Back again ...is habituation a myth?

Discussion in 'Support' started by Kathi, Apr 3, 2014.

    1. seppl
      Cool

      seppl Member

      Location:
      Germany
      Tinnitus Since:
      02/2014
      Cause of Tinnitus:
      Unknown
      I have T since February 2014. I want to habituate as quick as possible. I think my T caused by a damage in the Gaba-A, because of a side effect from a medication, so that my auditory went crazy. My T is not loud, so that low noises mask it very well. I can sleep very good without masking.
      Is there a chance that my T is going quieter over the time?
      Because I read in Forums that a lot of T goes louder over time. I hope for the most people the T will become quieter over time.
      Should I mask or try to get used to the T in silence?
       
    2. Leopardi

      Leopardi Member

      Location:
      Finland
      Tinnitus Since:
      03/2010
      If you can make yourself get up every morning to do a full time job I'd say you are very habituated. I can't even imagine doing that.
       
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    3. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Hi Leopardi! I have to get up every morning and go to work--I have no choice. My husband had a serious illness and we lost our business in a hurricane. I have to work now for the medical benefits and the salary. It's just how it is. It was my turn to provide--that's what partners do. I am fortunate that I have a good job and my husband is in remission and working again.

      I come to work--I wear white noise in the morning on an ipod until my cortisol drops and the morning loudness dies down a bit. I have a computer at work and play white noise all day. I have classical music on my ipod too, and can concentrate now--where at first it was difficult. I am not habituated. I am aware of my T most of the time--except those times when I am engrossed in work or play. It's only been 5 months.

      I do relaxation and self hypnosis every morning and night--I make suggestions for better days during my sessions--you can never tell what will work! I took a 6 week class on tools to handle anxiety and I take xanax. I am also seeing a CBT therapist once a week. I just started that. Soon, after I work on my distorted thinking a while, I may try TRT.

      I see your point, I am doing better than many and I am grateful for that. To be honest, if I stayed home I would dwell on my T that much more and it would not be good for me.
       
    4. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      Hi Kathi -

      I have a question for you. Above you refer to your "distorted thinking" - but in reading through your posts, I confess that I really do not see much evidence of distorted thinking. Can you elaborate a bit?

      Thanks -

      Stephen Nagler
       
    5. billie48
      Sunshine

      billie48 Member Benefactor Ambassador Hall of Fame

      Location:
      Canada
      Tinnitus Since:
      03/2009
      Cause of Tinnitus:
      not sure
      You are on the right path, Kathi. Everything takes time and on a progressive mode to get to the other side, even with following a good strategy like CBT for youself. As long as you are improving and living a normal, productive and hopefully enjoyable life, your brain will gradually harden to the ringing to the point you just don't care. When I first joined Dr. Nagler's forum discussion a few years back, I often thought there was no way to do 'I just don't care' on T. The sensations of T were too alien and too new for the body to ignore it's presence. But I trusted his words of encouragement as he had done it himself even after immense suffering initially. So I wanted to give myself enough time (plus some form of CBT strategy to help deal with my cognitive distortions). Now even when I have T blasting in the morning, I am doing just that 'I don't care' on my T and it just fades from my consciousness most of the day. Now I know the human brain is capable of improving to that point even though we don't have to be endowed with superhuman strength or stamina. Consider I was previously anxiety/panic prone person with a weakened nerve prior to T & H, if I can get to this 'I just don't care' stance on T given enough time and following a good strategy, I hope most people can too.
       
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    6. AUTHOR
      AUTHOR
      Kathi
      Balanced

      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Hi again Dr. Nagler,

      I have always been an anxious person since childhood--you would have to know more about me to understand why but it's not for support forums. I have a tendency to think in all or nothing, black or white terms, and to see situations as worse case scenarios. I worry excessively. Since my husband's illness and losing the business I have lived waiting for the other shoe to drop....and it did...T. I am trying to work on my inner self talk--watch the filtering and catasropic thinking. I am trying to be more positive. For the first month that I had T, I thought my life was over--that I would end up debilitated, just a ghost of my former self. I lost weight, only went out to work, and just hid. My thought were my own worse enemy--they were hopeless and self-blaming. I really didn't want to go on but didn't know what to do. My GP gave me Xanax and my life turned around. I started doing the things I wanted to do to get well instead of wallowing. I realized that I needed professional help with my thinking. That is why I was so worried when I read that I might have to give up Xanax to habituate. I am a person that needs whatever it is that is in Xanax to be whole. I should've started taking it a couple of years ago but I didn't realize I had an anxiety disorder. I am like my old self now except for my T.
       
