Lots of People Talking in an Enclosed Space — Tinnitus Spike After Years of Habituation

Hi everyone,

I used to be a regular poster many years back, but haven't visited for a long time as I'd consider myself fully habituated.

A quick back story:
I got tinnitus around 17 years ago from loud noise exposure (nightclubs). I struggled to cope and a few years in I didn't leave the house, I stopped working, sunk into major depression, had to wear maskers 24/7 to cope, spent most of my days reading about tinnitus, and was to be honest, suicidal. Being exposed to any level of sound above a normal conversational level would induce worry lasting weeks and constant checking behaviours to see if the T had changed, my limbic system was tuned in to it constantly.

Habituation:
Around 9 years ago I sorted myself out. I'm not quite sure how it happened, but there were significant changes in my personal life that meant I had to work, I had to leave the house, and I think in some ways this put me on the path to habituation. Up until last week, I would have considered myself a 'conqueror of tinnitus'. I now have a great career, a home, a relationship, I go on holidays, take long car journeys without putting plugs in (all thing I would never have dreamed off in the earlier years). I still have ups and downs of course, but noise exposures seldom worry me now, and even if I do the worry is transient. I'm still careful and avoid anything overly loud (concerts, cinema, power tools etc) but on the whole can do most things without issue. I often look back at how far I've come and think wow, the progress is something I feel grateful for, and I guess I'm almost proud of.

I should add I adopted my own perhaps unusual technic over the years which really helped me - if I'm somewhere a little 'noisy' (e.g a busy restaurant) , I plug ONE ear. This may seem strange, but plugging one ear mitigated the agonising worry that I'd done damage after being somewhere 'noisy'. With one ear plugged, if the situation had induced damage, well then I could be sure of it (because of course the unplugged ear would have an increase in T and the plugged ear would remain unchanged). This allowed me to go out and socialise still (because I could hear conversation through my unplugged ear) but also eliminated any worry that I had done damage as ultimately, there was never a distinguishable increase in my unplugged ear. Over time as I've got braver, there are many situations now where I don't even feel the need to use my one plug technic, however I still reserve it for some situations (e.g. places with crowds, and also places were I feel like there is a chance of sudden loud noise exposure)

Wednesday last week:
Last week I went to a training session, there were 30 people in a small-ish room, however as the majority of the session would simply be one trainer talking to the attendees I hadn't anticipated it would be an issue, and I decided not to use my one plug technic (my first error). I arrived to the session early (my second error!) and was in the room about 20 minutes before the session started. Many people hadn't seen each other since the pandemic so there was a lot of talking, all at once, in this enclosed room space, I was having to raise my voice to talk to the person next to me. I should have one plugged at this point, or better still left and returned at the session start, but bravery got the best of me I think and trumped sense. The session started my habituated brain quickly chalked the exposure up as not enough to worry about (I'm guessing high 80db's max at some points in those 20 minutes). I had a couple of other 'exposures' that day, the trainer wolf whistled at one point to get everyone's attention, and later, I got in a friends car and her music blared out for a few seconds before she turned it off. Still, I came home and told myself my usual mantra 'it wasn't that loud, you may spike for a day or two, but it will settle and you'll be fine'. I honestly thought that would be the case....

Today:
My ears did spike in the days following the incident, louder, new Morse code sounds, ears zoning in and out. A couple days in I was still able to keep my worry at bay using the resilience I've built up over the years and told myself it would settle.

I'm now on day 12, and the spike is real, my ears feel full with the sound, the sound hasn't much changed, but it has definitely ramped up in volume. I feel like I've been catapulted backwards 9 years to my darkest days. It's always been my biggest fear to go back to that place, and now I feel like I'm heading back to that headspace fast. I'm also dealing with intense anger at myself that I didn't leave the room, or at least use my 'plug one ear' method which would have determined one way or the other if this is indeed an increase or if I'm simply focusing on the tinnitus more. However, after years of having T at the same baseline, and being able to erase worry quite quickly, I'm quite certain this is indeed an increase and not 'all in my head'.

