Tinnitus Reaction - The Perfect Storm

March 27, 2018

Tinnitus is experienced by people of all ages. People are more likely to hear it at night after they've settled into bed and there is no other sound. Tinnitus might sound like ringing, hissing, white noise, roaring, screeching, buzzing, crickets, pulsing, clicking, or a combination of sounds. Almost everybody will hear some type of tinnitus during their lifetime and for most people, it will have little, if any impact on daily life.


However, for a small proportion of people who have tinnitus (0.5 - 2 %) it can be debilitating. The person might find it hard to get to sleep at night on account of their tinnitus, even feel like it wakes them up because it is so loud. They might find it so intrusive that they can't concentrate at work or in social situations. It can change the entire routine of life.


Interestingly, it's common for two people with these polar opposite experiences to have the same results on a standard hearing test and even a tinnitus matching test. The difference is in the reaction.


There are connections between the auditory system and the limbic system in the brain that governs emotional reactions. In people who are distressed by their tinnitus, the limbic brain attaches a negative emotional association to the tinnitus sound – this is completely involuntary. One of the earliest studies demonstrating the link between intrusive tinnitus and emotional state was presented by Dr. Jonathan Hazell at the 5th International Tinnitus Seminar in 1995. Out of 100 patients surveyed about the circumstances surrounding their tinnitus onset, most patients reported that their tinnitus reaction started during a time of acute stress.

The following scenario might seem surprising but it is very common:


Scott first started hearing tinnitus ten years ago. The tinnitus didn't bother him and he eventually forgot he had it. Recently, Scott was made redundant from a job he loved, and he was forced to find work elsewhere. This experience caused him a lot of stress. He has recently developed severe tinnitus that keeps him from getting to sleep at night, it prevents him from being able to concentrate at work, and he can't stop thinking about it.


Of course, Scott's next step should be to see his doctor. Medical and audiological investigation are important in order to detect, and possibly treat potential medical causes of tinnitus. What happens next is just as important as finding a cause. The onset of tinnitus represents a critical time for many people, where pervasive beliefs about tinnitus form very quickly. For example, if Scott is told during this time that tinnitus is a disease, that it is incurable and will only get worse (this is called negative counselling) his tinnitus reaction could actually get worse. Unfortunately, material to this effect is extremely prevalent on the internet. Scott would be much better off finding a tinnitus specialist to help form a plan to manage the hearing, sleep, concentration, and/or emotional impacts of his tinnitus.


Most evidence-based tinnitus treatments involve structured counselling combined with sound therapy to achieve habituation to tinnitus. Tinnitus Retraining Therapy (TRT) and Tinnitus Activities Treatment (TAT) are two such examples. These are by no means the only options for managing tinnitus and often it is appropriate to seek help from other professionals such as psychologists.


For more information about tinnitus treatment options, please feel free to contact us on 02 9413 8491 or email contact@lindfieldaudiology.com.au.




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