Have I Experienced What Habituation SOUNDS Like?

I have currently had (very intrusive, loud) tinnitus for about 2 months. The "volume" has not decreased whatsoever during this time (except for temporarily in the mornings, when it is a bit less loud/intrusive). The hyperacusis that I got a week after onset has reduced greatly though and some days it is completely gone.

I no longer hold any hope for the tinnitus to go away like I did in the beginning, now I just want it to stop taking all of my focus and attention. I can always hear it - over the TV, all sorts of fans, traffic and any masking I attempt. Even in the shower, but only very faintly. The one thing that completely blocks it is when I brush my teeth with an electric toothbrush.

However, sometimes when I cover my ears for a while and then let go, or when I step out of the shower or right after I stop brushing my teeth, it can take a few (1-3) seconds before my brain "finds" the tinnitus again and during those seconds I feel this amazing clarity just like before getting tinnitus. It FEELS like silence even though it doesn't fully sound like silence.

I am wondering - is this what my habituation would sound like? Can I expect it to one day be like that all the time? Or at least in environments with some background noise? It only works when there is some other noise my brain can pick up before hearing the tinnitus again. Or is this some other phenomenon that will never last longer than those few seconds?

I really need something to look forward to in order to keep putting up with this hell and I am hoping these tiny "breaks" are a good sign?

 

Hi @Panna.

You are new to tinnitus at just 2 months. The way it is affecting your mental and emotional wellbeing at the moment is the same for most people in the early stages of this condition. I suspect your tinnitus is noise induced since you are experiencing hyperacusis or having some oversensitivity to sound. You will start to feel better with time but there are a few things I advise you to do which are explained in the links below: New to Tinnitus, What to Do? Tinnitus, a Personal View.

When you have finished reading them, go to my started threads and read the following posts mentioned below. It is better to print the articles and take your time to read them without skimming. This way you will absorb and retrain the information better. They explain the habituation process and the importance of having a positive mindset which takes time to acquire. If you have been using any type of headphones, including earbuds, AirPods or headsets, my advice is not to use them even at low volume.

• How to Habituate to Tinnitus
• The Habituation Process
• Tinnitus and the Negative Mindset
• Acquiring a Positive Mindset
• Will My Tinnitus Get Worse?
• Hyperacusis, As I See It
• From Darkness Into Light
• Is Positivity Important?
• Can I Habituate to Variable Tinnitus?

All the best,
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

Hi @Panna - I believe the term for the phenomenon you're describing here is residual inhibition. I don't know the underlying mechanics, but it's like your brain suppresses the tinnitus in the presence of a masking sound.

I'm not sure whether residual inhibition is what is at play when you habituate to tinnitus. With habituation, your brain decides that a sound isn't worth focusing your attention on, but if you look for it, you'll find it. We already readily habituate to many sounds around us, like the humming of the refrigerator, the ticking of a clock, the coughing and shuffling of the audience while you're focused on a movie in a theater.

Yes, habituation is a state that people with stable tinnitus often arrive at. It can take some time and differs by individual. If your tinnitus persists for a long time, habituation usually comes hand in hand with with your adjusting to the new normal--living your life with tinnitus. At some point if you focus on staying positive, learn to accept it, and start focusing on things in your life other than the tinnitus, you may find that any severe negative reaction you have to it subsides. Your mind stops regarding it so much, and you go with longer and longer periods of time when you "forget" it's there, especially when you're focused on things like work, hobbies, social interactions. The trick is to get yourself to move past focusing on the tinnitus as this all-consuming intrusion and to focus on other things in your life.

 

I would like to add that according to Dr. Hubbard even people with fluctuating tinnitus can habituate as there is always a certain pattern or the same repeated sound, but it's obviously harder and more time time consuming and the degree to the habituation may also be somewhat less, but even if 100 % is not achieved it is still a success in most cases.

The key to habituation is simply not caring how loud your tinnitus is on any given day, i am going through a very rough patch recently with my tinnitus but I notice there are times, even when my tinnitus is loud I do not care and it does not give me distress. I was there for 100 % but recently a couple of setbacks are making it very hard again to deal with it, hope it settles back down again but only time will tell.

 

I agree with you but only up to a point. Unfortunately, habituation does have its limitations which I have explained in my thread, The Habituation Process. If tinnitus becomes loud enough, then no amount of positivity or not caring how loud it becomes, will enable a person to dismiss it so they are no longer in distress. Under these circumstances medication will usually be required and in some instances admittance to hospital will be necessary. This is the dark and very sinister side to tinnitus and habituation.

My tinnitus changed to variable in 2008 after a second noise trauma. I took 4 years to habituate. It can vary between complete silence, mild, moderate, severe and very severe. When it reaches severe levels, Clonazepam is sometimes needed to calm the tinnitus down over two days, then the medication is stopped. I have learnt to live with this and consider myself completely habituated.

Some time ago, my doctor advised me to start taking a statin medication to help lower my cholesterol. He said my levels were slightly raised, but not alarmingly high. Over a period of time, I tried three different statin medications but all of them increased my tinnitus to excruciating levels that it was impossible for me to habituate. Fortunately, Clonazepam helped reduce the severity of the tinnitus, but this wasn't practical as I would have to constantly take it which could lead to addiction and unpleasant side effects. I have managed to reduce my cholesterol with weight loss and change of diet.

