How to heal from chronic dizziness or PPPD (first steps!)

Summary

In this video, Dr. Yonit Arthur, an audiologist, strength coach, and personal trainer, delves into Persistent Perceptual Postural Dizziness (PPPD), a common cause of chronic dizziness. She explains how the brain's fight-or-flight response, normally set off by an acute vertigo or dizziness incident, might stay activated beyond the initial event. This heightened state can lead to ongoing symptoms, despite normal medical findings. Dr. Arthur emphasizes that managing the fight-or-flight response through techniques like parasympathetic breathing is crucial for alleviating symptoms. She guides viewers through specific breathing and eye exercises to help retrain the brain's responses, promoting healing from PPPD.

Highlights

• Understanding PPPD: It's a chronic dizziness condition often linked to past vertigo or trauma. 🤔
• Your central nervous system wants to protect you, but it can go into over-protection mode, causing ongoing symptoms. 🚨
• Parasympathetic breathing: A powerful tool to reduce stress chemicals and adjust your nervous system’s response. 🌬️
• Eye exercises can gradually desensitize your reaction to visual triggers. 🎯
• It’s all about repetition and not giving up; slowly but surely rewiring your reactions. 🚀

Key Takeaways

• PPPD is a genuine condition, and it's definitely not 'all in your head!' 😌
• Our brains are just trying their best to keep us safe, even if it feels like they're going overboard. 🧠💡
• The first step to healing is calming your body's fight-or-flight response. Deep breaths, everyone! 🧘‍♀️
• Visual exercises can help retrain your brain to respond appropriately to movement and prevent dizziness triggers. 🔄
• Consistency is key! Retraining your brain, much like strength training, takes time and persistence! 💪

Overview

Dr. Yonit Arthur welcomes you to ‘The Steady Coach’, where wellness, dizziness, and balance issues are the order of the day. Today’s star? PPPD - or Persistent Perceptual Postural Dizziness. Imagine experiencing dizziness out of nowhere thanks to your brain's enthusiastic overreaction from a past event. This has your alarm bells ringing, but there’s no real danger afoot!

In her engaging explanation, Dr. Arthur points out that this state is not just a flight of fancy. It's your nervous system cranking up anxiety levels, courtesy of your brain's fight-or-flight response. And, no - it isn’t just in your head. She delves into how the brain, in its bid to protect you, might actually keep you stuck in a state of hyper-alertness.

Dr. Arthur doesn’t leave us hanging. She introduces parasympathetic breathing and eye exercises as stepping stones to healing. By focusing on calming practices, you can begin to reshape your brain’s reaction to perceived threats. Like a good coach, she reminds us that repetition is key. Slowly and consistently, you can reclaim control over your symptoms and live a balanced life.

Chapters

• 00:00 - 00:30: Introduction to the Channel and Topic The chapter starts with an introduction by Dr. Yonit Arthur, an audiologist, strength coach, and personal trainer, greeting the viewers to her channel, 'The Steady Coach.' She outlines the channel's focus on vertigo, dizziness, balance problems, fitness, and wellness. The chapter sets the stage for discussing a specific form of chronic dizziness.
• 00:30 - 02:00: Understanding PPPD The chapter discusses Triple PD (Persistent Postural-Perceptual Dizziness), a prevalent cause of chronic dizziness. It typically follows an initial trigger, such as an attack of vertigo, dizziness, or trauma. While most affected individuals recover, some continue to experience symptoms like persistent vertigo, dizziness, and difficulties with visual motion.
• 02:00 - 03:00: Role of the Central Nervous System The chapter titled 'Role of the Central Nervous System' addresses the misunderstood condition known as persistent perceptual postural dizziness (PPPD). It highlights that despite patients being frequently told by healthcare providers that their symptoms are imaginary due to a lack of detectable medical abnormalities, PPPD is indeed a legitimate condition. The chapter underscores the importance of acknowledging the reality of these symptoms and reassures patients that healing is possible. It poses the critical question of why symptoms persist even when medical reports indicate no issues, aligning this inquiry with the central theme of the chapter.
• 03:00 - 05:30: Fight or Flight Response The chapter 'Fight or Flight Response' explores the persistent symptoms of dizziness and vertigo despite medical clearance and proper medication adherence. The explanation is found within the central nervous system, comprising the brain and spinal cord, which processes sensory information to help us understand our environment. Additionally, it communicates with the rest of the body to indicate what is happening around us.
• 05:30 - 10:00: Heightened Sensitivity and the Brain's Response The chapter explores how the brain responds to acute dizziness or vertigo, particularly focusing on the brain's fight or flight response. When an individual experiences a dizziness or vertigo attack, the brain recognizes that something is wrong and activates this response, much like the instincts humans had in prehistoric times to protect themselves from threats such as saber-toothed tigers.
• 10:00 - 16:00: Steps to Healing from PPPD This chapter provides an overview of the body's fight or flight response, particularly in the context of PPPD (Persistent Postural-Perceptual Dizziness). It explains how the body's natural reaction to dizziness or vertigo involves the release of chemicals that trigger this response.
• 16:00 - 21:00: Breathing Techniques The chapter "Breathing Techniques" explains how the body reacts to stress by initiating a 'fight or flight' response. During this response, the brain signals the body to become highly alert due to a perceived threat or sudden event, such as an acute vertigo or dizziness attack. This heightened state is described as a reaction where the brain tries to process and understand the situation by using available information. The chapter likely discusses methods to manage or control this response through breathing techniques.
• 21:00 - 29:00: Eye Exercises This chapter titled 'Eye Exercises' discusses the persistent state of alertness the body experiences even after episodes of dizziness or vertigo have passed. It uses the example of BPPV (benign paroxysmal positional vertigo), which is a short-lived type of vertigo. People who suffer from BPPV may continue to feel a sense of fatigue and disorientation long after the primary symptoms subside. The chapter explains that, despite the acute episode ending, the body remains in a state of heightened alertness as a protective mechanism to prevent future occurrences.
• 29:00 - 30:00: Conclusion and Encouragement The chapter concludes by discussing how the brain adjusts the sensitivity of our senses in response to previous experiences of dizziness or vertigo. This is an effort to avoid future occurrences. It highlights how the brain may become particularly sensitive to certain sounds or smells associated with past episodes, aiming to tune these sensory 'volume dials' to prevent reoccurrence. The phenomenon begins often with the inner ears, leading to heightened sensory awareness as a protective mechanism.

