If you’ve had dizziness and gone to see someone about it, you may have worried whether this is a real disease, or if you’re just nuts. Maybe a doctor or a friend thought that your problem could be psychological. If a disease can’t be seen easily on exams or tests, it can mistakenly be chalked up to something going on in your mind. Let’s explore how and why this mistake happens.
Let me make this perfectly clear. If you feel spinning or another form of motion in your head, this is never caused by a psychiatric disorder. Dizziness makes people feel very anxious and frightened, and being anxious makes dizziness feel worse, so there is a connection between them. However, your anxiety is not causing your vertigo. Anxiety can make you hyperventilate, and that can make you feel lightheaded, but you don’t feel a clear sense of motion like spinning, tilt or elevator sensations. Hyperventilation causes the carbon dioxide in your blood to fall, and this results in faintness, weakness, muscle spasms in the hands and feet, and other symptoms. Hyperventilation-caused dizziness goes away if you hold your breath or breathe into a paper bag, so if that doesn’t help you, you probably have a real vestibular problem.
This all started centuries ago with the medical belief that the mind is somehow separate from the body. If a disease affected your mind, like Alzheimer’s, autism or schizophrenia, this was blamed on poor upbringing or disordered thinking and not on something going wrong with brain function. Now that we know how to better study brain function, it turns out that these disorders of the mind are due to disturbances in how the brain works, and not to vague things like your attitudes and thoughts.
Yet there is still a strong tendency to blame the patient when nothing is found on examination. Of course, most doctors don’t do a very detailed examination of the balance system, so naturally many also fail to note key findings. Sometimes the abnormalities can only be seen on very detailed balance system testing, and if this is not done the findings would be missed. Certain problems develop very gradually, and the tests and exams start out normal, only to become abnormal later.
Reading old medical textbooks can be very entertaining in this regard. I’ve read that patients in the past were blamed for getting cancer because they didn’t have the right attitude. One textbook said people who worry about their heart will give themselves heart disease. This nonsense is still going on.
One problem is the need in medicine to have a diagnosis for every symptom. There are a lot of diseases that are not yet known or described. New diseases are found all the time. They’re not really new, they just failed to be identified before. An example is semicircular canal dehiscence, which was “discovered” in 1998. Before that, the symptoms would have been called functional, which is just another word for psychological in nature. Providers usually have a few waste bucket terms for anything that doesn’t fit into current diagnostic categories, and often these are blamed on your mind. I will go over some of these in the next few posts.
Ending Vertigo Today 