    7. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      @Kathi posted:

      Hi again Dr. Nagler,

      I have always been an anxious person since childhood--you would have to know more about me to understand why but it's not for support forums. I have a tendency to think in all or nothing, black or white terms, and to see situations as worse case scenarios. I worry excessively. Since my husband's illness and losing the business I have lived waiting for the other shoe to drop....and it did...T. I am trying to work on my inner self talk--watch the filtering and catasropic thinking. I am trying to be more positive. For the first month that I had T, I thought my life was over--that I would end up debilitated, just a ghost of my former self. I lost weight, only went out to work, and just hid. My thought were my own worse enemy--they were hopeless and self-blaming. I really didn't want to go on but didn't know what to do. My GP gave me Xanax and my life turned around. I started doing the things I wanted to do to get well instead of wallowing. I realized that I needed professional help with my thinking. That is why I was so worried when I read that I might have to give up Xanax to habituate. I am a person that needs whatever it is that is in Xanax to be whole. I should've started taking it a couple of years ago but I didn't realize I had an anxiety disorder. I am like my old self now except for my T.


      ............

      Thanks much for responding, Kathi. Sounds to me like you're well on your way!

      All the best -

      Stephen Nagler
       
    8. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Thank you so much for your encouragement billie! It means a lot to hear that I can get to the "I don't care" stage with my T. I'm making small steps in that direction--I'm not changing any plans because my T is loud that day. I'm not frightened anymore by my T--not even in the morning. It's like, "yeah, here it is trying to get my attention." :) Some days are still bad though--I have ups and downs but lately I'm having more ups and the downs aren't quite so bad. I'm so happy that you are here for me and others like me. We need you to keep up positive and inspired.
       
    9. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      You're welcome Dr. Nagler. You're post made me feel very good. I must be getting better if you didn't pick up my negativity in my posts. :) I appreciate your interest and your explanations.

      I'm happy you are here.
       
    10. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      Just a quick word about negativity.

      Negative thinking and distorted thinking are not necessarily the same thing.

      "I cannot get out of bed today because of my tinnitus" represents negative thinking that is also distorted.

      "I wish I hadn't gone to that rock concert" represents negative thinking that is not distorted. It is certainly pointless to beat yourself up over something in the past, but it is not distorted.

      Thank you for the kind words. Glad to help.

      Stephen Nagler
       
    11. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Update: I was seeing my GP today --he checks me out every other month since T. He looked up my MRI results so I don't have to wait until 4/15. There is no abnormality in my brain or inner ear. I know it's probably silly but I was worried in the back of my mind that I had a brain tumor! I know the odds were against it but it was good to hear. That is the last of my fears. My biggest fear, that I couldn't live with this has subsided as day in and day out for over 5 months I have lived--and I'm becoming more of my self all the time. The noise now annoys me rather than scares me.

      I called my audiologist and after my follow up with the ENT, I will go talk to them about options for treatment. I have learned here that I will most likely habituate but if I can facilitate the process, I want to do that. My insurance won't pay for anything except the ENT's visits and tests. It also covers my CBT. I will have to pay for the tinnitus treatment but like eyeglasses and dental repair, this is one of the things I feel need to be done.
       
    12. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      ... and just like lousy eyeglasses and lousy dental work, lousy tinnitus treatment is pretty much guaranteed to be a waste of time and dollars. So please do yourself a favor, and do your homework!

      All the best -

      Stephen Nagler
       
    13. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Well that's scary! Do you have any suggestions as to what I should look for? The two clinical doctors at the audiologists seem very dedicated.

      Maybe I should just continue like I'm going and try to habituate myself but I still don't know exactly how to do that--even after this whole thread. :)
       
    14. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      Sure.

      It's the exact same thing you would do prior to the purchase of any service.

