How to Habituate to Tinnitus

How to Habituate to Tinnitus.

Whenever I see habituation discussed in tinnitus forums, it seems to cause a lot of frustration and controversy. Perhaps it's because each person is able to have a different opinion on what it actually is? Some believe it's only obtainable for a select few but I don't subscribe to that thought and neither do I think it's an enigma. My interpretation of it may be different from yours and that's fine for we are all entitled to an opinion.

Whilst I don't consider myself an authority on habituation, I have lived with tinnitus for quite a while, corresponded and counselled people with the condition and believe, I've acquired a level of understanding about tinnitus based on this experience. I feel quite comfortable expressing my views and opinions on it and the way it can affect our mental and emotional well-being. I believe I have a good grasp on what it means to habituate to tinnitus and how best to achieve it.

I have habituated twice to tinnitus. The first was 25 years ago. I had TRT for two years. I wore white noise generators and had regular counselling with a hearing therapist. Treatment lasted two years. At its completion the tinnitus reduced to such a low level that most of the time I was unaware of it. Hyperacusis often accompanies noise trauma and I had it very severe. It was completely cured using the white noise generators and has remained this way.

In 2008, I had a second noise trauma and had TRT again for two years. It took a total of four years to habituate but the tinnitus changed considerably from what it was. I now experienced large fluctuations in intensity, from complete silence, mild, moderate, severe and extremely severe. It was an incredibly difficult period of my life. My ENT consultant and hearing therapist said they don't see many patients that experience such large fluctuations in tinnitus to the point where no two days were the same. Thankfully, over the years it has improved but I have to stress that it has been slow. I am able to live comfortably with my tinnitus. There are times it can be severe and I may need to take Clonazepam for a day or two just to calm things down. Other times it will reduce to a manageable level by itself. I have habituated and accept my tinnitus and feel I'm in a very good place from what it used to be.

Whether you are new to tinnitus, seasoned to it or a veteran experiencing a resurgence after a long habituation period, you are all going through a similar thing and that is having difficulty coping with it. You are probably thinking will my life ever return to some normality? Many times I had those same thoughts particularly in 2010, when my tinnitus began putting restrictions on the things I wanted to do. Life at times wasn't a pleasant experience but somehow I managed to hold it together and wouldn't give up. Please read my thread: My Experience with Tinnitus.

Your life can improve but first you need to believe it, for this to become a reality. I am not saying this is an easy task, because the path to habituation is a process that has many twists and turns along its way and therefore, it's something that cannot be rushed. To start the process one has to make conscious effort to engage in things they like to do or find a new interest that will ignite that spark.

Little by little the seeds of doubt will be replaced with positivity, vitally and verve. Once a person learns to accept the tinnitus with all its idiosyncrasies, life will become easier and less problematic. No longer will you feel anxious or afraid even when you might notice a sudden change in the tinnitus, which is often temporary until it settles down again. Particularly noticeable with people that have suffered a noise trauma and their auditory system is oversensitive to sound or they are experiencing hyperacusis.

Accentuate the positive things in your life and focus on them, as I truly believe this is the way forward to getting your life back on track. Remember, it doesn't happen overnight and since we all have busy lives, you may need to seek help managing stress because tinnitus is closely associated with it. Stress makes tinnitus worse and tinnitus makes stress worse. It can become a vicious cycle. Talk to your doctor who may advise taking a light medication, to help keep your mental and emotional well-being on an even keel. Counselling with an Audiologist, that specialises in tinnitus and hyperacusis management can be helpful too along with sound therapy.

Please don't sit there and do nothing and attempt to tough it out because tinnitus is quite capable of surprising you how resilient it can be, by sapping your mental strength and resolve. Believe me for I have been there. Habituating to tinnitus is a process and I describe this process as the reconditioning of the mind in order to achieve it. The reason being tinnitus is mostly mental, but I don't mean the intensity of it can be controlled by mere thought.

When negative thinking is removed and demystified, the tinnitus no longer takes centre stage and therefore, its perception is pushed further back into the mind. Treatments such as TRT and CBT are based on this. Counselling with an Audiologist or Hearing Therapist specialising in tinnitus and hyperacusis management can help the rearrangement of one's thoughts about tinnitus by incorporating positivity in your life.

Some of my articles on tinnitus, available on my started threads are a form of counselling. Anyone wanting to get the full benefit from them, I advise to print and refer to them often. This way the information will be better absorbed and retained rather than reading on a phone or computer screen and then forgotten.

