Starting to Think My Tinnitus Is Mostly Psychosomatic?

I have always suffered health anxiety and being a doctor myself has made that extra hard. Often knowing a little (ie. not being a specialist) is worse than nothing at all, because you're trained to know when to worry more than you are when not to worry. So we pick up on red flags.

I tend not to worry about too much in life, although maybe that worry is more subconscious. When it manifests physically I then latch onto that symptom and obsess over it, becoming convinced I have a terrible disease. In the past I have given myself severe bouts of irritable bowel syndrome I was convinced was Crohn's disease, and benign fasciculation syndrome (you know those little muscle twitches you get from time to time? Basically those, non-stop, rippling around your body to the point of cramps) and being convinced it was some terrible progressive neurological disease.

When my tinnitus started just over 2 weeks ago it was in the middle of a stressful time in life, in fact Ib had just been texting my partner about how stressed I was when I decided to distract myself by cleaning the kitchen. After that I sat down and noticed this hiss. The same kind of hiss that basically all human beings experience from time to time ie. fleeting tinnitus, possibly associated with some momentary pressure change.

Within about 3 seconds of noticing the sound I thought to myself "oh my god, I hope this doesn't stay forever, imagine that". And of course, it did.

It didn't matter that the exact same thought had a few years earlier turned a few twitches in my bicep into the aforementioned benign fasciculation syndrome, this time, as each time, I told myself was different: now I have some terrible disease.

Now I have to make the disclaimer that since all this started I have been consulted by a GP and multiple ENT doctors, some extremely specialist, and have had an extensive audiogram. All of them have told me that I have not significant pathology bar maybe a bit of EDT and a bit of TMJ but that there is not real reason to expect me to have developed a physical cause for tinnitus that day 2 weeks ago. My audiogram too was normal, in fact showed my hearing was actually a little too good.

Finally I managed to get in touch with a doctor that specialises specifically in auditory medicine and has a special interest in tinnitus. He explained to me that tinnitus is, in the absence of the pathology that some on this forum may of course have, is otherwise a normal part of the human experience. Just as if you close your eyes and look into the darkness you will eventually see it's not perfectly black but made up of "noise" as in a camera photo in low lighting, your brain is just used to filtering that out unless you fixate on it.

For this reason, people with totally normal hearing like me (1/3 of all people who complain of tinnitus, and we are a subset of the near 100% of people who can, if they try hard, detect their own tinnitus), can turn this normal physiological occurrence into a problem.

What's likely for myself is that I, like everyone, have a few physical factors contributing to the auditory noise my brain perceives: a bit of TMJ, a bit of ETD, a bit of sensitive hearing. None of these things caused me an issue before, but for whatever reason we all experience fleeting tinnitus, my anxiety then hooked onto it and amplified it and within 2 weeks I had a near total nervous breakdown because of it.

Being a doctor it is easy for me to quickly call around and speak to specialists without an appointment. That's a blessing and a curse, it means that I get addicted to asking for more and more input without putting full faith in any individual, and each potential physical diagnosis with the advise "just try not to worry about it, you'll get used to it" made me fixate more and more on the precise nature of my tinnitus to try and prove or disprove those physical diagnoses.

I feel now that that is actually part of the problem and not the solution in those of us with no disease, no hearing loss, but intrusive tinnitus.

Instead I had to realise that tinnitus is just like those other anxiety related symptoms I've had in the past. I have told my brain the tinnitus is a threat, that my subconscious and conscious should track it's every move, because it's imperative for me success and survival in life.

This feedback loop only makes the tinnitus worse until the brain itself changes physically to make it a part of my everyday life.

That's why "habituation" for people like us is not just "a way to cope" with tinnitus but the cure itself. Our tinnitus was always there, it's there in everyone, and it's our habituation to listening to it that is the disease - therefore habituating to ignore it is literally a cure.

Since taking this advice on board and with the help of some counselling and anti-anxiety medication, the last few days I have noticed how strong my own mindset is over my tinnitus. It has gone from being present at all times to actually being absent or extremely quiet when I'm in a quiet room, to being maskable in loud environments. Still I find that high pitch sound near it's frequency makes it spike, but I theorise this is part of my brain's heightened alert system attempting to lock onto it still.


So my success is in it's early stages. Things could obviously changes although things are definitely a little better already, 2 weeks in. However, seeing my tinnitus in the same spectrum as the other psychosomatic conditions I have had in the past, I feel I now understand what is happening to me and I have some idea of how it will progress.

1) Understanding the nature of tinnitus in people without ear disease/hearing loss is essential for us to de-prime our CNS, to stop it from being super-sensitive and super-alert to it. If we don't understand that then we will always fear it, wondering what could be the cause and what might happen next, and the result is always for it to become worse

2) That just as TRT recommends, time, distraction and NOT avoiding the triggers WILL remove tinnitus as an issue in your life. With my benign fasciculation syndrome, I can't even recall the day it disappeared. One day I was beside myself, a wreck with anxiety, unable to function, convinced my life was over and I would soon be paralysed. A few months later I just realised.. oh wait, it's gone. That healing only began when I stopped thinking about it, stopped analysing it, stopped giving those twitches emotional power over me and just got on with my life.

