13 Facts About Vertigo

Illustration by Mental Floss. Images: iStock
Illustration by Mental Floss. Images: iStock

It comes on suddenly. You feel like you're spinning—or maybe the world is spinning around you. Your stomach heaves, and you hold onto something so you don't fall. This is vertigo, a hallucination of motion—a mismatch between reality and the signals your eyes, inner ears, and sense of touch are sending your brain. Vertigo is a symptom, not a disease—an indication that something is wrong in the body—and it's surprisingly common. Here's what you need to know about the condition.

1. HAVING VERTIGO ISN'T THE SAME THING AS BEING DIZZY.

Dizziness is an umbrella term that describes the sensation of feeling lightheaded or faint. As kids, many of us experienced (and even enjoyed) that kind of garden-variety dizziness while spinning on a merry-go-round, but the sensation can also be caused by dehydration, motion sickness, or even a drop in blood pressure after standing up too fast.

While vertigo does make you dizzy, it also makes you feel like you’re spinning, swaying, or tilting. Some people with vertigo sense their bodies moving in space even though they’re standing still, while others sense their surroundings moving around them. A good way to tell you're experiencing vertigo and not just dizziness is that you feel like you're going to lose your lunch: “A person with vertigo can feel ill with nausea, vomiting, and other motion sickness-like symptoms,” says David Zee, a neurologist at Johns Hopkins University and a specialist in vertigo.

2. IT'S A VESTIBULAR DISORDER.

The name refers to the system located in parts of the inner ear and the brain that control balance and eye movements. The most common vestibular disorders often induce vertigo. Others include bilateral vestibular hypofunction (which causes balance problems), acoustic neuroma (a kind of benign tumor that can cause tinnitus or hearing loss), and a variety of autoimmune inner ear diseases.

3. MOST CASES OF VERTIGO ARE CAUSED BY TINY ROCKS IN YOUR HEAD …

Doctors split vertigo into two categories: peripheral or central. The former, which originates in the inner ear, is far more prevalent than the latter.

The most common form of peripheral vertigo is benign paroxymal positional vertigo (BPPV). BPPV comes on quickly, causing disorientation and stumbling; some even fall out of bed. (People can mistake it for a stroke, and not without reason—sudden vertigo and loss of balance experienced at the same time can be signs of one.) Most episodes last about a minute and recur over a period of a few days or weeks.

The majority of peripheral vertigo is caused by otoconia (also called canaliths), tiny limestone and protein crystals that reside deep inside your ear in the vestibule. You’d need a high-powered microscope to see a single otoconium—they’re roughly 10 microns across, or about 0.000393701 inches. Despite their small size, "otoconia create a lot of mischief,” Zee says. “These little stones can get dislodged and kind of float around, producing a powerful false sense of spinning.”

Most of us likely have a few renegade stones floating around in our inner ears, but it’s only when large clumps of more than three or four stones form and get loose that there’s a problem. Why they dislodge and relocate remains a mystery, but in some cases, the stones' movements can be triggered by external motion—a knock on the head or a ride on a bumpy road.

4. … BUT THERE ARE OTHER TRIGGERS.

Migraine headaches can bring on the dizzying sensation, as can lying in the magnetic field of an MRI machine. Other causes include labyrinthitis, an infection in the inner ear, and vestibular neuronitis, an infection of the vestibular nerve, which controls balance. Some people have a rare type of chronic peripheral vertigo called Meniere’s disease, which is caused by a buildup of fluid in the inner ear. Often doctors can’t pinpoint a specific cause for an episode of vertigo.

5. ONE TYPE OF VERTIGO CAN PERSIST FOR A LIFETIME—BUT IT'S RARE.

Far less common is central vertigo, which originates in the brain. Symptoms can vary, but a person with central vertigo is often unable to walk due to severe imbalance and may have nystagmus—strange, involuntary eye movements. This type of vertigo can be caused by diseases or injuries to the brain, such as multiple sclerosis, tumors, concussions, or strokes. In some cases, it lasts for weeks or even the rest of someone's life, especially if they have permanent brain damage.

