Back again ...is habituation a myth?

I swear I can't get anyone in the medical community to really tell me...and I work in healthcare.

I was here in December when I had T for a month, I was panicked and didn't want to go on. I took the advice of the lovely people here--got some medication to sleep and later for anxiety. I suffered from anxiety before the onset of T in November. I couldn't drive on a crowded highway anymore--I couldn't even be a passenger but now I can do both from taking Xanax. It also seems to help me with the T--I'm not one of the lucky ones who get 'cured' from Xanax but I think it does lower it a bit and like I said, I feel normal for the first time in years. I had three years of very stressful events prior to the onset of T--dealing with a dire illness of my spouse and then losing our business. Fortunately I have a good job--so I had to make myself come to work. Some days were a nightmare and I was very panicked.

Now, I have gone through a 6 week group to handle anxiety. I practice relaxation and self hypnosis on a regular basis. I'm starting sessions with a CBT psychologist tonight as I know my thinking is distorted and catastrophic. My T is very low on at least 2-3 days a week and just lately, I had 4 days that were good in a week. By good, I mean I only hear a tinkling sound and/or a soft hiss. Today is it buzzing along but I'm not that upset--I'm wearing an ipod with white noise because I'm at work and it helps me. I can't totally mask the T but it does soften it. I'd have to say that my reactions today are so much better--I am managing my T most of the time whereas in the first three months, it managed me. I lost 12 pounds then and really was a mess but now I've gained some of it back and I have not missed one day of work.

I went to an audiologist who said my ent did not do a thorough exam as I had no scans and I have unilateral T. The doctor can't do an intervention for me until I'm cleared by another ENT that she sent me too. He was very thorough but I won't get the results until April 15th. I'm hoping I don't have a brain tumor but the ENT pretty much told me that I don't--it's been 5 months since the onset and I have no other symtoms. He may have just said that so I don't worry myself. He also was more encouraging than the first ENT--the one who told me it was hearing loss and something that I'm doing--that I'm the problem! When I asked the second ENT if I'll be debilitated he said, "you've had it for five months and you are working and living--if you get debilitated it will be because you did it to yourself." Not sure what that means.

Back to habituation--is this a real thing? No where can I find out how to go about habituating, or if I'm even a candidate for it. I must be a "tough case" as I didn't spontaneously habituate like 85% of people who get tinnitus do. ENT's say that habituation is just 'getting used to T'. I've also read that one can't habituate while taking Xanax but it has made such a huge difference in my life--I didn't realize how dysfunctional I was becoming because of anxiety. I hope I don't have to choose between habituation and living without excessive worry and fear.

Sorry to write such a long post!

 

Kathy there is no set time frame to habbitute. And some people need professional help to habituate. Also it does take work and a good game plan. Hopefully your cbt therapist has experience with t and can help you better. Others on here will give you better advice then me aw well but when you say " I must be a tough case because I don't habbituate" I would be careful with those kind of thoughts because they may keep spiraling and become obstacles for you on the road to habituation. Before you know it your going to be telling yourself my t is so loud that I can't habituate. Of course these are just my thoughts anyway Good luck and try to stay positive hope the cbt works!

 

Kathi, my T started about the same time as yours, but I think you are making real progress especially considering you had some serious personal troubles to deal with on top of the T. I haven't habituated either, but as I understand it, the amount of time it takes is different for every individual and depends on the severity of the T. Like you, I have 2 or 3 good days a week where the T is low; what a relief. I've not had 4 days in a row, but I've had 3 (but it was quite awhile ago). Sounds like you are doing all the right things. I only went to an ENT way back when my T first started, and all he said was "it might go away, it might not". My hearing test was normal. Do you recommend going to an audiologist? I'm not currently on anything like Xanax, so can't help you with that question, but if it is helping you function then maybe you should stay on it until you feel you've habituated. Good luck!

 

Hi Kathi! Good stuff from cullen and DebS! Habituation is a funky thing. For some it happens sooner than others. Cullen is spot on about attitude and thought process regarding your T. The key to habituating (in my humble opinion) is taking control of one's life back from the T. If you get a chance read my post from earlier this year;

https://www.tinnitustalk.com/threads/habituate.3120/

It is NOT a myth and you CAN do it!!

Stay on the Xanax until you are stabilized, but be very careful with it. It is very habit forming and can hamper habitation if you become dependent! You should explore other means of stabilizing. Make sure you get proper SLEEP!! Another key to habituating. SLEEP. Get tired, exercise, get naturally tired.

Again, my opinion, great idea to seek therapy with a psychologist, and forget the ENT's!! I hope ou find relief soon, and don't lose hope!!!! You'll get thru this!!!

 

Thank you and you're exactly right--I need to watch my negative thoughts. I hear what you say about a good game plan but I've never seen a gameplan on how to habituate. I'm not sure how to even start. I've read a lot on the internet but there doesn't seem to be a step-by-step habituation plan. It seems to be time and just ignoring T without trying too hard.