I hope too that the link my tinnitus has to sound will being to resolve with habituation to white noise, as I have been doing the wrong thing lately by avoiding noise as much as possible. Even now as I type, each click of the keyboard triggers a slight hiss, but now I know it's not a threat I can start to let go. In a few weeks or months I hope to realise all of a sudden that hiss is no longer there.


If you have a clear cause for your tinnitus like hearing loss then your strategies might have to differ slightly, for example avoidance of noise may be right for you whereas for those of us on the verge of hyperacusis must quickly attempt to re-habituate ourself to (safe levels of) noise. Treating conditions like ETD and TMJ that are contributing is obviously a good idea, but be aware that the anxiety you have experienced toward that pathological tinnitus may well have made you hypersensitive even to the "normal" tinnitus that exists in all of us too, so this information still applies.

I myself have eye floaters that I initially struggled immensely to deal with and which are physically and objectively there and will not go away, but I have habituated and they no longer have any impact on my life beside always keeping some sunglasses handy - so in all but the most extreme cases I believe there is every reason to expect similarly good results for those with noise-related tinnitus and so on.

I can tell you now that these links of brains make with physical symptoms may never disappear totally int he sense that when I am stressed, as I am lately, I can detect the odd twitch in my calves. But the cramps are gone, and between my periods of stress, even these tiny twitches are gone. We may always be prone to reacting to stress in certain ways but once we have finally made that disconnect between those symptoms and their power over us then their ability to create a downward spiral and disrupt our lives is gone.

I believe this is why TRT has over 80% success rate, and I am sure that starting it as soon as possible is a good idea but that it's never too late.



The brain is immensely powerful, the physical effects it's can have on our bodies and on our perceptions is far greater than we give it credit. If you have no ear disease, no hearing loss but you are struggling with tinnitus then you are not struggling with tinnitus: you are struggling with a brain that has trained itself to make normal, natural tinnitus present in everybody a priority in your daily experience.

If you thought your fridge was about to explode at any minute, you'd probably always hear it in the back of your mind even whilst trying to cook or watch TV. But you don't, so you are unaware that it's humming away all the time you're around it. That was you before tinnitus, and getting back there is all in the mind. Yes it takes time, but you'll get there, so will I, and I can already feel myself taking the first steps.

 

It is possible that among people who had attended multiple concerts mild tinnitus is common. However, most those who have been protecting their ears, can enjoy complete silence. I have tinnitus in one ear. My other ear is Completely silent. Perhaps that doctor just wanted to make you feel better.

 

The problem is that tinnitus is a symptom and not a diagnosis. Just like diarrhoea is a symptom of IBS, itself caused by anxiety, it doesn't mean to say there aren't people with actual pathological processes going on in their bowels that cause diarrhoea.

Habituation should be possible for most people either way I assume, but I don't want to assume or pretend to know the specifics for those with clear pathology, including loud noise exposure. I'm speaking from the position of those with normal examination, no other symptoms and a normal audiogram but a history of health anxiety and psychosomatic disorders.

But habituation in should in general be incredibly beneficial but requires divorcing your emotional response to the perceived threat (tinnitus in this case) and that's easier said than done and takes time. But I think step one is understanding that tinnitus to some degree is normal in all people - those who claim not to hear it, will hear it if instructed on what to listen to in a very quiet environment.

My thread is supposed to be for those in whom pathology has been ruled out as best as possible and who have a normal audiogram. People with noise related tinnitus presumably do not have normal audiogram.

What I want is for people who come here with a history of anxiety (like me) in the early stages of noticing tinnitus and letting it drive them crazy despite reassurance from ENTs and audiologists - great this as you would any other psychosomatic episode you've been through, whether it's twitches, irritable bowel, heart palpitations, blephospasm... the list goes on.

Just start early in accepting what's going on in your head so you can start turning your brains attention elsewhere asap.

Those is us with health anxiety often delay getting to this point for months while we search for ever more invasive investigations and opinions from more and more doctors to reassure us we aren't dying or becoming disabled. I'm just trying to learn my lesson from my previous experiences and start that healing process earlier than I have in the past - because they are such dark and draining days.

 

Like I said, it Might be normal in people who haven't protected their ears by going to multiple concerts. But it is not common among those of us who have been protecting their ears. Silence has always been important to me. I have had multiple experiences (before my acoustic trauma) when I enjoyed the silence, listened for sounds and couldn't hear anything. I still have that in my good ear.

 

The classic study would be this:

"In 1953 Heller and Bergman performed an simple and classic experiment. They placed 80 tinnitus free individuals (university members) in a sound proofed room for 5 minutes each, asking them to report on any sounds that might be heard. The subjects thought they might be undergoing a hearing test, but actually experienced 5 minutes of total silence. 93% reported hearing buzzing, pulsing, whistling sounds in the head or ears identical to those reported by tinnitus sufferers."

