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PPPD from panic attack recently?

Hi all,

I have been suffering from a rocking sensation, similar to being on a boat, all of a sudden,from a few days ago which came with a mini panic-attack that i was able to contain and not freak out over. I’m not sure if the dizziness preceded the panic attack vice versa. The sensation is noticeably worst when i sit at a computer, it feels as though my computer screen is swaying side by side and it makes it really hard to concentrate. When i walk, it feels like the ground is moving slightly in an oscillating motion. I was having dinner recently and at the table i could feel my vision rocking again. I wonder if anyone has a similar experience and managed to overcome it? It’s been 6 days and not knowing whether the dizziness will go away on its own is making me worried especially since I am due to start a new school term in a few weeks time.

Could this be BPPV/PPPD or Anxiety related? I say anxiety related because i quit smoking recently ( I’m a light smoker, for a total of maybe 8 months ) It’s been two months and following the cessation I have been getting hypoglycaemia and anxiety about getting a low blood glucose level. I have cut down on caffeine the past few days as i read that it would be make dizziness significantly worst. I drink a double shot Americano every day for the past year or so. I actually don’t really feel anxious anymore, aside from the fact that i do worry about finding a cure for this lightheadedness. I also feel detached and heaviness in my eyes, with brain fog. In addition to this, i feel as though my eyesight has deteriorated ever since COVID started, not sure if this could contribute to the issue but yea.

I have a history of vertigo attacks, 3-4 times in total over the past 7 years, which include spinning and nausea that lasts for HOURS, and usually subside only after 24+ hours, followed by a week of lightheadedness. I have not had an attack until this dizziness just cropped out of nowhere.

I try my best not to think about it and sometimes it gets better but the moment i start moving/walking around the sensation comes back. Would appreciate any advise or help from anyone going/gone through a similar situation!

Also to add I’m not diabetic, have no history of any other illnesses except a slipped disc at my lower back. I’m 23 M and have been exercising regularly the past few weeks / months since COVID.

Hi and welcome.

Trying to get your story straight in my head. You mention Covid couple times. Have you caught it? Do you currently have it? And next question Migraine? You have it or close family members maybe do?

Not a medic in sight on here so no diagnosis available here. You need to speak to the medics, at least your own Doctor but with dizziness better a specialist neuro-otologist or neurologist. They should be able to get a better idea of what you are suffering from. Your vertigo attacks could have been migraineous. What is called ‘silent’ migraine, no headache or something completely different. There are various conditions with similar symptoms, MAV, PPPD even MARD (migraine anxiety related) so you do need to seek out medical advice. From all I know and have read of vestibular type conditions continuous dizziness is most unlikely to just ‘go away’ as quickly and suddenly as it arrived. Unfortunately. Constant dizziness is an indication that there is a problem with the vestibular system. Something has kicked it into overdrive/hyperactivity and that something needs sorting. You have abruotyky reduced your caffeine intake. It could just be that is what pushed your balance too far, you were addicted and this is done withdrawal reaction in which case it might take a while to stop. It’s years since ?u read up!in caffeine withdrawal but check it out on the internet for full details and indication of time it takes to calm down. I cannot remember off the top if my head.

Do my advice would be seem out medical help promptly, meanwhile check out caffeine withdrawal and read up on this site more about MAV and PPPD and work out which cap fits you nearest. And stop worrying. It won’t kill you and once you have a closer idea you can obtain the correct treatment.

Hello,

Thanks for the response. Sorry for my post being unclear, I meant since the COVID period started.

I do recall having migraines before, but they are uncommon. As far as i know, none of my family members suffer from migraine attacks, except my Mom who recently had an incident of vertigo (once or twice in the past few years).

After my first vertigo attack i went to an ENT to get my system checked but everything came back normal. Was diagnosed with BPPV, the vertigo went away and life resumed to normal. My next few attacks were the same. They just came and went, like that. I agree with you on the point that there might be something from with my vestibular system. I’ve been reading alot online and came to the conclusion that it might either be MAV or PPPD. But i’m leaning more towards PPPD since there’s a likely hood of it being triggered by my past few anxiety/panic attacks.

Caffeine intake wise, yes it could possibly be that as well. However I drank 3 cups of coffee today(in an effort to rule out dizziness caused by caffeine withdrawal) and the rocking feeling is still persistent. The reason why i actually stopped caffeine was because i thought it was messing around with my blood glucose levels causing hypoglycemia > anxiety attacks.

I’m just wondering if anyone ever got cured of PPPD? I haven’t seem to find much success reading online of patients fully ridding the problem. It is scary as I’m still very young and don’t want to see my quality of life being affected by this. Also found out that when i’m in motion i don’t seem to be affected by the rocking / swaying motion. For example I was on a 13 hour flight last night and didn’t feel it at all.

