Persistent Postural-Perceptual Dizziness (PPPD) is a condition that often flies under the radar, leaving those affected to silently struggle with symptoms that impact their everyday life.
But what exactly is PPPD, and how can it be managed effectively?
In this blog, I’ll delve into the specifics of PPPD, its symptoms, triggers, and the most effective treatments.
PPPD Unpacked: What You Need to Know
PPPD is a chronic vestibular disorder that causes persistent dizziness, unsteadiness, or a sensation of swaying or rocking. Unlike vertigo, which is typically associated with spinning sensations, PPPD does not involve nausea or spinning.
Instead, those with PPPD may feel constantly off-balance or disoriented, especially when standing or in visually complex environments.
The Hidden Challenge: Why PPPD Goes Undiagnosed
The problem with PPPD is that it is often misunderstood or misdiagnosed. Many people with this condition do not experience the classic “spinning” sensation of vertigo, making it harder for healthcare providers to diagnose it.
The symptoms tend to worsen with time, particularly when the person is in environments that trigger dizziness, such as crowded areas, busy shopping centres, or even in a moving vehicle.
- Persistent dizziness or unsteadiness lasting for more than three months.
- Worsening of symptoms as the day progresses.
- Sensitivity to motion, such as when standing, sitting, or moving.
- Increased sensitivity to complex visual environments (e.g., patterned floors, large crowds).
The Ripple Effect: How PPPD Impacts Your Life
PPPD can have a profound impact on an individual’s quality of life. Everyday activities such as shopping, travelling, and even socialising with friends may become difficult or overwhelming.
The condition often leads to anxiety, depression, and fatigue, further compounding the problem.
Psychological & Behavioural Factors
Anxiety and depression frequently co-exist with PPPD. Fatigue can intensify symptoms by keeping the brain in a heightened state of alert, making it more sensitive to motion and stimuli. This creates a cycle where dizziness causes fatigue, and fatigue worsens dizziness.
Many individuals avoid environments or activities that trigger symptoms, unintentionally reinforcing their brain’s maladaptive response and prolonging symptoms.
Management & Treatment
With the right approach, symptoms can be reduced by up to 60-80% through Vestibular Rehabilitation Therapy.
This form of therapy involves exercises aimed at improving balance, reducing sensitivity to motion, and retraining the brain to interpret signals from the vestibular system more effectively.
It is essential for therapy to be continued for at least 3-6 months for optimal results.
Other treatments include:
- Cognitive Behavioural Therapy (CBT) for managing anxiety and stress.
- Selective Serotonin Reuptake Inhibitors (SSRIs) to treat depression and anxiety symptoms.
- Lifestyle adjustments, such as managing stress, engaging in regular physical activity, and gradually exposing oneself to motion triggers.
Hope is Within Reach
PPPD is a condition that deserves more attention, as its impact on daily life can be debilitating.
However, with the right treatment plan, including vestibular rehabilitation, psychological support, and lifestyle changes, individuals can regain control and improve their quality of life.
If you think you might be experiencing PPPD, it’s time to take action and seek the right help.
Reach out today, and let’s work together to tackle PPPD and get you feeling your best again.
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References
Kaski, D. (2024) ‘Persistent postural-perceptual dizziness’, Dizziness and Vertigo, pp. 161–168. doi:10.1201/b23234-19.
Popkirov, S., Staab, J.P. and Stone, J. (2017) ‘Persistent postural-perceptual dizziness (PPPD): A common, characteristic and treatable cause of chronic dizziness’, Practical Neurology, 18(1), pp. 5–13. doi:10.1136/practneurol-2017-001809.
Popkirov, S., Stone, J. and Holle-Lee, D. (2018) ‘Treatment of persistent postural-perceptual dizziness (PPPD) and related disorders’, Current Treatment Options in Neurology, 20(12). doi:10.1007/s11940-018-0535-0.