But I'm not trying to downplay hearing loss related tinnitus, it's just that not all of us have hearing loss or any other identified pathology. For us the important concept is that noise is an inherent part of all human perception, that this noise is amplified in all individuals during episodes of fleeting tinnitus, and that if those individuals are highly alert and extremely anxious their CNS is primed to pick up on that noise and amplify it from a central rather than peripheral (ie. in the cochlear) source.

Those individuals may not have any hearing loss, any damage to the cochlear, any pathology at all... But they are creating intrusive tinnitus in the same way their anxiety might create a hyperactive bowel (IBS), muscle twitches (BFS, blephospasm) and so on.

For these people, the solution is to understand that there is nothing wrong with their ears but rather their thought process. If someone with IBS does not understand that then they may constantly seek more and more investigations: CT scans, multiple colonoscopies with biopsies, blood test after blood test. People that that (me) are never satisfied until we find a physical cause that can be corrected, and so we remain constantly vigilant of the symptom - and given that symptom originates in the brain all that happens is it's amplified.

I'm just trying to speak to those people in my boat who just realised one day recently oh shit, I can hear ringing in my ears and it won't go away, and the GP and ENT and audiologist all tell me everything is fine and "just to get used to it".

Really what they should be saying is, "just get used to it - the way you have always been used to it". Nothing changed apart from the way you perceived what was always there, and reversing that is something you can only achieve though distraction, re-habituation and time, rather than endless MRIs, ENT visits and pills.

If you have a diagnosed disorder of the middle or inner ear or brain then this doesn't apply. Habituation does, as it does for everything, the example I have personally of my floaters. But for those of us with anxiety issues and idiopathic tinnitus, making this connection quickly seems to be important for a quick recovery.



You had acoustic trauma, I am very sorry that you went through that and I can't pretend to know anything about your experience with it. I do think habituation is important for everyone, but I am not trying to pretend I know more about hearing loss related tinnitus than you I assure you - I'm really just trying to speak to the idiopathic tinnitus sufferers with health anxiety here, of which I think there's probably quite a lot (statistically, 1/3 of all who complain of tinnitus).

 

It sounds like 92% of the people attend loud concerts.

There could also be something physically wrong with certain neural networks stuck in a feedback loop.

Did you know that the hearing tests are imperfect and don't pick up on certain types of hearing loss? Person A might be less able to hear Person B in a loud crowd compared to what Person C hears, and both A and C get the same score on the hearing test. It is possible that you had experienced sudden hearing loss (that would be picked up by hearing tests if only those tests were more accurate).

I had a hearing test done and was told that I don't have any hearing loss.

 

The problem, you try to explain, is even bigger.
Even, if someone has a real damage, he will find additional somatosensoric sound phenomenons, - and cannot know, whether they were unnoticed before or not. I call it: attention shift.
I - for example -, can produce a loud tone in my left ear when turning my head clockwise up to the stop, which is similar to my tinnitus. Most probably this phenomenon has always existed, but unnoticed. Now it has become part of the problem...

 

It seems that most tinnitus regardless of cause (other than I think things like acoustic neuroma and menieres etc with very structural causes) are "somatic", like almost up to 85%? That may be as you say, a characteristic of "normal" human hearing that we just didn't notice before but our attention was drawn to t through hypervigilence.

My concern is for people who experience a single episode of normal "fleeting tinnitus" that is expected in all people but who are in such a state of anxiety already that they manage to tune into it and make it a problem. I think I'm one of those.

I can even recall a time a few months ago when I had just such an episode of fleeting tinnitus. I was mildly anxious at the time but distracted by a movie, but I did have the thought "I hope this goes soon I hope this goes soon" and what do you know it, instead of the 3-4 seconds these things normally last I could still pick it up a few minutes later. Then I'm managed to get engrossed in the movie again, and an hour or so later realised it was "gone".

My speech hearing test scores in the top 0.5% though so I guess I might be wired to be a bit prone to this already but theoretically in the absence of pathology there's no reason that those is us without pathology (and maybe even many who do have it?) can't go back to that "pre-noticing" state we were in when we didn't describe ourselves as tinnitus sufferers.

I mean this is the case for just about all somatosensory disorders that exist, and they have all been told have "no cure" until theirnsomatosensory origin become better understood and are now considered controllable to the point of curable in many cases: IBS for example. You might have a flare when you're very anxious, but otherwise it can be removed from your life with the right psychological approach.


We might also want to think that we on this forum, at least those without a distinct pathology, are a self-selected group of individuals who particularly struggle with somatosensory issues, and in this case specifically tinnitus. We might require more and more tests, more and more medical treatments and be less able to allow our brains to let go of this normal tinnitus that likely was always with us. When basically all people complain of ringing in the ear at some point in life, you could safely assume that a larger portion of those that first present to the GP and are reassured GP home and forget about it and habituated back to their normal level quicker than those of us who just can't stop analysing it, can't stop seeking new answers and new treatments and end up here.

