Fiancée Is Desperate: Tinnitus Caused — and Made Worse — by Propranolol, Looking for Guidance!

Hello,

I am new to Tinnitus Talk, and am a desperate partner looking to help my desperate fiancée.

Back story follows.

5 years ago my fiancée's brother was going through a tough time and was suicidal. This led to my fiancée to become ridiculously anxious herself surrounding it all. She is not an anxious person normally.

She was prescribed a low dose of Propranolol. This sorted the physical anxiety symptoms out. But left her with tinnitus.

She habituated fairly quickly after some short term stresses surrounding it and it was pretty low and she got on with life comfortably.

Fast forward to now.

During April 2020 we had a miscarriage, and then a month later my father passed away suddenly. Then in September we had a letter from the NHS stating my fiance has Endometriosis. This basically pulled the rug from under my fiancée's legs and floored her (considering we were trying again for a baby) and was the icing on the cake for a very stressful year.

With this diagnosis, it brought on a serious amount of stress and anxiety, and the symptoms got worse and worse. She is now off work.

After 2/3 different opinions, spread over a couple of months, it was concluded that she didn't have Endometriosis and the symptoms were all anxiety related.

Over the course of 2/3 months, she was in such a state, not sleeping, physical symptoms in areas the Endometriosis would have been in and generally a mess. I was basically her carer.

We needed some help and was prescribed many different antidepressants (Sertraline, Mirtazapine, Trazodone) but my partner didn't trust anything due to the past experience.

However, she got so desperate, the doctor prescribed her a ridiculously low dose of Propranolol as it worked last time for her anxiety, just that she had the after effects. Unfortunately, this has now made the tinnitus ten times worse after a couple of days and she has now come off it. She is still left with the anxiety and stress of the last few months.

She now how as multiple (5) noises spread across both ears.

She has hardly slept for 5-6 months due both problems and now she has been forced to take Mirtazapine (15 mg) to get control of her sleep.

Her sleep has been good for 2 weeks but there is no change in her tinnitus or anxiety levels.
So she has now been upped to 30 mg for the last 3 nights.

We have seen ENT (all tests fine) and hearing specialists (all tests fine).

I am so worried. She is having negative thoughts all the time, it is horrible to sit through a session to hear how she speaks and her thoughts worry me.

We are both desperate for any help, guidance or even success stories. PLEASE.

Thanks in advance.

 

I am so sorry to hear about the loss of your father, your baby, and everything else going on.

I just started in Propranolol less than a week ago. 20 mg in the morning and 20mg at night. This is to treat blood pressure and migrane. I must say I am concerned. She was just on 30 mg at night, is that right?

 

Thanks, obviously a terrible year for everyone with what’s been going on but it’s been rough personally...

She was on a very mild dose of Propranolol taken in the morning for a couple of weeks (in the first instance).

And she was on it for a few days the second time round.

She has taken 15 mg Mirtazapine to enable her to sleep (2 weeks in) and now upped to 30 mg to help with her stress and anxiety; this hasn’t kicked in yet as it has only been 2/3 nights.

 

I know it must be difficult for you. It is such a blessing that you have followed your partner's situation and are seeking support for her. I remember in my most difficult days, I needed someone to listen, be kind and supportive. Even something as simple as buying flowers, my favorite magazine or drink would have been very meaningful.

Best to you,
twa

 

First of all I’m very sorry to hear of the ongoing problems you have had. Prolonged stress can cause all sorts of health problems.

Secondly, how very nice of you to be concerned and supportive of your partner, she is a very very lucky lady. Not many of us females here on the forum can say the same about our other halves.

My advice would be to give Mirtazapine a fair go. It may not help with tinnitus but once the anxiety and panic are under control she may be able to deal with it better.
I’ve been on it since 2018 and all I can say is that it has been a life saver. I still have my old tinnitus, I have new sounds (I don’t believe it’s medication related), I have ups and downs, I get depressed and desperate but overall I’m coping a little better than before medication.

Good luck and I hope she feels better soon.

