Habituation Lost?

I'll start by saying that I have a very, very severe and intrusive tinnitus (super high pitched LOUD dental drill inside my head, unmaskable), that I contracted from an antidepressant (trazodone = trittico = desyrel) almost 5 years ago. After spending three years in absolute agony (living as a hermit, suicidal every day, loosing everything I've built up to this point [had to move back in with my parents]) I slowy, slowly started to recover and somehow and somewhat started to enjoy life again.

While I was never perfectly happy with my tinnitus I was capabable of coping with it and was starting to enjoy life more and more!

This has taken a sharp turn in the last few weeks again though, and I'm not sure why. I'm now again SEVERLY distressed by my tinnitus, having extreme crying spells and just generally feeling like I'm not able to cope with the extreme noise in my head. The worst part for me is that I'm not able to enjoy anything anymore. I used to be able distract myself with my favorite hobby (Gaming) but I'm so agitated and distressed that I don't enjoy this anymore either. My sleepquality also has taken a sharp nosedive, and as a last resort I had to take benzos again to be able to sleep.

The noise did not get louder or change, it is still exactly the same as 5 years ago, but somehow my reaction changed in the past few weeks? Why? I don't understand it and makes me extremly anxious and scared that I won't be able to get back to my previous reaction level again.

 

I think I'm in a somewhat similar situation. Not as severe as yours. But some months ago (My T has come and go, but has seemed to stay now) I could cope with it. Irritating at nights but I could sleep and function. Now I'm not sure if the volume has increased or not, but all of a sudden I have more trouble coping with it. I think anxiety/stress has a big part to play in this.

Hope you will get better soon, bro!

 

@tdn,
Sorry to hear your feeling out of sorts and your tinnitus causing you a bit of a wobble,
If nothing's changed that is a good sign and over time you will adapt again.
Our emotions play a big part in how we cope day to day with any problem or illness and it could be the low mood through sleep loss causing it.
I have sever bilateral tinnitus that is hard and did have It in my head also.
My doctor put me on Nortriptyline a low dose for sleep and backfiring signals and my head tinnitus has gone and sleeping great most nights.
I'm sure you will start coping better again so go at your own pace and off load any stress and some nice treats.
We are here around the clock to support you.
Love glynis

 

Yeah, I totally understand that. I had to get on a medication called "Lamictal" to prop me up. Its possible your emotions were in a place that was less than good and then you thought about T and had a "fight or flight" response which caused you to consider T a danger again. I'm not sure. Did you stop taking caffeine, sleep more, get sick, or do something differently before it started?

 

While the origin of Tinnitus can be found in hearing loss, its expression (and our sensitivity to it) is actually grounded in a very complex set of triggers. Each person is very different. However, scholarship tells us that the primary factors that drive our awareness of Tinnitus (and counter Habituation's progress) are:

• Sleep, or lack thereof;
• Emotional state (specifically, anxiety);
• The Memory Centers of the brain; and,
• Acoustic sensitivity at any given period of time.

So, to accelerate the habituation process, cognitive behavioral therapists emphasize "mindfulness" techniques and meditation that, from a medical perspective, are actually doing several things:

• We get better sleep.
• We become less anxious.
• Our memory centers become more focused.
• We become desensitized to sound.

If you want to amplify habituation and tune down your Tinnitus, I would recommend:

1. Getting sleep, first and foremost. Use medication if necessary (but lay off the benzos, obviously).
2. Get exercise, specifically cardiovascular and strength training, and this has the added affect of flooding the system with endorphin hormones and driving down anxiety.
3. Play a memory game or two. Try ones that repeat build orders, matching, etc. City-building games, if you're a PC gamer, are known to help here.
4. Use notched music or neuroacoustic electronic modulation.

Best of luck in regaining your tranquility. The good news is - you were habituated before, so you can get there again. It just requires some time and, if you want faster results, some effort.

 

Do you wear headphones when you are playing your games on the computer? If you do (even at low volume) this could be the reason your tinnitus has become more intrusive. Headphones and tinnitus do not mix well together even at low volume and especially when the tinnitus was originally caused by loud noise. Some people with tinnitus are not affected by headphone use, but it's something I don't recommend even at low volume, as there's a risk of the tinnitus becoming worse in my opinion.
Michael

 

I know you do not like headphones Michael but what is different from headphone wavelengths to other wavelengths?

 

I suggest you read some of the many posts in this forum from people that habituated to their tinnitus and it was low. Returned to using headphones (at low volume) only to find the tinnitus increasing and staying that way. With respect, I won't go into this further as you already know my views on headphones.
Michael

 

I would say that habituation is not a steady state, but varies from day to day and even hour to hour.

I've had loud hissing bilateral tinnitus for nearly 3 years (24/7, 365) and intermittent bilateral PT and have habituated for about 2 years. Though most of the time I handle it and my life has returned to pre-tinnitus form, tinnitus still becomes intrusive at times. The difference is that I no longer feel anxious/depressed/hopeless about it....more mildly irritated.

tdn, it sounds to me as though you have become depressed.......maybe not related to the tinnitus, but making it seem more unmanageable again. Has anything else affected your mood? (but remember a lot of depression has no obvious external precipitant) Yes, benzos will help your sleep short term, but are addictive and ineffective long-term.