 

You say it was always there and you didn't notice it, but then you noticed it? Because of anxiety? I've had terrible anxiety for years especially when my children were younger worrying about them and never heard T. And my husband has had T for years and we would talk about it alot. So you would think that my anxiety thinking about his T and how loud he said it was would have freaked me out and brought out my T. Believe me I've obsessed plenty of times over aches and pains and wondering what they were. Like Bill Bauer my T is only in my left ear and my right is quiet. I'm going to agree with you though that when I first heard it and it didn't go away my anxiety made it louder and in my head. But anxiety is long go and the hissing is back in left ear and out of my head. Maybe if you said years and years of anxiety caused my brain to finally snap or something and the T appeared, I might believe it. But always being there I don't believe. I would have to be triple deaf not to hear this hiss. And I don't think the threat or fear you have over T is thinking something is wrong with your ears or having a brain tumor etc. I think it's worrying you are going to have to listen to this noise for the rest of your life because you are told there is nothing wrong with your ears and to get use to it! My anxiety left a few months ago when I realized the head T would go away with clonazepam. I don't take it now but just knowing I have something to take if it gets bad has stopped the anxiety. But the hiss in left ear is persistent and does not want to completely go away! It can be almost nothing to about a 3 when bad. So I'm not complaining even though I hope it eventually it goes away.

 

Was your audiogram an extended one? (up to 12000khz)

 

I am having trouble locating my audiogram. You are right, there is a good chance that it wasn't an extended one...

 

Not that it changes anything, unless you want to buy a hearing aide, but I did an extended audio last year, and found that I have further losses from 10000 - 11500khz. Explains why white noise up around these frequencies helps suppress my noise for a whole minute!

 

In 1953, a "loud concert" was probably no noisier than a mid-level home theater system of today, probably even far less, lol.

But I get what you're saying.

Have a good one!

 

Since IBS has been mentioned several times in this thread, I would like to add that I thought I had it for a number of years, until I began to get really, really sick. Turns out I had Celiac (or Coeliac in the U.K.) Disease, an autoimmune disorder that affects approximately 1% of the population, and is caused by eating gluten, a protein found in wheat, rye and barley, which causes antibodies to attack the villi in the small intestine, and results in nutritional deficiencies and can bring about a host of other problems including IBS type symptoms, diarrhea or constipation, depression, cognitive impairment, and more. America lags, in comparison to many other countries, in recognizing and diagnosing Celiac Disease. The majority of Americans who have it are undiagnosed - many of them are under the impression they have IBS. If you have IBS symptoms, with no explanation, I would strongly advise getting tested for Celiac, it's very important. The good news is, most people diagnosed with Celiac Disease, who maintain a gluten free diet, will recover.

 

I would always advise full workup of any symptoms including tinnitus and the GI symptoms associated with IBS.

With my experience of IBS, I didn't fit the demographic nor had much of a clinical history to suggest celiac. However having health anxiety it was one of my concerns, although with HA I tend to worry about life-threatening/seriously morbid conditions, in that case it was inflammatory bowel disease.

Either way I had an auto-antibody screen for celiac and a faecal calprotectin test for IBD - both of which were negative, and luckily I was able to allow myself to be reassured by these highly specific tests and stop worrying about the symptoms I was having. It took time, but they eventually disappeared. Now they only return in very very mild form when I am stressed, and the symptoms themselves cause me no stress.


No I didn't have an extended audiogram, mine went up to 8k. I'm not going to try and advise people who may having high frequency hearing loss on anything because I am not even close to knowledgeable on that issue.

However I have to think about the context of when my tinnitus appeared:

1) I have no personal or family history of any ear pathology or head injury, no history of loud noise exposure and no other associated symptoms (vertigo etc.)

2) I was already in a state of high anxiety due to life and work on the day the tinnitus started

3) I was at home, alone, finding it hard to distract myself when I first noticed it

4) What I noticed was identical to the momentary few seconds of ear ringing, "fleeting tinnitus", that appears to be normal in all humans. As tinnitus is normal, so too are brief spikes in it, and the current theory seems to be that it is largely to do with brief alterations in middle ear pressure relating to eustachian tube function or position/muscle tension in the jaw/neck

5) My tinnitus is effectively "generalised", neither right nor left sided, just "central" or "in my head". It's also high pitch and continuous when it is present, two things which are very much not associated with many of the more serious inner ear/neurological pathologies.


When anxiety manifests as a physical symptom, as it does constantly in all of us, those of us with health anxiety focus intently on that symptom. Lets say you have a twitch in your eye lid, it is a normal temporary occurrence in all people but it is more common and more severe during times of stress. It's also an extraordinarily unlikely first presentation of a serious neurological disorder - but to someone like me with HA, despite being a doctor myself and presumably I should know better, I don't think of that, I think my life is about to be destroyed by a serious illness.