I wish you well,
Michael

 

Hello Michael Leigh.

I really enjoyed your piece on habituation.

As I mentioned I am getting maskers in a couple of weeks. My tinnitus started 3 months ago... Do you think that’s too early to start with the maskers or should I wait till 6 months?

Thank you.
Eleanor x

 

I am curious as to what you mean when you say 'demystifying' negative thinking. Could you elaborate on that, please?

Thanks in advance.

 

Hi @Eleanor89.

Thank you for your kind comments. I didn't realize the post was so long until a friend said wow.

I think it's okay for you start with the maskers (white noise generators) as you are well seasoned to tinnitus but it has increased recently. Since you are sensitive to sound, I am wondering if you were a user of headphones or exposed to loud sounds. Oversensitivity to sound is usually but not always an indication the tinnitus is noise induced.

Best of luck with your treatment.

Michael

 

Michael Leigh,

No, I’ve never used earphones, headphones etc.

I’ve always been aware of noise x

No cinemas etc.

I always wore earplugs to loud situations.

Although a dog barked near my ear and it hurt slightly... But I’ve always had dogs etc.

I was so anxious before and after my operation. I was awful and so scared. I was a year in pain before it due to COVID-19. I had to use hot water bottles on my tummy daily to help with the pain. As well as medication.

They didn’t realise how bad it was until the procedure, which lasted 4 hours. x

My tinnitus started 26 years ago due to an abusive relationship and stress. It was a horrendous chapter in my life.

But I’ve slowly rebuilt my life over the years.

Always been careful with parties etc, and wore earplugs.

Thank you for all your help.

My name is Jacqueline. I chose Eleanor 89 as that’s the year and name of my daughter.

Thank you,
Jacqueline

 

Hi @Óscar PP.

Negative thinking about tinnitus can be detrimental to the habituation process and can make tinnitus worse, if one isn't careful. Negativity can start as early as talking to a doctor that does not have much knowledge about tinnitus, or looking up information about it online. It is awash with information. Some of it is good but a lot of it is bad. Negativity towards tinnitus is also found in forums and other social media platforms.

I want to make a few things clear, I am not talking about people that express how downtrodden or depressed tinnitus makes them feel. There are some that try to convince others that no tinnitus treatment is helpful. For this reason I advise anyone starting a treatment for tinnitus, not to discuss it on social media sites.

The onset of tinnitus or the resurgence of the condition can make a person feel isolated and depressed. If this is not managed, a person's mental and emotional well-being can seriously be affected. One to one counselling with a tinnitus therapist, can help remove and demystify the negative thinking that is often attached to tinnitus. Medication in the form of an antidepressant can help prevent a person feeling too down.

Once a person is reassured, that having tinnitus doesn't mean their life will be one of impending doom and gloom, they often start to improve.

Please go to my started threads and read the following posts: New to Tinnitus, What to Do? Tinnitus and the Negative Mindset. Acquiring a Positive Mindset. From Darkness into Light. Is Positivity Important? Tinnitus, A Personal View, Hyperacusis, As I See It. Tinnitus and Negative Counselling.

All the best,
Michael

 

Thanks another great post from you @Michael Leigh. Your other writings have helped me tremendously throughout my 7 months journey so far.

I don't listen to anything through headphones or ear buds and I always wear plugs and defenders while at work since I'm exposed to 105 dB throughout the day. I'm slowly habituating and feel like I'm in stage 3. It doesn't have a emotional hold on me like it did before only once in awhile it becomes really annoying but I know it will subside. I've seen a TRT specialist who studied under Jastreboff and says everything I'm doing I'm on the right track and doesn't think I need TRT at the moment. I spoke to Dr. Nagler and Dr. Hubbard as well and both are pleased on the course I'm on. I have sound enrichment throughout the day and at night I can sleep without it and my tinnitus is really low when I wake and slowly gets louder throughout the day but from what I'm told that's normal. I just ordered custom plugs as well for those loud moments when out and about. Throughout the 7 months only had a few spikes and has been a high frequency hiss now for about 3 months. I enjoy your writings and refer to them on my bad days and wanna thank you for helping those in need like myself. And other thing I should be doing please let me know.

 

Hi @Kevin Hallowell.

Thank you for your kind comments they are much appreciated.