For anyone who has read the entirety of this post thank you. It is now, as it was when I posted many years ago, therapeutic at least to get my struggles out onto a page knowing the people who read it will 'get it'.

If there are any old timers who've experienced a spike after years of habituation, I would appreciate any insight you have to offer.

Thank you x

 

Hi Rhea!

I am sorry this has happened to you! I do remember you.

I have had tinnitus for many years. I am currently experiencing a relapse since late last year (probably menopause and stress).

I totally relate to your fears. Thing that tinnitus feeds off (as you probably know) is fear. Do what you can to stay calm if you can (easier said than done).

It doesn't take much to bring back all the old fears and behaviours that dominated our lives around the time of the original onset. You are not alone there.

What I did get from your post is this. You are resilient. 'I sorted myself out...' I believe you will again. Your limbic system is probably lit up like a Christmas tree now. What you are going through is scary. You will have to work on reassuring your emotional brain now that you are safe.

I have been known to take Nicotinamide Riboside after unexpected noise exposure, as I believe it has been shown to be potentially helpful to protect against hearing damage even in the aftermath. I don't know about recommending steroids as this seems controversial.

I know you are going to be totally fine. You have overcome it once. You are going to get through this again.

I really do know what you are going through. You are not alone. Hugs.

 

Hi Rhea,

I am sorry to hear about the increase in your tinnitus after a long habituation period and hope that I might be able to give you some help.

Even though a person habituates to noise induced tinnitus they are never completely out of the woods. While it's good for a person to get on with their life and put tinnitus firmly behind them, there is a risk of slipping into the old lifestyle the longer habituation continues. This is no fault of your own, so try not to blame yourself as the same thing happened to me and many others that have noise induced tinnitus.

The fact is, if external sound is too loud no amount of hearing protection will prevent the auditory system being affected by it. The increase in your tinnitus is not from one event but rather a series of them that you have not been aware of. The plugging of one ear gave you some reassurance you we taking precautions not to expose yourself to loud noise. However, the brain has only one auditory centre and not two so plugging one ear might not have been of much help if external noise is too loud.

When noise induced tinnitus increases after a long habituation period, the usual cause is further exposure to loud sounds. It can happen from one event but usually it's from a series of them as already mentioned. It is also caused by listening to audio through any type of headphones even at low volume. This includes earbuds, Airpods, headsets, Noise cancelling and bone conduction headphones.

From what you describe you are showing symptoms of variable tinnitus. Please click on the link below and read my thread. It mostly affects people that have habituated to noise induced for more than a year, then noticed an increase. No two people will experience it the same but they often share similarities of the condition. You can habituate again.

Please click on the link and read the post.

Take care and all the best,
Michael

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

 

I can relate so much to this. That’s basically my story as well. Only that it was an ambulance with sirens passing very close to me. My spike is only 3 days old but over the years I have a fairly good idea about when it‘s just a spike that makes me hear my tinnitus more and when it is an actual „worsening event“.

I have been through this 2 times already and luckily I can say: yes, it does get better again over time. The new sounds either fade or you‘ll learn to adapt again. Both will take time.

But there will be situations again where we will be confronted with loud noises that will bring us back to square one (or at least it will feel that way). It’s just the way it is for us. Until there’s finally a cure. It will happen at some point. Probably within the next 10 years. But we won’t know until we know.

Stay strong - you’ll get through this.

 

Hey Rhea,

Great to read from you. Processing your emotions is important, especially after a tinnitus spike. It can be difficult, ranging from anger at yourself or others, sadness, disappointment or even hopelessness/depression. I've had many setbacks in the past three years and they all seem to be permanent (three a bit further back, three very recent), so I've kinda got some experience to offer. In my opinion it's important to get active again as soon as possible. I set my goals low, like: getting up, doing something I like, preparing a meal. Then I have to go working and at the end of the day I think "I got through the day, so it's doable." Sleep is okay enough once I sort the big part of my emotions out. And so I just start building again. As for the emotions, I try to accept them as good as possible, so they don't linger around unnecessarily long (which I did when I first got tinnitus and for my first two spikes). I have emotions, they happen to pop up during spikes, and eventually they'll leave me again, like annoying whether or a cold, even though the tinnitus stays. I accept that there are things that I can't control, including judging situations correctly since you never have access to all the information (like: is a split-second of a 100 dB noise loud enough for a setback? Before I would have said: I don't believe so. Now I know: it is in my case...). I just try to make the best out of my situation.