The result is constant monitoring of the symptom, increasing my anxiety, increasing my awareness of the symptom and through the two mechanisms together, making that symptom both more severe and longer lasting.

Weeks and week of intense anxiety requiring sick days, medication and counselling for this specific fear turned that little eye spasm into bull body spasms in my legs that causing painful cramps. At some point (with the help of education from experts) I was able to accept that this wasn't a neurological disease, it was my anxiety. Only then could I break that downward spiral and only weeks later did the twitches finally stop.


Now back to my tinnitus. My tinnitus has a specific characteristic at this point: it is is triggered by noise, particularly noise within the same pitch as the tinnitus, but in silence, when I am calm, I have no tinnitus at all.

The explanation given to me by a doctor of audiology and an audiologist specialising in tinnitus is that I likely experiencing a brief moment of fleeting tinnitus but at that moment I decided not to allow that natural ringing produced by my brain to fill in the gaps coming from my cochlear, and instead reinforced that centrally generated tone and turned it into an extreme threat that must be constantly analysed. I have nasal polyps, that's one reason for the fleeting tinnitus, I also had a recent fight, another reason, and have been recently clenching/having lots of tension headaches, again another possible cause - the point is the cause resolved, my hearing remained intact, but my experience with tinnitus persisted - that's where anxiety came in,

What I am left with now is a tendency to seek out that sound at brief points during the day, and when I seek it, I will find it, because my brain is still primed to produce it. Similarly, my brain, all the way to the muscles of my middle ear (particularly the tensor tympani that control the ear drum) are primed to detect sounds at that pitch or near it.

The only way that someone like me, without hearing loss (and I know I haven't had an extended audiogram but given my history I am not too fussed about getting one) and without an inner ear pathology by all clinical likelihood, can overcome this is to divorce my emotional response from my perception of tinnitus unless my brain continues to filter it out just as it did before that day 2 weeks ago that I decided it was time for another of my roughly 2 yearly health related nervous breakdowns.




This being a tinnitus board I know I have to be extremely respectful and careful to all of you who may actually have specific physical causes for your tinnitus, but from what I have learned from these experts it does appear that regardless of the origin of your tinnitus, it can lead to similar complications when anxiety enters the mix. Intolerance or provocation of tinnitus by certain sounds/pitches is one that I am experiencing now, and I am told that and if noise in general is actively avoided, this can progress to full on intolerance of sound in general.

The good thing is that just as for IBS or benign fasciculation syndrome or whatever other anxiety related symptoms you can develop, the brain remains just as powerful at resolving these issues as it was in creating them.

And indeed for those of us with anxiety induced tinnitus (which may be a minority, but a large one looking at the stats), it's probably better that we think of our battle with tinnitus not as one of habituation but re-habituation. You are the same as you were before, you just have to let yourself believe it.

This is a different story for those of you with physical causes for your tinnitus, but I do believe in the power of habituation and neuroplasticity and I really wish you the best of luck in that quest. Looking at the numbers regarding TRT I see absolutely no reason not to be incredibly hopeful and excited for you.




As for an update for me today, the best tinnitus day yet, barely present/not present for most of the day until I started writing this post and thinking about it too much again! I should probably stay clear for a bit but if anyone wants to PM me they can, otherwise I hope to post in some weeks with a more complete experience. After all, I have learnt from my brief battles with IBS and benign fasciculation syndrome that thought the brain is powerful at reversing the damage it can cause, that reversal still takes time on the order or weeks and months - you just want to get your head right and start asap.

 

How loud is it? How fast do you need to breathe in ear through your nose for the volume to match the volume of your T?

 

I just want to believe it's Psychosomatic but I can't
I can hear it like it's real so if this is Psychosomatic then it's my imagination which I don't think it's true

 

This...... !!!!! Last Sunday I woke up... I felt calm when I woke up...felt no anxiety no nothing....and I was resting on my T ear (got T in both but I was resting on the loudest side). I thought....where is my T ?????? I have mild to loud T and I just could not hear it. Than I try to sleep some more...but than my stomach felt strange....My OCD symptoms came up....and boom there was T again..... And I felt full anxiety again.

It seemed to me that my brain could not handle the normal me and switched into this alarm state which I am stuck in for 4 years now. So I think....what to do to get out of this alarm state.....it is like my brain does not filter anymore and let everything through....so I will obsess over all kinds of things.

So what you said makes a lot of sense for me...thanks!

 

I don't know if you have a history of health anxiety but this is a common trap to fall into, I have done it many times myself.

See an ENT, get an audiogram, if advised get an MRI. If these are all normal and you are told you have idiopathic tinnitus then chances are it's psychosomatic. Don't allow yourself to seek endlesss new investigations when medical science has confidently told you you are well.

