Why Do I Feel Dizzy?

Dizziness is a common sensation — as many as 1 in 5 adults experience it each year. Most of the time, dizziness improves quickly and without specific treatment. But if your dizziness doesn’t get better, or if you have other health conditions, it could be a sign that something else is going on. Read on to learn more about this common — and sometimes confusing — condition.

Kinds of dizziness

It’s common to feel dizzy once in a while. It happens for all kinds of reasons. But even though you’ve probably felt dizzy at some point, it might be hard to describe exactly how it felt. 

“Dizziness” is a word that people use to refer to a variety of feelings and sensations. And those symptoms may have different causes. You can’t always tell the cause of dizziness just by the symptoms. But in general, there are four kinds of dizziness:

1. Vertigo: This is a feeling of movement or spinning. Some people describe this as feeling like they’re spinning in circles. You may also have nausea or note changes in your vision or hearing.

2. Disequilibrium: This is an off-balance feeling, like you’re tilting or not quite able to move the right way.

3. Presyncope: “Syncope” is the medical term for fainting. So “presyncope” is that feeling you might have just beforehand, like you’re about to pass out. 

4. Lightheadedness: This is probably the hardest to describe. Some people say they feel disconnected, giddy, woozy, or like they’re floating.

More than 60% of people report feeling more than one kind of dizziness. So these types are a starting point, but there are other things to consider. It’s helpful to know what brings on the dizziness, the timing of it, your health conditions, and any medications you take. These details can go a long way in figuring out why you feel dizzy.

Common causes of dizziness

Just as you might feel different kinds of dizziness, there can also be different causes for the same symptoms. So you can’t rely on the kind of dizziness to give a definitive answer about the cause. But there are some common causes and patterns that are useful as a way to start.

Vertigo

Vertigo usually happens because something is inflamed or off-balance in the inner part of your ear. Sometimes that spinning sensation happens with certain kinds of migraine headaches. A tumor, injury, or stroke in some parts of the brain can also cause it. But these are less common causes. Usually vertigo happens because of conditions like:

• Benign paroxysmal positional vertigo: This is the most common cause of vertigo. You feel dizzy when you’re in a certain position or you move your head in a certain way.

• Labyrinthitis: If the fluid or nerve in your inner ear is inflamed, it can cause temporary changes in your hearing, ringing in your ears, and vertigo.

• Meniere’s disease: The symptoms are similar to labyrinthitis. But people with Meniere’s disease have repeated episodes and often some hearing loss.

• Motion sickness: Some people have vertigo and nausea in moving cars, planes, boats, or amusement park rides.

• Noncancerous tumors of the inner ear: These include acoustic neuromas and cholesteatomas and are less common causes of vertigo.

Disequilibrium

A sense of feeling off-balance often means that something is happening in the nerves or brain. This includes information that comes from your senses, especially vision and touch. Causes include:

• Peripheral neuropathy: Different health conditions can affect how well your nerves work. Problems with certain nerves can affect movement, vision, or blood pressure and make you feel unbalanced.

• Parkinson’s disease: Disequilibrium is common in people with this condition.

• Multiple sclerosis (MS): MS can affect the function of many nerves, so it’s not uncommon for people to have trouble with balance.

• Strokes or transient ischemic attacks (TIA): If these occur in particular parts of the brain they can cause unsteadiness and dizziness.

• Vision problems: These can affect your sense of balance.

Presyncope

There are some common reasons to have a vasovagal episode. This is when there’s a sudden change in your blood pressure that causes you to faint (syncope) or almost faint (presyncope). It could happen if you’re dehydrated, pregnant, sick, or suddenly stressed out. 

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But there are a few more serious causes of presyncope and syncope, such as:

• Heart disease: These can include problems with heart rhythm, valves, or blood vessels. 

• Orthostatic hypotension: This is a big change in blood pressure when you move positions, from lying down or sitting to standing. Different health conditions or medications can cause it.

• Hypoglycemia: Blood sugar that drops too low, especially for people with diabetes, causes presyncope or syncope.

• Bleeding: Active bleeding (like from the uterus or gastrointestinal tract) as well as low blood counts (anemia) can lead to dizziness and fainting.

Lightheadedness

Sometimes dizziness is just hard to describe. You might feel lightheaded or disconnected from your body. Some people say they feel woozy or just not quite right. 

Some other causes of dizziness include:

• Hyperventilation, stress, and anxiety

• Alcohol or other substances

• Anemia or low blood count, especially if it’s mild or happens slowly

• Dehydration

• Flu, cold, or allergies 

• Changes in metabolism with some health conditions or vitamin deficiencies

What should you do if you feel dizzy?

If you’re feeling very dizzy or unsteady on your feet, find a safe place to sit or lie down. Avoid sudden movements or position changes. Falls are risky, especially for older adults and people doing high-risk work or recreational activities.

Once you’re in a safe place, there are a few other things you can do:

• Note the timing, triggers, and severity of your dizziness. It might be hard to describe it in specific terms, but thinking about the categories of dizziness is a place to start.

• Check your blood pressure or blood sugar if you have a history of health conditions that put you at risk for high or low readings.

• Drink some water or eat some food if you could be dehydrated or hungry.

• Call for help if your symptoms are severe or if you don’t think you can move safely. It’s especially important to get help if you have a health condition, like diabetes, cardiovascular disease, or a high risk of bleeding.

When to talk to a healthcare provider about dizziness

There are some symptoms that go along with dizziness that need medical attention right away. Get help if you’re experiencing dizziness along with:

• High fever

• Severe headache or neck pain

• A recent head injury

• Seizures

• Severe vomiting or diarrhea

• Chest pain or irregular heartbeats

• Loss of consciousness 

• Shortness of breath

• Trouble speaking, seeing, or moving your body

• Falls or stumbling

At other times, your dizziness might not be severe and you may not have any of these warning signs. But it’s still a good idea to talk to your healthcare provider about your symptoms. This is especially true if:

• The dizziness is getting worse or isn’t improving

• It’s a new kind of dizziness for you

• You can’t hear as well or have ringing in your ears

• You started a new medication

• You have health conditions that may need additional attention

• You are at high risk of injury from falls because of your age, health conditions, occupation, or hobbies 

Why trust our experts?

Written by:

Anne Jacobson, MD, MPH

Anne Jacobson, MD, MPH has been a board-certified family physician since 1999. She worked as a full-scope family physician (inpatient, outpatient, obstetrics, and office procedures) in the Cook County Ambulatory Health Network for 15 years.

Edited by:

Katie E. Golden, MD

Katie E. Golden, MD, is a board-certified emergency medicine physician and a medical editor at GoodRx.

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