I believe you would profit a lot from the lessons of @billie48, which he wrote down here:

How to Habituate to SSHL and New Loud Tinnitus

His story has always helped me when I lost motivation. There's many other inspiring people here with severe tinnitus or worse who still try to squeeze the maximum out of their lifetime.

 

I recommend invisible in-ear hearing aids. You can wear them every time you’re outside and they are cutting off harmful frequencies. If the environment noise is too loud, you can quickly switch them off from your smartphone or adjust the volume, so they act like earplugs.

It’s like wearing contact lenses basically.

 

Hi Rhea,

Ohh I can relate. I had somewhat habituated 5 years ago (about a year after my tinnitus onset) and now I am on square one. I did have little spikes here and there but nothing major. I got sick with COVID-19 in January and it definitely worsened my tinnitus. I also got ear infection which I was given ear drops with Neomycin for and that spiked it quite a bit too Now I hear my tinnitus pretty much everywhere :/ It is loud hissing is what I have for the most part. Ear that is worse has louder hissing and still hurts sometimes so I think I’m not done with the ear infection.

I hope our spikes subside and we habituate back. I also hope that Dr. Shore’s device comes out soon so that we could just suppress our tinnitus so that we could fine peace and some sort of silence, until therapies with actual regenerative medicine/whatever come out.

 

Tinnitus spikes can take months to settle. When they do, habituation once again becomes possible. I've been through that cycle a few times. A few weeks is a relative short time frame in my opinion.

Bad luck can always spoil it, though. I would make the use of earplugs a daily routine while waiting for improvements.

 

Hi Michael,

I was wondering whether you think it is therefore necessary to wear earplugs when doing things like going out to busy restaurants? I'm fairly new to tinnitus (3 months) and am doing largely what @Rhea has been doing by trying to protect my ears during obviously noisy places but otherwise trying not to obsess over wearing earplugs everywhere but it sounds like actually it's advisable to wear earplugs pretty much anywhere outside?

 

Hi Tom,

Wearing earplugs and keeping away from normal everyday sounds is not the answer when trying to habituate to noise induced tinnitus. This also applies if a person is experiencing oversensitivity to sound or has hyperacusis. I understand the reasons wanting to wear earplugs, but if one isn't careful symptoms can be made worse by lowering the loudness threshold of the auditory system which will make it more sensitive to sound.

In addition to this, there is a risk of developing psychological problems linked tinnitus that can manifest themselves as phonophobia and misophonia. Please click on the link below and read my post: The Complexities of Tinnitus and Hyperacusis.

Noise reducing earplugs can be helpful but should only be used on a temporary basis. I have discussed them in my post: Hyperacusis, As I See It. Please click on the link below. Since you are new to tinnitus and live in the UK, you might find the posts mentioned below helpful. They are available on my started threads:

New to Tinnitus, What to Do? Tinnitus, a Personal View. Tinnitus and the Negative Mindset. Acquiring a Positive Mindset. The Habituation Process. How to Habituate to Tinnitus. Will My Tinnitus Get Worse?

I advise that you don't listen to audio through any type of headphones even at low volume. This includes earbuds, AirPods and headsets.

All the best,
Michael

Hyperacusis, As I See It | Tinnitus Talk Support Forum
The Complexities of Tinnitus and Hyperacusis | Tinnitus Talk Support Forum

 

Thanks for the response Michael. I'll take a look at your threads.

 

Hi Rhea!