      You want to ask them about their training specifically as related to the product they are selling, which in this case is tinnitus relief. You want to ask what their success rates are. And you want to ask how they define success.

      I mean no disrespect, @Kathi, truly I don't. But this isn't rocket science. It's business.

      As I see it, anyway.

      Stephen Nagler
       
    15. here2help

      here2help Member

      Kathi, in the title of your post you asked if habituation is a myth. Not only isn’t habituation a myth, but you are already on the way to habituating.

      In December, you wrote that you didn’t want to go on. Now, even when tinnitus is buzzing along it doesn’t upset you so much. After five months, you are going out again and living your life, going to work, and providing for your family. If you look at habituation as a process, rather than an end state (which is a good way to think about habituation), then there isn’t a single thing worth finding out about habituation from anyone here that you are not in the process of already finding out on your own or in the work you will do with your therapist.

      You write about yourself as a “tough case” whose thinking is “distorted and catastrophic”. I don’t think you are a tough case at all. I can think of hundreds and hundreds of people who didn’t automatically get used to tinnitus, including myself, who weren’t tough cases either. We were just having a tough time.

      Taking Xanax is helpful to you, not just by helping you to perceive tinnitus as lower, but also by helping you to feel less anxious. As you said, it has made a huge difference in your life. It has helped you to feel much less stress, worry and fear. You don’t have to exchange that for habituating tinnitus. You are already in the process of habituating tinnitus and there is no reason to believe you won’t continue to do that whether you take Xanax at this time or not.

      I very strongly agree with what DebS wrote to you that the time it takes to not be affected by tinnitus differs for every person. I feel differently than Deb does when she writes this can be related to the severity of the tinnitus. I think it is due to the response we have to tinnitus, rather than to how loud it is, or any other quality we use to measure severity. With everything that has been going on in your life – the illness of your spouse and the loss of your business – maybe your response to tinnitus was exactly what it needed to be. Maybe you had no choice than to respond exactly as you did at the time.

      One thing that comes through very strongly in your posts is that you are concerned you may not be going about habituating "the right way" and you wonder if there is a game plan on how to habituate. Well, take heart. There are steps you can take from the work you will do in cognitive behavioral therapy so that you can be your own game plan. Rather than “ignoring tinnitus” the key may have more to do with paying attention to the content of your thinking and, as you go forward, applying some tenets of CBT.

      I don’t think you will ever need TRT, or that you need to make an effort to ignore tinnitus or distract yourself from it, or that you should talk yourself into feeling positive (if that isn’t how you feel in a particular moment), or that you need to do your homework.

      After reading your posts in this thread, there isn’t a doubt in my mind that you will be fine. It is a good sign of more good things to come that you already forget about tinnitus when you are engrossed in something else that has your attention. Over time, chances are good you will become less and less annoyed by tinnitus and probably find yourself actively listening to it much less and “measuring” tinnitus less and less. Over time, you won’t even feel the need to distract yourself from it.

      Don’t worry about being flexible. You are flexible. You had these incredibly difficult stressors in your life and took action to get a handle on things – which you are doing beautifully.

      Don’t worry about Xanax. It is immaterial whether there is a theoretical basis for whether it can inhibit habituation. You are doing great and, as you say, taking it has helped your reaction to tinnitus – and especially helped you deal with the incredible amount of stress you have faced.

      Don’t worry if you don’t understand what habituation is all about. Anyone who can write the following has everything she needs inside her:

      “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.”

      Or this:

      “I'm not changing any plans because my T is loud that day. I'm not frightened anymore by my T--not even in the morning. It's like, "yeah, here it is trying to get my attention." upload_2014-4-9_1-14-13.png Some days are still bad though--I have ups and downs but lately I'm having more ups and the downs aren't quite so bad.”

      Remember, habituation is a process, not an end state. You are already on the way.

      here2help
       
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    16. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress

      Thank you Dr. Nagler, and I mean no disrespect either, but you've been a hearing health professional for years, while I am just a layperson--and it's my quality of life, not just business.
       
    17. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      We are talking about two different things.

      Everything about tinnitus and tinnitus-related distress is a quality of life issue. We are on exactly the same page there.

      In fact, as I noted in my Post #37, it seems that you are well on your way to improvement in that regard.