How to heal from chronic dizziness or PPPD (first steps!) Transcription

• 00:00 - 00:30 [Music] hi my name is Dr yonit Arthur and I'm an audiologist strength coach and personal trainer thank you so much for joining me on my channel the steady coach where we discuss all things related to vertigo dizziness balance problems Fitness and Wellness today we're going to be talking about a form of chronic dizziness that's
• 00:30 - 01:00 longlasting dizziness in Vertigo that's called triple PD triple PD is one of the most common causes of chronic dizziness and it's usually preceded by an attack of vertigo or dizziness or some kind of trauma that causes vertigo or dizziness in these cases most patients get better the patients who don't and continue to have symptoms of vertigo dizziness trouble looking at things that are moving those patients go on to often be
• 01:00 - 01:30 diagnosed with pppd or persistent perceptual postural disiness in many cases these patients are told that these symptoms are all in their head and they just need to get over it because there are no abnormalities or medical conditions that can explain their situation and I'm here to tell you that it is a very real condition and more importantly it is something that you can heal from so why are you still having symptoms if every everything is okay if
• 01:30 - 02:00 you are medically fine and you've done your therapy and you've taken your medications why are you still having dizziness and vertigo symptoms the answer lies within our central nervous system so our central nervous system is our brain and our spinal cord and their jobs are to take information that we get from our senses and put them together so we understand and can make sense of what's going on around us that's their first job their second job is to tell the rest of the body what the heck is going on
• 02:00 - 02:30 and to give it an idea of how it should respond okay so what happens when you have an actual dizziness or vertigal attack early on when you have an acute medical problem that causes dizziness or vertigo in that situation your brain knows something terrible has gone wrong and what it does is it activates your fight or flight response and that's something you're probably familiar with back in the old days when we were living in caves we had to make sure that if a saber tooth tiger came along that
• 02:30 - 03:00 probably doesn't line up with the timeline but if something came along that could eat us that we responded quickly and appropriately so we could get out of there and make sure we didn't get eaten so fight or flight you've probably experienced that feeling yourself it's that feeling feeling of an anxiety and wanting to move that's that fight ORF flight response that happens when you have an acute medical issue that leads to a dizziness or vertigo attack now at that point your body releases all these these chemicals
• 03:00 - 03:30 throughout your whole body to tell everyone every little cell in your body hey we're on high alert something bad something scary has happened at that point your brain uses all the information around you to try to make sense of what's going on okay so in your first acute vertigo or dizziness attack you had the fight ORF flight response your brain said oh my gosh something doesn't make sense here sound all the alarms and very frequently people end up in this very very heightened state of
• 03:30 - 04:00 alertness for a long period of time even after the dizziness passes say for example in cases like bppv or benign proxyl positional vertigo which is a shortl lasting type of vertigo people will still feel very off very fatigued even long after the vertigo subsides so even after the acute dizziness or vertigo or danger whatever that is has passed your body is still in the state of heightened alertness and your brain says we got to make sure that doesn't
• 04:00 - 04:30 happen again so it starts tuning the volume dials on your various senses it starts saying wait Okay let's listen really carefully if you heard a sound that happened before you had your dizziness or vertigal attack you might be extra sensitive to sound you might be extra sensitive to a particular type of smell your brain is trying to remember these things so that you don't have this happen again and for some of us again the attack starts in our inner ears so your brain turns turn the volume dial up
• 04:30 - 05:00 on the inner ears and on the other senses that are related to our movement which primarily includes our vision all right and this is why so many of us after we have an acute vertigo attack notice that things can sometimes be triggered by visual stimuli or Vision related things that we see such as driving in a car with the trees going by such as things that are moving in front of us that we have to follow with our eyes will have vertigo symptoms that are
• 05:00 - 05:30 triggered by our eyes because our brain has turned up the volume dial on the eyes to make sure that terrible awful dizziness and vertigo attack doesn't happen again so just like how you would train a muscle to make it stronger as your brain gets used to this process of keeping the volume dials turned up keeping yourself in that fight or flight state to make sure that nothing happens again just like when you train a muscle it gets stronger your body doing that over and over being in
