How to Habituate to SSHL and New Loud Tinnitus

Some of you may have already read about my new episode of sudden sensorineural hearing loss or SSHL from my prior posts. I'd like to write a success story on this new experience and how to live and habituate to this new challenges.

A year ago, I woke up finding I have suddenly lost my hearing on my left ear overnight without warning. Violent vertigo also struck me and I basically had to crawl my way on the ambulance to the ER. After all the tests, they ruled out a stroke and then sent me home with some Prednisone to take orally. Soon I saw an ENT and was given a full course of oral Prednisone. He ruled out Meniere's and booked me to get 20 sessions of hyperbaric oxygen treatment or HBOT. After about a week of HBOT, he gave me 3 weekly injection of more steroids. Unfortunately after all these standard treatments, the hearing on my my left ear hasn't been improved pr restored. Such is a new curve ball in life for me after a decade of the original high pitched tinnitus which I have habituated after much sufferings. I wrote my success story "From Darkness to Light..." for it.

However, now is a new journey of initial struggle with this new SSHL episode and I have to learn to live with it and hopefully still can enjoy my life again like the last episode over a decade ago. It is not easy though. Besides losing all hearing on the left ear, on top of that, there are nasty symptoms such as vertigo, dizziness, ear fullness, constant pressured and plugged ears, constant brain fogs and headaches.

But worse still, once again I was hit with a new jet-engine like loud roaring and rumbling tinnitus on the left ears. Then like over a decade ago when I was hit with an ultra high pitched dentist-drill like tinnitus, severe hyperacusis soon followed the new tinnitus. This time feels even harder to bear due to the plugged and pressured sensation which amplifies normal sounds even more. So I basically now have a bass and a tenor singing duet loudly inside my head 7/24. It feels miserable but funny at the same time.

However, I learned my lessons from the first episode of tinnitus a decade ago, that besides bearing up with the sufferings of an endless loud dentist-drill like tinnitus, a big part of the sufferings was mental. As explained in the success story of the 1st tinnitus attack, I was in a mess mentally, overwhelmed by relentless anxiety and panic attacks due to being a victim of anxiety and panic disorders and PTSD for decades prior to the first attack of sudden tinnitus and hyperacusis. I had to take medications to function and survive each day, benzos, anti-depressants, sleep pills, what have you. So it was a nightmare.

This time, however, I learn to smarten up and patiently wait out while practicing the many helpful strategies that I listed on my original success story, telling myself given time and following these strategies my brain will catch up and learn to habituate to the new conditions of SSHL. I list below the steps I followed in general to smooth out the process.


1. Avoid triggering the limbic nervous system, and how to restore the normal parasympathetic nervous system. This can reduce your fear and stress reactions.

Usually the tinnitus trauma will trigger your limbic nervous system so you function in fight or flight mode. Tinnitus will then be treated as a mortal threat and the brain will zoom on it and monitor it constantly, making it hard to ignore it no matter how hard you try. Unable to shake off tinnitus and realizing it may stay for life, you tend to panic with great anxiety about the future. This then causes more anxiety and sleeplessness which then aggravate the ringing. This is a vicious cycle and we tend to feel helpless and hopeless, and the brain will be flooded with dark thoughts. We tend to have a cognitive distortion of the future in this stage, called catastrophic thinking about the future which causes the anxiety and the feeling of despair to rise more.

So in short, when the limbic nerves are dominant with the Amygdala of the brain actively controlling your fearful, traumatic reactions to the tinnitus, functioning in fight or flight mode, your can face an uphill battle with tinnitus. So instead of worrying and focusing on the tinnitus, why not figure out how to avoid or recover from the limbic nerves?

In fact in my case, I did my best on avoiding triggering the limbic nervous system right at the start by using all the helpful strategies I have learned in my first episode of tinnitus, such as staying positive, accepting, adjusting, adapting, writing down all distorted thoughts and countering them with more positive or realistic ones, as taught in CBT. Consequently the brain didn't function in fight or flight mode, and the fear for the new tinnitus is much reduced. This then slowly caused habituation to happen over time. Now I can say I don't hear even the loud jet-engine like roaring tinnitus much during the day. Habituation is great!