I do believe habituation is possible, but it does have limitations.

Michael

The Habituation Process | Tinnitus Talk Support Forum

 

May I ask what the noise exposure was?

And do you think that one hour in a pretty noisy subtropical swimming pool with my four-year-old son can permanently worsen tinnitus because mine is spiking pretty badly for a week now after doing just that?

 

Yes, certainly. Like many people I developed tinnitus in 1996, from listening to music through headphones at too high a volume. I had fully habituated after 2 years having TRT with an audiologist and wearing white noise generators. The tinnitus reduced to a level that I rarely heard it. The hyperacusis was completely cured and remained this way.

Late one evening in 2008, I was listening to a symphony by Joseph Haydn through my HI-Fi. I was enjoying the music so much I turned up the volume without thinking, as I've previously done without any problems. However, the next morning my tinnitus suddenly appeared and all the bad memories with it. Over the following days and weeks, it got worse, so I returned to ENT. Please read my thread: My Experience with Tinnitus.

No two people will experience noise-induced tinnitus the same, because we are all different. Therefore, it's difficult for me to say what will or won't cause your tinnitus to permanently worsen. I note that you have had tinnitus since 2014. If you previously habituated, and this is the first time your tinnitus has spiked, then hopefully it should return to baseline in time. However, if you have previously experienced spikes or your ears were oversensitive to sound, this could be a sign your auditory system has remnants of hyperacusis albeit at a low level.

It is probably a good idea to see an ENT for tests. If everything is fine but the spike hasn't reduced, my advice is to see an audiologist that specialises in tinnitus and hyperacusis management. You might find my post in the link below helpful: Can I Habituate to Variable Tinnitus?

Hope you start to feel better soon,
Michael

Can I Habituate to Variable Tinnitus? | Tinnitus Talk Support Forum

 

Thank you. I have started reading through your posts and find them very helpful

I am assuming my tinnitus is noise induced, yes. I experienced several very loud bangs right next to my left ear which was the first ear to start ringing a couple of days later and is now still a lot louder than my right ear. However, the ENT took a quick look at my hearing test and told me it wasn't noise induced but rather stress induced. But to me that doesn't make sense as the last 8-10 months (before onset) have been the least stressful of my life. I have an appointment for a second opinion though.

 

Interesting. I haven't heard anything about residual inhibition before. Though before tinnitus I had serious trouble tolerating any of the sounds you mention, so habituation will probably take quite some time :')

What a massive relief! I had an image of habituation as constantly hearing the noise but not focusing on it (which also happens to me at times) and that just really didn't feel worth working for (or even sticking around for honestly). But the alternative of actually tuning out the noise makes this whole thing a lot less intimidating! It also felt really shitty of my brain to not offer the filter option when it clearly has the ability.

 

I've been at this (tinnitus) for a bit of time, so I'll say this:

Habituation is the process of reacting, responding to the stimuli less and less.

I don't believe in being 100% habituated. Habituation is a mental process that can possibly lead to a physical process.

It works different for every person. We are not all the same, our body/mind
chemistry are different. Our levels of intensity, and other factors are different.

Overall, habituation is all about timing and patience. It's about working on your goal (to try to manage or possibly better your situation).

Tinnitus affects all of us differently, our goals are different. It's best to best try to manage our situation (the best way we can).

Throughout my journey with tinnitus (35 years), I never aimed for habituation. I always planned on trying to accommodate for what I deal with (back then VERY mild (99% of time never heard it), now beyond aggressive).

All of this takes time, it's all about working on it on a daily basis and seeing how you can possibly help your situation.

 

I suspect your ENT doctor looked at your hearing test and noticed you have no hearing loss and assumed your tinnitus can't possibly be noise induced, which is the wrong assumption to make. Most but not all ENTs know very little about tinnitus because this is not their area of expertise.

ENT doctors are physicians and treat underlying medical conditions within the auditory system that cause tinnitus and there are many, but they don't treat tinnitus itself. Stress can cause tinnitus but since you have hyperacusis or experience some oversensitivity to sound, coupled with the fact you mentioned being exposed to very loud bangs close to your ear, this is enough to cause noise induced tinnitus.

If you have been regularly listening to audio through headphones, earbuds, headsets, AirPods, or attended venues where loud music was played, then the possibility of your tinnitus being noise induced increases. This type of tinnitus usually improves with time. My posts explains this in more detail.

I wish you well,
Michael

 

Ha, yeah @Panna, that'd be a rather convenient option I'd have to say. When my tinnitus is loud, I hear it but throughout the day, there are long stretches of time (by that I mean, like 30 minutes to an hour--I'm still early on in the habituation game) where I forget it's there. It's pretty much the same as being in a cafe with a lot of hustle and bustle and still being able to read a book as your mind defocuses all the noise around you. I often catch myself saying, "Oh yeah, I'm having a loud tinnitus day today, there I was going about doing something and forgetting it was there."