Dizziness: 4 Main Causes & What to Do

Medical review: Dr. Clarisse Bezerra
Family Doctor
February 2022

Dizziness is a sign of an abnormality or dysfunction in the body. It is not always a symptom of a serious health condition. Most of the time, it is caused by an inner ear infection, but it can also indicate balance issues, heart problems or it can be a medication side effect.

Another common situation that leads to dizziness is getting up too quickly. This is also known as orthostatic hypotension, and it is characterized by a drop in blood pressure that occurs when changing position suddenly. This type of dizziness is temporary and resolves within a few seconds.

Dizziness is most common in older adults, but it can also occur in young people. If dizziness occurs frequently, you should see your family doctor for consult. If you dizziness is very strong or does not resolve on its own within an hour, you should proceed to the emergency room for assessment.  

The most common causes of dizziness are:

1. Vertigo or labyrinthitis

Labyrinthitis is the most common cause of vertigo, and it usually occurs due to abnormalities in the inner ear. This type of dizziness causes a sensation of the world spinning around you, and can also be accompanied by nausea and ringing in the ears. You may feel dizziness even when lying down, and it is normally triggered by sudden movements in the head, like looking to the side or turning in bed.

What to do: Treatment of vertigo and labyrinthitis is usually done under supervision of a doctor or ENT. The plan will depend on the cause of the dizziness, but use of medications like betahistine or dimenhydramine is usually recommended during dizzy spells. You should prevent stress and avoid caffeine, sugar and tobacco intake, as all of these may contribute to dizziness.

Less common causes of vertigo include inner ear inflammation or infection, vestibular neuritis or Meniere's disease.

2. Imbalance

A feeling of imbalance can also cause dizziness. It occurs when you anticipate a fall or when you do actually lose your footing. Instability can cause constant dizziness, and is most common in older adults, or when there is a history of:

  • Vision abnormalities, like cataracts, glaucoma, near-sightedness or far-sightedness
  • Neurological diseases like Parkinson’s, stoke, brain tumor or Alzheimer’s
  • Head trauma, which can cause temporary or permanent wounds in the area of the brain that regulates balance
  • Loss of feeling in the feet and legs due to diabetes
  • Alcohol or drug consumption, which can alter perception, and brain functioning
  • Use of medication that can affect balance, like diazepam, clonazepam, phenobarbital, phenytoin and metoclopromide.

What to do: To treat imbalance, it is necessary to identify and treat its origin. Vision problems can be assessed by an ophthalmologist, for example, or neurological disease by a neurologist. Medication causing symptoms can be adjusted or replaced by the prescriber.

3. Drop in blood pressure

Dizziness can be caused by cardiac or circulation problems like pre-syncope or orthostatic hypotension. These problems occur when blood pressure drops and the brain is not receiving enough blood, which causes a fainting sensation, darkened vision on the appearance of dots in the line of vision. 

This type of dizziness can emerge when getting up in the morning, standing, during exercise, or even suddenly when at rest. The main causes are:

  • A sudden decrease in blood pressure, called orthostatic hypotension. It occurs when the body is unable to immediately compensate for a change. This is normally not a serious concern, a
  • Cardiac problems, like arrhythmia or cardiac insufficiency, which can complicate blood flow
  • Use of medications that can affect blood pressure, like diuretics, nitrates, methyldopa, clonidine, levodopa and amitriptyline, especially when used by older adults
  • Pregnancy, as this a time where changes in circulation occur, leading to a decreased blood pressure

Other situations, like anemia and hypoglycemia may not cause drops in blood pressure, but can affect how blood carries oxygen and other nutrients to brain cells. This can lead to dizziness as well.

What to do: Treatment for this type of dizziness will depend on its cause, which should be evaluated by a family doctor or cardiologist. He or she can order testing and make adjustments to existing treatment as necessary.

4. Anxiety

Mental disorders, like depression and anxiety, can cause dizziness. They usually come with panic attacks and changes to breathing, and are accompanied by symptoms like shortness of breath, shaking, and tingling in the extremities (feet, hands) and mouth.

This type of dizziness can come on suddenly, and emerge in times of major stress.

What to do: Anxiety should be treated through modalities like psychotherapy, and if necessary, with prescription medication, like antidepressants or anxiolytics. 

What to do when you feel dizziness

When you feel dizzy, you are advised to keep your eyes open, stop what you are doing, and look at a specific spot in front of you. By doing this for a few seconds, dizziness will resolve fairly quickly.

With vertigo, which is when you are stopped but feeling things are moving around you (like the world is spinning) a good solution is to perform gaze stabilization exercises.

If dizziness still doesn't improve or if it very intense or accompanied by other symptoms, you should consult a doctor for diagnosis and treatment as necessary.

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Atualizado por Tua Saude editing team, em February de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em December de 2021.
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.