The brain is more than capable of generating far more seemingly objective and physical psychosomatic symptoms than tinnitus, right up to seizures and paralysis! It's not about imagination, it's about powerful cerebral mechanisms going haywire - but the great thing is, you have the power to reign them back in.

With psychosomatic disorders you cannot begin healing until you understand and accept that there are very real causes for your symptoms but that their origin and cure lies in your mind.

It's not enough to just wait for a less stressful period in your life and monitor the change in your tinnitus (or diarrhoea, or muscle twitches etc), you have to understand their psychosomatic origin so that you stop monitoring and stop fearing it's every up and down.

If you close your eyes and stare into the darkness you will see optical noise generated at every point from your eye to your occipital cortex. The harder you stare and the more concerned you are with seeing it, the less darkness you will see and the more infuriating, distracting noise..

But nothing has changed in the anatomy of your eye, everyone else in the world can see that noise to, and no surgery or medication or supplement can or NEEDS to change that. The change comes in training your brain to go back to ignoring the noise and seeing the darkness it used to and still can.

And remember, being cured in this example does not mean being able to close your eyes and never see any noise no matter how hard you look. You will ALWAYS find it, EVERYONE will! The cure is getting back to the point where you stop looking; both consciously and subconsciously.

That's a game of willpower and time.

And evidently, TRT.

When it started it was the normal level of an episode of "fleeting tinnitus" like you might have when you can't pop your ear for a few mins on a plane.

Over the next few days it would fluctuate up and down but could be very loud, audible above anything but a heavy shower.

Then I noticed there were times it was almost inaudible or silent but provoked later back to being very loud by sounds.

Now my acute anxiety is over and I am actively trying to use mindfulness (with the help of diazepam) and I can sense it is barely any more obvious to me than it would have been before all this started if you just made me listen for it carefully - which all people can do.

I do still get a hiss associated with similar pitch environmental sounds, less than before, but my understanding is that this is a link between the hypervigilience of my brain and the muscles of the middle ear. This is quite fitting with something like blephospasm or IBS, and I have to keep myself calm and patient because reversing that instinct does take time... But I am very encouraged by the results so far.

I am using TRT including during sleep to reverse this.

OCD and other more severe expressions of anxiety no doubt make this struggle hard, I don't doubt it and I can't pretend to know your challenges.

But imo step 1 is always the same: when thoroughly investigated for the serious physical causes of tinnitus and those are excluded the first step is to truly accept it's origin in the complex networks of your emotional and perceptive centres of the brain.

Demystify it! Remove it of it's emotional power over you. Depending on how long you have been suffering and fixating on the tinnitus it may take many many months before your brain allows itself to take these natural sounds out of your consciousness, but you CAN do it. Your brain is strong enough to have rewired this way, it is perfectly capable of wiring itself back

Beware of expecting changes hour to hour or day to day though, our brains are to some extent physically wired right now to make tinnitus a very conscious experience. Rewiring away from that does take longer than days, so don't panic if you're feeling good but all of a sudden the tinnitus is bad again - that's us falling down the trap, instead just acknowledge it, remind yourself why it's there, and get on with your day.

 

The example with eye floaters is very good.i had exactly the same experience I hope this will be repeated with my ears It is called habituation.

 

The floaters I found very hard, they were undeniably physically there and like tinnitus you can go through a period of being terrified they are a sign of something worse. I suppose that I ended up habituated in the sense that someone with noise-induced permanent tinnitus might be - which is why I tend to think habituation should work for basically everyone.

But when anxiety is the prime cause of your tinnitus I think the phrase should actually be "re-habituation" - yes there have been plastic changes in your brains wiring that makes your experience of tinnitus far different to what it was before you knew yourself as a "tinnitus sufferer", but as far as we know there is no physical problem with any part of our auditory systems from our ears to our brains that we even need to overcome, everything is as it was before, it's just the way we perceive it.

I wish I could say I had learnt my lesson the first couple of times I have given myself anxiety induced symptoms and made them far far worse by freaking out about them, but it seems each time something crops up, "this time it's different, this time I have a terrible disease". At least I am back into a good headspace and working on this after 2 weeks, rather than the 6+ or more it took me in the past... But it does take a toll, and I will have to work hard for many more weeks to get over this than I did in causing the problem in the first place

But I suppose that kind of thinking does no good. Sometimes I catch myself thinking if only I had been distracted that day 2 weeks ago, at work or something, this would probably have never happened. But here we are, at least we know we can fix ourselves and have the stats to prove it works.

Today I'm finding it a bit harder. I have one last ENT appointment that I had booked a while ago that I've decided to attend anyway, and after such a good day of barely any tinnitus audible at all yesterday find my brain so tempted to "just check" if it's better or worse today - that only ever pulls you backward rather than pushes you forwards.

So I'll just try and stay as positive and distracted as possible.

Another good mental technique I find right now is that I just think to myself, ok, is my tinnitus right at this minute really affecting my ability to live and enjoy my life? The answer is basically no, so if you think to yourself "even if it never gets better than this, that's still ok", it's a good way to quickly disarm it's power over you in that moment - then before you know it, it is better, and theoretically weeks and months of that and it's "gone".