6. VERTIGO AFFECTS MILLIONS OF PEOPLE OF ALL AGES.

Nearly one-third of people over the age of 40 in the U.S.—roughly 69 million people—will experience vertigo at least once in their lives. It’s much more common in older people, especially those over the age of 60. But anyone can get vertigo, including children (though it may be harder to spot in kids because they can have difficulty describing their symptoms). Professional golfer Jason Day was just 27 when he developed vertigo during the U.S. Open, and basketball player Pau Gasol was in his early thirties when the condition benched him. Some medical historians believe Charles Darwin suffered from vertigo later in life.

7. WOMEN ARE THREE TIMES MORE LIKELY TO DEVELOP VERTIGO THAN MEN—BUT SCIENTISTS DON'T KNOW WHY.

Recent research suggests the disparity might be related to bone loss caused by aging, vitamin D deficiency (which impairs how the body metabolizes calcium—a key component of the otoconia’s mineral composition), or the increased frequency of migraine among women.

8. VERTIGO CAN BE EXTREMELY DISTRESSFUL.

Because it's so disorienting and comes on so suddenly, vertigo can cause anxiety and panic attacks. Chronic vertigo can cause depression in some people because doing everyday tasks—like caring for themselves, their children, or their family—is often impossible. They might even lose their job because driving is out of the question.

9. IT'S POSSIBLE TO GET SOME RELIEF FROM CERTAIN MEDICATIONS …

Drug treatments vary, based on the type of vertigo a person has, and generally target the symptoms of vertigo, not the cause. Antiemetics such as meclizine may inhibit the nausea or vomiting that accompanies most types of vertigo. For migraine-associated vertigo, doctors may prescribe beta blockers, anticonvulsants, or antidepressants. People with Meniere's disease may benefit from steroids or non-pharmaceutical approaches, such as a low-salt diet, which reduces fluid retention, or surgical procedures that help drain the inner ear.

10. … BUT PHYSICAL THERAPY IS THE ONLY THING THAT REALLY HELPS MOST CASES OF VERTIGO.

The most commonly used therapy for BPPV is the Epley maneuver (also known as a canalith repositioning procedure). Essentially, the exercises are human versions of those ball-in-a-maze puzzles you played as a kid, where you rolled a bead around in a maze, trying to get the bead to go into a hole. The goal is to roll the renegade otoconia (the beads) through the maze of canals inside your ear and return them to the vestibule (the hole). These moves, which take 15 minutes or less, resolve symptoms in about two-thirds or more of people with vertigo—usually after just a few tries.

11. DANCING CAN MAKE IT BETTER.

As you get older, you lose neurons in your inner ears, your brain’s coordination center, and in your feet—a triple whammy of losses that sets up a perfect storm for balance problems, Zee tells Mental Floss. But activities that challenge your sense of balance—like tai chi, yoga, or dancing—help in the long run. You don't get have to be as nimble as Johnny Castle log dancing or blind Frank Slade doing the tango—just get moving to the beat when your favorite songs come on.

12. VERTIGO DOESN'T STOP A GUINNESS WORLD RECORD HOLDER FROM SCALING BUILDINGS.

In 1982, French climber Alain Robert sustained massive injuries when he took a header from a rocky cliff during one climb—and though he recovered from multiple broken bones, the severe head trauma he sustained left him with chronic vertigo. Despite his condition, Robert returned to climbing (almost always without safety equipment), tackling the Empire State Building, the Eiffel Tower, and a multitude of other tall structures, eventually scaling the Burj Khalifa—the world’s tallest building. He now holds the Guinness World Record for climbing the most buildings.

13. IN VERTIGO, HITCHCOCK GOT THE SPECIAL EFFECTS RIGHT BUT THE CONDITION WRONG.

Named the “greatest film of all time” by the British Film Institute’s Sight and Sound magazine, Vertigo, starring Jimmy Stewart and Kim Novak, is a twisted tale about the human psyche, full of mystery, romance, and suspense—classic Hitchcock. The film is famous for its pioneering use of the dolly zoom—a camera technique sometimes called "the Vertigo effect" that recreates the unsettling experience. Although Hitchcock got the special effects right, the condition that Jimmy Stewart’s character had is not vertigo—it's acrophobia, or fear of heights. When a person with acrophobia looks down from a great height, they might feel vertiginous—but they're not experiencing a vestibular disorder. The reaction may be rooted in humans’ natural fear of falling.