 

Thank you for your words of support. I am trying to live my life. I hid for the first two months except for work but now I'm doing my chores, going out socially and just being.

I'm not in a position to make recommendations about audiologists but it would be a good idea to have an audiogram and some other tests that they do....also sometimes they can intervene. My audiologist may try TRT or a hearing aid. Even though I was told by my ent that I am not a candate because of my High Frequency hearing loss, the audiologist said that with all the digital advancments I might just find a hearing aid relieves my T. I don't know about the TRT--soome say it works and others say it doesn't. It's expensive and my insurance doesn't pay for it as they consider it 'experimental'.

 

Hey @Kathi , i should add i do use xanax as well and it has helped me a great deal, I am not using it as much as I did though. Things that help me is putting my T in perspective, Yes I have T and it stinks, but I have an uncle who has sever T and shingles which may never go away. Many other things have happend to me in my life that i think about and for it makes T not a big deal. I don't mean to belittle anyone else's T by saying that. Also I have used Dr.Naglers letter to a tinnitus sufferer, you can google it to find it. The Henry Wilson T management book seems to help some, but is a bit pricey. Realizing i can do many things I did before my T helps, my big fear was losing my old life, as it is for many others I presume.

 

Lol one last thing that is a huge help to me. When you have a positive mind set you are much more likely to succeed at anything you do, and with the negative less likely. So i do a lot of things involved in positive psychology. One thing I do is every day write down three things that i am grateful for and reflect on it. This is suppose to rewire your brain over time to see the positive things in life. This video refers to positive psych. In the business world but same things apply "to me at least" In dealing with tinnitus.

TEDxBloomington - Shawn Achor - "The...

 

Thank you. My Primary Care physician thinks I may need Xanax or something like it the rest of my life. I was a ball of anxiety before the onset of T. I am taking only .5 three times a day for 4 months now and never feel like I need more or that it's a habit. I did some research and Xznzx taken at a small therapeutic dose is not a problem. I am sleeping without sleeping meds--he only have me a week's worth back on Dec. 3, when I was such a mess from T and not sleeping.

Have people here really habituated to where their lives are fairly normal? Mine isn't too bad--on bad days I use the white noise and I use the white noise to sleep but mostly I just let myself hear it.

Thank you Jeff, thank you all. I feel so much better than I did when I came in December. I thought it was the end and I would go insane. I feel like I can live with what I have now but I still want to habituate if possible.

 

Habituation is a physiological process like the synthesis of proteins. You can't exactly make yourself "do it."

The ENTs are right that habituation is "getting used to it." But there's more they don't say. It is also losing your reaction to it. And as you get used to it and lose your reaction to it, you will likely notice it less and less.

Its a natural process.

Jim

 

You are so correct about gratitude. My mom lost her sight --I can't even imagine--and my spouse had cancer. I have T, it does stink but I'll try to stay positive. I've read Dr. Nagler's letter to the T sufferer and I have been doing a bit of writing down my distorted end-of-the-world thoughts. I'll explore that more with my CBT. Thanks so much!

 

"Have people here really habituated to where their lives are fairly normal?"

Great points by everyone. Yes, Kathi there are many people, including those who don't visit support boards, are habituated and live a normal life. I used to be on panic attack mode all day a few years ago, with loud & ultra high pitch tinnitus plus piercingly hurtful hyperacusis, and had to survive on meds. I was anxiety & panic prone before T & H for decades. My brain absolutely had no chance against T & H at the onset of them. It just caved into relentless anxiety & panic attacks with their horrible symptoms on auto mode. I used to think I could never habituate to such alien beasts of T & H and all the hurtful symptoms of anxiety/panic attacks. But never say never. Today I am back to living a normal, enjoyable and productive life. It takes some time and adopting a positive approach which works for you. I am glad you are starting on CBT therapy. Learning about CBT & cognitive distortions have helped me to turn around from T and those anxiety/panic attacks. So hope that will help you. If you have those quiet days in a week, you are already doing much better than a lot of people. So relax and take it easy. You should be just fine. God bless.

 

Thank you Jim. So based on what you say the longer I go about my life and distract myself from my T (sometimes I forget about it when I'm engrossed) I will lose my reaction to it. I've already lost quite a bit of the reaction--I'm no longer panicked or get that clenching feeling my stomach. Sometimes I'm okay with it but sometimes I'm still annoyed. I do not have that awful fear any longer but I still find myself listening to it many times.

 

You don't have to actively distract yourself. You don't want to be always looking for a way to keep busy so you won't focus on the tinnitus. Maybe have a fan running at night, a little music while working--that sort of thing. People get into trouble and don't habituate very well not because they don't work at habituating, but because they create barriers to it. Exaggerated, "catastrophic," thinking patterns are an example. If you don't do things like that too much, very slowly you will get bored with monitoring the sound and you will start not to react to it

 

@Kathi -

Habituation is NOT a myth.

But the idea that given enough time it happens automatically for every person with severe intrusive tinnitus is a myth.