 

I wonder if the Propranolol was the main cause of her tinnitus. It very well could be, but there are a lot of people on here, myself included, who take Propranolol for various medical issues. The majority of us tolerate it well, but that doesn't mean someone won't. It is very possible that this triggered her tinnitus, but I think it would reduce after she stopped taking it. Another possibility was that she always had tinnitus and never realized it because it was so low. When she took Propranolol is brought it to a noticeable level, but when it reduced she was now aware of it.

Another thing to know is that anxiety and stress are known to cause and increase tinnitus. It is a vicious cycle the feeds each other. This cause is always downplayed, but anxiety can cause serious issues when it comes to tinnitus.

Lack of sleep is another cause for increased tinnitus. I know if I get bad sleep my tinnitus is always worse until I get some good rest.

I have a good feeling that when her anxiety is under control and she gets good sleep her tinnitus will slowly get better. If she hasn't already, I suggest she see a mental health professional for CBT since she had such a traumatic year. I am sure this will help her anxiety overall, which will help reduce her tinnitus.

 

Very sorry to hear this.

The kind of protracted stress state you describe, especially combined with lack of sleep, is quite neurotoxic. I'd be much more suspicious of everything else going on, than taking tiny amounts of a beta blocker.

The way out is through; the nervous system has to be hugged and coddled and loved back into a more harmonious state. That is a hippy dippy way of phrasing it, but I've been through a number of protracted anxiety states, and there's truth in it. The sympathetic and parasympathetic nervous systems are connected through the hormone driven hypothalamus / pituitary axis, and when we spiral into this kind of severe, dysphoric anxiety, we're basically creating a horrible new homeostasis because of feedback loops between various hormones and conscious loops.

It sounds like you're in the middle of something pretty awful, and just need to keep moving through it. Sorry No one here can tell you what's going to happen with the tinnitus long term, but I'd be pretty surprised if it's not being made massively worse by everything else going on here.

 

Her anxiety and stress is through the roof and she cannot see it herself.

She is constantly screaming, shouting and using myself and her parents as verbal punching bags, whilst also having negative thoughts.

I'm hoping the 30 mg Mirtazapine can get into her system and help her quickly, but currently she has seen no change.

The doctors have prescribed her 50 mg Pregabalin to take in a morning (as and when she feels anxious, not everyday) to curb her anxiety but again due to past experiences with medication she is refusing to take it.

I know that the tinnitus is there and I am trying my hardest and desperately to explain to her we have two problems right now, tinnitus and anxiety.

The only one we can currently treat is the anxiety and stress, and with that the tinnitus may come down and be in a more level state to manage it herself. But she just cannot see this...

Has anyone had experience with their anxiety coming down and the tinnitus improving as a result, or at least being able to manage the tinnitus better...? I can then show her so that she can gain some trust from it all?

 

That's great because pre existing hearing loss is the major cause of tinnitus with any time taken and amount of Pregabalin. Drug probably caused neurotransmission to the sympathetic nervous system causing tinnitus.

Taking mind off tinnitus and lowering stress should greatly improve tinnitus.

 

If you search Tinnitus Talk, you will see countless experiences with this. Lots of people who reduced their anxiety also had a reduction in tinnitus.

It sounds like she is in a really bad state. Make sure she is seeing a mental health professional and not just a GP.

 

When it comes to the management of the accompanying anxiety, it doesn't sound as if your fiancée is presently in anything like the right frame of mind to explore mindfulness based cognitive therapy as a means to manage what she is going through. However, that does not mean that you can't take a look at a couple of publications that I personally found helpful when I was overwhelmed with a panic disorder, namely, these:

Susan Orsillo and Lizabeth Roemer: The Mindful Way Through Anxiety

Bronwyn Fox: Power Over Panic

The first book can be previewed on Amazon. That's not possible with the second one but it is fairly cheap to acquire a used edition via the Bookfinder website. Although I haven't retained my own copy of Fox's book, I dimly recall that some of the techniques she describes can be put into practice at the same time as someone is also taking a course of medication for their condition.