• 05:30 - 06:00 the fight ORF flight State being in that hyper tuned extra sensitive um state that is trainable as well the more you do it the more your brain is going to do it the more sensitive you're going to be to everything around you to the inputs from the various senses that were involved in the initial attack and possibly to other senses that your body or your brain have decided are really important to keeping you safe so so all this is coming from a place of your
• 06:00 - 06:30 brain trying to keep you safe but it ends up keeping you in an hyper alert and very unsafe State all the time so the first step to making sure that your brain starts to let go of all this let go of that fight ORF flight response and stops turning up the volume dial and all the different senses that were involved in the initial attack is to get your body out of the fight or flight response now your providers or doctors may have
• 06:30 - 07:00 told you that breathing techniques meditation relaxation can be really helpful for ppbd but you may not understand why so it's not because you're crazy and you just need to relax more it's not just oh you're just anxious and that's what's causings no you have a very real nervous system issue that we need to address by bringing some of those stress chemicals back down relaxation breathing yoga all those things are very helpful
• 07:00 - 07:30 specifically for that purpose but I want you to understand that you're doing them not because you're crazy but because there's a physical chemical Cascade going on in your nervous system that you can take control of if you use some of these techniques so let's talk about some of the exercises I have my patients do when they come into me with triple PD the very first thing that I have these patients do because every single one is
• 07:30 - 08:00 in that fight ORF flight state is do something I call parasympathetic breathing super fancy name it's basically deep diaphragmatic breathing in a specific method that I'm going to show you doing that again what we're trying to do is stop that brain chemical dump into your body that's causing you to go into that fight ORF flight State we have to stop that we have to cut that off before we can successful with any exercises you can do all these wonderful V vular exercises until the cows come
• 08:00 - 08:30 home if you are still in that fight ORF flight response your brain's going to say yeah that's nice turn the volume dial back up dizziness is coming again okay so the very first step is this diaphragmatic breathing so with the breathing I'd like you to get into a comfortable position most of my patients like to lie down on the floor with their feet up on something comfortable if lying down provokes your symptoms then you're welcome to sit stand sit in a recliner wherever you want to be I want you to be comfortable we're not trying to provoke your symptoms here we're just
• 08:30 - 09:00 trying to get you into a relaxed State again to bring those chemical levels down at that point I want you to put your hands on your sides like this so your thumb is going to be against your back and your fingers are going to be against your rib cage from here I want you to breathe into your entire hands and if you happen to have someone nearby who can watch you or have a mirror nearby that's even better so deep breath in and deep breath out now now what I want you to notice is a few things most
• 09:00 - 09:30 people when they breathe they do this their shoulders come up okay so I want you to take another deep breath and I want you to watch to see what your shoulders do do your shoulders rise if they do I want you to really consciously think about relaxing them down the second thing that I see is that people will breathe really hard into one part of their hand but not the other and that's why I call this 360 degree breathing rather than just belly breathing belly breathing is out here I don't want your belly moving out I want
• 09:30 - 10:00 your belly moving out your ribs moving out to the sides and then your back expanding your thumbs so let's try one more time I Want You to Breathe In into your hands feeling your uh torso pushing out against your fingers into the crevice between your first finger and your thumb and into your thumb making sure your uh shoulders aren't rising up so deep breath in and deep breath out okay now from here what you're going to do is you're going to bre breathe in on a four count
• 10:00 - 10:30 four slow count in and then six slow count out that may be a little too slow if you're not used to breathing this way you're going to work up to that you're working up to a four count in one Mississippi right two Mississippi four count in six slow count out if you can breathe through your nose that is better than breathing through your mouth but if you can't breathe through your nose use your mouth if you have to okay once you
• 10:30 - 11:00 have done that for at least 20 breaths that's a long time that's going to take you a few minutes I want you to stop and evaluate how you feel if you feel like you're still hyper alert and Hyper sensitive then great you're done for the day you can come back and do it again in another couple hours or revisit it again tomorrow if you feel like you're no longer in that same anxious or stressed out or dizzy state that you started in at that point I I'd like you to try a
• 11:00 - 11:30 few more [Music] exercises okay so for our exercises today you're going to need two regular playing cards this first exercise is called tracking and what I want you to aim for with the tracking exercise is feeling some symptoms but only up to maybe a three or