2. Forget about the ringing for the time being. If the limbic nerves are dominant, deal with the nerves and the distorted thoughts first. Once these improve then habituation will occur surely, even if slowly at first. I was lucky this 2nd time around to avoid the fight or flight reactions. However, most first time tinnitus sufferers will have to deal with this.

To deal with the limbic nerve system and restore the normal parasympathetic nerve system you may need to learn to relax. Try deep abdominal breathing often when you feel tensed. YouTube has lots of tutorial videos on it. Also try relaxing exercises or activities, such as going outdoors, slow leisure walking or hiking, even jogging. Then progressively increase the intensity of the exercise as that will produce endorphins which can benefit greatly to reduce stress and to feel happy.

You can also try to pursue your hobbies, both old and new ones. This will distract the brain from paying attention to the tinnitus and cause your brain to focus on other happy and positive aspects of your life. I use this approach a lot by going fishing, gardening, walking, hiking, etc. I take on bird watching and driftwoods collecting as my new hobbies. They help greatly as I need to move around a lot to do this and to research on these new hobbies can occupy the mind to distract it from paying attention to the tinnitus. Try deep breathing in outdoors too while you do these activities, as the outdoors give you fresh and abundant oxygen to benefit deep breathing to soothe the nerves.

3. Use CBT techniques for distorted thoughts. For the cognitive distortion of catastrophic thinking, try read up on CBT techniques. One easy way is to write down and counter your negative thoughts or fears with more positive and realistic ones. Dr. Hubbard wrote a success story on how he uses CBT techniques such as mindfulness and exposure to deal with his fear on his ringing. Try to read up on that.

When you do the above steps and activities, the normal parasympathetic nervous system will be back in control at some point. You will likely see that your fear and stressful reaction to the tinnitus will be much reduced. This is because the pre-frontal cortex of the brain will take up processing the tinnitus stimulus under the parasympathetic nervous systems from the Amygdala under the limbic nervous system.

This change is critical and most people are not aware of it. This is because while the Amygdala had caused you to have intense fear of a perceive threat, the pre-frontal cortex has the natural function to reduce the fearful response of the brain. This in turn will help you have better control of your situation and can help you manage your response to the ringing. This will then likely calm you down especially if you continue to live your life as normal as you can. Habituation will then begin when the brain no longer consider the ringing, even a loud one, as a mortal threat. Eventually it will learn to ignore and fade out the ringing sound from consciousness, especially when you are busy with other aspects of life. This is like how you can ignore or not be aware of the loud jet noise during a plane flight when you are deep in watching a movie, even though the loud noise is all encompassing around you.

All the best. God bless your recovery.

 

I can attest CBT works at least to a point. I’m trying real hard to be a success story but hyperacusis is kicking my butt. 4 pattern and behavior changes in my tinnitus within 8 months is very hard to get used to.

Not to mention 5 independent tones reacting and going haywire or being very calm. I’m double spiked right now for no reason and I’m trying to keep it together.

I needed this success story

 

Billie, thanks for writing this post.

It's a really phenomenal breakdown of how to deal with tinnitus and also understanding the science behind it our flight-or-fight system and how it operates. If I would have been able to grasp that a year ago I could have avoided a very dark place and saved myself from a ton of very obsessive and needless catastrophic thinking.

 

I needed this.

I'm constant in fight or flight mode since i got tinnitus 3 months ago.

But, yesterday I could suddenly feel the body relax like I was given a dose of Morphine. Totally relaxed and the tinnitus disappeared. It lasted just 15 minutes, but was weird.

So there is truth in what you are saying.

 

That is a good sign, Thomas. It just opens a crack in the armor of the tyranny of tinnitus over you. It gives you hope that given time and learning to do relaxing and interesting activities, this type of relax moments will increase in both frequency and duration. The the "D Day" to beat back the tinnitus tyranny will occur at some point as you feel more and more confident in winning back your normal life in due time. It may be 6 months or a year or 2 for most people. Habituation will kick in at some point.

