The dizziness symptomatic of vertigo is not psychosomatic, but it can have differing causes ranging from Meniere's disease to head trauma, which can make it difficult to accurately evaluate and diagnose. Many people with vertigo do not receive comprehensive evaluations because of the difficulty of accurately treating and assessing the condition.
While stress can cause a psychosomatic worsening of vertigo or, according to the case study "Cognitive-behavioral treatment of a patient with vertigo and unusual sensitivity to smells," a relapse to "cured" vertigo symptoms, it cannot cause vertigo on its own. Vertigo always has a ready medical explanation. These explanations are universally rooted in trauma and conditions which affect the human inner ear and cause a disturbance in the ability to balance and reason spatially.
Some forms of vertigo are chronic and require the attention of a trained neurologist. They may reflect an underlying problem such as Meniere's disease and could require surgery or a course of medication. Other forms, according to University of Iowa otolaryngologist Jay Rubenstein, M.D., may require treatment by professional surgeons specializing in the functions of the ear and inner ear, a highly specific form of surgical practice.
Some forms of vertigo can disappear and reappear. As a symptomatic condition, it often comes and goes with its underlying causes, which may be unknown depending on the patient and the case.