You are making good progress so please take your time, as the habituation process is not something that should be rushed. I know you want to get your life back on track but please be aware, one's mental and emotional response to tinnitus takes time to adjust. Habituating too quickly or the thought that you have, can result in throwing caution to the wind, thinking all is now well. The danger here is one tends to forget what they endured to get to the place they're at because habituation happened quickly for them.

I have seen it many times particularly with people that have noise-induced tinnitus. They soon return to using headphones or listening to loud music, taking the precaution to wear earplugs, thinking they will be safe but not realizing sound can pass through the head and transfer to the inner ear by bone conduction and spike the tinnitus. The sudden realization that all is not as they thought can be quite a shock, so my advice is to take things easy.

Wearing hearing protection at work because of loud sounds is a good idea. However, you need to be careful about wearing it when out and about with the intention to suppress any eventual loud sounds. This way of thinking can instil fear and negative thinking if you are not careful, and it's possible to lower the loudness threshold of the auditory system, making it more sensitive to sound due to the overuse of hearing protection. Please read my post: Hyperacusis, As I See It.

Keep the sound enrichment low so that it's not masking the tinnitus. My advice is not to sleep in a quiet room. Have it playing throughout the night until morning keeping the volume below the level of the tinnitus.

Take care and all the best.

Michael

 

Your posts are very helpful!

You are right on the money with bone conduction. I had an MRI on Monday as my otologist wanted one, my wife agreed - she is a cardiologist, and we thought that with earplugs the sound would do no damage to me. It did make sense for healthy ears, so we went ahead. Well, the night after I realised I had a few new sounds, namely a background 'static' and a few clicking/crickets-type noises. Furthermore, my T now reacts to a much broader spectrum of sounds such as taps, fans, rain, road noise. Basically, any broadband noise makes it beep in my head with a few different tones.

I was wondering if you had any advice for something like this. If I try masking with white noise, it starts beeping. If I don't mask, I hear a cacophony of sounds.

Thank you again!

 

Thanks for the advice @Michael Leigh. I don't over use the ear protection except for when I'm exposed to the 105 dB at work I don't wear them for driving the truck to make my deliveries. And only wear them at home when cutting the grass. I know I'm not out of the woods yet and still take every precaution to protect myself. When at work, I also wear a hard hat and have to wear a faceshield which also lowers my exposure to bone conduction.

Again your articles are great for anyone who needs the help and thanks for giving that help.

 

Hi @Tau.

Thank you for your comments.

Sorry to hear that you are going through a difficult time at the moment with tinnitus and I suspect hyperacusis because of the symptoms you have mentioned. In addition to this I note that you have noise-induced tinnitus.

You probably need to see an Audiologist that specialises in tinnitus and hyperacusis management. This can involve counselling, sound therapy using white noise generators and also medication if needed. I believe this is a way forward for your tinnitus will hopefully improve.

Please read the posts above that I have mentioned to Oscar PP. Please click on the links below and read my posts on TRT.

Hope you start to feel better soon.

Michael

What Is TRT and When Should It Be Started? | Tinnitus Talk Support Forum
What Happens in TRT Sessions? | Tinnitus Talk Support Forum

 

You are on the right track @kevin and going from strength to strength.

Well done and take care.

Michael

 

@Michael Leigh, I have noise-induced tinnitus that started in 1994. I was able habituate on my own, but just recently it spiked and I'm freaking out a little bit.

I know you mention those of us that have noise-induced tinnitus should not use earphones even at low volumes. Can I assume you hold the same opinion for earbuds? I tried this at a volume well below my tinnitus, but not sure if I should continue.

Thanks.

 

Hi @JHH.

My advice to anyone that has noise-induced tinnitus is not to use any type of headphones even at the lowest volume. This includes: earbuds, AirPods, SleepPhones, noise cancelling headphones and headsets. Some people with noise-induced tinnitus are able to use these devices without any problems. However, the risk of making your tinnitus worse is always there each time you use them.

The tinnitus might slowly get worse without a person realizing it because the brain has learnt to habituate to it. As time moves on, it can reach a stage where the tinnitus suddenly spikes or increases and won't reduce to its previous baseline level. You need to know, each time you use the pieces of equipment mentioned, you are playing Russian roulette with your health.

Michael

 

@Michael Leigh, thanks for the response.

I forgot to ask. Does that include low volume white noise that can be used as a source of sound therapy?

 

@Michael Leigh, is it also normal for tinnitus to switch ears? I have noise-induced tinnitus and have habituated to it mostly like I described earlier. And it was always louder in my left ear because that was the side of the trauma. But just yesterday it now seems like my right ear is louder. I haven't done anything differently from what I have been doing.

