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Is Motion Sickness All In Your Head? (yeah, actually)

"Space Mountain is just NOT for me."


Are you one of those people who gets sick reading in the car? Do you make sure to always sit at the front of the airplane or bus? Or do you call shotgun and aggressively fight for the front seat on a road trip because if not, you might end up puking in the rental car? Did you used to be totally fine with all of these things and then randomly one day realized you get nauseous when swiping through the dating app on your phone?


If you answered yes to any of these questions, read on, friend.


Motion sensitivity or motion sickness is a common experience for many of us. Maybe you were born this way or it just started happening out of nowhere. Depending on the cause of your sensitivity, there might be a way to re-train the brain and feel less stressed during travel or exploring the county fair.


Remember, there are three balance systems or inputs that the brain processes on a constant basis. For a refresher, check out my previous blog post, Your 3 Balance Systems Explained.


An analogy I just learned- that I love- is to think about these three inputs like outfielders on a baseball team. In a well-functioning team, we have our vision in left field, vestibular system in center field, and somatosensory or kinesthetic input in right field.


When we experience dizziness, nausea, vertigo, or other unpleasant symptom related to motion sensitivity, the brain decides that our center fielder, the vestibular system, is no longer a reliable player and they get benched from the team. This leaves the left and right fielders to shift over and cover center. This is also known as substitution.


Substitution is the brain's way of reallocating resources or re-weighing which sensory information is most important or reliable. On functional MRIs, we can literally see these changes happen as the brain connectivity shifts and it relies more heavily on visual and somatosensory inputs. This is why people who get motion sickness prefer sitting in the front of the car; the brain is getting crucial information from the eyes because they can see which way the car is moving before or as it happens.


Unfortunately, for my fellow motion sickness kids out there who've "always been like this", there's not much you can do to change your brain's wiring. Like Lady Gaga, you were just born this way. You can, however, use palliative strategies like breathing techniques, peppermint or ginger chews, medications, etc. to manage symptoms.


Remember that your brain likes to prioritize input from your eyes and sense of position in space, so try sitting somewhere that allows excellent visual input (permission to call shotgun, granted) and sit in an upright, comfortable position. Closing your eyes or lying down in the back seat can make things worse.


And set your outfielders up for success by decreasing additional environmental challenges, such as looking down at your phone or radio while riding in the car, boat, plane, etc. People who are motion sensitive typically have a visual preference, so the brain gets overwhelmed when vision is challenged.


If, however, you are someone who's never really had motion sensitivity but it's a new, not-so-fun thing for you, you may be experiencing Space and Motion Discomfort (SMD). This often occurs after a triggering event such as BBPV, vestibular neuritis, infection, psychological distress, etc. In these cases, vestibular rehabilitation therapy from a skilled physical therapist can help the brain re-wire itself and go back to playing ball with all three outfielders. This is typically done by gradually exposing the system to noxious (aka uncomfortable) stimuli while keeping the central nervous system calm, cool, and collected.


Drop in the comments if you've experience motion sensitivity and what it manifests as for you, as well as any tips and tricks you might have for fellow theme-park-ride-haters.


Seriously though, I almost vomited on a child on Space Mountain.


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