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    Panic/anxiety/fear and inner ear
    jimmymadison42 posted:
    Hi All,

    I'm always amazed but never quite surprised at how many people with anxiety disorders complain of ear symptoms/problems. I feel strongly that they are related.. Here is why I think so:

    I'm no doctor but I've studied the panic/anxiety connection to vestibular (inner-ear) disturbances for 16 years. First, this was discovered by Harold N. Levinson. He wrote a book called "Phobia Free." For an explanation on how this is connected, this is the best source. You can get it for cheap buying it used on the web, or for free at most larger libraries.

    The best way to do this is to send links that show this connection is real. Before that however, I'd like to say that I had panic attacks, anxiety and borderline agoraphobia before I found an answer. I was diagnosed by one of the leading anxiety specialists in the SF bay area. I was also diagnosed with an inner ear condition called "endolymphatic hydrops", also by one of the best ENT's in the country. This is not coincidence. One reason I know that, is because my attacks were stopped cold by meclizine, an over the counter inner ear med. Strictly targets the vestibular system. Not one attack in 16 years and anxiety reduced 95%. Meclizine may not be the drug that works for you, there are others to try. In any case, an ENT should be able to help and that is who one should see for vestibular problems (if you in fact do have a vestibular issue, see the symptoms list below). Any treatment by the ENT should focus on reducing both the anxiety and the vestibular discomfort at the same time. Find one that is willing to treat you on the basis of a vestibular/panic connection. Please don't self medicate based on what I've said here. Always consult a medical professional before starting any medications. There may be allergies, or drug interactions to consider. Here are the links:

    symptoms list

    (Look at all the symptoms but please take special note of the Cognitive and psychological section which clearly lists panic and anxiety as possible symptoms of vestibular dysfunction, )

    Here are the professionals responsible for the above list:

    (my ear doc is the first name on the above list)

    And below are medical studies again showing links between inner ear problems and panic/agoraphobia and anxiety. If not "clickable", copy & paste. Also, make sure the "reader" on pubmed is set to read "abstract plus" by clicking on the dropdown box near the top left.

    (although I disapprove of the SSRI recommendation at the end of that abstract. They are not the best and first line of treatment in my opinion IF your anxiety disorder is vestibular based)

    (60% with panic/agro in the above study had vestibular problems) (71% in that study) (and this study from Levinson himself) (and another by Levinson showing a 94% correlation)

    I have 3 more studies bookmarked in my browser that I haven't added to my canned message yet that also show this link. One has 19 out of 19 panic patients with vestibular abnormalities. 100% in that study. Here is the link (BTW, this study says that these cases weren't pre-selected for dizziness ect..., just panic disorder as the only criteria to be met to be in the study):

    Please write back
    valkyriescream responded:
    That is really interesting. I had allot of ear problems when I was a kid. I would get ear infections allot and when I was in my teens my ears were producing to much wax and I had to get them cleaned out once in a while. I haven't had any problems with my ears in years now. How do they check for this?? I do get weird feelings from getting off elevators sometimes. I always thought it was an inner ear problem or equilibrium? I thought about that because there was a test they did for motion. SO if I just go to a Ear Nose and Throught Doctor they can test for this?
    jimmymadison42 responded:

    Yes, they can test for this, but it would be a test for an underlying vestibular problem. It's link to your anxiety symptoms will have to be brought out by you to get them to treat on the basis of the connection. As I said in my original message, the treatment should reduce the symptoms of both the anxiety and any lingering vestibular problems you have. Make sure when tested that they check for "compensated peripheral vestibular dysfunction" by running the tests both eyes open and eyes closed. Also, have them check for abnormal nystagmus in both horizontal and vertical movements of the eyes during ENG testing.

    Again, this may not be your answer. It was for me though. You have a history of ear problems and anxiety issues. Coincidence? The 14 medical studies I linked to, the book by Levinson, the thousands of patients he's treated via this nexus and my own case history should tell you whether or not it should be passed off as coincidence.

    If I were you, I'd be looking for a referral to a vestibular specialist (ENT). I'm not a doctor though, as I said. I'm just saying what I would do if I had both a history vestibular issues and still suffering attacks when evidence showing a link as strong as what's been presented in my message was presented to me.

    Please print out and use anything I have written anywhere on the web, including my own case history to help you get any help you may decide to seek. Print out all the links and take them to your appointment as well.

