PREVAIL over PPPD
Living with Persistent Postural-Perceptual Dizziness (PPPD) can often feel like being trapped in an unsteady, dizzy, swaying, tilting, rocking, swimming and floating world. It’s a condition that challenges your sense of balance, your perception of the world, and even your confidence in your own body. Despite its relentless grip, there is hope.
This book is for you—the person living with PPPD, the caregiver, the medical professional, and anyone seeking to understand this often missed, misdiagnosed, and misunderstood condition. It is a comprehensive guide to navigating the complexities of PPPD.
The first section offers insight into what PPPD is, why it occurs, who is at risk for it, what goes wrong in the brain, and its relationship to anxiety, migraine, and vestibular migraine. The second section lays out the PREVAIL strategy, a practical, holistic, multifaceted plan designed to help you reclaim your life, one step at a time. The PREVAIL strategy empowers you with the tools to fight PPPD on seven fronts.
The practice of medicine is often viewed from a purely scientific standpoint but we are not automatons. We are thinking, sentient beings and unsurprisingly, many disorders have physical and psychological dimensions. PPPD, as you will see, is a condition that exists at the intersection of neurobiology and psychology. Failing to understand the psychological facet of PPPD will be detrimental to your healing. You will gain a greater understanding of the psychological strategies to help you overcome PPPD.
This chapter outlines what to expect from pharmacologic therapy in PPPD and what medications are available. While there are no FDA-approved treatments for PPPD, you will learn about what medications are usually prescribed, how they may help, what to expect, and potential side effects. This chapter discusses the typical treatments as well as other potentially helpful (albeit unorthodox) medications.
Science is gaining a greater understanding of the gut-brain axis – an important connection between the digestive and neurological systems – and how our gut health and what we eat influences our brain health and vice versa. You will learn about how your gut health is influenced by what you eat, the importance of the gut microbiome, and most importantly, the two-way connection between your brain and gut. This helps you understand how you may overcome PPPD through your diet.
Supplements can play a big role in brain health and help support recovery from PPPD. Certain vitamins, minerals, amino acids, and herbs may improve your symptoms and even augment the benefits of pharmacological therapy. This chapter will furnish you with knowledge about what supplements could potentially help, how to take them, and what possible side effects to expect.
Nothing is more important to PPPD remission than exercise. There are many different types of exercise, all of which can improve PPPD. Vestibular rehabilitation therapy (VRT) is another efficacious treatment for PPPD. The principles of VRT in PPPD and some simple home VRT exercises are laid out in this chapter. Finally, other potentially effective measures like breathwork, nature therapy, and neuromodulation are detailed here.
Many other symptoms or disorders may coexist with PPPD. While they may not be directly related to PPPD, they contribute to the impact of the condition. Thus, addressing these symptoms and disorders will improve your quality of life. A holistic, integrated approach is invaluable to effectively managing PPPD.
PPPD may shape and affect your life but never let it define who you are. You have to contemplate and plan your future directions. This section outlines several important considerations, including advocating for yourself, insurance, finances, medical emergencies, school, and work. This chapter also discusses how you can build a support network to help you navigate your journey to conquering PPPD.