Motor Vehicle Disorientation Syndrome (MVDS): The disorder commonly misdiagnosed as driving anxiety

With sweaty palms, a clenched jaw and white knuckles on the steering wheel, along with a feeling of being off-balance while driving on a freeway, my contribution to long family road trips over the past four years has been non-existent.

What I’d thought was driving anxiety (from a trigger I couldn’t determine) has, as you could imagine, been quite inconvenient, not just for my husband on long road trips but also for me, given the limits it has put on my driving, which have relegated me to trips around the city I live in and, on occasion, one-lane country highways that don’t involve going over 100km/h.

Despite my best efforts to get to the root cause, my GP and a psychologist couldn't quite work out why I would be feeling this way, when I hadn't been involved in an accident to trigger the anxiety, nor had anything meaningful occurred when the symptoms began out of nowhere.

Fast-forward to this year, when, after another failed attempt on the M1, my husband and I began researching my symptoms online. While this isn't usually something to be advocated or recommended, in my case it yielded some interesting results. After a new appointment with my GP and a physiotherapist, our search may have been on the money this time. And with this, it has also provided a sense of hope that I may be back driving on a freeway sometime soon.

The result that came up in my search, and also at my appointment with my GP, was Motor Vehicle Disorientation Syndrome (MVDS), also known as Motorist Disorientation Syndrome.

It’s a condition I’d never heard of, but it can have a significant impact on your driving.

“MVDS is a vestibular disorder in which people experience dizziness, disorientation or a sensation of movement that occurs primarily whilst driving. Unlike ordinary motion sickness, symptoms are often triggered by specific driving situations rather than simply being a passenger in a moving vehicle,” explains Laura Power, Vestibular Physiotherapist at The Vertigo Co.

“People commonly report feeling as though the car is drifting sideways, being pulled into another lane, floating, tipping, or that the road is moving beneath them. Many patients describe the experience as extremely unsettling despite knowing intellectually that the vehicle is travelling normally.”

Some of the common symptoms of MVDS include:

“Many people notice that symptoms are worse in environments with limited visual references, such as wide freeways, bridges or open country roads,” Power tells carsales.

And, as in my case, symptoms can overlap with those of driving anxiety and are commonly misdiagnosed as such.

“Many people with MVDS are initially told their symptoms are simply anxiety because the physical sensations can provoke significant fear whilst driving. However, anxiety is often a consequence rather than the primary cause,” says Power.

“When someone repeatedly experiences dizziness whilst driving, it is understandable that they begin anticipating symptoms. Over time, this creates an anxiety response layered on top of the underlying vestibular disorder. This is why many patients have not improved despite psychological therapy alone.”

Power adds that although MVDS is increasingly recognised within vestibular medicine, it remains underdiagnosed.

The impact of MVDS can be substantial, with many, myself included, opting to restrict their driving, which can progressively worsen over time.

“[They may] initially avoid freeways, then bridges, then unfamiliar roads, before eventually becoming unable to drive independently. This can significantly affect employment, family responsibilities, social participation and overall quality of life,” Power says.

“Some patients become unable to travel long distances, attend work, or even drive locally without considerable distress.”

While these impacts are significant, Power says the majority of drivers experiencing MVDS are still physically capable of controlling the vehicle.

“The sensation of losing control is usually a perceptual disturbance rather than an actual loss of motor control,” she explains.

The exact cause of MVDS is unclear; however, evidence suggests MVDS reflects abnormal processing of visual, vestibular and spatial orientation information within the brain.

Several factors appear to increase susceptibility, including:

“People with migraine appear to be over-represented, suggesting that altered sensory processing may contribute to the condition,” Power says.

The good news is that there is treatment available, and the earlier you get onto it, the better.

“Early intervention generally leads to better outcomes,” says Power.

“Many patients improve significantly with appropriate treatment, although recovery varies depending on symptom duration, underlying diagnosis and individual factors.

“The most effective approach usually combines:

While a common response, avoiding driving can make the problem worse, as it often reinforces the brain’s perception of driving as threatening and can make recovery more difficult.

“A structured, graded return to driving under professional guidance is generally more effective,” Power says.

“With an accurate diagnosis and targeted treatment, many people experience substantial reductions in symptoms and are able to regain confidence behind the wheel.”

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