      But in Post #41 you indicated that you wanted to facilitate the process - you wanted to do more. Moreover, in Post #43 you asked whether I had any suggestions as to what you should look for in the way of a clinician or consultant to help you.

      And that is very much analogous to a business decision. As I stated in Post #44, when you seek out a clinician or consultant:

      "It's the exact same thing you would do prior to the purchase of any service. You want to ask them about their training specifically as related to the product they are selling, which in this case is tinnitus relief. You want to ask what their success rates are. And you want to ask how they define success."

      Stephen Nagler
       
    18. AUTHOR
      AUTHOR
      Kathi
      Balanced

      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress
      Oh my here2help, what a lovely, comprehensive, compassionate post. Your words brought tears to my eyes. The way you laid it all out really made me see the progress that I have made since that dark day whent I came here in December and didn't want to go on. It is like night and day. I can see now that I have been on the path to habituation without really knowing it. Somehow I got it in my head that I needed a manual of sorts--step-by-step directions on how to habituate. I scared myself into believing that I would become part of the small percentage that would become totally debilitated and I worried about my family if I should get so that I couldn't work.

      Thank you for pointing out the progress and the strengths that I couldn't see. Your post has lifted my confidence and helped to quiet my internal negativity--something I worked upon in the classes I took to build an anxiety toolkit and will continue with my CBT therapist. Thank you again...from the bottom of my heart.
       
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    19. AUTHOR
      AUTHOR
      Kathi
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      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress

      Yes Dr. Nagler, I totally misunderstood--thank you for the explanation. Your patience is limitless. Now I get what you mean, when seeking TRT or other options, one should treat it as a business, kind of like buying a used car--kick the tires and check under the hood. :)

      I'm so happy you are all here. Now, I'm getting on with things. I think I'll give my CBT a few months before I try other options. I'd like to see how just living my life goes. As I said, I have more good days now and the bad days --although still frequent--are not so bad as they were in the beginning. Either that, or my reaction to it has changed so my perception of bad days is not as bad. Maybe I can help some new people a bit with the early stages. I did once learn that helping others takes you out of your own head too.
       
    20. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      In tinnitus the perception is the reality. If you perceive that your bad days are less bad, then they are less bad.

      sp
       
    21. Mclovin

      Mclovin Member

      Tinnitus Since:
      1/2012
      Kathi, believe me when I say you are making really good progress, unlike many others (including myself).

      I, like you are working full time and do all the stuff I used to (almost), but I still can't seem to lose the constant fear and anxiety T has brought. So kathi, you are on your way, just continue doing what you are already doing, and you will be fine.
       
    22. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      @Mclovin, what strategies have you been using to address your "constant fear and anxiety?"

      Also, is there any time at all during your day that you are not afraid - even for just a moment?

      Stephen Nagler
       
    23. Mclovin

      Mclovin Member

      Tinnitus Since:
      1/2012
      Hi Stephen. I haven't done anything, except eating antidepressants, which don't seem to work at all. I really want to try CBT and TRT but i honestly can't afford it. I lost my previous job due to getting T, and it brought me in
      enormous financial problems, in which i still suffer from. I have the Henry & Wilson book, but it's alot of pages, and i am not that good at English so it seems like much for me.

      The last time i wasn't anxious was about 2 weeks ago. I started on antidepressants (again) about a month ago. 2 weeks after i began to feel a lot better. The anxiety mostly vanished, and i felt much better. I hadn't felt that good in over a year. That lasted 2 weeks and i am now back to anxiety hell, that kills me slowly. Not a single break during the day, except when sleeping. I guess the two good weeks i had, was some kind of placebo because i thought that maybe it was the antidepressants working. I just miss some peace of mind so extremely much.

      Kenneth
       
    24. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      Hi @Mclovin -

      Well, the Henry & Wilson book is excellent. Take it in small pieces - and it won't seem like so much, even with the language barrier.

      Regarding the rest of your response - you were talking about anxiety, while my question was about fear. They are related, but not the same thing. So what I want to know is as you go through your day engaged in whatever activities you are engaged in, is there ever even a brief span of time when you are not afraid. Like maybe when your mind is elsewhere for a few moments. Or are you consciously afraid every moment you are awake of every single day?