If you have a sympathetic health care professional, seek advice as soon as you can would be my suggestion.

Good Luck.

 

Unfortunately for me, the only time I get complete uninterrupted sleep for a solid 8 hours is through the use of my headphones and white noise apps. I use them as my one method of relief if I am desperate for good sleep. May I ask what is the difference between wearable white noise generators and a pair of headphones on the lower quartile of volume? Would they not pose the same risks in terms of hearing damage? Or am I missing something?

 

Please read my post in my "started threads" titled: Headphones and tinnitus. The link is here: https://www.tinnitustalk.com/threads/headphones-and-tinnitus.12062/ It covers the difference between white noise generators and headphones.
If you find using headphones gives you relief then carry on using them. However, my personal opinion, I don't think what you are doing is a good idea, as you are "masking" the tinnitus and this will not allow you to habituated to the tinnitus but it's your choice.

All the best
Michael

 

Trust me my friend, it does not mask it. However, the prominence of the sound allows my brain to maintain focus on the white noise, whereas with my sound machine, i'll hear any form of outside noise such as a dog bark or a floor creak and my attention breaks and I'm left having to refocus on the white noise again. The machine also makes a weird noise and I begin to hear the pattern of the recording and I can pick out when the track loops, this doesn't happen with apps for some reason, probably something to do with the quality of MP3.

 

@Believin' Steven
We are all different and whatever works for you that's fine. I gave you the wrong link to my post. Please find the correct one below.

Headphones and Tinnitus.

The views on whether a person with tinnitus should listen to music through headphones are controversial. Some people show no adverse affects while others do even when the volume level is kept low.
We are all different so the only way a one can know is to experiment for themselves if they want to. In my opinion, when the tinnitus was caused by exposure to loud noise/music and it has become intrusive - by this I mean a person having to seek help at ENT, then they shouldn’t listen to music through headphones no matter how low the volume is set.

Most music has syncopation throughout its frequency range, so it’s constantly changing in pitch, rhythm and timbre. The beat of the music and volume can also change while listening. This evokes pleasure and can stir our emotions. This happens whether we listen to music loud or soft, although certain types of music does sound better played at a higher volume than others, and vice versa.

Once the Cochlear in the inner ear becomes damaged by noise exposure, it is much more sensitive to sound. This is one of the reasons hyperacusis (sensitivity to sound) is often experienced with noise-induced tinnitus. The wearing of WNGs (white noise generators) as part of TRT treatment can often cure the condition. I have covered Hyperacusis and Habituation in a post further down in the forum.

The organ of the Corti, which is attached to the Cochlear, has approximately 20,000 hair
cells. These hair cells move to the vibration of sound and are just one of the components in the auditory system that enable us to hear. Someone that already has a sensitive auditory system due to noise-induced tinnitus and listens to music through headphones at a low volume, risks irritating the Cochlear further; this can make the tinnitus louder and more intrusive.

In my opinion, it can be misleading when some health professionals tell tinnitus patients, listening to music through headphones is fine as long as long as the volume is kept low. These health professionals mean well and know a lot about the anatomy of the ear and therefore, it is not my intention to try and undermine their abilities or expertise. However, It must be said, that many of them have never experienced intrusive tinnitus. This leads me to say, one of my ENT consultant’s who is an Audiovestubular consultant said that I know more about tinnitus than her because she had never experienced it.

I have spoken to people and corresponded with them by email and at Internet forums, complaining their tinnitus has become worse after listening to music through headphones even though the volume was kept low. My advice to anyone that has tinnitus that was caused by exposure to loud noise is not to listen to music through headphones, as the auditory system is more sensitive.

White noise generators.
Some may question the use white noise generators and in-ear types that emit white noise directly into the ear. White noise generators don’t usually irritate the auditory system due to the volume being kept low and its frequency range remains constant, so there is no syncopation within it unlike music.

Although white noise generators can be bought privately to treat tinnitus I don’t advise anyone to do so, unless a Hearing Therapist/Audiologist has first tested their auditory system for suitability. A person must also be shown how to use these devices correctly, as improper use can make the tinnitus worse. Furthermore, they are normally used in conjunction with Tinnitus Retraining Therapy to get maximum benefit.

Michael

PS. I also don't advise listening to white noise, pink noise, brown, noise etc through headphones even at low volume. It is best to always be under the care of an ENT clinic /Hearing Therapist.

 

This is something that really puzzles me...

When I look at pictures of "in-ear white noise generators" as used in TRT they simply look like hearing aids with earbuds ?

As such, I assume they simply produce some preloaded White Noise type sample sounds that are channelled straight to your hearing system?
Whilst I am sure they only play at lowish volume (set below your T)....so can standard earbuds.
As such, why would I need pay say a thousand pounds for these 'medical devices' and not say a hundred pounds for some quality earbuds - who's volume I can also control to next to nothing and through wich I can play a world full of quality sound samples ?