Note that if the results of the FX-322 trial show promise in relation to tinnitus, we can look forward to a time when we might get beyond strategies like the ones outlined in the resources that I have referred you to above, that only address the psychological impact of intrusive tinnitus and the overwhelming anxiety that frequently accompanies its onset.

Hope that this post proves to be helpful in some way.

 

Thank you for the replies.

She took 2.5mg Diazepam, which was half a dose, after I persuaded her as she just couldn't see how she was being and the stressful effect it was having on her.

This acted like a massive circuit breaker for her. She was calm (but empty) through the whole day, but it was a much needed break for her (and me).

The next day she was also a lot calmer even though she did not take another dose of Diazepam.

A week has now gone and she has not really changed at all. I know this is a long process, but I'm just looking for some hope for her.

I don't want her to be on medication, but in my head, I feel like she needs a good time chilling her body out on Diazepam (for a short period) and Mirtazapine together rather than every odd day when she feels like it (even though she refuses) taking the Diazepam.

She is almost inconsolable at times, almost like PTSD maybe?

What are your guys' thoughts please? Is the 'secret' to at least getting things more normal to control the anxiety and stress she's been through?

 

Have things gotten better?

 

Unfortunately these things can’t be rushed, there is no quick or overnight solution for tinnitus and the havoc it causes. It may take many months before she gets to some sort of “normal”.

If I could give one piece of advice it’s to be very very patient, do not push, do not despair, do not expect her to bounce back quickly, she won’t. Tinnitus can and does cause an enormous amount of stress, the loss of silence and ability to relax is like no other health problems.

Best to consult your doctor and seek professional advice regarding medications. Some people have no choice but to go on a short (or long) course of benzos while others take them as needed, whatever is needed to survive the acute phase.

Good luck and keep us posted of her progress.

 

I'm so sorry to hear what you and your fiancée are going through. To have both ears affected like that is horrible, hopefully some of the noises will go down / disappear over time.

Like your fiancée I'm not a big fan of medication because, unless there is something concrete for the doctor to diagnose like a chemical imbalance of the brain for example, it is still very much a guess the right medication game when it comes to antidepressants. But there are times where you have to choose between the devil and the deep blue sea and cross your fingers that the choice that you've made was right.

So, fingers crossed that you'll find something that works and doesn't come with a truckload of side-effects really really soon!

 

Hi, first of all, I'm sorry to OP and his fiancée. I want to highlight this comment here, Leila. We shouldn't have to do this, as humans we shouldn't have to make such choices and ''hope''. In my opinion this is far from optimal medicine. We are hundreds of years behind advancements if we have to think things like these.

In my opinion it's high time for a massive worldwide revolution of medical science and research. Medicine should be individually catered on a nano scale and to each person's unique DNA. This would require much more advanced diagnostics and breakthroughs. Which are ENTIRELY possible. The current state of medicine and medicinal research is a reflection on the current state of the world.

 

In short, no.

If anything, things have gotten worse.

She is sleeping, due to the Mirtazapine 30 mg, which is a positive, but the only one.

Other than this she has got much worse anxiety, stress levels and more negative thoughts. She also seems to get a lot more pressure build up than previously reported.

She wakes up everyday and goes through the same routine, which is straight into an anxiety attack.

She got prescribed Pregabalin (50 mg) to tackle this but is fairly resistant at taking it everyday due to past experiences with medication.

We signed up to a lady called Debbie Featherstone for CBT but she is yet to start that.

We have also been to see a specialist tinnitus audiologist who examined her ears and did numerous tests which came back all clear, and again suggested she needs to keep busy, focus on 'filtering' the sounds out by having constant noise and eventually her 6/7 noises should, through experience, go to a low hissing noise which will be much more manageable.

She is also booked to go to an anxiety retreat in a few weeks.

Myself and her family have gathered as much information surrounding this condition as we can from online, ENT, audiologists and other people's experiences and trying to get her to try all the techniques everyone has suggested but she is so resistant to it all, even though she knows there is no magic wand to cure all of this.

