How ‘supermarket syndrome’ complicates the shopping experience
In 2013, food service coordinator David Morrill suffered a cerebellar stroke, leaving him with central vestibular dysfunction that affected his balance and coordination. Later that year, while shopping at his local Walmart in Brewer, Maine, with his wife, he started to feel uneasy.
“I was getting really dizzy and I thought I was going to pass out because it was just getting overwhelming,” he said. “I had to leave the store and go sit in the car. My wife and I always do things together and it was kind of like I was leaving her because I just couldn’t handle this anymore.”
What Morrill, 63, experienced in Walmart that day is called environmental motion sensitivity, also referred to as “supermarket syndrome.” It’s an umbrella term that describes what patients with an underlying vestibular condition can experience in a visually overstimulating setting, such as a grocery store. And it’s not a condition people know much — or talk much — about.
“On a daily basis, I have to recalibrate everything I want to do,” he said.
Located in the inner ear, the vestibular system is what controls balance and coordination. It can be altered by many things, including underlying medical conditions or external factors, such as consuming too many alcoholic drinks, which can affect the vestibular system and make the room feel like it’s spinning.
According to Kathleen Stross, a Houston-based vestibular and neurological physical therapist, it’s a relatively new medical field. But she’s been working in it for more than 30 years — since before vestibular rehab was a thing. Stross has seen many patients who have trouble shopping in big box stores, but said they often don’t receive proper treatment for their underlying medical needs.
“Supermarket syndrome is one of those experiences where we need all of our sensory systems to work for us perfectly,” said Stross. “When one or more of them doesn’t, peo
‘On a daily basis, I have to recalibrate everything I want to do.’ DAVID MORRILL, food service coordinator
ple feel a symptom that other doctors or practitioners don’t really know how to deal with.”
Stross is associated with the Vestibular Disorders Association, known as VeDA, which offers support to anyone afflicted by balance conditions. She said there are a lot of misconceptions surrounding what supermarket syndrome is and what vestibular disorders in general are. These conditions can often get diagnosed as anxiety, which Stross said is a secondary response to the vestibular system being overwhelmed.
“[VeDA] and other organizations around the world are trying to ring the bell to say we need to understand this inner ear thing better, but it just hasn’t happened yet,” said Stross. “We’re always working on advocacy and awareness.”
The condition can manifest itself in a grocery store in a myriad of ways. Vestibular nystagmus is one example, where the eyes move repetitively in an uncontrolled manner. When looking for certain items on a stocked, visually busy shelf, this can quickly lead to the vestibular system feeling overwhelmed and imbalanced.
“Your eyes have a task of focusing on something,” she said. “When you’re walking down the aisle, you’re going to look at the ketchup, and then you’re going to jump ahead to look at the mayonnaise, and then you’re going to jump ahead to look at the cereal. The eye movement is a misinterpretation of signals from the environment, and your brain doesn’t quite know what to do with it.”
The degree to which a vestibular patient may be able to withstand the supermarket also depends on the severity and nature of their condition. In Morrill’s case, he was able to retrain his brain and get many of his symptoms to a manageable place. He now lives in Florida and works at VeDA as a community support coordinator, running online groups for patients all across the country.
Other people, like Greg Ryan, a 62-year-old retired accountant from Cromwell, Conn., are still in the throes of extreme vertigo brought on by multiple conditions, including TMJ disorder (which causes pain in jaw joints and surrounding areas), stenosis, and a pinched nerve in his neck.
“When vertigo happens, all of life shuts down,” he said.
Ryan’s vestibular problems began after he was involved in two car crashes in six months in 2017. Failing to keep his neck straight can now induce severe vertigo attacks, which makes scanning grocery store shelves a struggle. His condition has caused him to rethink his approach to shopping.
“I can’t do a lot of heavy lifting, but I just have to buy what I need,” he said. “I’d rather make a smaller trip and spend less time in the supermarket and get out of there than to go on a Saturday afternoon and buy a week’s worth of stuff to stay in line.”
VeDA has an extensive guide to shopping on its website and YouTube channel. Tips include always holding onto a cart, planning out a trip to the supermarket in detail, going at off hours, and not attempting to push through if symptoms begin to worsen.
In some cases, Stross runs physical therapy sessions where she brings clients to a supermarket and shops with them, reminding them of coping strategies. One of her longtime patients, Barbara Ferring, a 74year-old retired teacher from Kingwood, Texas, suffers from bilateral peripheral vestibular loss. Her symptoms were once so bad she would crawl around her house to avoid falling over, so she would rarely leave except to go to church. Her condition remains severe, but she’s been working with Stross since the late 1990s and has improved over time. She said her anxiety around shopping has gone down as well.
“When I run errands, I want to get everything and do everything at the same time, and I have learned that if I’m starting to get a little bit bad to close [my] eyes,” she said. “Just ground yourself, feel your feet, hold on to something, then open your eyes and see how it is.”
Because of her extreme symptoms, Ferring will often walk the aisles with an ice pack around her neck to help keep herself grounded. (Sometimes people stare; she just smiles back.) Occasionally, however, she still feels overwhelmed and has to leave.
“I just think as I go in, ‘Oh please, Lord, let me be able to stay more than 10 minutes,’” she said.
‘Supermarket syndrome is one of those experiences where we need all of our sensory systems to work for us perfectly.’ KATHLEEN STROSS vestibular and neurological physical therapist