Loudness Hyperacusis vs Anxiety

Does anyone here have info on this? At what point does an aversion to loud noises actually get classified as hyperacusis? How do you distinguish if it’s from actual damage or due to anxiety from a sudden onset of tinnitus leading you to be afraid of noise?

I’m really struggling lately.
Has anyone actually been helped by an audiologist?
Should I look into TRT?
I understand that pain hyperacusis has a different pathology but seeing that a lot of people here went from minor tinnitus to pain hyperacusis does show that they are similar somehow right?

If loudness hyperacusis is all in your mind and you can be desensitized with pink noise or TRT, but loud noises can also cause pain hyperacusis, how do you ever heal?

 

Pain hyperacusis is very easy to identify. Any loud sound would give you pain for days or weeks. For instance exposure to a car horn nearby would give me pain for like 2 weeks, huge headache, pressure, tightness, fullness in my ears, distorted sounds... pain.

 

Wondering the same. I think researchers have come up with a tentative framework of 4 main presentations of hyperacusis - loudness, pain, fear, and annoyance hyperacusis. In reality, these tend to overlap and most people will tend to have multiple forms of hyperacusis.

I feel like I've made some progress but it's not totally gone away and I feel like I'm trapped in a nightmarish negative feedback-loop where I've developed real anxiety about certain noise - for me it's artificial audio sources in particular so watching/listening to anything on my laptop. My setback was originally worsened in Jan from watching netflix so I've built up a lot of anxiety and hesitation about resuming using my laptop speakers.
But then I feel like the fear is warranted because here I am in a 2-month long setback.

 

Loudness hyperacusis and anxiety over tinnitus are not at all the same thing. Trust me, when you have hyperacusis and it develops, you know, no questions asked. You won't be able to be around any sound at all, and you will get this when you aren't even anxious.

 

Sooo familiar. Not everyday but yes after flare ups. Does it improve over time?

 

I don't believe it's all in your mind. I don't think more noise wng will help. There are probably those that will agree and disagree. You need to avoid loud noise but not over protect. Until your hyperacusis settles down you run the risk of aggravating it to unimaginable levels.

 

I wouldn't say exactly that it improves. It is more like it changes...

 

I’m seeing a therapist to help manage the emotional toll of having a condition like this, and what she told me was that it’s most of the time both. She has experience with patients with Trigeminal neuralgia/tinnitus/hyperacusis/you name it and she was saying that a lot of the time it’s actually both together. When a person is suffering from anxiety their stress response is skyrocketing which has your whole body on edge. This on edge state of being can actually increase pain levels. Therefore, when a sound happens, not only is it hurting you because of hyperacusis, but it’s causing a stress response which is intensifying the pain.

I have techniques that my therapist is currently teaching me right now, and some that I’ve figured out myself over the years, that bring down the emotional response to a point where I can see with clarity and evaluate what my pain is.
I wish you well, let me know if this interested you and I will be happy to share more. *hugs!*

 

I came across this today:

http://www.hyperacusis.net/what-to-do/questions-and-answers/

Basically claiming that 40% of tinnitus sufferers have sensitivity but that it’s not hyperacusis. Is hyperacusis.net a trustworthy site?

What @Juan and @Zugzug describe isn’t recognisable to me. My issue is artificial sound on the whole. I wonder if I’m in the ‘annoyance’ or ‘sound sensitivity’ category. I’m just hoping that means I’m not at risk of worsening/developing ‘true’ pain or loudness Hyperacusis. I think it was @Juan that allayed my fears about this the other day.

 

The thing about hyperacusis is that it's basically an umbrella term to describe a whole assortment of sound sensitivities from the truly debilitating to minor issues and doesn't distinguish between, say, loudness and pain. So I think it's a bit of a spectrum.

Yeah, I'm in the exact same position as you - artificial audio is my main issue. I don't know how to categorise myself tbh - I wouldn't describe myself as a 'severe' or even 'moderate' case because all my other issues have gone away again but then at the same time I've still been having trouble with video calls on my laptop or watching a youtube video. So it's an odd position to be in. Granted, I don't get ear pain any longer from it but it still triggers the bizarre facial symptoms. For me, I would definitely class it as more 'sound sensitivity' than 'annoyance' as it definitely feels like a physiological issue. I'm not really keen on the term 'true' hyperacusis but I get what you mean. It is weird though tbh you're one of the only people I've come across who has like the exact same issue as me with this very specific hyperacusis.

