1. The Basics of Neural Circuit Dizziness

[Music] Welcome to the Steady Coach Podcast with Dr. Yumi Arthur. This podcast is all about chronic dizziness symptoms that are medically unexplained and more importantly, how to recover from them. You might have a symptom-based diagnosis like PPPD, NDDS, vestibular migraine, or a different diagnosis that is not fully explained why you have chronic symptoms. Regardless of what diagnosis you have been given, this podcast will provide resources, tools, and education to help you on your recovery. You are not alone and you are not broken. And now, please enjoy today's episode with your host, Dr. Yumi. Hello, everyone. My name is Dr. Yumi Arthur, and you are on the Steady Coach Podcast. For our first episode, we're going to be covering chronic dizziness basics. So in today's crash course, you're going to learn how chronic dizziness happens, what you can do about it, and the first steps you can make towards recovery. I have tons of free resources available on my YouTube channel, so please check that out at youtube.com/atthesteadycoach. You can also take my free healing chronic dizziness course by visiting my website at thesteadycoach.com and scrolling down to free course. Please enjoy this episode, and thanks for tuning in. [Music] Hello, everyone. So today, we're going to be talking about the basics of neural circuit dizziness. And if you're here listening to this podcast, chances are that you're suffering from chronic medically unexplained dizziness symptoms. And that may come with a whole bunch of different diagnoses. So some of you may be diagnosed with persistent postural perceptual disorder or PPPD. Some of you may be diagnosed with malda debarck mont syndrome or MDDS. Some of you may have a diagnosis of vestibular migraine. Some of you may even have a many years diagnosis as a diagnosis of exclusion. And then in many countries around the world, this chronic unexplained dizziness is also known by names like chronic subjective dizziness or CSD, phobic, postural vertigo, and others. But the commonality between all of these conditions is that you have symptoms that can't otherwise be medically explained. And I want to start by saying that whether you have one of these diagnoses or not, if you have dizziness and it's become chronic, so it's lasted longer than about three months, it is a hundred percent real. And I want you to hear this very clearly because I know some of you have been told that the dizziness is just anxiety or it's all in your head or no one really knows why it's there, but you just have to get over it. So none of those things are correct. Your vestibular system is indeed malfunctioning. It's a hundred percent real that you have these symptoms. However, these symptoms and again, whatever diagnosis you've been given are a little bit different from how we think about many diseases. So things like the flu, like strep throat, like infections of other kinds, like tumors or other disorders that cause tissue damage. These conditions, triple PD, MDDS, and other types of unexplained chronic dizziness, what's causing symptoms here is a circuit in your brain, which is why I call it neural circuit dizziness, rather than tissue damage or disease. And if that sounds completely strange, we're going to go into a whole lot more depth on this in this episode. But I want to first say that this is great news because if indeed your symptoms are being caused by a problem with the way your brain is interpreting information from the outside, that can be changed. Your brain can adapt, and you can be rid of these symptoms. And I want to be clear here that when I say chronic dizziness symptoms, that can actually include quite an array of different symptoms. Beyond dizziness, these medically unexplained chronic dizziness symptoms can include visual issues, like feeling like you can't track moving objects or you can't follow things with your eyes when you're moving. Sometimes patterns, large spaces or small spaces bother people's eyes. Sometimes people feel that they have bouncy vision when they're walking, or they have unusual light sensitivity or difficulty with screens. Many people often report having a constant perception of motion, like rocking, swaying, or bobbing. Some of those people feel better in motion when they're actually being moved or when they're walking, and others don't get that kind of relief. There are people who report to me that they have heavy heads or head pressure or head pain or neck pain, shoulder pain, back pain, people report feeling like their legs are wobbly or really heavy, or just a general sense of unsteadiness, or like they don't know where their bodies are in space. Some people have difficulty in low light. So again, this is not an exhaustive list, but all of these symptoms can absolutely be brought on by what I'm going to be calling Neural Circuit Dizziness. So let's back up for a minute here. How can it be real and yet not caused by tissue damage or disease? Well, many of you already know this to be true. So one very large subset of you has already had a whole bunch of medical imaging and laboratory testing done and have no abnormalities. And then another subset of you had maybe some abnormalities on testing, but nothing that really fully explained why you have long term symptoms. So you were given these diagnoses, whatever you were given, based on your symptoms alone, and no physical cause was really found. So this may seem strange to you, but there is actually a really clear explanation for this. So to really understand this, there are two concepts I'm going to review right now. The first is that our nervous system has an automatic danger response, sometimes known as fight or flight. And the second is that our brain is a prediction machine. So let's start with the danger response. So this is something you may already be familiar with. Our bodies respond very quickly to potential threats with this fight or flight response or danger response. This is very important so you can jump out of the way of a car that's coming your way or potentially run away from a tiger. The thing that most people don't think about here is that your body can also have a danger response to emotions or thoughts, not just to physical causes of danger. So for example, if you've ever been asked to give a big presentation or you knew that you had a big test coming up, what did you notice? Did you find your palms getting sweaty? Did your heart rate go up? Did you feel a flutter in your chest or maybe some stomach upset? These are examples of the brain's threat response or danger response to a thought or an emotion. So again, this. response does not just happen to physical sources of threat, but very regularly, very normally also responds to emotional or thought-related threats. In other words, our minds and our bodies are one system. They're connected all the time. Okay. So let's put that aside for just a moment and talk about brain predictions. So our brains, our nervous systems, don't