Because there’s a constant reference point for down. It’s where gravity pulls us 24 hours a day, every day of our lives.
[This person](https://www.wired.com/2007/04/esp/) built a belt with 12 motors that would vibrate whichever one was facing north and throughout the experiment he developed a much better sense of where he was and could navigate much better.
Up and down are very different. Left and right are pretty much the same, just mirrored. We even have a very common word for “either left or right”: it’s “side”.
People who confuse the two probably think about things more in terms of being to the side of something than specifically to the left or right of something. In many cases it doesn’t matter and is a more efficient way to remember concepts, but when it does matter it takes some effort to figure out which side is the correct one.
because reference you used when determining right/left is the direction you are facing, and therefore changable
whereas up/down is determined by gravity essentially
even if you are doing a headstand, the direction your sweat fall is down
if you are lying down, your front & up is the same direction
in short, reference axis for front/back/left/right is different from reference for up/down
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