 

Her and I have a lot in common. I understand her anxiety, and her resistance to medications. This condition is like no other. I wish her well, as I wish everyone well who has been dealt this affliction.

 

Is her tinnitus the root of all of this or is something else causing it, like a traumatic event, and the tinnitus is an additional stressor?

 

Update:

No improvement in either anxiety or tinnitus.

Sleep is fine. She is still on Mirtazapine.

Her anxiety is so out of control on a daily basis despite the daily 50 mg Pregabalin. She refuses most drugs and hates being on these at it is.

She is constantly scared about her future and cries 90% of the day, not functioning daily.

She cannot accept what has happened and that she now has these sounds... I feel like this is all getting in the way of her being able to move forward.

We have seen audiologists, she has been on an anxiety retreat (no help) and seen many doctors.

However, all of these have said to play masking noises, white noise etc to distract her brain and potentially push back some of the noises but she doesn't want to. I feel this would massively help her.

We are booked in at the Tinnitus Clinic too, but she keeps saying it is rubbish and no use.

As a family we are really struggling with how to get her to focus on what she should be doing each day to help but she won't listen.

Has anyone got any daily tips they live by to help them?

 

Firstly, I am so sorry to learn that your partner is in great distress. And I am also sorry you’re having to watch her go through this. It’s incredibly hard for both parties involved.

I can offer my advice, but it’s not much...

What I did to help overcome my uncountable number of noises, was to just try and live day by day. I didn’t even bother to think about the future, I just focused on the here and now.

I took it slowly. I started going for short walks, which I was initially anxious about, but felt better and better each time I went.

I put sound apps on whenever I was faced with quiet situations, and I forced myself to watch tv/films - even though my tinnitus mostly distracted me from enjoying them.

I forced myself to socialise again, even though when people were talking to me, all I could hear was the relentless ringing in my ears.

Day-by-day, all the forcing of these little things started to slowly distract me from the tinnitus. But I can’t deny, my absolute biggest help and life saver, was this incredible forum! I owe my life to it and the people on here.

Can I suggest that she joins us? I have the feeling that she could really do with placing her anxieties and worries on us - we are all here to hold each other up.

Maybe you could try something as simple as asking her if she would like a shoulder rub, and whilst you’re doing that, put on a film, and some low level masking. Relaxation is key. As soon as she starts having brief moments where she forgets it here and there, then you’re on the right path... though I am aware some people’s paths are more complex than others’.

I sincerely wish you both well. And I am glad you came here for advice - you are a very kind and compassionate human. <3

All the Best,
Steph

 

I kind of get why she does not want to mask her tinnitus.

But she really has to start looking at this as a disability that can be made a lot more manageable by masking.

Sounds like a dumb comparison but would she not use a wheelchair if she would get paralyzed or glasses if her eyesight went down?

There are SO many people with a lot of afflictions, and they are all finding ways to live with it with whichever help tools they can find.

Masking is your fiancee's best tool until hopefully in the near future a medication will come onto the market that will cure or alleviate the burden. She has to hold on until then and put herself into survival mode.

This has been said in multiple success stories: your fiancee needs to find someone to talk to that also has the condition. It can be even online. I'm sure you try your best to understand what she is going through but in all honesty, it hits so much closer to home when you can chat with someone who also has tinnitus. I hope you understand.

 

I couldn’t have said it better myself.

Something has to switch in her brain to tell her to cope. She has to accept the little help that is available i.e. masking. She can’t fight it forever.

Tell her it’s okay to be weak. Tell her it’s okay to think terrible thoughts. Tell her that her suffering is valid.

However, I do think because it’s been so long she’s felt like this now, that you need to intervene with other options such as masking, light exercise, relaxation therapies.

Why don’t you (once places have reopened) try going to a spa? The sound of the water will help to mask the tinnitus, and at the same time, the heat and environment will be relaxing. You have to find something that will distract her from it for just a little while.

