Panic/Anxiety/Fear and the Inner Ear

[Paul_H]

Hi All,

The following was previously posted for me by Bridgie. At the time I han't met the required number of messages to post with links. That is no longer the case. Also, I wanted my original title and I've added information so I would like to re-post it. If you've already seen it, I apologize. If not, enjoy. My only hope is that someone may be helped by this information.

I've been working on the panic/agor issue on you tube in the agoraphobia and panic attacks videos. Anyone who writes me on you tube regarding this issue gets this message. What I've found there on you tube was that so many of the people on there with panic videos have links to money-making sites hawking one cure or another, all for financial gain. After having panic attacks myself and knowing how dreadfully damaging they can be to one's psyche, I couldn't imagine any previous sufferer making money off other sufferers. The thought makes me ill. I'm not hawking anything here except help. If what I post here doesn't help you, or if you disagree with it, just ignore it. My goal here is to help. I HAVE to. The attacks (even though they stopped over 16 years ago due to focusing on the cause and taking a med related to that cause) have driven me to do so.

I am not a doctor but I have studied the panic attack/anxiety connection to vestibular (inner-ear) disturbances for 16 years. First off, this was discovered by Harold N. Levinson and he wrote a book on it called "Phobia Free." For an explanation on how all this is connected, this is the best source. You can get it for cheap if you buy used online or at most larger libraries. I have no financial interest in Levinson's work so get your hands on it any way you can if this interests you. The best way to show this connection between vestibular problems and panic/agor/anxiety is to send you the links that show this connection is real. Before that however, I'd like to say that I had panic attacks, anxiety and borderline agoraphobia before I found an answer. Officially diagnosed by one of the leading anxiety specialists in the SF bay area (Dr. Brauer in Palo Alto, Ca). I was also diagnosed with an inner ear condition called "endolymphatic hydrops", also by one of the best, F. Owen Black, here in Portland, OR. This is not a coincidence. One reason I know that, is because my attacks were stopped cold within 45 minutes by taking meclizine, a simple over the counter inner ear med. It strictly targets the vestibular system. Not one attack in 16 years and anxiety reduced 95%. Even though Meclizine is an OTC med, please don't self medicate based on what I've said. There may be drug interactions or allergic reactions to consider. Also, meclizine may not be what works for you. There are dozens of vestibular meds as well as vestibular re-hab that may work better. Here are the links:

http://www.vestibular.org/vestibular-di ... mptoms.php (http://www.vestibular.org/vestibular-disorders/symptoms.php)
(Look at all the symptoms at the above link, but please take special note of the Cognitive and psychological section which clearly lists panic and anxiety as possible symptoms of vestibular dysfunction)

Here are the professionals responsible for the above list:

http://www.vestibular.org/about-veda/bo ... visors.php (http://www.vestibular.org/about-veda/board-of-med.sci.-advisors.php)
(my ear doc is the first name on the above list)

And below are medical studies again showing links between inner ear dysfunction and panic/agoraphobia and anxiety. Copy and paste these links into your browser if they aren't clickable. Also, make sure the "reader" on pubmed is set to read "abstract plus" by clicking on the dropdown box near the top left:

http://www.ncbi.nlm.nih.gov/pubmed/17538210

http://www.ncbi.nlm.nih.gov/pubmed/17045776

http://www.ncbi.nlm.nih.gov/pubmed/16570379

http://www.ncbi.nlm.nih.gov/pubmed/15814159

http://www.ncbi.nlm.nih.gov/pubmed/11591430

http://www.ncbi.nlm.nih.gov/pubmed/11388356

http://www.ncbi.nlm.nih.gov/pubmed/9669539
(although I disapprove of the SSRI recommendation at the end of the above abstract. They are not the best and first line of treatment in my opinion if your anxiety disorder is vestibular based)

http://www.ncbi.nlm.nih.gov/pubmed/9416586

http://www.ncbi.nlm.nih.gov/pubmed/8599398

http://www.ncbi.nlm.nih.gov/pubmed/7755529
(60% with panic/agro in the above study had vestibular problems)

http://www.ncbi.nlm.nih.gov/pubmed/2240177
(71% in that study)

http://www.ncbi.nlm.nih.gov/pubmed/2928069
(and this study from Levinson himself)

http://www.ncbi.nlm.nih.gov/pubmed/2928066
(and another by Levinson showing a 94% correlation)

Here is one I found recently that had all 19 panic patients showing signs of vestibular problems. Right in the abstract at the following link, it states that the patients were not pre-selected for dizziness. The only criteria for inclusion was panic disorder. Here is the link.

http://www.ncbi.nlm.nih.gov/pubmed/8134136

I have several others studies as well and I'm sure there are more since my search was not exhaustive. I think I have included enough here though to convince any skeptic that there is a connection. I'm not going to say that everyone that has anxiety issues has an ear problem. I've been accused of that before and then viciously attacked in several forums even though I never said it. But I will say this, the connection is more prevalent than most may think. You can prove this to yourself by just scanning the messages here for symptoms of dizziness, ear noises and pain or even motion sickness symptoms like weak knees, jelly legs and nausea.