 

Great thread Michael, really interesting to read through.

 

I am pleased that you find the thread interesting Tanni.

 

No two people experience tinnitus the same. It is not uncommon for the tinnitus to switch ears. Please remember, the sound is coming from the brain although we often perceive it through the ears. The switching of the tinnitus will seem less important to you and will probably settle down, as you continue to habituate.

Michael

 

Yes it does. Listening to white noise through any type of headphones can sound crude, harsh and unregulated. People often find it can spike the tinnitus and hyperacusis. If you want to use white noise, than listen to it through proper white noise generators and be under the care of an audiologist.

White noise generators sound smooth without a hint of harshness when used correctly.

Michael

 

Thanks for the response @Michael Leigh. I know I'm slowly habituating to the tinnitus because it gives me no emotional response really anymore like I explained earlier.

But when I have some slightest changes in it like it now being a little louder in my right ear, I just get worried that it's getting worse.

I take a lot of precautions when it comes to being around noise especially at work. Like I said, I do get exposed to 105 dB and drive a truck which is around 80 dB. And when exposed to the 105 dB, I'm double protected and stand away from the tanks I fill and wear a hard hat and faceshield which also protects from any bone conduction.

I just worry about making this worse. But I'm sure everything I'm experiencing is normal.

 

I understand your concerns @Kevin Hallowell but each person's experience with tinnitus will be unique to them. Therefore, the things you are experiencing is difficult to know whether they are normal because tinnitus is not normal. It is usually an indication that a problem has occurred within the auditory system. Many things can cause it but often exposure to loud is responsible.

You are taking the right precautions with the sound levels you are exposed to at work, whether they will be enough only time will tell, so you will have to monitor things closely but try not to worry too much, as this can cause stress and can affect the tinnitus. Consider taking something herbal like St John's Wort, to help you relax or have a word with your doctor about your concerns.

Michael

 

Is playing nature sounds in my phone near me ok? I’ve been doing it during the day and trying at night. Trying to keep it lower than my tinnitus as it goes up and down. Night time it’s usually quieter.

My brain feels like it’s buzzing to the sounds I’m listening to, and my high frequency tone kinda gets masked even at low volumes. My other tinnitus is still louder than the nature sounds.

 

That should be fine. If you are able to Bluetooth your phone to an external speaker the sound quality will be better or use a dedicated sound machine. Oasis Sound Machines are good and specifically made for people with tinnitus. Model S-650 is popular.

The way to use sound enrichment during the day, is not to sit and focus on it but have it playing softly in the background. If it is drawing attention to itself then it is too loud.

I wrote to you a short while ago and think you need to see an audiologist. Please see below.

I suspected all along that the increase in your tinnitus and the spikes you have been experiencing are the result of listening to audio through headphones, or being exposed to some type of loud sounds. A similar thing happened to me after a long habituation period, although it was caused by listening to music at too high a level through speakers one evening without realizing it. I know what you're going through and it's not pleasant. Things will improve but you may need professional help. Please read my post: My Experience With Tinnitus.

Your hearing needs to be at optimum so hearing aid/s should help. If you are able, get a referral to an Audiologist, that specialises in tinnitus and hyperacusis management I think this would be best for you. This is not the area of expertise for an ENT doctor. You need to see an Audiologist and preferably one that has tinnitus. It is my belief you will benefit from tinnitus counselling and using a combination of hearing aid/s with white noise generators - these devices have hearing aid and white noise generator within the same unit. Medication may be needed to help with stress.

If you can, please stop keeping a daily journal of how your is affecting you. Go to my started threads and print my articles: Tinnitus and the Negative Mindset, Acquiring a Positive Mindset, The Habituation Process, Tinnitus, A Personal View, Tinnitus and Negative Counselling. Take your time and read them and refer to them often. This will help to reinforce positive thinking.

Try to engage in things you like to do. My advice is to never use any type of headphones again even at low volume.

Take care and all the best.
Michael

My Experience with Tinnitus | Tinnitus Talk Support Forum

 

Hi Michael,

thanks a lot for this great post and many others which I now have read from start to finish.

Our story is very similar and I am also trying to habituate again after many years of moderate tinnitus.

I go from mild, normal, severe, intrusive to extreme on a daily basis.