I’m currently quarantined for 14 days so i am unable to visit a GP to get a diagnosis. Meanwhile I hope any one who has found a cure or who has overcome PPPD do share your experiences, it would definitely be heartwarming to hear :slight_smile:

Thank you!

If it is Caffeine Withdrawal you would need to be back to your previous intake for at least and probably longer than the length of the period you have not been drinking it. Three cups in one day might give a temporary boost but as I already said constant dizziness doesn’t ‘just stop’ without time and treatment.

The 13 hour flight didn’t affect you! Not at the time maybe. Delayed reactions can take days to kick in. From my experience if anything affects me instantly I am really badly affected. Longer delays mean less so? From my experience if you can cope with 13 your flights it’s more likely you have some Anxiety dizziness. MAV is a migraine associated balance disorder and the vast majority of sufferers have balance issues resulting in Motion Intolerance which would be very adversely affected by travel.

Nothing in medicine happens instantly. Depends where you live but you could have to wait months to see a vestibular specialist. Your own GP? Telephone call appointments/Zoom calls?? My own GP hasn’t seen patients for any initial investigation for about three years, long long before Covid.

If you read through the PPPD threads on here you will find people who have got their condition under control enough to be able to improve QOL and get on with their life. Trouble in finding success stories on line is the most successful ones stop posting and go away to get on with their lives and don’t leave a legacy for the future so you can easily draw a blank Treatment for PPPD differs from that for MAV so have another go at getting a diagnosis. Only then can you sensibly compare yourself and your symptoms to similarly diagnosed people.

Can vm look like chronic dizziness after an illness and can pppd look like that too? I’m wondering if mine is manifesting

Look at this video: Vestibular Migraine Verse Persistent Postural Perceptual Dizziness (PPPD) - YouTube

Joey explains PPPD very nicely and she thinks it can be cured because its a false signal of movement that needs to be tuned out of your brain (which your brain does when its moving!).

Just an update,

I realised my eyeglasses were contributing to the brain fog and depersonalisation symptoms. I changed the lenses a few weeks ago, it is weird because i told the optician to keep the exact prescription of the old lenses. I manage to grab hold of my secondary pair of glasses ( with the same prescription ) and immediately I felt much better, in terms of being more “present” and focused, The swaying didn’t affect me as badly as before when i was wearing my new pair of glasses.

That’s one achievement, the only problem left I have is whenever I enter an indoor space, I tend to immediately feel a tightness around my head and the dizziness comes back more profoundly as compared to when I am in an open area. Still trying to figure how to fix that. I haven’t seen a doctor as I’ve been moving houses and stuff so I was really busy. Overall I’m happy with the improvement but still have a bit more to go in conquering this.

I had a broadly similar experience. My ‘Depersonalisation’ I suddenly realised was in fact the result of wearing a prescription that was way out of date. It was way past time for an update I wrote it up in my diary May 2019.

That sudden tightness and resultant dizziness. According to neuro that tightness is the migraineous element. @mav Karen gave it a super description by posting how her head would suddenly feel inflated. I know that feeling. The way you describe it moving from open space to closed or vice versa I would say it’s the migraineous element kicking in because of a sudden change of light levels. It happens. I have experienced it many times just like that. Yesterday I experienced it whilst standing on the top of a box (practising my balance) when it kicked in immediately I closed my eyes. It can come and go in a matter of about a minute or like yesterday hang on for 45 minutes or so. I can have numerous occurrences through the course if a (bad) day.

You may find once you reduce stress levels further, (home move very high stress I understand) otherwise, as I found, once you reach an effectively high dose of preventative tolerance levels will rise and such instances will reduce.

Thank you for your anecdote. I feel slightly relieved that there’s an explanation behind this phenomena. However I find it weird as I never ever had this problem in my entire life, and why it would just crop up all of a sudden. As for you, does it always happen when you transit from outdoor to indoor, or is it subjective to the light source, brightness, density etc? Also read online that SSRI’s are the main cure for PPPD. In my case, do you think it will be the same? I don’t exactly see the link between SSRI’s and migraine triggers.

Also to note, when i stare at my smartphone it doesn’t trigger any dizziness whatsoever, however my computer is a huge trigger for the rocking feeling.

Veda just had a virtual vestibular conference and there was an excellent presentation on PPPD. You can purchase the recordings to all of the conferences for $20. The presenter discusses SSRI’s/SNRI’s and why they help with PPPD.

Nothing weird about it at all. You haven’t had such a severe state of MAV/PPPD before obviously. These conditions morph over time generally in the direction of worsening. The more hypersensitivity the more symptoms can emerge. Simple as that. As for me. At one time it would always happen in certain circumstances for example coming indoors from outside whenever there was a light difference. Certainly going from an artificially lit room into an unlit room and usually the wider the light difference the more severe the reaction. The less symptomatic I am and the better the control of the drugs the less often it happens. As I said before tolerance levels need to be higher for the system to cope. I am convinced mine has strong links to photophobia which is a typical migraine symptom. But any strong challenge to a struggling vestibular system can cause it hence the incident whilst balancing on the reduced base support of the box.