 

Chronic stress no doubt makes a lot of things worse, tinnitus included, but I'm sorry to say that this sounds like Propranolol-induced tinnitus and anything to suggest that it's something else (stress/miscarriage etc) is only going to invalidate her feelings, which she is absolutely right to have and will make things even worse. Like others here, she's been let down by modern medicine, although I use the word 'modern' rather loosely. Propranolol can induce tinnitus through two different mechanisms:

a) Ototoxicity, causing hair cell loss (which allow us to hear)
b) Neurotransmitter issues

I say all this to you because you need to prepare yourself with the idea that there is no silver bullet. No medication will treat tinnitus and any anti-depressant that makes the tinnitus more bearable is only going to have other side-effects. The fact she habituated the first time but is now struggling this time round tells me she's probably ended up with some kind of catastrophic tinnitus that must be very difficult to mask or ignore. She would not be in this state unless her symptoms were very serious, even in the absence of other stress factors.

All this to say, you have a mountain to climb. She needs to avoid other medications and if anything should probably come off what she's currently on. She can try to habituate and mask the noise, but as I said above, this is a huge mountain to climb even for mild tinnitus, never mind for someone who sounds as if they have it at a catastrophic level (5 different tones). You can console her with the fact that there are regenerative drugs for hearing that should reach the market within the next 5 years or so, so even if her life is difficult now it is unlikely to be completely doomed long term.

In the meantime, she just needs to be distracted, and that may involve you taking some time out to help her. Go for walks or exercise together, try some breathing exercises (without excessive breath holding), yoga, EMDR.

As for managing her stress and anxiety, you'll find Magnesium does wonders for a lot of us here. Most people with chronic stress have completely depleted Magnesium levels because of the demands stress puts on the body, so this is a really big deal that a lot of doctors fail to take account. I personally take Calm by Natural Vitality, which is magnesium carbonate form (liquid), but I hear liquid Magnesium chloride is also very good.

Good luck.

 

This condition ruins so many people's lives... There should be some treatment available by now. How do we still have this middle ages' medicine when it comes to tinnitus?

 

Your partner sounds very much like me when I first acquired tinnitus. I was suicidal because I believed wholeheartedly that my life was ruined, and tied myself in knots reading up on tinnitus online. I was terrified of making a mistake and worsening my tinnitus, and convinced myself that nothing would help me.

What helped me:

1. I cannot stress enough the importance of masking for me. It gave me a break from the tinnitus long enough to be able to cope with it.
2. Not researching online. I suffer with anxiety so reading about tinnitus terrified me and made me afraid to do or try anything. I had to step away until my anxiety was under control.
3. Talking to my sister. She listened to all my fears without invalidating me, and constantly reassured me that it would get better.
4. Medication. This is a personal choice, but I needed it and it got me through.
5. Going back to work. It distracted me, and showed me that life could be normal again.
6. Success stories. I read all the positive stories that I could find. It helped loads.
7. Keeping up with upcoming treatments. It gave me hope for the future.

It sounds like your partner has suffered through an extremely distressing time and it is very common for tinnitus to temporarily spike under extreme stress. I've had tinnitus spikes that last for months, and then completely return to normal. She is not necessarily stuck with these noises. Give it time. I hope she feels better soon.

 

6 months have now passed. WE NEED HELP.

My fiance is almost manic most of the time.

She has been upped to 45 mg Mirtazapine but I can't see what difference this is making to her depression although her sleep is still ok now.

She wakes up in a morning pleading with God (who she doesn't believe in) to help her and give her silence back. For anyone to help her.

She won't listen to anyone, we have seen so many experts (ENT, Audiologists, Tinnitus Clinic) who have all suggested the same things to mask, exercise, keep busy etc. but she won't do any of it. She is off work literally, reading through forums getting herself into a hole of tinnitus all day everyday.

Every time myself or her family suggest to do the things she has been advised she gets so angry, nasty and violent at us and we are unable to get through to her she needs to do some things her self.

She won't accept any more medication due to medication getting her into this situation. She won't accept any advice or help from experts in the fields we have seen.

The crisis team have withdrawn help due to it being a 'physical condition' and they have done all they can do for us.

