or being short of breath while you are resting, use the emergency and same day lines above instead.
Common questions
Can stress cause vertigo?
No source we could read says so, and several pages ranking for that question assert it while citing nothing. Here is the distinction that settles most of the confusion. The NHS describes vertigo as the feeling that you or everything around you is spinning, and the causes it names for vertigo are BPPV, labyrinthitis, vestibular neuritis, Meniere's disease, migraine, some types of medicine, and sometimes a cause that is never identified. On its separate page about dizziness, which covers feeling off balance, light-headed or faint, stress or anxiety does appear in the list of causes, alongside dehydration, an ear infection, migraine, iron deficiency anemia, low blood sugar because of diabetes and motion sickness. So stress has a documented place in dizziness and no documented place in spinning. Being under strain also does not rule anything out, which is why a new dizziness still needs its cause confirmed.
Can anxiety cause dizziness and vertigo?
Dizziness, yes, in the sense that anxiety sits on the NHS list of causes of feeling dizzy. Spinning is a different matter, and nothing we read puts anxiety among the causes of it. One more sentence from the NHS is worth having, because it describes something readers recognize: its self-help advice for vertigo includes trying to relax, on the grounds that anxiety can make vertigo worse. Making something worse and causing it are not the same claim, and the difference matters when you are deciding whether to get your ears examined. Being told your dizziness is anxiety, without a blood pressure reading, a look in your ears and a heart rhythm check, is an explanation rather than a result.
Is there a relation between vertigo and anxiety?
There is, and the best documented direction is the one people expect least. The Barany Society's diagnostic criteria for persistent postural-perceptual dizziness report that high anxiety about dizziness during and after bouts of acute vestibular neuritis or BPPV predicted continued dizziness at 3, 6 and 12 months, and that anxiety-related personality traits or an existing anxiety disorder appear to raise the risk of developing that chronic condition (Staab and colleagues, 2017). The same document is careful about what it is not saying: it classifies the condition as a chronic functional vestibular disorder, states that it is not a structural or psychiatric condition, and notes that functional is not a synonym for psychogenic. If you have been left feeling that your symptoms are being filed as imaginary, that paragraph is worth taking to your appointment.
Can chronic stress cause vertigo?
Nothing we read supports that, and the question usually comes from somebody whose dizziness has gone on for months. That pattern has a better explanation available, and it is worth knowing it exists. Dizziness or unsteadiness on most days for 3 months or more, without spinning, worse when upright, worse when you move and worse in visually busy places such as supermarket aisles or scrolling screens, is the picture of a defined diagnosis. All five of its criteria have to be met, including the last one, which is that nothing else accounts for the symptoms better (Staab and colleagues, 2017). That is a diagnosis made at an assessment, not from a page or a checklist, and what else vertigo can be describes it and the other possibilities properly. Months of unexplained dizziness is a reason to be reassessed rather than to accept stress as the answer.
References
- Staab JP, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): consensus document of the committee for the Classification of Vestibular Disorders of the Barany Society. Journal of Vestibular Research. 2017;27(4):191-208. https://doi.org/10.3233/VES-170622
- NHS. Dizziness. https://www.nhs.uk/symptoms/dizziness/
- NHS. Vertigo. https://www.nhs.uk/conditions/vertigo/
- Hall CD, Herdman SJ, Whitney SL, et al. Vestibular rehabilitation for peripheral vestibular hypofunction: an updated clinical practice guideline from the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. Journal of Neurologic Physical Therapy. 2022;46(2):118-177. https://doi.org/10.1097/NPT.0000000000000382
- NHS. Symptoms of a stroke. https://www.nhs.uk/conditions/stroke/symptoms/
- NHS. Heart palpitations. https://www.nhs.uk/conditions/heart-palpitations/
- NHS. Fainting. https://www.nhs.uk/symptoms/fainting/
- NHS. Chest pain. https://www.nhs.uk/symptoms/chest-pain/
- Rushton A, Carlesso LC, Flynn T, et al. International framework for examination of the cervical region for potential of vascular pathologies of the neck prior to musculoskeletal intervention: International IFOMPT Cervical Framework. Journal of Orthopaedic and Sports Physical Therapy. 2023;53(1):7-22. https://doi.org/10.2519/jospt.2022.11147
- NHS. Falls. Page last reviewed 06 March 2025. https://www.nhs.uk/conditions/falls/
- NHS. Low blood pressure (hypotension). https://www.nhs.uk/conditions/low-blood-pressure-hypotension/
- NHS. Shortness of breath. Page last reviewed 30 January 2024. https://www.nhs.uk/symptoms/shortness-of-breath/
Written and checked by the PocketPhysio editorial team. Last updated 2026-10-18.
This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.