Understanding PPPD: Why You Feel Dizzy, Unsteady and Overwhelmed (and What Helps)
- ponderingtherapies
- May 5
- 2 min read
If you’ve been experiencing ongoing dizziness, unsteadiness or a “rocky” feeling that doesn’t quite make sense, you might have come across the term PPPD.
PPPD stands for Persistent Postural-Perceptual Dizziness.
It’s a condition that can feel confusing and, at times, quite frightening. Many people are told that nothing is physically wrong, yet their symptoms feel very real and impact daily life.
So what’s actually going on?
What is PPPD?
PPPD is a functional neurological condition. This means the structure of the brain is fine, but the way it is functioning has become a little overprotective.
Your brain is constantly processing information from:
your balance system
your vision
your body
In PPPD, the brain starts to misinterpret these signals as unsafe.
It becomes more alert, more sensitive, and begins to “over-monitor” movement and balance.
This can lead to symptoms such as:
dizziness or feeling off-balance
a “wobbly” or “floaty” sensation
sensitivity to busy places, movement or visual stimulation
symptoms worsening when upright, moving or in crowded environments
“It’s not in your head” – but it is how your brain is working
One of the most important things to understand is this:
You are not imagining it.
But your brain is playing a role in maintaining the symptoms.
Often PPPD begins after something has triggered the system, such as:
a panic attack
a period of high stress
a vestibular issue (like vertigo)
illness or fatigue
Your brain learns: something felt unsafe here.
And instead of switching back to normal, it stays on high alert.
Why symptoms keep going
Once the nervous system becomes sensitised, a cycle can develop:
You notice dizziness or discomfort
Your brain interprets it as a threat
Anxiety increases
Your body becomes more alert
Symptoms feel stronger
Over time, people might:
avoid certain places or movements
check their body more frequently
feel less confident in their balance
All of this makes sense, but it can unintentionally keep the cycle going.
How CBT can help with PPPD
Cognitive Behavioural Therapy (CBT) focuses on gently breaking this cycle.
It’s not about pushing through symptoms or ignoring them.
It’s about helping your brain relearn that you are safe.
CBT can support you to:
understand the link between thoughts, body sensations and behaviour
reduce fear around symptoms
gradually reintroduce movement and environments
build trust in your body again
step out of avoidance and safety behaviours
The goal is not perfection. It’s increasing confidence, reducing sensitivity and helping your system settle over time.
What can help day-to-day
Small, consistent steps tend to be more effective than big changes.
This might include:
gentle movement (walking, stretching, gradual exposure)
reducing avoidance where possible
grounding and breathing exercises
improving sleep and routine
limiting constant checking or reassurance seeking
Progress can feel slow at times, but it builds.
A final note
PPPD can feel isolating, especially when others don’t fully understand it.
But it is a recognised condition, and support can make a real difference.
Your nervous system is not broken. It’s trying to protect you.
With the right approach, it can learn to feel safe again.
If you’d like support
If you’re struggling with symptoms of PPPD and would like support through CBT, feel free to get in touch.
Nicole Ponder Pondering Therapies
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