So-called phobic dizziness has psychogenic causes and usually occurs in psychologically stressful situations. Behavioral therapeutic measures can be helpful here.

There are different forms of vertigo. Phobic postural vertigo is one of the most common forms of vertigo and is typically triggered by situations that are usually associated with psychological stress. In some cases, however, the cause is also based on a physical illness. Vertigo usually occurs with a panic-like fear of falling and can lead to unsteadiness and unsteadiness. The duration ranges from a few minutes to a few hours.In the context of psychogenic postural vertigo, an anxiety disorder or depression can be observed as a basic disease in some cases. In women, the disease occurs between the ages of 30 and 40, and in men around ten years later.

Read more on this topic: Types of vertigo


Dizziness is generally understood to mean insufficient orientation in space, which is accompanied by a feeling of insecurity. When staggering vertigo, those affected describe themselves as "feeling like on a swaying ship". It is usually a form of psychogenic dizziness that can be triggered by psychologically stressful situations and is accompanied by a sudden fear of falling. However, the cause can also be organic.


It is assumed that short-term, normal disturbances of the equilibrium lead to overinterpretation and result in a strong reaction. In a healthy person, the temporary imbalance is corrected with a reflex-like, small movement. A person with postural vertigo reacts much more strongly and changes their posture excessively. This results in dizziness and perceived insecurity when standing and walking. The system at which the disease develops is based on the attempt to consciously influence the balance. Those affected can get into a spiraling cycle, as the self-caused dizziness is interpreted as being caused by outside.

Typical triggers include not only interpersonal conflicts, but also upsetting situations for those affected, such as large gatherings of people, traveling in an elevator, traveling in an airplane or general situations that are perceived as stress.

Read more about this at: Dizziness from stress.

The occurrence of postural vertigo can also have organic reasons. Changes in certain brain structures, for example in epilepsy, in the context of cardiovascular diseases or strong visual stimuli can trigger dizziness.

Read more on the topic: Dizziness and circulation

Kinetosis is the dizziness that occurs during travel, sea or air sickness.

Through the cervical spine

Vertigo and unsteadiness when standing and walking can be observed in connection with cervical spine syndrome. The complaints get worse with movement and constant head posture. Those affected often complain of neck pain. Disturbances in sight and hearing as well as sensory disturbances are observed less frequently.
After prolonged immobilization (not moving) of the cervical spine, for example after getting up in the morning, there may be blockages between the individual bones of the cervical spine (see: Dizziness in the morning). The same applies to degenerative processes of the cervical vertebrae and accidents that lead to damage in this area. The sudden release of the individual blockages can be accompanied by the sudden onset of dizziness. If, on the other hand, the blockages persist, the muscles in the neck area tense as the process progresses.
Over time, the muscles on the opposite side shorten synchronously. As a result, there are sensitive effects on the sense of balance and an intensification of the vertigo symptoms. In rare cases, changes in the cervical spine cause compression (narrowing) of the artery running there. Turning the head can lead to an insufficient supply of oxygen to the brain and cause dizziness.

You can find much more information under our topic: Dizziness in cervical spine syndrome


Vertigo does not necessarily have to be organic. Tension can also trigger it - especially the neck, upper back and eye muscles, if they are permanently contracted, can lead to dizziness. Neck and back muscles are responsible for keeping the head and trunk upright. If the posture is not optimally adjusted due to tense muscles, this can lead to difficult orientation in space, which in turn can cause dizziness. The eye muscles can also play a role. If the eye movements cannot be carried out as usual due to tension in the outer eye muscles, blurred vision and dizziness can result. A physiological contracture of all muscles in the face, neck and back area is therefore essential to counteract postural vertigo.

Visual disturbances

Diseases of the eyes are a possible cause of vertigo symptoms. This form is known as ocular vertigo. Even if other symptoms have existed for a long time, a visual impairment as a symptom of the actual cause is perceived very late. Unspecific symptoms such as dizziness, headache and back pain manifest themselves beforehand.

Possible causes include, for example, inflammation of the eye such as iritis (inflammation of the iris), infections or the flu, reduced vision, visual disturbances in the case of eye muscle paralysis with strabismus and existing high blood pressure with significant vascular changes.

Read more on the topic Dizziness and blurred vision and Dizziness and eye.

Causes from the ENT area

The organ of equilibrium is located in the inner ear. If there is a disease in this area, this usually leads to vertigo. One form, for example, is benign, paroxysmal positional vertigo, in which there are small fragments in the inner ear that cause dizziness when moving. Another clinical picture is Menière's disease. There is too much fluid in the inner ear, which can trigger episodes of vertigo from a few minutes to hours. Inflammation of the nerves leading from the balance organ to the brain can also cause dizziness. This clinical picture is called vestibular neuritis.