Her anxiety, depression and stress levels have been at an all time high for months and she isn't giving her body a rest at all.

She is out of control, she is suicidal. I don't know how to help.

 

Unfortunately it looks like you can't do anything more. You've tried your best. If she doesn't accept the help, there's nothing to be done.

At some point you need to give up and move on. It can mean breaking up with her and continuing with your own life. Otherwise you risk making yourself seriously sick too.

 

Hey there, @DesperatePartner.

I've wanted to comment on this thread for a while but I've been at a loss for words. Mostly because I feel physically sick from reading about your partner and her challenges. I'm going to say some things that are not so helpful to you, and some things that may be helpful.

The not so helpful things first.

What your partner is going through is one of the most difficult, challenging and devastating conditions a human being can experience. Her reaction is exactly the same I had. I have deep, deep empathy and understanding with how she thinks and reacts. It's extremely difficult for someone who does not have tinnitus to understand. I was a complete, sobbing mess. The anxiety was so bad it felt like a poison and a cancer in my body. I could almost physically feel it in my fibers, in my veins. My brain felt like it was submerged in fear. I lost all memory of who I used to be and all my thoughts were centered around panic, fear, a feeling of deep, intense distress. I was always crying, almost 24/7. This is what this condition can do to you. You have a completely foreign sound that you (or rather, your brain) identifies as extremely "hostile" to you and you cannot shut it off in any way. This is the definition of torture in my eyes. And she got it from medicine? I'm really, really not surprised that she now hates all medicine and never wants to take anything again.

On to the more helpful things.

You are completely right that she needs to do something herself. If she just sits around in forums all day and reads, looking for answers, she is going to sink into a hole, just like you say. This is awful and not helpful at all. You need to help her realize this, no matter how angry or sad she gets. Please show her my message. I'm talking from experience.

Secondly, I did take some medicine when I realized the anxiety was so bad that it had become impossible to manage and it was eating me from the inside. I made a mistake of using them for 2 years - I wish I had started to taper them sooner. But for getting the anxiety under control, they helped. I now have 90-95% management of my anxiety and the loudness of my tinnitus is mostly the problem these days.

God will not help her. But she can help herself. She really can. But first she has to come out of this fear-induced mania. Tell her to consider anti-depressants or anti-psychotics for a short period, like 3-5 months. Make her taper them slowly (I did it over 2-3 months). It's just to take the edge of the anxiety so she can get back in her headspace and feel like she's in control again.

I think she should also begin experimenting with masking and getting used to keeping a busy mind (but not looking at forums all the time), because this will, over time, adjust her brain to the sound and make it easier for her to accept it. Now I'm not working from a "habituation" perspective, because I hate that word and I think it's a very meager help. I think she can have silence again, but I'm pretty convinced that silence doesn't come suddenly, like a miracle. You have to work for it and with tinnitus you have to work really hard. She should prepare to spend years on this. Very unfortunate, but a lot of us are struggling here, it's just how it is. However, I am of the firm belief that more people get silence than we realize. I've had silence myself lately, for brief moments. But my brain is very volatile at the moment. So it's hard to say what the future will hold.

I deeply sympathise with your fiancee. She does not deserve this and she needs a hug and understanding. That's what I missed the most during my acute phase. But she also needs to realize that the path she is on right now is not helpful. Try to make a deal with her, go very slowly at first. Baby steps. Eventually it should become slightly easier, but I don't know how severe she has it. Even for us with tinnitus, it's sometimes hard to imagine how the other people are suffering, how their sounds are perceived. A perceived tinnitus score of 7 might be a 4 to someone else, a perceived 2 might be a 9 to your neighbour.

I hope deeply from my soul and heart that your fiancèe will be rid of these sounds in the near future. You become quite empathetic to others with this condition. I never knew true suffering until I got this crap.

She might also want to check out Dirk De Ridder. I'm thinking of contacting him directly myself.

Best wishes.

 

I do not agree! We should never give up on anyone, least of all people we care about. We just have to make them see that they are wrong and everything will be easier.