Depression and Tinnitus

Hello Dr. Hubbard.

I have a few questions regarding Tinnitus and Depression (just as the title says).

I have had Tinnitus for over 9 years now. The first couple of years were really tough but somehow I got through it. Then came a period of maybe 4-5 years where I actually don't remember being bothered by my Tinnitus. It was always there but I didn't think about it much.

Now in January this year (2015) I started to notice my Tinnitus again. I remember sitting with my laptop one evening and as I shut it down I told my self "Damn this Tinnitus is really loud." And this has thrown me into a tailspin of emotions these last few months that I haven't recovered from. I notice my Tinnitus more now then ever. It feels as though it has progressed and increased in volume but some days it doesn't. It's very strange. Sometimes when I compare it to how it was I feel as though it's the same as always and sometimes I feel it has definitely become worse.

My question is really if this new "onset" or what I now should call it, can it be due to depression? I remember lying awake at nights just before the Tinnitus started feeling worse and thinking of death and the thought of dying scared me. My life was going so great that I started thinking that I was afraid of it ending. I'm turning 32 in a couple of months so I have thought a lot of growing old. I don't feel young anymore.

If it is due to depression. What should I do? I have seen my GP a few times in these past few months and he has prescribed Mirtazepam that helps me sleep and I also went to see and ENT and it was just same old story "Learn to live with it, there's nothing I can do" while seeming to be bothered by my visit.

Should I seek counseling? Should I request my GP to prescribe anti-depressants, and if so then which kind? I'm thinking mostly that I don't want any drugs that might worsen my condition.

I think I've always had times of depression. And as far as I can remember I've sometimes had depressions that have lasted for quite some times. I have sort of always pended between being so happy that I feared death and then sinking so low that I've been thinking of just putting my self out of misery.

What do you think I should do?


Best regards,
Silvio Sabo

 

Hi Silvio
there is a strong association between tinnitus and depression so I think your hypothesis is likely correct. Perception of tinnitus is such a subjective experience that it's difficult to really know sometimes if the volume is gradually increasing or the anxious, despairing attention we bring to the sounds makes it seem louder. So if you have bouts of depression, it's not unusual that depression triggers a renewed, emotional awareness of life's challenges, like tinnitus. So I recommend practicing reasonable hearing protection moving forward, and then doing what you can to soften your emotional response to the sounds and, primarily, just get out of your head and back into your life! With CBT, you can learn to notice when your mood is starting to dip, and take action then to keep your thinking grounded and get into your life in a meaningful way. Lot of acceptance needed also, e.g., about aging. But you are young and don't want to lose track of the moment by worrying about the future. You can try medication, and i highly doubt it will have any affet on your tinnitus, pro or con. However, for depression, i recommend a CBT approach called Acceptance and Commitment Therapy. If you can't find a local therapist, there's a good workbook: Mindfulness and Acceptance Workbook for Depression (Stroshal).
All the best!
Dr Hubbard