Here it goes to Dizziness caused by the ear


Coffee can make you dizzy through the action of its ingredient, caffeine. Caffeine has a stimulating effect and can stimulate the central nervous system. This can, for example, increase the heart rate, which in the worst case can lead to cardiac arrhythmias. This in turn can cause dizziness. In addition, caffeine can cause blood vessels to dilate, which can cause blood to sag under gravity, which can also make you dizzy.

Read more about this under Dizziness after coffee

Psychosomatic causes

As already mentioned above, the phobic postural vertigo is one of the most common forms of vertigo. This is a psychosomatic cause. The person concerned feels a phobic fear, which affects the physical well-being. This can be noticeable through a wide variety of symptoms, including dizziness and lightheadedness. The occurrence of postural vertigo is often accompanied by a racing heart and blurred vision. Psychiatric treatment of the underlying illness, for example a phobia, can be useful in this case.

By a flight

Vertigo after or during a flight can have various causes. On the one hand, many people suffer from fear of flying, which can result in psychosomatic dizziness, as already described above. On the other hand, physical processes can also cause vertigo. The body has to adapt to the changing pressure conditions, and on a long-haul flight it can happen that the long periods of sitting can cause the blood to build up in the legs. If the body is unable to regulate the circulation due to these external conditions, dizziness can occur. This can continue until after the flight.

By a train ride

Any kind of driving can cause dizziness. For example, it can happen that while the vehicle you are in is stationary, you focus on a moving vehicle. This is then sent to the brain as information that you are driving yourself. This discrepancy can cause a brief feeling of dizziness. The same mechanism takes place when reading, for example, while driving. The focused object, for example a book, is perceived as immobile, which does not match the information that one is in motion. This can result in nausea and dizziness.


In the diagnosis of postural vertigo, the detailed anamnesis with regard to the triggering factors, duration, strength, etc. plays an important role. The diagnosis of phobic postural vertigo is based on a typical anamnesis and the absence of physical and neurological abnormalities. Further examinations serve to rule out other causes. These include, among other things, the control of the organs of vision and hearing, the orienting examination using Frenzel glasses (glasses that prevent the eyes from "focusing") to exclude so-called nystagmus and the rinsing of the external auditory canal by the ear, nose and throat doctor, about the function of the equilibrium system. In unclear cases, imaging methods such as ultrasound or CT (computed tomography) and MRT (magnetic resonance tomography) are used. Masses, for example an acoustic neuroma, can be recognized in this way.
There is no specific investigation in the diagnosis of the so-called cervicogenic syndrome. After definitely excluding all other diseases, the diagnosis of the cervical spine syndrome can be considered. In the case of muscle tension, those affected often stand out due to a crooked head position.

In a routine examination by the ophthalmologist, visual disturbances, general diseases and diseases of the eye itself can be detected. A full examination not only checks the eyesight, but also the fundus including blood vessels and intraocular pressure. Annual check-ups have a preventive function in the presence of certain diseases.

Frequency distribution

Vertigo is relatively common with 15% of all types of vertigo. The phobic postural vertigo occurs together with the Vestibular neuronitis and the benign paroxysmal positional vertigo most numerous in the population.


A typical symptom of vertigo is the panic-like fear of falling that occurs in attacks. Those affected usually do not fall, but complain of insecurity when standing and walking. Drowsiness is often reported. From the outside, there seem to be no abnormalities. In addition, vegetative symptoms such as palpitations, sweating and a slight tremor (shaking) can be associated with the dizziness symptoms.
Vomiting and nausea are not typical of the phobic postural vertigo. Symptoms improve in combination with alcohol and physical activity.

a headache

Headache is an accompanying symptom in some cases. If the cause is a cervical spine syndrome, headache and vertigo may occur in connection. If the first severe headache occurs, a cerebral haemorrhage should be excluded in any case. If, on the other hand, the symptoms are accompanied by pronounced vertigo, this can indicate a vestibular migraine.
Headaches also occur in the context of kinetoses.

Visual impairment

The vertigo can be accompanied by visual abnormalities. Those affected perceive their surroundings as blurred, see streaks or flickering light.


Nausea and vomiting are typical symptoms of the dizziness that occurs in the context of sea, travel or air sickness.

Dizziness when lying down

In patients with vertigo, vertigo is usually not observed when lying down. In this case, the benign paroxysmal positional vertigo is more likely, which is often associated with these symptoms. It should be excluded as a differential diagnosis.

You can find more information on the topic here: Dizziness while lying down - these are the causes

Gait uncertainty - why does it happen and what do I do about it?