• 11:30 - 12:00 four on your symptom scale up to 10 so you might feel a little hint of dizziness or nothing at all which is fine too but I don't want you to feel more than that not to the point of feeling ill or feeling like the room is spinning around you can provoke some symptoms up to a three or four no more than that okay so the way to do this and keep the level low when you first start is to move your hand slowly and then if you want to speed it up up and make it harder that's going to help bring on
• 12:00 - 12:30 more symptoms okay so you're going to stare at your card directly in front of you and you're going to slowly move it side to side watching it with your eyes you're not going to move your head or your neck you're just moving the card side to side and what you're going to do is move it fast enough all right speed it up if you can just till you feel again about a three or four on that dizzy symptom scale okay you're going to do
• 12:30 - 13:00 this 10 excuse me 20 times in each Direction 20 times in each Direction once you're done you're going to stop you're going to put your fingers and your hands back on your waist and you're going to take five grounding breaths if you feel dizzy at this point and like you can't continue congratulations you're done come back again later start with your breathing and then go back into the exercises if you you feel like you can continue we're going to do the same
• 13:00 - 13:30 thing except moving the card up and down so cards up face stays pointing forward eyes are following the card card goes down up and down and again you're looking for no more than a three to four on your symptoms you're going to just speed it up as you can without making yourself feel more than a four on that dizziness scale okay you're going to again do 20 in each Direction the last variation of this is on the
• 13:30 - 14:00 diagonal so you're going to take five more breaths here five more breaths and then from here you're going to take the cards on a diagonal again moving them at the speed that works for you you're following the card with just your eyes not letting your head and neck move you're going to do 10 on One diagonal and 10 on the other diagonal at the end of those exercises take a moment ground three to five breaths and we can move on to the
• 14:00 - 14:30 second exercise of the day the second exercise is going to be something we call sads which is looking quickly from one target to another so I have two playing cards now I'm going to hold them out in front of me and I'm going to quickly look back and forth between the Cards looking back and forth and again to make this easier you slow it down a little bit to make it harder you speed it up card stay still head stay still
• 14:30 - 15:00 you're just looking back and forth between the Cards you're doing this 20 times in each Direction after that stop and ground three to five breaths we're going to go vertical same thing looking from card to card not moving head or neck looking up down up down up down and you're going to go as fast as you can while keeping your symptoms to no more than a four all right stop and ground three to to five breaths then sads again one two one two
• 15:00 - 15:30 keeping your head and neck straight you're doing them on a diagonal then you're going to switch to the opposite diagonal 10 in each directions on both diagonals at the very end when you're all through with all of those so tracking side to side with one card up and down diagonal and diagonal then sad side to side sods up and down diagonal diagonal you are finished with your
• 15:30 - 16:00 exercises for the day take one final set of grounding breaths three to five breaths and go on about your day I recommend doing these two to three times a day if you can but the key here is while you're first getting started again what is our main objective our main objective is fight ORF flight response bring the figh ORF flight response down enough that we can start to retrain the brain to appropriately listen to the SE the input it's getting from our eyes and
• 16:00 - 16:30 from our ears okay if you're in that hyper Alert state if the breathing doesn't calm you if you still feel really stressed out then no worries you did your breathing you're still accomplishing something whether your body wants to or not it's still going to bring those levels of chemicals down and you're going to be more successful the next time you try so go about your business come back and try it again later and when you feel like you are at no more than a three or four with your
• 16:30 - 17:00 symptoms that's when you can start doing your eye exercises you might start very slow you might only be able to get through a few repetitions and that's fine every repetition counts think about it this way if you came to me as a personal training client and you said I want stronger biceps I would say okay let's do some bicep curls so for this whole time your brain has been doing repetition upon repetition of fight ORF flight of fight ORF flight and dizziness fight ORF flight and dizziness so every
• 17:00 - 17:30 moment that you're not in that fight ORF flight state every moment that you're teaching your brain to pay attention to your eyes in an expected way in the way that it should is one step away from your [Music] symptoms thank you so much for watching this video if you have any questions please drop them below and I will either
• 17:30 - 18:00 answer you or maybe even make a future video on the topic you suggest Please Subscribe please share and again thank you for tuning in bye