Vertigo is the physical sensation that the world is spinning around you, or that you are spinning while the world stands still. “In addition to this dizzying sensation, you may have nausea or double vision as associated symptoms. Some people also have decreased hearing or ringing in their ears based on the cause of their vertigo,” says neurologist Arif Dalvi, MD, MBA, of Palm Beach Neuroscience Institute.

Here are six medical reasons that you could feel dizzy.

1. Orthostatic hypotension

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Hypotension, also known as low blood pressure, can cause dizziness, particularly when going from lying down to sitting or standing. “When you get up too quickly from a sitting or lying position and your blood doesn’t travel as quickly up to your head, you can experience a ‘head rush’ feeling,” explains Sherry Ross, MD, ob-gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California. To prevent this type of dizziness, take your time changing body positions. Also, talk to your doctor about possible issues with your circulation.

2. Dehydration

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Being even slightly dehydrated can cause you to feel faint, unsteady, or unbalanced, as it slows blood circulation. A lack of proper hydration can cause blood pressure to drop quickly which, in turn, causes dizziness. You can prevent dizziness by following these 5 simple tips to help you drink more water every day:

  • Set timers or alerts on your phone to remind you to drink periodically throughout your day.
  • Keep your water cold – you’re generally more likely to drink more water if it’s refrigerator-cold.
  • Drink a straw – you tend to drink more water in a shorter period of time if you use a straw.
  • Load up on foods with high water content, such as cucumber, lettuce, celery, radishes, watermelon, tomatoes, spinach, bell peppers, strawberries, broccoli, zucchini, and other raw fruits and vegetables.
  • Reduce the number of sugary sodas you drink during the day because sugary soda pulls water from your surrounding tissue to dilute the concentrated sugar in soda, thereby reduced your body water and hydration levels. Drink a glass of water instead!

3. Caffeine overdose

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Drinking more than the recommended daily amount of caffeine—which is 400 mg—can lead to dizziness. Caffeine is a stimulant, and stimulants restrict blood flow to the brain. Blood not flowing properly to the brain could be a cause of dizziness.

4. Panic attack

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We all worry sometimes, but when anxiety is accompanied by dizziness, it could be a panic attack or an anxiety disorder. Panic and anxiety disorders can make you feel lightheaded because they often involve rapid heartbeat and shallow breathing, both of which trigger dizziness.

5. Hyperventilation

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When you hyperventilate, you breathe too quickly or too deeply, leaving the body with low levels of carbon dioxide and an inability to properly deliver oxygen to the extremities. Hyperventilating, which we tend to do during an anxiety attack—but which can also be a sign of bleeding, a heart or lung disorder, or an infection, according to the National Institutes of Health—can cause tingling sensations as well as dizziness.

6. Middle ear infection

When you have an infection in the middle ear—when a cold, allergy, or upper respiratory infection leads to a buildup of pus and mucus behind the eardrum—you might experience vertigo, a drastic feeling of imbalance. The body’s balance system being out of whack can cause major dizziness.