 

I think that tinnitus levels including somatic and pulsatile T is often more of a concern when something is off balance, infected or diseased on one side. Many muscles, nerves and joints appear on both sides. Modulation of T to one side.

 

So I saw an ENT today, this will be the last I do see. He told me that my hearing is just as expected for someone my age, that I have very minor TMJ, very minor ETD, quite bad neck/shoulder tension/spasms but that the overall message is that nothing changed on the day I noticed my tinnitus besides my brains intensity on detecting it.

So it all fits with my theories about myself above and what other's have told me.

The whole process of going to the ENT has gotten me a bit more anxious and the tinnitus itself is a lot more on my mind today than it should be, and again I experience big spikes of it when I am around white noise similar in nature to it - for example taking a shower.

That's the aspect I am finding most hard to deal with, as at other times the tinnitus is already barely audible/gone entirely, but these situations are impossible to avoid and do stir it up.

My concern is more about how to specifically deal with that. The ENT told me that habituation just happens naturally for most people regardless of what they do, that's why of the countless millions of people who go to the doctor every year complaining of a ringing ear, only a small percentage of us end up having a real issue with it longer term - but I know my anxiety is on the higher end of the spectrum of those millions of people, maybe not the max, but upper end, and so I know I need to do the right thing to get on top of this specific aspect of the tinnitus which I believe is related to both the way I'm thinking and perceiving sound, but also this tonic tensor tympani syndrome that is mentioned - the muscle connected to your eardrum being hyper-sensitive, and causing anything from spikes of T with sound, dislike of certain sounds, all the way up to full on hyperacusis.

For that issue the general consensus in the scientific community seems to be that you avoid silence even though silence is more comfortable, because it only increases your sensitivity to the sound. That's why I will carry on with the white noise therapy, particularly at night, I just hope that I am not making a mistake with the volume and frequency of that white noise - is it supposed to mask it? Or is it supposed to provoke it and leave it audible? I'm not exactly sure....

 

Hi Ciaran,

Thank you for your story. I am a bit like you. I think you could definitely make a point that your mind is capable of making tinnitus worse. With regards to your question; I read that it's better to mask your tinnitus to the point that you can still hear it. By doing this you allow your brain to habituate. If you completely mask it your brain has nothing to habituate to. However, I have read conflicting stories regarding masking. Some people say it caused the tinnitus to back off, while others say that have you using the wrong masking device/sound and it got worse. So maybe you should first consult a specialist regarding masking. Maybe there are people here with more experience who can help you with this?

Kind regards,

Tjeerd

 

The problem seems to be that these specialists charge huge amounts of money to give you this information

I certainly don't want to do any harm, but I very specifically have an issue with "reactive tinnitus" or "mild hyperacusis" (there seems to be some dispute here about whether it's one or the other) and I want to make sure I target that issue directly.

For all intents and purposes the ringing in my ears that triggered my whole experience has now "gone", and by that I mean, it was presumably fleeting, prolonged by my brain deciding not to filter it out when it returned to it's normal level (present in "everyone over 25"), then at some point over the last 2-3 weeks my brain decided to filter it out again...

Except when exposed to higher pitch environmental sounds.

Running taps, showers, high pitch music, strong wind, sometimes street sounds - if these are high pitch then they gain a kind of ringing/hiss on top of them and that persists despite the sound ceasing, for maybe 10-20 mins. Most of the time it's not even that bothersome, it's just noticeable, but once in a while it'll be pretty loud and v very annoying.

The noise I'm using to sleep to is rain sounds, and I'm trying to vary the recordings, and set the volume low enough to trigger this "reactive tinnitus" but not mask it. As far as I can tell that's the right thing to do but I don't know how much solid science there is behind that.

I mean I have run it past a specialist in vestibular-cochlear medicine and his advice was basically don't avoid the sounds that trigger it, just don't give a fuck about it, expose yourself to whatever (safe) sounds you like and your brain will eventually decide to stop being so hyper-aware. Whether it's mainly "gain" in the CNS, or mainly an acoustic phenomenon in the middle ear caused by the tensor tympani overreacting to sounds it perceives as threatening.. or both, I don't know, but I guess the same process should apply as to regular tinnitus in people with normal hearing.

I do think I have had progress even in this area although I suppose it's early days. Definitely the baseline tinnitus is 99% resolved, so that's progress, and with the "reactive tinnitus" I do feel that it's generally a bit better each day although there are times when I can really get it stirred up quite bad - whether that's because of the sounds I'm exposed to alone, or it's because I'm failing to distance myself from this ringing emotionally, I don't know.



