PPPD Treatment: How We Treat Persistent Dizziness

Nobody wants to have a vertigo attack. They are alarming and sudden. They throw you off of your day. And recovery is not as easy as sleeping it off. To add insult to injury, the experience of having a vertigo episode can actually cause more dizziness. Specifically, a vertigo episode can lead to a condition called PPPD or Persistent Postural-Perceptual Dizziness, which is essentially a prolonged, ever-present sensation of movement. Living life “always off” is no way to live, which is why PPPD Treatment should be high on your priority list.

Before we dive into PPPD Treatment, it’s important to understand its causes, as these will inform you why PPPD Treatment is the way it is.

Causes of PPPD

PPPD is a type of chronic dizziness that is most frequently described as a sense of rocking or floating. PPPD is not true rotational vertigo, where it feels as if the world around you is abnormally spinning. Rather, PPPD exists in the background, causing dizzy patients to always feel “off-center”.

The primary difference between PPPD and other balance disorders is that PPPD is constant. One of the diagnostic requirements, for example, is that the symptoms are present for at least 15 days out of a month. For more information on what PPPD is and its symptoms, head over to our article: Intro to PPPD.

PPPD is the third most common vestibular disorder in adults, according to the Mayo Clinic. It’s so common because its causes are things experienced by many adults.

1. PPPD is caused by other vestibular disorders. Yes, it’s quite a conundrum. The fact that one balance disorder (BPPV, Vestibular Migraine, Post-Concussion Syndrome, etc) can lead to another balance disorder is discouraging. But it’s a good reason to get your dizziness checked out.
2. PPPD is caused by behavioral triggers such as heightened stress, anxiety, and panic attacks. Emotionally stressful moments exhaust our bodies, changing our perception of space and motion. When those moments are resolved, PPPD patients will find that their balance system has overcorrected for this fight-or-flight moment, and thus cannot recenter to normal balance.

Because PPPD is somewhat of a silent nuisance, many people go through their life with PPPD. It’s like the annoying mosquito that won’t stop flying by your ear, but you cannot seem to get rid of it. Fortunately, at the Dizzy & Vertigo Institute, we have a proven process for alleviating the symptoms of PPPD and helping to put the disorder to rest.

PPPD Treatment

Those with PPPD are usually fighting two battles. One, they’re fighting an actual problem in their vestibular system. Two, they’re fighting a cognitive battle with how they handle stress, which is a major contributor to triggering PPPD.

Thus, PPPD Treatment must address both the vestibular problem and the cognitive-behavioral problem.

At the Dizzy & Vertigo Institute, we have a firm grasp on solving the vestibular dysfunction of PPPD. Through Vestibular Rehabilitation Therapy, we retrain the body’s ability to rebalance and find that center of gravity you’ve lost because of your vestibular disorder. VRT for PPPD Treatment is customized to each patient’s needs, however, they usually include some assortment of:

• Sensory Reweighting – Helps the brain integrate sensory information properly
• Immersive VR Therapy – Using simulated environments to strengthen your vestibular system in visually stressful environments.
• Vestibular Therapy – Exercises designed to align your physical balance sensors (nerves throughout the body) and the brain’s balance GPS (vestibular system)

Oftentimes, PPPD Treatment stops here. But the equally important part of the equation is cognitive-behavioral therapy (CBT). PPPD patients must be able to manage their stress and anxiety because it’s a major trigger for them.  Living with chronic movement is unsettling and scary. 

Just look at these stats of PPPD patients:

• 60% have clinically significant anxiety
• 45% have clinically significant depression

One benefit of becoming a patient at the Dizzy & Vertigo Institute is that you get access to our network of renowned specialists. And as far as CBT for dizzy patients goes, one of the best in the business is Hannah Wolfe, LCSW. Locating a therapist who understands vestibular disorders and how to treat them collaboratively with vestibular specialists is challenging for many. We understand how important PPPD Treatment is to embody both vestibular therapy and cognitive therapy for many patients. And when you work with us, we’ll make sure that you’re making progress in both areas on your way to recovery. Hannah Wolfe, LCSW outlines her approach to treating the mental battle of PPPD:

“It is very common to experience emotional and physical distress as a result of these disorders. Through a three-pronged psychotherapy approach (Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, and AEDP) I help my patients learn techniques to cope with their triggers and process associated anxiety, depression and trauma. I work closely with the patient’s vestibular rehab team in order to achieve the best outcome.”

If you’d like to learn more about our treatment process in greater detail, from when you walk into our vestibular clinic to when you’re feeling relieved of dizziness, then we suggest you check out this article: How We Treat Dizziness – What To Expect Working with the Dizzy & Vertigo Institute

Otherwise, if you’re ready to put dizziness behind you, then please reach out to us at (310) 683-4679 or by filling out our contact form.