I would be interested to know the difference if anyone knows ? I have read your excellent advice @Michael Leigh but cant work out what makes these devices so different ?

For some reason I find most White Noise samples I have tried incredibly aggravating and seem to find more relief in softer Pink or Brown Noise. Could I choose from a host of samples with in ear generators or is it just a few...which may not suit !

Out of pure interest and research...I tried some Bose Quiet Comfort noise-canceling over ear headphones at the weekend and I put them on with no music but the noise cancelling active. These completely eliminated the horrible pulsating hissing I hear most days. Whats that all about ? Maybe thats the answer for me for whatever reason. A life of headphones playing no music...

Wishing you all some peace today.
X

 

Hi @Kelvin,

Thank you for your kind comments. Thank you also for writing such an interesting post, which I will try to answer. Please remember this is just my personal opinion based on my experience wearing white noise generators.

I have worn these devices for around 20 years in various forms and used them continuously for ten hours a day for two years as part of TRT. They completely cured my severe hyperacusis and helped reduce my tinnitus to a very low level. In 2008 my tinnitus increased to very severe levels but thankfully the hyperacusis didn’t return and remains that way.

Please don’t let the diminutive size of the white noise generators fool you. They are highly sophisticated devices and will deliver smooth broadband sound to your auditory system and brain that no earbuds, headphones can match. Modern types like the ones I’m wearing at the moment can be programmed by an Audiologist for 2 or 3 different sounds to be selected by the user. I can choose: white noise, pink noise or shaped noise. They are dual-purpose units with hearing aids. I don’t have hearing loss, so that part was disabled on the computer by my Audiologist when I was fitted.

WNGs are free the NHS if you are referred to a hospital that stocks them. They can be bought privately and don’t have to cost a thousand pounds. However, they must be used correctly. If used incorrectly they can make tinnitus worse. I will give a website link at the bottom of this post. I recommend a person use them under the guidance of a Hearing Therapist or Audiologist.

White noise generators are also convenient and can be discrete if one chooses to use the in-ear types. These fit directly in the ear canal and don’t resemble a hearing aid that fit around the back of the ear. The MM10s are the smallest in-ear white noise generators and cost £250 each. Two WNGs should be worn to keep the auditory system in balance. I use my WNGs whenever the need arises but there are times I wear them as I’m so used to using sound enrichment.

Michael

http://www.puretoneretail.net/tinnitus.html

 

Again...many thanks.
So the difference then lies in the quality of the sound produced by the device and probably more importantly the support of a professional Audiologist. This makes sense.
After a year of T and H I find for me its Hyperacusis that is so annoying, disabling and downright baffling.
Wearing the Bose noise cancelling over ear headphones with the electronic cancelling active and no music playing was startling...nothing !! Pure Bose silence and the Hissing all but gone...no reaction of the hiss to speech around me. Just peace.
I could have stayed for hours but the staff in John Lewis soon pounced for a sale. Still maybe...!
Not sure what electronics is used to cancel the sound but it may be my relief...
I have now realised there is no cure and probably no answer as to why? but just need some relief or a 'crutch' to grab when its bad.
Will speak to GP about NHS.

Thanks again @Michael Leigh.
Sorry to read elsewhere you had an aggravation of your T recently and hope its now calming down for you

 

Hi Kelvin,
When a person finds tinnitus, hyperacusis or both are giving them problems counselling with a Hearing Therapist or Audiologist, trained in tinnitus management is advised as I've mentioned many times in my posts. A person can only do so much themselves. Try and get a referral to Hearing Therapist or Audiologist for tinnitus counselling and management.

Thanks for showing concerns about my tinnitus. It has calmed down a lot my clonazepam helped.
All the best
Michael

 

Michael, Do you find yourself in a down mood after stopping Clonazepam? I have used it but shy away because I experience a terrible crash when I stop, even after a few days of .5mg.

 

Hi @Ambassador

I only take clonazepam occasionally now and usually for just 1 or 2 days. The dosage 2x 0.5 tablets. I haven't noticed any down moods. It does make me quite drowsy though even after taking if for just one day. However, I'm thankful that I have it as my tinnitus was very loud and intrusive. Sorry to hear that it makes you feel down...

 

Strictly speaking, using headphones at a reasonable volume will not cause (or exacerbate) hearing damage. However, with individuals who have Tinnitus and a Hyperacousis complication, using headphones at any volume can impact habituation. If you've overcome your hyperacousis, there is relatively little risk to using headphones at a reasonable level. If you are suffering from H, then using headphones will drive up Tinnitus volumes.

As a hard and fast rule, most people overcome their H within 6-8 weeks of acquiring it; if it's delayed for any reason, you may want to look at an underlying physiological cause.

 

@Kaelon
I disagree with a lot of what you've said regarding headphone use, tinnitus and the habituation process but respect that you are entitled to your opinion as we all are.
Michael