SSRis are standard treatment for PPPD according to articles I read. I am not a medic but my understanding of PPPD is it is a condition which occurs as the result of a vestibular incident. After the event. And according to what I have read any active migraine needs to be under control and stable in order for the other elements (therapy, VRT) to work. If you check out PPPD through the site’s Search facility you should find a link to a paper written by a Matthew Whalley which is most enlightening on PPPD.

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Helen, I assume you mean this one?: https://mvertigo.org/t/it-appears-everyone-is-misdiagnoised/15633/4?u=turnitaround

Unfortunately your link no longer works.

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That’s just about par for the course the way today is going for me. Constant irritations mostly linked to electronics and technology. So much so the fact my MAV started to play up from mid afternoon? I have hardly noticed. Suggest to try Researchgate.net. paper by Matthew Whalley and Deborah Cane entitled ‘A Cognitive Behavioural Model of Persistent Postural-Perceptual Dizziness’. I won’t attempt to link my very unstable Broadband link currently being just one of those irritations. Helen

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Went to the post office today. The lighting was really dim and immediately upon stepping in my head started tightening up. Was worst as there was queue and i think some sort of anxiety started kicking in. Had to try my best to stay calm and not think about it. Prayed that the dizziness didn’t come and thankfully it didn’t manifest, however the pressure remained. Good thing I was distracted by the assistant and the self-check out machine. Think that helped with the anxiousness. Like you said the head pressure was a symptom of migraine. I never once suspected i had silent migraines in my life, but looking back, I now recall 2 years ago during my conscription service that I had a workspace with similar dim lights which triggered some form of brain fog and sluggishness whenever i stepped into the office. It was horrible because i spent the entire day there. I couldn’t pinpoint the reason behind this other than lack of sleep. After having caught up with my sleep i felt much better but i think it was still subtly impacting even afterwards. I guess I’ll try to expose myself to more of these environments in order to build up my tolerance and curb my anxiety for it like what you suggested?

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There’s various ways to look at this. Personally I think the most helpful course would be to obtain a more accurate diagnosis because the two conditions have quite distinct treatments although at first glance they seem very similar. One important difference is timing of intro of the retrainjng/ therapy side, particularly VRT. The vestibular condition which supposedly caused the resultant reaction which is the PPPD should be behind the patient in their past, under good control. With MAV symptoms active, and this is from my own personal experience, exposing yourself to such triggers as you describe in your post office trip just winds the system up further and results in you being even more sensitive… A good stable baseline needs to exist for the vestibular system to work back to. Once stable (most probably achieved through medication and lifestyle changes of which trigger avoidance is a Main one) then would be best time to build up a tolerance to stimulating environments. Could be you misunderstood when I mentioned Building Tolerance. I was referring to theory that the MAV preventatives supposedly work because they decrease the sensitivity to triggers such as light etc or in other words build up our tolerance to triggers and that it is this tolerance which will reduce symptoms to a manageable and eventually hopefully a stable level so that attacks stop occurring.

Yep that’s the biggest realization for me in all this too. Nowadays I take note of that head pressure immediately and take a triptan and try to relax for an hour or two. Even if I know that I could just power through it and keep doing what I was doing without much pain, I don’t anymore. Because I know now that each one of those mild migraines builds on the next until well… chronic MAV arrives.

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IMO totally the crux of the matter. Until the head pressure is under control the imbalance will continue. Now quite heavily medicated I can see mine is inextricably linked. And that pressure can come/go almost in an instant which means the condition can fluctuate virtually minute to minute. I remember @Jojo65 being told that by a OH specialist years back. I don’t think enough emphasis is ever placed on this head pressure aspect. For many it could be virtually diagnostic. I well remember, when still episodic but beginning to have breakthrough, between attack symptoms, seeing an ENT who dismissed my comment ‘and I keep getting this sort of tight pressure feeling above my ears and around the back of my Head’ very sharply with a ‘that’s nothing to do with it’. Obviously an ENT totally in denial with regards migraine or MAV. ‘Crystal Clear Head’ days have to be the aim. Of course all this applies to MAV. Not so sure about PPPD. Have always thought to ‘qualify’ as PPPD you had to have continuous non vertiginous dizziness for more than three months to start with.

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Hello Guys long time no speak…i have had a LOT going on but when i finish work today i will try and find time to update you all…hello my friend Helen !! :smiling_face_with_three_hearts:

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Great. Do post an update under the appropriate category. Here’s hoping it’s a Success Story. We could do with more of those. Helen

Get well soon buddy. I know you can do.