I recently had the chance to connect with “S” through her wonderful blog, the Chronic Advocate. S is a licensed psychotherapist and struggles with multiple chronic illnesses including bilateral Meniere’s Disease, chronic Migraine with Complex Aura, and Migraine Associated Vertigo. Her writing is largely focused on patient education for migraine, Meniere’s Disease, chronic pain, and mindfulness meditation. I can’t recommend her work enough, and I encourage you to check it out at the Chronic Advocate, and on Facebook, Twitter, or Bloglovin’.
Today, S has written a fantastic guest post to teach a very important skill: How to walk and get around while experiencing vertigo.
During a vertigo attack, our every instinct is to stay still, because visually and physically, it feels like everything is spinning.
My guess is that virtually everyone with Meniere’s disease has had the experience of attempting to walk during an attack, only to fall, clinging to the ground.
What makes the intensity of Meniere’s vertigo so difficult is that the entire body is experiencing a full rotation. Between the nystagmus causing vision to spin, and the internal sensation of rotation, walking feels impossible.
However, movement during a vertigo attack can be done safely. The techniques that I am going to teach you in this article will not stop the vertigo attack, or the sensation of spinning, but they can help you get around.
I will be blatantly honest, when I use these techniques, I still don’t want to move because doing so is incredibly nauseating. It’s like walking through one of those rotating tubes at the end of a fun house except that it’s rotating at 40 miles per hour.
But I still enjoy having the power to move during an attack. If I need to get more medication, go to the bathroom, or change the heat or the air conditioning, I can do so without fear of falling.
These techniques have allowed me to not only to be more comfortable (and safe) during attacks, but also to feel more empowered. Meniere’s attacks are no longer a cause of overwhelming panic for me, though they are still extremely uncomfortable and annoying.
Nothing is ACTUALLY moving
The trick to navigating during an episode is to recognize that while it feels like everything is moving, it isn’t.
Your body is still physically in one place along with all the objects around you. One of the most important coping skills that is taught to ease an attack is to focus on a single spot because it helps us get our bearings and focus our eyes as much as we can. It also helps us emotionally to be calm, because we become aware that we’re not actually going anywhere.
Navigating during a vertigo attack starts with a very similar premise. You aren’t spinning and the world isn’t either. Objects, including your body, continue to be the same distance from one another. Even when it appears that everything is spinning if the TV is 7 feet in front of you it remains 7 feet in front of you.
During Meniere’s vertigo our perception of distance does not change. Objects, including you, continue to be in the space relative to one another.
How to get around during vertigo
When we’re really dizzy, most of us will lean against a wall or a railing that is going in the direction that we want to go so that we feel more stable, and so we know that we are going the right way. My techniques accomplish the same thing, only without holding the wall (at least most of the time).
During an attack, I will walk holding one of my hands up in my field of vision. I focus my vision on my hand and my target, centering my perception on the space between my hand and the object.
This is the same concept as the vertigo relief technique of focusing your vision on a single spot or object during an attack. Reducing the amount of things that our eyes are paying attention to makes it easier to focus and lowers the impact of nystagmus and the sensation of rotation.
How to use the video examples & VERTIGO TRIGGER WARNING
The following techniques have video examples to demonstrate these concepts. I filmed these videos simulating the focused perception on my hand and target. I also simulate vertigo.
If you have high visual dependency and/or Migraine Associated Vertigo you should watch with caution. If you’re concerned about whether or not these videos will trigger you I advise not watching them in fullscreen and to keep your finger on the space bar so you can pause when needed.
Due to the potential of triggering visual dependence vertigo and/or migraine, I have embedded these videos at a small size to reduce the impact. To watch them in a normal sized window click the Youtube button on the far right of the play bar.
While watching the videos, I recommend attempting to focus your perception on my hand and my target. Not only will this help you learn the techniques, it will also help reduce the sense of vertigo while watching the videos.
Navigating with vertigo – parallel object perspective
If I am trying to walk straight across the room I will pay attention to the space between my hand and the wall and ensure that the space is staying the same. If the distance between the wall and my hand remains the same and I am walking forward then I know I am walking in a straight line. I have merely confirmed where I am in space using only portions of my field of vision and other contextual cues.
Shopping at the store example:
Navigating with vertigo – perpendicular object perspective
To walk towards something across an open space I hold my hand in front of the object I am walking towards. For instance if I am walking across a parking lot towards my car, I hold my hand in front of my car and walk forward ensuring that my hand remains in front the car. If my hand continues to remain in front of my car I am continuing to walk in a straight line towards my destination.
Crossing a parking lot to a car example:
My car is the silver Nissan Altima (sedan).
Can I use a cane?
Vertigo often can make the ground feel unsteady too, like your walking on shifting sand, or on a boat in rough water. Canes can help improve stability because they provide contextual evidence that the ground is not shifting.
Usually when the ground feels like it is moving, vertigo is severe, and it can often help to use a lower gaze while trying to cope or navigate. Using your hand on the top of a cane as a visual guide is entirely possible, however it may take additional practice. It’s harder to navigate to more distant targets with a lowered gaze, and more difficult to keep your hand in your visual field.
When navigating with a lowered gaze, especially across an open space, the trick is to leap frog from target to target. For example, if you are walking on a tiled floor, focus on a tile towards the edge of your visual field. When you reach that target, focus on another tile near the edge of your visual field.
Just keep in mind that this can cause additional discomfort and visual instability, so practice is crucial, especially when it comes to quickly changing your visual focus from one target to the next.
Practice makes perfect
Like any skill, practice is incredibly important. It is important to practice all of these techniques and get comfortable with them while not experiencing vertigo. Using only a portion of your visual field to navigate is enough to cause anxiety all on it’s own. It also takes practice to be able to keep your entire visual focus on your guiding hand to the target.
In the end it is all about confidence
As human beings we are all driven by our emotions. Vertigo causes a huge loss of control in visual perception. By it’s very nature, vertigo also causes extreme anxiety and panic.
Practicing and learning to build confidence during an attack is critical to learning to successfully manage life with vertigo.
When we reduce our anxiety, we also reduce our tunnel vision, and enable ourselves to identify more creative ways to solve problems and work around the limitations that vertigo imposes on our lives.
I hope this has been helpful, and leads to confident dizzy walking!