10 Things You Should Know About Asthma

iStock.com/Wojciech Kozielczyk
iStock.com/Wojciech Kozielczyk

To anyone with asthma, the feeling of an attack is unmistakable. Patients have compared an asthma attack's feeling of breathlessness, caused by inflammation in the lungs and airways, to being smothered by a pillow or having an elephant sit on their chest. Medical experts have already figured out some aspects of asthma, like how to diagnose and treat it, but other components, like what causes asthma and how to cure it, remain unclear. From the triggers people encounter at work to the connection to allergies, here are some facts about asthma symptoms and treatments you should know.

1. Asthma attacks are related to allergies.

The physical process that occurs when someone has a sneezing fit during pollen season is similar to what happens during an asthma attack. But while the former causes discomfort, the latter produces potentially life-threatening symptoms. When people with allergies are exposed to an allergen like pollen, they produce antibodies that bind to that allergen. This signals the body to release the chemicals that cause allergic symptoms. In most people, the symptoms are limited to the head, such as a runny nose or watery eyes, but in people with asthma, they're felt in the lungs. If the lungs are inflamed, the airways that carry air swell up and fill with mucus, constricting airflow and causing common asthma symptoms like coughing, wheezing, and shortness of breath. Such asthma attacks can be fatal when patients can’t get enough air to their lungs.

2. Asthma is the most prevalent chronic disease among children.

Asthma is common, affecting 25 million in the U.S. alone, and of those patients, about 7 million are children. Most people with the disease develop it during childhood. Asthma is the most prevalent chronic illness among kids, and each year, students miss 13.8 million school days because of it.

3. Asthma may be inherited.

Doctors aren’t entirely sure what causes asthma, but they know it sometimes runs in families. A 2010 study found that people with one parent with the condition were nearly twice as likely to have it themselves, and people with a parent and a grandparent with asthma were four times more likely to develop it. Because asthma is connected to allergies, a genetic disposition toward allergies, known as atopy, may explain some inherited asthma cases.

4. Asthma is surprisingly easy to diagnose.

One of the simplest ways to diagnose asthma is through a lung function test. If a patient is reporting asthma symptoms (coughing, chest tightness, a feeling of not getting enough air), their doctor may check the strength of their exhalations before and after having them use an inhaler. If their breathing improves with the medicine, they likely have asthma. An X-ray of the patient’s chest can also be used to reach an asthma diagnosis.

5. Kids who grow up around germs are less likely to have asthma.

A person’s environment early in life may also play a role in whether or not they develop asthma. People who grew up in rural areas, around animals, and in large families are less likely to have asthma than those who did not. One possible explanation is the hygiene hypothesis: According to this theory, kids who were exposed to germs and pathogens while their immune systems were developing are better equipped to deal with allergens, while kids who were sheltered from germs may be more likely to have an exaggerated (and in the case of asthma, potentially deadly) immune response to harmless substances. The hygiene hypothesis hasn’t been proven, however, and it’s definitely not an excuse to expose children to infections in an attempt to strengthen them against asthma attacks in the future.

6. Asthma triggers are everywhere.

To manage their symptoms, doctors tell asthma patients to limit exposure to their triggers when possible. Common asthma triggers include irritants and allergens like dust, tobacco smoke, car exhaust, mold, pet dander, and smoke from burning wood. Triggers that don’t come from the environment, like colds, sinus infections, acid reflux, and hyperventilation brought on by stress, can be even harder to avoid.

7. There's one asthma trigger patients shouldn't avoid.

Physical activity causes fast breathing, which can provoke asthma attacks in some people with the condition. There’s even a type of asthma called exercise-induced bronchoconstriction that specifically describes people who suffer from these kinds of attacks. But the risks of living a sedentary lifestyle outweigh those of exercising carefully, even with asthma. Instead of cutting out cardio altogether, doctors work with patients to come up with an exercise plan that’s safe for them. This might include warming up and using an inhaler before working out, practicing cool-down activities afterward, and wearing scarves or masks to limit exposure to irritants that may also trigger asthma symptoms.