The hell with the ringing.

 

https://www.tinnitustalk.com/threads/sshl-and-tinnitus-update-—-i-have-habituated.26098/

Here is another success story with someone struggling mightily initially with SSHL and tinnitus. Some of the comments are very helpful too for new sufferers to understand the need for some time for the body to function more normally. They didn't mention the switch of the nerves system from limbic Amygdala mode to the parasympathetic pre-frontal cortex mode but that is what happens inside the brain. Once the switch is made, you will have a much better chance to habituate.

So instead of worrying what tinnitus will do each day, perhaps focusing on what you can do to kick limbic mode out and restore the parasympathetic nerves back. Trying to stay positive, do positive self talk or counter the distorted thoughts, get busy with things like relaxing exercises or fun hobbies. Try your best to accept the new normal. Acceptance doesn't mean liking the tinnitus, but that you accept the reality of living with the tinnitus, at least before habituation kicks in. Tell yourself if you are going to be OK in 6 months or a year or two, why worry about what tinnitus will do now. Take the setbacks as little bump on the road to final habituation.

Practice deep abdominal breathing often, perhaps meditation or yoga too. Finally, give it time for the body to turn around and be patient with the process. Don't anxiously monitor tinnitus or count the days why habituation hasn't kicked in yet. Every body is different on how long it will start the switch. Just flow with the process and don't offer emotional resistance to any setbacks. Accept it as a necessary step in the process of final habituation. Before you know, it will happen and will get better with time as you get more confidence. This is really the secret of gradually turning the tide on tinnitus.

Of course if your tinnitus is due to a medical or health reason, your recovery may be achieved by just rooting out the medical issues. If you are having tinnitus due to diet issues then changing the diet or taking the necessary supplements will do miracle too. So there are many roads to Rome for tinnitus recovery. Habituation is just one of these.

 

@DebInAustralia, I think my story here may help you understand how to turn around your situation with the spikes. So consider this my reply or general advise on the subject of acceptance and habituation. Try a different route to deal with the limbic nerves first. Take good care. God bless your recovery.

 

Thank you Billie.

I am a veteran of over 30 years, but I still needed to read your story - especially today.

Love and best wishes,
Dave xx
Jazzer

 

@billie48, thank you for sharing your story. It’s good to see you have found the strategy that works for you. As with your previous story, it’s inspiring.

 

Thanks for the kind words @Johan001.

What I have learned from the previous episode of tinnitus has definitely helped avoid tremendous mental sufferings which then makes habituation to kick in easier and faster.

 

How does someone handle unstable tinnitus? I’ve done the ignore and live my life approach but my tinnitus says “nah ah!” and will get worse until I acknowledge it lol.

 

You can try the Back to Silence method by @I who love music. It is the most read method. It requires one to acknowledge the tinnitus, express how you feel by talking It. It works for @I who love music and many of his thread followers. It is a form of mindfulness actually. So it works.

BTW, when I say ignore it, I don't mean stay away from it by blocking it. I mean accept, adjust and adapt. Then focus on other aspects of life. If the tinnitus is there, don't worry or focus on it. Acknowledge it is there, talk to it if you like, then move on with life. Usually time and the body will do the rest of the habituation.

 

Ok, yeah, I’ve been doing this for the most part. Just have to plug up and hear the blaring tinnitus, hard to ignore when it is intrusive, haha.

 

The recommendation of deep abdominal breathing was a phenomenal help! Really makes a big difference.

 

Yes, there are actually studies done on deep breathing and its effect on the body.

The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults

This article actually states that constant meditative deep breathing can shrink the Amygdala, the fight or flight center of the brain and the shrinking is permanent, which means you will become more calm and composed. That is encouraging.

This Breathing Exercise Will Help You Keep Calm and Carry On

 

Another suggestion on reducing anxiety and tensed nerves really fast right at the spot is to do one or more of the following things that I did and still do when needed.