    My only hope is that someone can be helped by this information. If I can help just 1 person beat this thing, just 1, then all the years of study, my own attacks and the permanent mental scars from them will have all been worth it. To allow anyone to needlessly suffer 1 more day or even 1 more attack from this horrid and dreadful condition by keeping information that I have dug from a deep hole with a very long shovel is unconsionable (I know, I had them myself). I have for the most part recovered. I take the meclizine daily and live with the very minimal side effects. If this information doesn't lead to an answer for everyone, I apologize in advance. However, to not present it to the ones it may help, regardless of the consequences to those that may experience letdown by it, isn't right either. Those that may not find an answer here should feel good that their fellow sufferers are getting the help they need.

    Any medical professional, or pharmaceutical company that attempts to withhold this information from the general public or other members of the medical community should have their licenses to practice revoked or be subject to civil suit. I'm not saying this is happening, but my case history shows evidence that in at least 1 case it did. Also, with 14 medical studies (and there are more as my search was not exhaustive) showing this link, several of which were published in the Journal of American Psychiatry, one would think that it would have been shouted from the rooftops, yet that is not the case. Even if this information only applied to 5% of the anxiety sufferers (the studies I presented indicate a much higher prevalence), we anxiety sufferers would know of the connection. Again, that is not the case. My goal and mission here, and on every other panic/anxiety board I can find, is to correct that disparity. Lets just say I've been a very busy boy. Look out big pharma, here I come.

    I'll let the readers of this message draw their own conclusions from the present situation. But I will say this, if panic and anxiety could be eliminated or greatly reduced by cheap and effective vestibular medications, then there would be a few bottom line profit margins at several big pharmaceutical companies that would be greatly affected. Just sayin'

    Sorry for the rant, but I'm a little bit miffed. That happens on an hourly basis every time I think of someone out there having a panic attack. I wouldn't wish one of those on my worst enemy (if I had a worst
    Dr_Patricia_Farrell responded:
    Thanks for the information.
    jimmymadison42 responded:
    Anytime. I just feel the info needs to get out there. If it was true in my case and following that link helped me to free myself from all attacks and the majority of the anxiety, I figured I wasn't the only one on the planet out of 6 billion to whom it may apply. Watch the topics for ear complaints, especially if you have never heard of this before, you'll be surprised.

    rrb01 responded:
    Hi. I appreciate the information. I am online now looking for links to inner ear problems and anxiety. I stumbled onto some information linking the two problems while researching child anxiety disorders. I have a six year old who has had severe ear infections, having his adenoids removed last Jan and having had IV antibiotics, along with oral antibiotics and ear drop antibiotics recently. He seems to be healthy now but has some type of anxiety related problems. I am wondering if now that the ear is healing and stays healed, the anxiety problems will eventually resolve themselves? I don't know. I am frustrated. I am just a regular mom who wants a happy boy.
    wind40 responded:
    Hi everyone,

    I would just like to answer that I have also had the vestibular diagnosis and am a new patient of Dr. Levinson via the phone. After eleven years, I am finally free of panic. Get the book "Phobia Free" used. You're not alone and most of all you are not crazy. It's an inner ear thing.

    bdm27 responded:
    Hello, I am reading what everyone is saying - so you think there is a definite link between my headaches, dizziness, anxiety, and a "plugged up" and "popping" ear? I just want the pressure to go away, and for it to be all resolved! Thanks for the links
    hockupa responded:
    Thank you for posting this. Im glad to see that I am not the only one with these problems. I have had terrible allergies for several years, and more recently, issues with my ears. I have this constant feeling of pressure and every time I swallow, yawn, or even open up my throat as if i were about to yawn, it makes this clicking noise that sounds like fluid is moving, its so loud, people near me can hear it. It isnt my jaw(i dont even move my jaw when this happens) its in my ears. Also, I have awful anxiety. Between the attacks and just that general feeling looming over me on some days, I cant take it much longer. I unfortunately don't have health insurance.

    I have dizziness, tinnitis, and short periods of time where my hearing is distorted. Only by certain frequencies or sounds. Sometimes it sounds like things are underwater or coming through a soup can. I've been a musician all of my life and this, as you can image, is really making it difficult to do what I love.