I totally relate to your struggle. I too was what I considered completely habituated for many years. I would wear earplugs for louder events such as a bar, louder party, movies etc but not even temporary spikes freaked me out. Until now. A few months back I got COVID-19 and a huge spike to boot that seems to have become permanent. So I'm back here on the forums, and struggling, trying to get back on track. I'm doing better than about 2 months ago but not doing as well as I would like. Last night I had a horrible night with my tinnitus going through the roof, impossible to sleep, panicking. I absolutely hate being back in this panicky headspace planning my life around noise. I'm avoiding all loud venues now even with earplugs, and my hyperacusis is back with a vengeance. Family sounds in the kitchen makes me freak out etc.

However, I do believe things will get better for us with time! I'm sure of it! We just need to cling to the fact that we did this once before, so we can do it again. One day at a time, we'll get there.

 

Hi Rhea,

How are you doing? Any improvement?

 

The most annoying thing about members here is they don't provide closure to their posts. This includes me as well.

This time when my flare up settles I will write a post about it so the people who come here looking for answers can find one instead of more complaints without end results.

 

I can't wait until the day we have a treatment so we can all ride of into the sunset and members not providing closure will never be an issue again because a quick trip to CVS would calm our tinnitus down.

 

Hi, I definitely relate and sympathize. It is so frustrating, the wonderful work you did.

FWIW, my opinion is you did get a spike, but not a nightclub type of spike. So I feel, that you knowing you overcame it once, you will do it again.

If you need to raise your voice to be heard, that is 80 dB. However, low frequencies are much more injurious, since they don't sound all that loud, so if your training session was with music and subwoofer, then that is what I would say the culprit would be. Anytime you can feel the subwoofer sound in your chest, it is definitely time to get out fast. As for a room of people? ven if there is one person only, in my vicinity, I caution them: I've got hyperacusis, please speak quietly. I often just use my hand to signal: please lower the volume.

I have had so many spikes like you wouldn't believe. Suicidal, I don't like to use the un-alive word, but it is a fact of life, sometimes things are so miserable, and our memories of what it was like to be completely healthy, puts anyone into a dark dark place. Just please don't do it! I didn't, and I am very expert at how to, but if I had, then so many things I would never have seen, and likely so many things that would result (children following suit), by the same token, I did not see.

For me, a spike can last a week, a month, even six months, before I am feeling sort of ok. When I was taking a course (required for my work), some loud machine outside slammed into the curb, it gave me a ridiculous spike. Fortunately, I happened to personally know a doctor in the city I was in, and he gave me prescription for Clonazepam. I took 1 mg, it suppressed the spike quite well, otherwise I would have not been able to complete the course and I would be unemployed, that was in 2014/2015. This is now 8 years later. I still use Clonazepam to suppress spikes, and then taper it off quickly. Unfortunately, I'm a bit tolerant to it now, so I take a larger dose to suppress. When you're tapering off, do that within a couple of weeks, or be prepared for rebound insomnia from hell.

So I don't need to have a competition around here, who has the worst tinnitus, I'm just here to relate and offer encouragement, I have had so many spikes, they generally basically do subside. I'm at the point I always wear a Bose QC25 if there is the slightest chance of a loud noise, but I also have a tiny FLAC player feeding quiet "Restful Rain" which is recording of rainfall designed to reduce the suffering from the tinnitus. I play it very quietly, so I can just hear it, and it is quieter than the tinnitus.

As for your strategy of blocking one ear, that doesn't sound right to me, I would specifically ask an audiologist who specializes in tinnitus. It just makes me feel uneasy and I would feel better if someone who knows this subject in great depth would weigh in. I'm familiar with how the brain works, I had to pass medical school, but what you're doing is beyond my expertise except to say I'm worried about upsetting the equilibrium of how your brain sets the sensitivity, I'm perhaps more concerned about that then whether you will recover from the current spike. I'm not going to list my spikes or that will definitely put everyone into a deep state of depression, if they weren't depressed enough already.

And yes, I know the discouragement, sometimes I don't even know how I keep going, but somehow I do. You will too.