1) Do some simple mental math or calculations. You can do something as simple as counting up from 1, or down from say 500. So count 1, 2, 3, 4 or 500, 499, 498, 497, etc. If you want it harder, count only odd or even number. For me and my history of anxiety panic disorder, I needed to make the math harder, by actually adding or subtracting with a difficult number, say 17. So I will start with 1 + 17 = 18, 18+17=35, 35 + 17 = 52, etc. If I want even harder, I would do subtraction, so 500 - 17 = 483, 483 - 17 = 466, etc. The harder the mental math, the bigger the distraction for the brain to stay away from continuing the anxious or panic thoughts. That works for me. You may find it not suitable. Then consider the following options.

2) Try mentally singing your favorite songs or if you can, sing along loudly in karaoke style by focusing on the displayed lyric. This should be a pleasant way to distract your freaky mind instantly from continuing to worry about things. Try new songs to add more interest and more distraction. Singing can also relax you and calm the nerves. So why not try it to see if it works.

3) Call good friends and chat if you have some good friends or loved ones. Since not everyone is available instantly when you want to talk, and that you yourself may not be free to call, option 1 and 2 are easier to do right away. If you can do some exercises, say walking or hiking, you can also singing loud or mentally as you walk. The benefits will be doubled since you can distract and relax your anxious mind while your body muscles are working. Great combo for helping to stay away from the limbic nerves. If you do deep breathing also your limbic nerves will not be easy to dominate your life.

 

I bought some Lego sets to keep me calm. My mind is focusing on building and I enjoy it very much.

And calming music in the background had helped me.

 

@billie48, this post really is a gem. Today a firecracker blew up 5 meters away from me and might have caused hearing loss. Will know for sure tomorrow but right now I am really depressed and this made me a little happy when I read it.

 

Thank you Thomas. Everyone should find what works best for them. My suggestions are what have worked for me at the instance when I felt anxious and panicky and they can be done instantly and silently when done mentally. My experience is that with instant interruption to the anxious mind, it is less likely that the Amygdala is activated and the limbic nerves get triggered. So I stop it dead cold before it can become a mental storm.

 

May I ask do you have hyperacusis or erratic tinnitus?

 

Yes I have had hyperacusis twice. The first time was a decade ago when the ultra high pitched tinnitus hit me suddenly at night. It went away in about a year. Now the hyperacusis developed after the SSHL episode about a year ago. Now it also fades away after a year.

If by erratic tinnitus you mean it is not constant and can fluctuate, yes, both of my 2 tinnitus tones can fluctuate. The jet-engine like roaring loud tinnitus is there mostly 7/24 but it does have low and louder moments, especially very loud after waking up or when I get not enough sleep, typical of a new tinnitus. The original high pitched dentist-drill like tinnitus is more erratic. It can drift in and out of consciousness much more and so it feels like quite erratic. Perhaps being with me over a decade the original tinnitus is much more accepted by the brain and so it can ignore or fade out the original tinnitus much easier or faster. Hope I answer your questions.

 

Hi @billie48, since a permanent spike just over 3 years ago I have a very intrusive tinnitus in my right ear. There was a period earlier last year when I would have 2 days really bad then 2 days manageable and so on - now I'm not even getting the 2 good days.

Anyway for the period I suffered with this - 3 years. Do you think it is now ingrained in the amygdala?

Do you think I will still be able to habituate after all this time?

I am currently meditating 15 minutes each day for the last 3 months.

 

Since I am not a doctor nor expert on tinnitus, I am really not in a position to say for certain how each person's tinnitus journey can be. I can only relate my experiences and what I have learned. From the stories of some gurus on tinnitus, such as Kelvin Hogen, Paul Tobey etc., they had severely intrusive tinnitus for ears and yet at certain point, they turn around and get on with normal life. In the most read success story "Back to Silence" by I who love music, he stated he suffered from intrusive tinnitus for a long time. By using a simple technique, he manages to turn around his condition. So there are enough evidences that can be assuring to those who have tinnitus for a long time that there is hope that they can still get better one way or another. It seems that when one gives up struggling with tinnitus, accepting whatever and moving on with living, something miraculous can happen towards habituation. My humble 2 cents.