Best,
Troels

 

Hi Troels,

Thank you for your kind comments. I am sorry to know that your tinnitus has such large fluctuations in intensity. I know it isn't easy and hope you are able to get some help. Try and see an Audiologist that specialises in tinnitus and hyperacusis management. If you haven't tried white noise generators yet then please give them a try. If it's possible try and get some tinnitus counselling too.

Best of luck.
Michael

 

I am going through a tough time at the moment and I'm crying while writing this. My tinnitus started almost 6 years ago.

Everything was fine until this year when I went on and off meds. The meds I was taking damaged my ears and withdrawing from them caused more damage. I'm suicidal everyday. I went to the audiologist yesterday and I was given an audiogram which does in fact show some hearing loss in the high frequency (6 kHz-8 kHz). I'm always on edge and can't relax like I used to. My days are always filled with darkness. I'm scared of living. Scared that this will be me for good. My tinnitus is so severe to a point where masking does no good. I'm only 27.

Where do I go from here?

 

Hi @Kenilworth

I am sorry to know of the difficulties that you are going through at the moment with tinnitus. When it severe as you say, it is best to talk to your family doctor who might suggest taking an antidepressant. Some people don't want to take it as they believe it will increase the tinnitus. However, it is important that your mental and emotional wellbeing is managed, to help prevent you from slipping into depression and having suicidal thoughts as you have mentioned.

Your doctor may suggest going into hospital for treatment to help with your low moods. When tinnitus is severe as yours and I have no doubt that it is, this is the route I think you should take. Please talk to your doctor and explain how the tinnitus is impacting on your life.

On your profile it says cause of tinnitus unknown? It is important to know what originally caused the tinnitus. Whether it was an underlying medical problem within your auditory system or elsewhere within your body, or was it noise induced? Noise induced tinnitus is one of the most common causes of tinnitus. Typically, it is using any type of headphones at too high a volume that eventually causes tinnitus. Sometimes hyperacusis, oversensitivity to sound accompanies it but not always. Exposure to other types of loud noise can be responsible too.

You have mentioned everything was fine until you started going on and coming off medication. If medication is the cause for the increase in tinnitus, then it's something your GP and ENT specialist need to look at.

However, if medication isn't the cause for the increase in tinnitus, and no underlying medical problem is found to responsible, then I suspect it is caused by exposure to sound which doesn't have to be necessarily loud. If you have been regularly using headphones, earbuds, Airpods, noise cancelling headphones, bone conduction headphones or a headset for computer games - any of these devices are capable of making noise induced tinnitus worse even at low volume. If you are oversensitive to sound, this often indicates noise induced tinnitus with hyperacusis.

You have mentioned having hearing loss. Hearing loss can make tinnitus worse but it depends how severe it is to warrant whether hearing aid(s) will be beneficial to you. Is is not unusual for some people with noise induced tinnitus, to have some hearing loss but the impairment may not be severe enough for them to need hearing aids. Your ENT doctor and audiologist should be able to advise you on this.

Please talk to your doctors and hope you are able to get some help soon.

I wish you well.
Michael

 

Hi @Eleanor89, I am pleased to know you are being fitted with white noise generators tomorrow. Your audiologist may advise wearing them straight off for 6 hours or more. If you decide to do this and notice any irritation or the tinnitus increases, I suggest trying my method. This is to slowly introduce the generators. Start by wearing them for 1 or 2 hours keeping the volume below the tinnitus. After 1 or 2 hours remove them for the same duration, and then put them on again. Do this throughout the day for up to 6 to 8 hours, for the first week or two.

Experiment to see what works best for you. The idea is to work towards wearing them continuously for up to 8 to 10 hours. They should not be worn when asleep at night. Instead, use a sound machine by the bedside, setting the volume below the tinnitus. Sound enrichment should play throughout the night until morning.

When you are able to wear the generators continuously for 8 to 10 hours then I suggest the following: Put them on in the morning and set the volume slightly below the tinnitus and do not adjust the volume again. Some people increase the volume when out on the street, because the external sounds traffic etc makes it harder to hear the white noise. Please do not turn up the volume. If you keep adjusting the white noise it makes is more difficult for the brain to habituate to it.

After a while the brain will habituate to the white noise generators and slowly push the tinnitus further into the background. This will not be achieved if the volume of the white noise is frequently adjusted.

Best of luck,
Michael

 

The hospital just messaged me that they are not in stock.

Extremely disappointed. I've waited for weeks.

Thank you for your advice.