Patients who suffer from vertigo often complain of an unsteady gait. This results from insufficient orientation in space. The brain receives permanent feedback from the muscles, visual stimuli and the organ of equilibrium, in which position and orientation the body is currently. If one of these components is omitted, the other systems may still be able to compensate for this coupling. For example, it is possible to stay upright with your eyes closed without feeling dizzy. However, if a disease-related process takes place, the balance of the body's own information systems may no longer be maintained. The brain then no longer receives sufficient or possibly incorrect feedback about the posture of the body, which can lead to a feeling of vertigo.

The therapy for this unsteady gait depends on the underlying cause. These can be versatile. Neurological disorders are a common reason for gait disorders. As mentioned above, tension in certain muscles can also cause such an imbalance. This can be counteracted with targeted relaxation exercises. An ENT medical examination can also provide helpful information, as there may be a disease of the balance organ in the inner ear. If the unsteady gait is only slightly pronounced, it can also help to consciously concentrate on fixing certain objects in the room while walking. This promotes the visual information system. If this is not possible, an ophthalmological clarification should take place.

Here is the main article Gait disorder

What is the difference between vertigo and vertigo?

First of all, the two types of vertigo differ in how the person feels. Spinning vertigo is described by those affected as feeling “like they are in a carousel”. So you have the feeling that everything revolves around you, which is where the name "vertigo" comes from. The cause of vertigo is usually organic, most often the organ of equilibrium or related structures is affected. Vertigo, on the other hand, is often psychogenic, for example phobic. People who suffer from vertigo describe this feeling as if they were on a ship that sways back and forth.


How long the dizziness lasts depends on the underlying cause. It can range from seconds to hours; the duration cannot be determined in a general way. Since postural vertigo is often a consequence of a phobic episode, the vertigo usually lasts as long as this episode. However, this is very different for each individual. If an insufficient blood supply to the brain is the cause of the dizziness, it can last until the circulation has normalized again. However, it can also lead to unconsciousness if this condition lasts too long.


In the case of phobic postural vertigo, which is based on a psychogenic cause, behavioral therapy measures often lead to an improvement. Various relaxation techniques, such as Jacobsen's progressive muscle relaxation and autogenic training, are helpful tools in treatment.

Medicinal active ingredients that are used in the symptomatic treatment of motion sickness are, for example, scopolamine, dimenhydrinate, cinnarizine and meclozine. Before taking the medication, it is useful to seek advice from the pharmacy.
Various drugs are used to treat vertigo caused by a cervical spine syndrome. They relieve pain, have anti-inflammatory effects and relieve muscle tension. In addition, conservative measures such as physiotherapy and physical applications can lead to an improvement in symptoms and muscle relaxation.

Malpositions of the bony skeleton, which result in muscle tension, are treated with appropriate muscle training or orthopedic shoe insoles.
In the treatment of dizziness in the context of an eye disease, the appropriate therapy for the underlying cause helps. This can be, for example, prescribing glasses with the right prescription.

If the vertigo is present, a doctor should urgently be consulted for further clarification. The various causes of the form of vertigo almost all require therapy that is prescribed by a doctor.
First of all, it is important to be aware of the characteristics of the vertigo.Which form of vertigo is present - is it vertigo or vertigo? How long does the dizziness last? How often does it happen? Does the dizziness occur at rest and / or while moving? Can certain triggers be filtered out? Are vegetative symptoms such as palpitations and sweating felt in addition to dizziness? Do you experience nausea, headaches and changes in hearing and sight?
In the acute situation, it helps to lie down or sit down. If this increases the symptoms of dizziness, holding on to a static object can reduce the fear of falling. The eyes should be focused on an object in the distance and the neck should be moved as little as possible. In all of this, deep, calm breathing plays a particularly important role. It supplies the brain with sufficient oxygen and at the same time has a calming effect. If the dizziness primarily occurs while traveling, it is advisable to spend a large part of the time sleeping.


An attempt can be made to treat vertigo homeopathically, even if this therapy option has not been scientifically proven. The following remedies can help. In states of exhaustion e.g. Due to lack of sleep, taking ambergrisea could have positive effects. If there is a phobic postural vertigo as a result of an anxiety disorder, Argentum nitricum could provide help. Gelsemium is recommended against dizziness caused by tension in the neck or visual disturbances.


The prognosis of postural vertigo is usually good after identifying and eliminating the triggering factors. Chronic dizziness often indicates a psychological trigger. This can also disappear again with appropriate psychotherapeutic treatment.


As a general rule, vertigo cannot be treated prophylactically. It is therefore all the more important to recognize the symptoms in good time and initiate appropriate treatment.