Fear of Heights? Vertigo? or Something Else?

You climb the steps in the building and step out on a balcony on one of the highest floors. A strange feeling comes over you as you approach the railing. You suddenly see yourself in your mind's eye throwing yourself over the rail from this great height. The urge to jump from the building becomes nearly overwhelming, and you become slightly dizzy. After you back off and are safely inside, the feeling dissipates. The experience bothers you, though. You don't want to die, but the urge to jump from that height was intense. Are you suicidal?

This kind of experience is actually incredibly common. People are often uncomfortable trying to explain it to others, however, since they worry they might be considered mentally ill. So it this tremendous urge to throw yourself off a high place "normal?"

Fear of Heights (Acrophobia)

A true phobia can cause a variety of reactions including intense avoidance of the threatening situation, difficulty breathing, sweating, and overwhelming anxiety. People typically think of a phobia as something that leaves you basically paralyzed. Acrophobia, the fear of heights, is one of the most common such fears. Someone who is terribly acrophobic probably couldn't have stepped out of that door onto the balcony in the first place.

Most of us know what fear feels like, and this experience with the urge to jump doesn't usually feel like fear.

Vertigo

Some people use the term vertigo to differentiate what most of us call a fear of heights from feeling like throwing yourself over the edge. But technically vertigo is very different from both experiences. Although most of us use the term interchangeably with "dizziness," vertigo is actually the feeling like everything around you is moving when nothing actually is. It is definitely a disorienting feeling and can accompany a phobia, especially a fear of heights. But it does not explain the urge to jump.

Anxiety disorder?

Some posters on message boards regarding the urge to jump from great heights suggest the problem may actually be related to Generalized Anxiety Disorder or some other disorder, perhaps even Obsessive-Compulsive Disorder. But again, the label doesn't precisely fit. "Anxiety" does not aptly describe what most people are experiencing on the rooftops and cliff edges. The anxiety typically stems from the fear that you might actually jump rather than a fear of falling or being pushed.

The answer

Although it is not officially part of the diagnosis, the best answer seems to be that the urge to throw yourself over such an edge is, actually, a component of acrophobia. Some research indicates that the brain sometimes reacts in inappropriate ways to external stimuli, and this may be one of them. Just as someone may sometimes act unsuitably in a social situation, the brain may react to the fear of falling by basically wanting to get it over with and just jump. Some people admit feeling curious about falling when they feel this urge, but others are understandably horrified at their own reactions.

Treatment

The good news is that it is typical and is a condition for which many people find relief. Treatment for acrophobia can help mitigate, if not prevent, these feelings from occurring. Treatment might include cognitive therapy (changing what you are thinking during such experiences), medication (anti-anxiety medicines), or desensitization (slowly becoming used to being in high places and so lessening the anxiety associated with them).

If the urge to jump is accompanied by depression or truly suicidal thoughts, that is quite another matter, and you should seek professional help immediately. If you are the typical acrophobic, however, take comfort in the fact that somewhere around 1 in 20 people share your fear of heights, and many of them feel this same urge.

References

"Phobias." Mayoclinic.com.

"Vertigo." Webmd.com.

"Is a temptation to jump off high buildings normal?" The Straight Dope. Straightdope.com.

"Anxiety Versus Anxiety Disorders." Helpforanxiety.com.