Persistent Posturo-Perceptual Dizziness (PPPD)
My daughter found me on the bathroom floor.
After an ambulance ride and an examination, I was in the operating room for a 6-hour craniotomy. Along with four ventricles that hemorrhaged I also suffered from an acute malfunction in the cerebellum that hemorrhaged. Part of the surgery was close to the brainstem and it was difficult to find where the bleeding was coming from because of all the blood, the neurosurgeon and his gifted hands saved me! I am very grateful! Two weeks prior I suffered from a hemorrhagic stroke. It has taken me over three years to, “almost recover.” I am still struggling but I have used my mind to deal with my difficulty. It has been a brutal journey, not just for me but my family, however; I have learned valuable lessons, more than I could possibly imagine. While I would never want to repeat this tragic journey, I am thankful for the lessons I have learned. I always thought that my practice was special; I now know that I still have more to learn and more to give.
The spiritual journey that I have been summoned to experience has tested to me to my core. When I talk about the lessons we choose to learn from and the power of the mind, I’m talking from experience. I have taken my practice to a whole new level; I have even more tools to help others now because of what I have suffered through! When we uncover the meaning behind our suffering, when we choose to accept uncertainty and make it ok we can heal. I did and so can you.
“I feel compelled to help others learn to deal with their trauma and learn to change their thoughts around it.”
I have had to take my practice and apply it to myself, at times this has felt impossible, however; as well know, how you choose the way you think about your situation play an important part in healing.
Working with someone who can relate to your issue and draw upon their strength can aid the healing process. “I can hear you and I understand your pain.” Hypnotherapy is instrumental to speed up the healing/dealing with and accepting process. I combine several modalities, nothing is cookie cutter, and everyone is different. This quote has been my mantra!
“It doesn’t matter how you fall down it matters how you get up.”
My office is in Marina del Rey. Some people cannot travel so I also work with people via Skype, Zoom and the telephone. Thanks to the internet I can work all over the world.
What is Persistent Posturo-Perceptual Dizziness (PPPD)?
Other names for it include Visual Vertigo, Phobic Postural Vertigo, Functional
Dizziness or Space and Motion Discomfort PPPD have recently been defined by the World Health Organization as “Persistent non-vertiginous dizziness, unsteadiness, or both lasting three months or more. Contact your doctor.
Persistent Postural-Perceptual Dizziness, or PPPD, is a vestibular condition previously referred to as Chronic Subjective Dizziness. People with this condition don’t feel a ‘room-spinning’ type of dizziness or have trouble focusing during head movement like many people with vestibular problems experience. Instead, they may feel:
- Heightened sensitivity to busy or moving visual environments, like a crowded mall/supermarket, heavily patterned carpet, scrolling on the computer or watching an action movie.
- A sense of unsteadiness or swaying/veering when on their feet (not necessarily noticeable by others)
- A feeling of their head being “off” or just not quite right in a way that is difficult to describe;
- A difficulty with scenarios where it is harder to use vision or the feeling of the ground for orientation, such as being in a darkened environment or on uneven/unstable surfaces. Things like walking down the sloped aisle to find a seat in a dimly lit theatre, or walking on the grass at night.
Symptoms tend to worsen as the day progresses but may fluctuate or ‘come and go’ momentarily.
Symptoms typically worsen with:
- Being upright as opposed to lying down
- The head or body is in motion
- Being in environments where there is a lot of motion or pattern
Accompanying symptoms – Do you get any other symptoms along with the dizziness, such as nausea/vomiting, hearing change, headache, visual disturbances, shortness of breath, sweating, heart pounding, numbness or ‘pins & needles’, neck discomfort, confusion, difficulty speaking or moving? Be sure to mention these to your healthcare provider as well, as they are additional clues.
Treatment of PPPD / Functional Dizziness
Specific treatment of PPPD takes time and there is no ‘quick fix’ but good recovery is certainly possible even after months or years of symptoms. Ingredients of treatment include
- A clear positive diagnosis and explanation that you can work with.
- An understanding of how the nervous system has become sensitized can help you work to desensitize it.
- Recognition during an assessment of all the various component symptoms that may or may not be going along with your PPPD including dissociation, neck pain, anxiety, fatigue and poor concentration. Some of these problems may have treatment approaches in their own right.
- Physiotherapy/ Desensitization of movement. As the symptoms of PPD have built up, most people avoid moving their eyes, neck, and body as much as they used to. Physiotherapy and specific vestibular physiotherapy can be useful to help desensitize the nervous system and start to overcome ingrained patterns of movement. There are additional special exercises for dizziness that a physiotherapist can introduce FACTSHEET you to if they have training in that area.
- Some of the medications listed on this page may be useful –especially so-called antidepressants. This may be the case in patients with PPPD who don’t have anxiety or depression, but more studies are needed to be confident of this.
- Psychological treatment. Can be helpful in addressing understandable fears of falling, or other sources of anxiety.
- PPPD can help break bad habits that many patients with PPPD get in to with respect to their symptoms. Seeing a psychologist does not mean that your symptoms are ‘all in the mind’. www.neurosymptoms.org