Success stories:

Doing nothing for tinnitus works for this guy who has long sought after every treatment:

Doing Nothing Worked for Me

This guy was suicidal at first and even his fiancee abandoned him, but he has found joy in life again traveling the world:

Who Said Our Life Is All About Tinnitus? I Share With You Some Pictures I Took After

This lady mining truck driver turns around her suffering when she realized most of her colleagues had tinnitus but not suffering like her:

6 Months & Tinnitus Still Going Strong, But So Am I

So in short, there are many ways to habituate to intrusive tinnitus. Don't give up hope.

 

Hi @billie48,

I was just wondering if you have experienced a feeling of fullness/pressure in your ears? I have been suffering with this for over 6 months - very little improvement.

I have come along way with emotional reaction to both my ‘regular’, and pulsatile tinnitus; however, the pressure inside my right ear is just awful.

I have seen it said on this forum that fullness indicates some hearing has been lost, so I’m interested whether you experienced this symptom after SSHL.

 

Yes, I have that sensations on both ears a lot of times. Please re-read my first post, paragraph 3 and 4 do mention about this issue. It wasn't easy to deal with but I don't emotionally oppose it. Now I am getting more used to it after a year living with it. I have heard from SSHL and cochlear implant support groups that such plugged sensations can slowly ease off over time for some people naturally. Others who have done the implant to restore hearing also report easing of the pressured, plugged sensation.

 

Very well written, and no doubt a good approach to put hearing problems in focus.

But how do you deal with the hearing loss in your daily activities? How did you adapt?

 

Thank you for redirecting me to the appropriate paragraph, reading and retaining information is not my strong suit! The pressure on my right ear is pretty much constant, the left comes and goes. It is definitely correlates to the intensity of my pulsatile tinnitus, when it’s bad, I feel the heartbeat in my ear, it’s not the nicest of sensations.

Anyway, since this is the success story section, I won’t dwell on the negative. I am seeing improvements generally.

Hope things improves for you going forward.

 

Yes this helps as it gives me the whole “if they can do it, so can I” attitude lol. Dumb I know.

 

Well I spent a few days grieving the loss of hearing on my left ear at first. But prior experience taught me besides seeking treatments generally recommended, there is nothing I can do about things beyond my control and it is counterproductive to get emotional to give more fuel to the new challenge of living with 1 ear only. I have to turn my head to let the good right ear hear a conversation and I tell people I have trouble with hearing so they may need to repeat or speak louder. But other nasty symptoms are just as hard to deal with, like new loud jet-engine like roaring tinnitus, hyperacusis, plugged and pressured sensations, having problems with wobbling when I walk, and losing the ability to pin point where a sound is coming from, etc., etc.

But despite all that I told myself to be patient, sticking to apply those helpful strategies I learned in the 1st episode of tinnitus a decade ago which I share in my success story. I just live my life with the new motto of "Finding Joy Amidst the Pain and Living Life Abundantly to bury tinnitus and now SSHL". Well it works for me. I go fishing, grow my garden, dance and exercise with extended family virtually during lock down, even planning to go on a cruise to the Caribbean (which we finally canceled due to rising cases of Omicron). So I am not letting the ears and tinnitus define me and my life. So perhaps this approach has helped me weather the storm of SSHL better. It wasn't easy at first but it gets better as time goes by.

But I do try to get my hearing improved if it can be done medically, such as having cochlear implant for the deaf ear. I joined a SSHL support group and learned that it is an option I can consider after exhausting all other treatments and proving after one year of waiting out, that the left ear is not coming back with any hearing at all.

 

That's the right attitude! Living life to the fullest even if there are hearing issues. That's my approach to hearing problems too. I try to live as normally as possible, and enjoy the things and activities I can do.