At the end of the day, without significant pathology I think we have to accept that perception is about more than just sensory organs - everything ends up being filtered in the brain/mind, it may be very hard to filter certain things and with significant disease maybe it's not possible, but SO many people here have totally normal hearing for age so I see no reason the neuropsychological model of tinnitus doesn't apply to us regardless of the intricacies of.. what makes it better worse, what pitch it is etc. etc. I think it's very easy for us to be drawn back into thinking that these things mean we are different and that we need physical cures and that's just taking us further from going back to filtering out these irrelevant noises that have probably been with us for years and at most are slightly worse for some mostly harmless reason like muscle tension or a stuffy nose.

I was hoping to go a tinnitstalk.com free day today but I guess I'm not quite there yet. Definitely the best day yet for my tinnitus, but still I tend to have that bad spike at the end of the day that drags my mind back into thinking too much about it.

EDIT: In fact, I'm gong to ban myself from any tinnitus related websites for the next month. Talking about tinnitus is good for what, two things? Education and reassurance. I've had more than enough of both of those so I think that I need to try and get through those trickier parts of the day on my own with my own thought processes.

So I'll see you guys in a month and I have no doubt I'll have even more good news And I hope to hear the same from the rest of you!

 

Little update, still having ups and downs but generally better each day.

The tinnitus in quiet environments or noisy environments without high pitch sounds is gone, or in other words, my brain has successfully gone back to fully filtering it out of my consciousness just like it did before all this started.

But I'm still having issues with "reactive tinnitus". Not to loud sounds, just to high pitch sounds. The duration the reaction lasts after being exposed to those sounds (typically showers, typing on a keyboard, a fan etc.) is decreasing, but it's still there and it does still get under my skin as hard as I try to just not attach any emotional response to it.

Just trying to fight the feeling of being so disappointed in myself that I created this problem out of nothing through sheer over-reaction and anxiety, I guess I've basically induced a kind of mild noise phobia, and also trying to be patient and not keep expecting every minute/hour/day to be better than the last - but those are things I struggle with so in a way, the better one day is, the more I expect the next, and when the improvement can't meet those expectations I get myself down again.

Just gotta stop thinking about it and monitoring it I guess, even though I'm not losing my shit about it like I was 2 weeks ago when it was really bad, I'm still probably letting my brain drift into thinking about it way way too much.

 

Update:

Switched from youtube pink noise videos to a pink noise generating app on my iPhone as I had a feeling that youtube encoding etc. was not a very accurate reproduction, and this way I could gradually increase the level of "whiteness" of the noise each day hoping to gradually desensitise myself to higher and higher pitches.

Also I got through one of the stressful hurdles I have in my life atm (although a few more to go).

Should also mention I had about 3 very strong remedial massages of the head/neck/shoulders over the last few days too, as my tinnitus is/was very somatic and I get a lot of tension headaches so I figured that muscle tension might be contributing.

Anyway the effect is that my problem is nearly completely cured already. Specifically switching to the pink noise app seemed to make a huge difference. I still get a bit of tinnitus when exposed to high pitch noises but I need to be exposed for longer, fewer frequencies trigger it (seems to be easier to desensitise to the lower pitches) and whereas before the tinnitus lasted for about 30-60 mins after exposure now it resolves within seconds to the sound ceasing. The volume of the tinnitus is also significantly decreased to like 20-30% of what it was.


In fact yesterday I went almost the entire day without a single moment of tinnitus even when exposed to sounds that would normally trigger it and it was literally the second I got a text from someone asking how my tinnitus was that I thought about it again and within a few seconds it kinda creeped back.

So I am pretty much 100% convinced that I understand my tinnitus now: it is a form of mild hyperacusis triggered by acute anxiety that is making me sensitive to probably unchanged, pre-existing tinnitus levels that I have had for a long time without realising - and those levels are probably no more than the average person my age although perhaps currently worsened slightly by head/neck muscle spasms/tension.

At the current rate I would be very surprised if I wasn't completely "cured" within 1-2 weeks if I continue sleeping with pink noise and not avoiding triggering sounds, but I think that relies on my mental state more than anything else - pretty sure that if I let myself get acutely anxious about it again, things could easily go backwards.

Also have some reservations about the noise exposure I will be subjected to on a long haul flight I'll soon be taking but who knows, maybe that will actually be beneficial rather than a problem!

 

@Ciaran88 Good to see you doing better. I prefer pink noise - waterfalls or rain. When I had hyperacusis the first time, it disappeared during a heavy rain season. So now I'm waiting for the rain again.

 

I have always heard a hissing or extremly mild tinnitus even since young age, and I havent attended a single concert.

 

With respect to @Ciaran88 and hope that you don't me saying the following as I'm only trying to give you a little advice. You have had tinnitus for a very short while and I feel that you are putting pressure on yourself. Many people new to tinnitus do this especially when focusing on wanting their tinnitus to be "cured". It is understandable but this often reinforces negative thinking when they start putting time frames on when they should be seeing improvements in the tinnitus. Try to take things slowly. Continue using sound enrichment of your choice. At some time I recommend you seeing a Hearing Therapist for tinnitus counselling if that is possible.

All the best
Michael