      Stephen Nagler
       
    25. Mclovin

      Mclovin Member

      Tinnitus Since:
      1/2012
      Stephen, I see what you mean about fear and anxiety.
      Sometimes on VERY rare occasions, i can loose some of the fear, but that's very rare but they do occur.

      The funny thing is that it's not the the T itself i fear so much, it's more the fact that i will never get better and loose the anxiety, and the thought that i will feel this awful for the rest of my life. I think that's the thing that keeps my anxiety going. A vicious circle, i know.

      Kenneth
       
    26. AUTHOR
      AUTHOR
      Kathi
      Balanced

      Kathi Member Benefactor

      Location:
      NJ/USA
      Tinnitus Since:
      10/30/2013
      Cause of Tinnitus:
      HFHL and stress

      Thank you Mclovin! It really makes me feel good when I'm told I'm making progress but why not you too? I had a paralyzing fear of the noise--my stomach used to clench if I so much as heard the noise on my ipod when I was trying to block it out--eradicate it with white noise--so I know the fear. I take Xanax and I know it has a lot to do with losing that fear and helped tremendously with my anxiety. One of my anxieties was that I had something serious and that I would lose my life as I knew it and become debilitated. Look at how long you've been living since the onset of T--you are proof positive that you can have a life--you are having one. That's what I finally realized. Also, have you had scans and bloodwork so you know there isn't anything life threatening? That will cause major anxiety. My 2nd ENT took an MRI with and without contrast and I'm okay. My GP tested my thyroid, my blood sugar, blood pressure--anything he could think of. It turns out that I have tinnitus. Thank goodness it's not a brain tumor or any other life threatening disease.

      I'm sitting here typing and the noise fades in and out--I've noticed when I'm engaged that I really do forget and now, when I hear it, I'm a little less annoyed every day.
       
    27. Dr. Nagler

      Dr. Nagler Member Clinician Benefactor

      Location:
      Atlanta, Georgia USA
      Tinnitus Since:
      04/1994
      So you don't have "constant fear and anxiety." You have a lot of fear and anxiety - but you do not have it 100% of the time. I see that as a good sign and something you can build on.

      The Henry & Wilson book talks a lot about emotion-based all-or-nothing thinking and how it can be counterproductive to what you are trying to accomplish. Believing that you live in constant fear and anxiety when such is not really the case is an example of just that sort of thing! So please do go through the book slowly at your own pace. And do all the exercises on paper - not just in your head. It will make a difference, I am sure!

      Stephen Nagler
       
    28. billie48
      Sunshine

      billie48 Member Benefactor Ambassador Hall of Fame

      Location:
      Canada
      Tinnitus Since:
      03/2009
      Cause of Tinnitus:
      not sure
      Thank you Kathi for the kind words. I am doing my share to help newer sufferers. I myself am still learning from the true stalwarts of tinnitus support such as Dr. Nagler & here2help. They are titans of tinnitus knowledge & experience, and you are in good hand talking to both of them here, and their words are most re-assuring about your progress. Don't underestimate your strength and how much your have achieved since coming on board here. You are proving to us an amazing case of turning around right before our eyes with the help of the kind board members and with your own ingenuity. Keep it up and give it time. You will be just fine.
       
    29. inadmin

      inadmin Member

      Hi Stephen, i'm in the exact situation as Kenneth. 15 months into this. Trying ad's -currenly on cymbalta. The difference is that the mornings are bad, while in the afternoon towards the evening my mood gets better and my reaction to the T lessens. This is typical to depression i guess.
       
      • Agree Agree x 1
    30. Katkin

      Katkin Member

      Location:
      Lancashire UK
      Tinnitus Since:
      July 2013
      Dr Nagler, Could I ask you about spikes please. I keep getting them approximately every 4 days, when my T becomes high pitched coupled with sharp sounds that seem to zap around in my head and between my ears, and this is quite distressing. In between I get better, quieter days when I feel more positive about life. What do you think could be triggering these regular spikes. I'm female, 49, in UK and have had tinnitus that has gradually changed in nature since July 2013. I'm really hoping one day that I can get T back into my subconscious where it belongs, through not reacting to it and achieving full habituation and hopefully not hearing it at all! Thanks in advance for you help.
       

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