8. There are two types of asthma treatments.

Long-term controllers and quick-relievers are the two types of medications used to treat asthma. Immediate medicines like short-acting beta agonists and anticholinergics relax muscles in the airways when flare-ups occur, and they’re typically administered directly to the lungs with an inhaler. Long-term medications help keep asthma symptoms under control over time are taken as often as once a day, regardless of whether symptoms are present. They include inhaled long-acting beta agonists and corticosteroids, biologic injections, and theophylline and leukotriene modifier pills and liquids. All of these medications suppress asthma symptoms by either relaxing muscles, reducing swelling, or preventing inflammation in the airways.

9. Asthma can be an occupational hazard.

Occupational asthma develops when a patient’s triggers come from their work environment. According to the National Institutes of Health, wood dust, grain dust, animal dander, fungi, and various chemicals are some of the most common asthma triggers that patients encounter in the workplace. Bakers, farmers, laboratory workers, millers, and woodworkers predisposed to asthma are all at higher risk.

10. There's no cure for asthma, but symptoms can lessen over time.

Though asthma is treatable, there’s no cure for the chronic illness. Some people, however, do appear to grow out of the condition after suffering from it as kids. It’s possible for asthma symptoms to become less severe and go into remission as patients get older, but once someone is diagnosed with asthma, the risk of an episode never goes away completely. Changes in hormone levels are a factor that could possibly bring asthma symptoms back in patients who haven’t experienced an attack in years.

When You Feel "Chemistry" With Someone, What's Actually Going On?

iStock
iStock

We know chemistry when we feel it with another person, but we don't always know why we're drawn to one person over another. Is it just a cascade of neurotransmitters and hormones conspiring to rush you toward reproduction? Is it attraction borne of a set of shared values? Or is it bonding over specific experiences that create intimacy?

It's probably a combination of all three, plus ineffable qualities that even matchmaking services can't perfectly nail down.

"Scientists now assume, with very few exceptions, that any behavior has features of both genetics and history. It's nature and nurture," Nicole Prause, a sexual psychophysiologist and neuroscientist, tells Mental Floss. She is the founder of Liberos, a Los Angeles-based independent research center that works in collaboration with the University of Georgia and the University of Pittsburgh to study human sexual behavior and develop sexuality-related biotechnology.

Scientists who study attraction take into consideration everything from genetics, psychology, and family history to traumas, which have been shown to impact a person's ability to bond or feel desire.

THE (BRAIN) CHEMISTRY OF LOVE

Helen Fisher, a biological anthropologist at Rutgers University, Match.com's science advisor, and the author of Anatomy of Love: A Natural History of Mating, Marriage, and Why We Stray, breaks down "love" into three distinct stages: lust, attraction, and attachment. In each stage, your body chemistry behaves differently. It turns out that "chemistry" is, at least in part, actual chemistry. Biochemistry, specifically.

In the lust and attraction phases, your body is directing the show, as people can feel desire without knowing anything personal about the object of that desire. Lust, Fisher asserts in a seminal 1997 paper [PDF], is nothing more than the existence of a sex drive, or "the craving for sexual gratification," she writes. It's a sensation driven by estrogens and androgens, the female and male sex hormones, based in the biological drive to reproduce.

Attraction may be influenced less than lust by physiological factors—the appeal of someone's features, or the way they make you laugh—but your body is still calling the shots at this stage, pumping you full of the hormones cortisol, adrenaline, and dopamine, effecting your brain in a way that's not unlike the way illicit substances do.

Fisher has collaborated multiple times on the science of attraction with social psychologist Arthur Aron, a research professor at Stony Brook University in New York. Aron and his wife Elaine, who is also a psychologist, are known for studying what makes relationships begin—and last.

In a 2016 study in Frontiers in Psychology, the researchers proposed that "romantic love is a natural (and often positive) addiction that evolved from mammalian antecedents by 4 million years ago as a survival mechanism to encourage hominin pair-bonding and reproduction, seen cross-culturally today."

In the attraction phase, your body produces increased amounts of dopamine, the feel-good chemical that is also responsible for pain relief. Using fMRI brain imaging, Aron's studies have shown that "if you're thinking about a person you're intensely in love with, your brain activates the dopamine reward system, which is the same system that responds to cocaine," he tells Mental Floss.