I guess the bottom line here is that if you feel this information may apply to you because you have a full feeling in the ears, ear ringing or noises, or dizziness or maybe you might not have any of these but what I've said here just makes plain old sense, you may want to get a thorough vestibular work-up from a specialist in the field which would be an ENT doctor. I would ask them to be treated on the basis of a vestibular/panic connection and that any vestibular meds, or vestibular re-hab should be aimed at greatly reducing or eliminating the symptoms of both the anxiety and the vestibular symptoms (dizziness). Most importantly though, get your hands on a copy of "Phobia Free." I got my first copy at the library which is generally free unless you don't return it on time. I have since bought 4 or 5 copies for cheap online and they are all on loan to friends. I'll have to get more I guess, at a $1.17 a copy used, no real pain.

If your doctor needs convincing to get a referral to an ENT, print out the abstracts at the above links and the symptoms page at the very first link above and highlight the vestibular symptoms on there that you have and take them with you. The ENT should "get it" when it comes to this connection since panic and anxiety are listed on their official website. In the face of 14 medical studies, the symptoms page from the veda website, Levinson's book and his work in this area, plus my own personal case history, if the connection is denied by your doctor, then he or she has another agenda and your health and well being isn't a part of that agenda, and it may be time to find a new health care professional. Also feel free to use my case history (the meclizine "cure") or anything I've written on the web (there's a bunch) to help you get the help you need.

Please write back with any further questions.

Sincerely,

Paul.

Just 1 more thing. If this information has touched or helped you in some way, Please make a small comment, positive or negative, to help keep it on the front page where it can help as many as possible. As I said earlier, my goal is to help, and you can further that goal with comments. Thank you so very much for your time in reading this.... Paul.

[Stevieboy]

This post makes soooo much sense to me. I have had dizziness/headache issues for the past few years and also suffer from anxiety. I have believed for so long that the anxiety and panic attacks were responsible for my dizziness. I tend to be off balance and have vertigo. As the anxiety got worse, so did the dizziness. Luckily, my therapist as well as any doctor I have talked to also agreed with me. I am wondering though, is it necessary to see an ENT? If i were to treat my anxiety and be rid of it, do you think my inner ear systems could recover and stabilize on their own?
Also, thanks for the book recommendation. Would this book help anyone with anxiety?

Thank you!

-Stevieboy

[Paul_H]

Hi,

What I'm saying is a chicken or egg thing. The chicken = a faulty vestibular system and the egg it lays is panic and anxiety. Meaning the inner ear problem is the cause of both the dizziness and the anxiety. In the case of a vestibular basis for panic, the panic and anxiety is just a symptom of an underlying inner ear issue.

The inner ear problem needs to be treated more so than the anxiety because in this particular connection (a vestibular one), that is the underlying cause. Your dizziness increases (due to changing and uncontrolled fluctuations in the fluid levels in your ears) and all of that triggers more panic and anxiety. That is why it seems your dizziness gets worse when your anxiety does, but it isn't the anxiety that causes the dizziness to get worse, it is your ears IMO. Google "causes of dizziness" with the quotes around the search term just like I typed here and you'll see the first 4 pages of links are all vestibular in nature. The number 1 cause of dizziness is a vestibular problem. If you get the proper treatment for the vestibular issue, chances are you'll have a more profound effect on your anxiety and panic than any therapy, SSRI, benzo if in fact your anxiety is vestibular based. Judging from your short description, I'd say the odds are that yours is.

I'm not a doctor, but an inner ear med stopped my panic and anxiety cold and the links above show a connection and from what you describe, I strongly suspect that connection to be applicable in your case. But only an MD (not a therapist) or and ENT can make an ear diagnosis. The therapist will reject this connection out of hand, even if you slap him/her in the face with printouts of the 14 medical studies that show the connection. Try it on your therapist and you'll see what I've just said here is true. I don't feel providing an explanation at this time for why I'm sure your therapist will react this way will further the cause of your finding relief so I'll keep my suspicions to myself for now.

There is one psychotherapist that is on board with this and he wrote the book I recommended in my post, Phobia Free. Start there. With the book.

Thanks,

Paul.

[jennismortal]

This is very interesting. Many of the symptoms listed are right on target with what I experience. I have a sensitivity to light , sounds, excess stimuli in general. Constant headaches, transient tinnitus, feeling of fullness in ears (such as from a sinus infection-"plugged up feeling", transient vertigo. Motion can bring on the vertigo, riding in an elevator leaves me with a dizziness for several minutes afterward. My 88 year old grandmother has had an inner ear disturbance for her entire life. She is now taking Antiviral. The concept of inner ear disturbances leading to anxiety and panic does indeed make much sense. I will make an appointment with my doctor to further look into this. Thank you so much for this article. I now have hope that this may possibly be the source of my dreadful anxiety and panic symptoms. Thank You

[dtrotter]

thank you very much for that information. It will be real helpful for all of us out here. Thanks alot!

[CindyE]

I just ordered this book, i have these inner ear symptoms lately along with my anxiety. Then I had anxiety about ordering the book- duh!

[markko]

Hi Paul H,

Wow. Great info. Thorough too!

Have long felt my problems have varied depending on how my inner ear feels. Sometimes they feel really clogged up and achey and that's when I get vertigo, travel sickness and panicky in public.

Markko