    I'm becoming more frustrated with this each day and I would love to find an answer, hopefully sooner than later.
    stronghuman responded:
    I am looking for solutions and treatments for anxiety. I know that sinus headaches, changes in altitude, loud spaces that affect my hearing, etc. trigger anxiety and attacks and so it seems that this would be a good avenue to explore. You seemed to have success with finding the right doctor. What should I look for when seeking an ENT? With complicated discussions regarding anxiety and visits with limited time, I understand how important it is to be able to direct and express concerns and symptoms to the doctor. What topics, things did you discuss that you found most helpful?
    quacka827 responded:
    I signed up for WebMD just to say THANK YOU! I had a cyst in my mastoid at the age of 12 and had it removed. removing it caused some significant damage to my ear and as a result I am 80% deaf in this ear. The damage also requires me to have my ear cleaned once a year, since my ear doesn't clean itself. Well needless to say I missed a couple of appointments . One day I get really dizzy and suddenly I'm sure my cyst is back and I'm about to die. Rush to the hospital and they tell me I have a pretty serious ear infection. I took the antibiotics got my ear cleaned out and no more ear infection. No more panic attacks either. Thanks for all the research you did and thanks for sharing it. Really happy to know it's not a coincidence
    ihatephobias replied to quacka827's response:
    I'm with stronghuman. What should we look for in an ENT? I just called the local one and asked the receptionist if they are open/experienced to treating patients with vestibular problems (I get dizzy spells and have motion sickness as well as a terrible memory) and anxiety. She said she would ask the doctor but didn't seem to understand what I was talking about. I read Dr. Levinsons book and I can definitely see the connection. 5 years ago as a 27 year old, I suddenly received a huge panic attack while reading in front of a group. I volunteered to read and had a lot of experience with public speaking. I didn't think twice about reading out loud until I became panicked and literally lost my voice. My hands became cold, my teeth were chattering, and I could barely talk. I played it "cool" like I had something in my throat and excused myself to get some water. But that is about the last time I read in front of a group. And it is not just reading, but there are a lot of small group or large group meetings/speaking/etc. that are very difficult for me to do.

    Long story short, I have been to a family doctor and been to a psychiatrist with little results. The psychiatrist put me on Lexapro and Clonazepam (generic for Klonopin) which helped some, but made me feel like a zombie. I took both for a few years and have weaned myself off the anti-depressant and now take the clonazepam only before big meetings at work where I have to present. I never read in public anymore. Heck, I completed an MBA (by the grace of God) and switched a class from in person to online because the professor had 5 or 6 students read out loud in the 1st class. Talk about fight or flight! If I was going to have to read, I was gonna excuse myself to the bathroom! I laugh about it, but it is extremely difficult and awful to live with. I despise social anxiety or social phobia or performance anxiety or whatever you want to call it. I am fine 1-1 and sometimes I am fine with meetings or with small groups etc. if I am leading the discussion. There is something about "performing" and being called on to read or talk that can be difficult for me. Like I can lead a meeting at work on a conference call with 50 people and feel ok, but when we have a team meeting with 7-8 people and it is my turn to talk, it can be very difficult.

    Sorry this is so long. Anyone else feel this way? I am wondering now what to do. I have lived with this way to long and am very curious if I can be treated for what I consider minor nuisances (occasional dizzy spells, getting motion sickness from spinning in circles, etc) to also resolve my anxiety. I have half a mind to call New York and set up a time with Dr. Levinsons office. Please offer me your thoughts. Thanks!
    bonhill responded:
    I can't believe this. I just now joined the WebMD support group for Panic Disorder&Agoraphobia, and up pops comments re the connection between vestibular problems and panic. I started having dizziness (more of the floor-or road, etc. seeming to tilt up and down, back and forth) and diagnosed with PD&A. I'd read Harold Levinson's book at the time and had ENT testing and when nothing else worked, was put on Valium. Seen at House Ear Institute in LA, and several ENT's in San Francisco. Have been on Valium, then Xanax, and for past 20 yrs, clonazepam. I went from having constant panic and behind housebound for years to fairly functional once on benzodiazepines. Now, after 40 yrs, my psychiatrist wants to take me off clonazepam, and I am pretty devastated. I'd love to be off it, never took more than rx'd... Anyone know of a knowledgeable psychiatrist in N. CA? Any suggestions? (I tried l0 years of all sorts of cog/beh and other therapies and was able to become a therapist myself, but now retired.
    bonhill responded:
    After being diagnosed with peripheral vestibular dysfunction by several ENT's, after I started having severe panic attacks which led to agoraphobia and being housebound for l0 years, I was put on Xanax, and now on clonazepam. WHAT OTHER MEDS WORK with vestibular-induced panic disorder. I had been tried on meclizine and OTC motion sickness meds. Pls help - also any specialists in N. CA?

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