Sometimes you need a strategy. Sitting around and waiting for it to happen on its own (like some) is not, in my opinion, a strategy.

It seems that you are not doing that, @Kathi. You are taking positive steps, which is good.

So Strategy is the first key. (You're good there.)

The second key is Determination. (Seems you're good there as well.)

The third key is Flexibility. That means having the ability to recognize that your chosen strategy may not be getting the job done for you in spite of your determination ... and being willing to change strategies. Sometimes that means going back to square one!

One other thing. A person can most certainly habituate while taking Xanax. If you read that you can't, then what you read was wrong.

Stephen Nagler

 

Thank you for such kind encouragement!

I had my session with my CBT therapist tonight. He was one of the facilitators of the anxiety group toolkit workshop that I attended for six weeks. I really liked him since I met him and there was an instant rapport. He already has me redefining my 'self talk' and we are working on my distorted thinking...I'm going once a week.

Thanks so much billie48--you and everyone here are so supportive.

 

Okay--I see what you mean. I can't always distract myself. I need more than just a fan at night--I play a white noise video from youtube. It's 9 hours and keeps the room from being silent. I am working on the catastrophic thinking...hopefully I'll make progress. Thank you for explaining it to me. I've learned more here today than in the previous five months.

 

Thank you Dr. Nagler...your encouragement is very much appreciated. I will try to be flexible. I talked about TRT with my new CBT therapist tonight and we both think it may be something I should pursue. As soon as I get my MRI results and do the follow up with my 2nd ENT, I will get back in touch with the audiologist who referred me to this ENT for the scan. I will continue to work with my CBT therapist and the audiologist.

I read your letter to us during my research (because my ENT gave me no information, I had to research Tinnitus) and it brought tears to my eyes when I read your story.

Thank you for reassuring me about the Xanax--it is really helping me but I was afraid it would inhibit habituation by all the bad things written about it.

 

Please do not misunderstand me about Xanax. There is reason to believe that - at least on a theoretical basis - Xanax can, indeed, inhibit habituation. But it does not prevent it.

For me, I do not believe I could have gotten through TRT without Xanax. So the fact that it might have taken a couple of months longer for me to largely habituate my tinnitus because of the drug ... is irrelevant.

Stephen Nagler

 

Now I am confused about Xanax but really, it is helping me so like you, if it takes a bit longer to habituate because of it, then so be it. I think it would be counterproductive to stop taking it. I don't know the theory you speak of but I know it has helped with my reaction to my tinnitus as well as to other anxieties.

Thank you again Dr. Nagler.

 

You are welcome.

Stephen Nagler

 

Your first 3 paragraphs show that you are a person of action. Good.
Habituation doesn't have to be difficult. Just stop measuring the T and judge your response instead.
It works.
It requires action on your part.

 

Thank you. My reaction is lessening--from full on panic to annoyance. T was just tinkling and soft hiss today but I'm sure it'll be buzzing tomorrow--it seems better on weekends. I'm sure I'll be disappointed tomorrow. It's hard when it's fairly quiet because I think I'm habituating but then it's loud again every morning. It's always the loudest when I first wake up.

I'll try to stop measuring it but it's easier said than done for me.

 

Tip:
when you catch yourself listening to your T, well, ... I'll tell you what I just did. I said to myself,"I hear it. I'm on the computer. I'm chillin' and kinda tired."
I do this several times a day.

I know what you mean about the morning.

 

I do try to distract myself from listening--yesterday I absolutely forgot about the T for about 1/2 hour while I was watching an engrossing program.

You've had T since the mid seventies and you still have it loud in the morning? I thought that once habituation happened that wouldn't be ...

 

For me, I don't just have it loud in the morning. I have it loud all day long. But I don't care. And because I don't care, I am largely unaware of it unless I purposely listen for it. I don't have to distract myself. I can be kicking back and doing nothing ... and I am still largely unaware of it unless I check for it. That's habituation.

It does not take strength. It does not take character. What it takes is Strategy.

Strategy
Determination
Flexibility
Insight

Stephen Nagler

 

Hi Dr. Nagler,

Well you said above that I'm good in the first two and I said I'll be willing to try something else if my current plan doesn't work but I'm not sure on the Insight. Do you mean insight into myself?

 

No. I mean the insight to realize that at some point you may have to change your entire geometry and start back at square one. The simplest example would be if you are convinced you understand what habituation is all about, but you are wrong in that regard. So all this time you have been operating under a false set of assumptions.

Stephen Nagler

 

Thank you! I think that point would be now and you saved me future pain by explaining to me that it's not about how long I can distract myself from my T--it is getting to the point where I don't care (react) about my T. I am already taking steps to live my life--work, make love with my husband, go out socially--no matter what my T is doing so maybe I'm on the right path ...

I will continue with my CBT therapist and my audiologist but I will try to do so without a preconceived notion of habituation and work mostly on my reaction.

 

I actually think it is advantageous to have an idea of what habituation is all about. But it helps if that idea is accurate and at the same time matches your needs!

Stephen Nagler