Vertigo and Tinnitus: Two Symptoms, One Brain Response

by Dr. Jennifer Gans

Balance Is a Sense—Just Like Hearing

Beyond the traditional “five senses,” the brain relies on several additional sensory systems to understand the world. One of the most essential is the vestibular system—our sense of balance, motion, and spatial orientation. Like hearing, it lives in the inner ear and continuously sends the brain information about head position and movement.

When this information is reliable and symmetrical, we feel stable without ever thinking about it.

 
When Balance Input Is Lost or Distorted

When vestibular input is reduced, asymmetric, or suddenly altered—due to infection, migraine, concussion, aging, or inflammation—the brain loses part of the information it expects to receive.

And just like with hearing loss, the brain begins to search for what is missing.

 
Vertigo as a “Phantom” Sensation

When balance input is disrupted, the brain attempts to fill in the missing information. This can produce phantom motion—sensations of spinning, rocking, swaying, floating, or visual instability. This is often referred to as Benign Paroxysmal Positional Vertigo (BPPV).

In this way:

• Tinnitus is a phantom sound created by missing auditory input
• Vertigo and imbalance are phantom motion sensations created by missing or distorted vestibular input
• Neither means the brain is broken.
• Both reflect a brain trying to recalibrate in the absence of clear sensory data.

 
The Role of Fear and Attention

Just as with tinnitus, vertigo becomes more intense when the brain interprets the sensation as dangerous.

When the brain asks, “Is this a threat?” and answers yes:

• Attention narrows
• The sensation is elevated in the brain’s triage system
• Monitoring increases
• The symptom becomes louder, stronger, or more persistent
• This is why vertigo and tinnitus often co-occur with anxiety—and why reassurance alone rarely resolves them.

 
Why Vertigo and Tinnitus Feel So Alarming

Both sensations disrupt our sense of safety:

• Tinnitus challenges auditory certainty
• Vertigo challenges spatial certainty
• Because orientation and balance are core survival systems, the brain treats disturbances here as urgent—even when they are benign.

 
The Shared Path to Relief

The brain resolves both tinnitus and vertigo through the same principles:

• Accurate education (An explanation of what is happening--“This is not dangerous”)
• Repeated safe exposure
• Anxiety Reduction--Nervous system regulation
• Reduced vigilance
• Time and consistency
• As the brain relearns that the signal is not a threat, it stops prioritizing it. The phantom perception loses salience and fades into the background.

 
In Simple Terms

When you lose hearing, the brain creates a sound.
When you lose balance input, the brain creates motion.

In both cases, the symptom is not the enemy—it is the brain doing its best with incomplete information. With education, anxiety care, and calm, the brain naturally finds its balance.