Earlier, Fisher's 1997 paper found that new couples often show "increased energy, less need for sleep or food, focused attention and exquisite delight in smallest details of this novel relationship."

The attachment phase is characterized by increases in oxytocin and vasopressin; these hormones are thought to promote bonding and positive social behaviors to sustain connections over time in order to fulfill parental duties.

There is no hard and fast timeline for how long each phase lasts, as it can vary widely due to gender, age, and other environmental factors, Fisher writes.

Additionally, while oxytocin has long gotten the credit for being the love hormone, Prause says that scientists are now "kind of over oxytocin," because it has broader functions than simply bonding. It also plays a role in the contraction of the uterus to stimulate birth, instigating lactation, and sexual arousal; low levels have been linked to autism spectrum disorders. 

Now they're focusing on a charmingly named hormone known as kisspeptin (no, really). Produced in the hypothalamus, kisspeptin plays a role in the onset of puberty, and may increase libido, regulate the gonadal steroids that fuel the sex drive, and help the body maintain pregnancy. But Prause says there is a lot more study about the role kisspeptin plays in attraction.

CHEMICAL AND PERSONAL BONDS

Biology may explain our initial attraction and the "honeymoon" phase of a relationship, but it doesn't necessarily explain why a person's love of obscure movies or joy of hiking tickles your fancy, or what makes you want to settle down.

The Arons' numerous studies on this subject have found connection boils down to something quite simple: "What makes people attracted to the point of falling in love—presuming the person is reasonably appropriate for them—is that they feel the other person likes them," he says. 

In the process of doing research for her book How To Fall in Love With Anyone, writer Mandy Len Catron of Vancouver became her own test subject when she came across the research the Arons are most well-known for: their 36 questions, which promote bonding.

The questions were originally designed to "generate intimacy, a sense of feeling similar, and the sense that the other person likes you," Aron explains. Romantic love wasn't the goal. "It was a way of creating closeness between strangers."

The Arons first tested their questions by pairing up students during a regular class section of a large psychology course, as they related in a paper in the journal Personality and Social Psychology Bulletin. Some students were paired with someone of the same sex, while others were matched with someone of the opposite sex. Each partner then answered a series of 36 increasingly personal questions, which took about 45 minutes each. (Question 2: "Would you like to be famous? In what way?" Question 35: "Of all the people in your family, whose death would you find most disturbing? Why?") Small talk during class hadn't made them bond, but the questions made the students feel closer.

In another version of the study, heterosexual, opposite-sex pairs follow the 36-question session with four minutes of staring deeply into each other's eyes.

Catron decided to test these methods out with a casual acquaintance, Mark, over beers at a local bar one night. They were both dating other people at the time, and no one exclusively. As she answered the questions and listened to Mark's answers, "I felt totally absorbed by the conversation in a way that was unlike any of the other first dates I was having at the time with people I met online," Catron tells Mental Floss.

She was ready to skip the four minutes of soulful eye gazing, but Mark thought they should try it. "It was deeply uncomfortable, but it was also an important part of the experience," she recalls. "It's so intimate, it requires you to let your guard down."

The process instilled in Catron a deep feeling of trust in Mark and a desire to know him better. Within three months, they began dating in earnest. Now, more than three years later, they live together in a condo they bought.

The Arons' questions offer "accelerated intimacy," she says, in a time of increasingly online-driven dating experiences.

A LITTLE MYSTERY, A LOT OF SHARED VALUES

Despite all that we’ve learned, scientists may only ever be able to brush up against the edge of a true understanding of "chemistry." “We understand a fair amount about what happens when [attraction has] already occurred, but we're really bad at predicting when it will happen," Prause says. "People who try to claim magical matchmaking, or that they're going to somehow chemically manipulate an aphrodisiac or something—well good luck! Because we can't figure it out.”

And anyway, what's romance without a little mystery?

If you must have a definitive answer to the puzzle of interpersonal chemistry, Prause says to keep this in mind: "The best predictor of long-term outcomes is shared values."

This piece originally ran in 2018.

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