just respond to things in our environments. That would actually be really slow, and it could potentially get us into trouble, which I'm going to illustrate in just a moment. Our nervous system actively predicts things that are going to happen. And then it compares the information coming in from your senses to its predictions. That's a lot more efficient and a lot quicker than just trying to build up all that information from scratch. So a simple example, as promised, well, if you ever learned not to put your hand on a hot stove. So if every time you came in contact with a hot stove and you had to put your hand on it to realize that it was hot, that would not be very effective or efficient and you'd get injured. So it's really good that your brain knows how to predict that the stove might be hot and prevents you from putting your hand on it. That prediction makes that process much quicker than it would be if you had to learn it every time. All right. So putting these two concepts together, the brain can go into danger mode from both physical threats and emotional ones and the brain predicts danger and everything else. And here's where it gets really interesting. Sometimes the brain makes mistakes. It makes bad predictions. So one of the famous stories that are often told in pain literature, so research that's been done on chronic pain, is about a construction worker who had a nail go through one of his boots. And he was screaming in pain and he had to be given all sorts of pain killers. And when they cut the boot off, they found that the nail had in fact not injured him at all, but had gone through his boot in between his toes. So his brain was actively predicting danger in the situation and sending him a message of pain, but it had predicted wrong. So if you have chronic medically unexplained dizziness, this is what's happening and it's completely normal. This is a completely normal function of your brain. Your brain is in danger mode, whether for emotional reasons or thought reasons. And we're going to go into a lot of depth on those two things in episodes coming in this podcast. Your brain, because it's in danger mode, it's making predictions that are incorrect about you being in threatening situations and about what the sensory information coming in from your eyes, your ears, and your sense of touch mean. So you may be getting completely normal information from your eyes, your ears, and sense of touch. And because your brain is predicting danger, it's not interpreting that information correctly. In other words, your dizziness is the result of a circuit in your brain that's not really working the way that you want it to. It's just a brain error and this is fabulous news because our brains are constantly changing and adapting to our environments. And that means that this is a reversible process. In order to reverse this though, what we need to do is reverse that danger mode response that's leading your brain to make these errors. And that is done through a pretty simple three step process. The first is something you're already doing right now. It's getting education about the source of your symptoms and understanding that your body and brain are healthy, your brain is just making an error. When we get education about that, this reduces danger mode in and of itself. And for a significant number of people, that's it. That resolves the symptoms because the brain goes out of threat mode or danger mode and the circuit stops working the way it is. The second step in the process, and this only applies to some people, is reducing danger mode by addressing stress and reactions to the symptoms right now. So if you're under a lot of stress and you're having a strong reaction to your symptoms because they are, as we all know, actually terrifying. So that makes sense. These things can increase danger mode in the brain. And there are a whole lot of tools for addressing stress and for addressing our reactions to symptoms that we'll be talking about in this podcast. And finally, for some people, there needs to be a little bit more digging into the emotional components of the threat. So as we talked about before, the things that lead our brain to go into danger mode can be thoughts and outside stress and emotions. And for some people, these emotions that are causing threat mode aren't always so obvious. These people include folks who've gone through traumatic experiences in their lives or sometimes people who just have certain backgrounds and certain personality traits that makes it harder for them to feel their emotions. And I know that might sound strange, but don't worry, we're going to be going a lot more into depth on emotions in this podcast as well. Again, the overarching idea here is whether the cause of danger mode is lack of knowledge or stress or reactions to symptoms or deeply held emotions. The whole purpose here is to get your brain out of danger mode so it can make better predictions. So it stops making the error that is leading to your symptoms. If all this sounds way difficult or impossible, please don't worry. There is a lot more to talk about here and I'll be giving you lots more information through episodes of this podcast. But if you want to learn more right now, the best way to do that is to take my course. It is 100% free. I made the course because people started finding my YouTube channel and needing help and they were all around the world and didn't always have resources to find a therapist or get more testing done or more education. So the course is free and I will link to it in the show notes. It's comprehensive and it's going to teach you a lot more about everything we've talked about so far. You can also consider visiting my YouTube channel. I have a ton of content on there specifically about medically unexplained chronic dizziness with lots of great actionable tools that you can implement right now. I also have a paid membership community that I keep very low cost so people all around the world can access it. And in that community, I do live weekly Q&A sessions where I stream the Q&A and you can ask questions either live in a chat or before the session as well. And I also offer coaching and one-on-one sessions and you can learn more about all those options at my website, thesteadycoach.com, which I will also link to in the show notes. So I hope you enjoyed this episode and found this useful. Whatever you do from here, I really want you to understand that what you're suffering from is reversible, treatable, and I believe you can fully recover. So if you want to learn more, please subscribe to this podcast wherever you get your podcasts I hope to see you soon. Take care everyone. Thank you all for tuning in to this episode of the Steady Coach podcast. As always, if you'd like more information on what we talked about today, as well as many, many other free resources, please visit my YouTube channel at youtube.com/atthesteadycoach or my website at thesteadycoach.com. Thanks for tuning in and I'll see you next time.