 

Joining this thread because I relate to this so much right now. Had a loud accident last week. No adverse effects, at least not yet, but I can't stop thinking about Joyce Cohen and all the poor people suffering on here. I keep thinking "Was that loud? How loud was this? Should I be worried?" Etc.

My tinnitus is finally at a manageable level again and I don't have hyperacusis. I do have symptoms of TTTS, but they're mild. It's the fear of it getting worse that just fucking kills me.

I'm only 21 and they're so many things I haven't done. And I know that the only way to prevent my fears from coming true is to just keep social distancing long after COVID-19. Avoid any and all interaction and socialisation that could lead to worsening. No get togethers, no shows, no parties, no dating.

But I can't do that. I just can't. I know I can't because I lived that way until I was 16, and it wasn't until I started putting myself out there that I ceased being anything less than a socially awkard, borderline suicidal misfit who read on the bench during recess while everyone else played.

I'm sorry, I'm just really tense and fucked up right now.

 

I first got tinnitus with 21 and it was very mild. If someone would have explained me what pain hyperacusis is back then and said I had the option to a) Live as a reclusive monk or b) Get pain hyperacusis by 33, I would have chosen option a).

 

So my only options are A: Live a miserable life of self imposed isolation or B: A miserable life of severe tinnitus and/or hyperacusis?

What a fucking joke this whole situation is. I wish I had been shot, or had a leg blown off, or, hell, just had normal hearing loss. At least then I could still keep living like a human being.

 

Unfortunately we have to play with the cards we are dealt and since a viable treatment or even cure will be years off in the future, I would play it save.

 

What distinguishes TTTS and hyperacusis? I don't feel like what I have is 'pure' hyperacusis as it's mostly lingering facial symptoms/possible trigeminal nerve involvement though but unsure if that would be deemed hyperacusis or TTTS.

This shit sucks so bad and the fear of getting worse is so pervasive.

 

I hope something comes thru for us in the next 3-5 years - FX-322, Hough, Audion, Thanos's drug even - just SOMETHING to deliver us from this misery.

 

I also have the weird facial symptoms/Trigeminal involvement rather than the classic “pain from noise” and it’s so frustrating not knowing what’s happening

TTTS is more so an actual spasm in your ear I believe. Most have it right after sound where it feels like a butterfly fluttering in your ear or a thumping. I’ve had that a month or so ago as well and still not sure if it was related to anxiety or being in a noisy office all day.

 

I don’t really experience classic pain from sound. My issues were things sounding unbearable for my ears, mostly things like dishes being put away, loud coworkers, car on the freeway. I’d say loud voices were the worst of it all though they kinda made my ear tremble a bit. Then the issue with the Trigeminal burning and TTTS (on top of really loud hissing tinnitus).

If you have tips on how to manage it all emotion wise I would love to hear as I’ve been struggling a great deal lately.

 

It seems like most with loudness hyperacusis have it towards very specific sounds (dishes, voices, cars, traffic, toilet flushing, shower). I have yet to speak to a single person with loudness hyperacusis where ALL things sound louder such as a hair brush running through your hair, ironing running across clothes, etc

I don’t think it’s even possible to not be anxious when having loudness hyperacusis and tinnitus especially in the beginning stages. I can be in my room alone with no tv playing no stressors and my anxiety is still 10/10 because I know there’s something wrong with me.

 

Is it constant or only triggered by certain sounds? It's honestly so frustrating and baffling and I legit don't get how mine will react to very specific sounds and not others (laptop speakers etc).

 

For what it's worth, I've noticed my TTTS/earpopping/crackling like a blown out speaker, whatever you wanna call it, has been significantly reduced after taking clonazepam (ya ya I know benzos are the devil). It's by no means gone, but I can actually speak now without my own voice constantly setting it off. So I'm guessing anxiety and the nervous system can be a contributing factor in at least some etiologies of TTTS. It's literally the only minor victory I've achieved over any of the aspects of my hearing damage.

I haven't been able to manage my emotions/fear by any other means. At this point I don't care if I'm a benzo zombie until regenerative medicine comes out, it beats having rampant anxiety that chains me to my room. No amount of CBT, ACT, or mindfulness is going to make a difference for me. In lieu of cryosleep being a viable alternative, I'm just going to numb myself the fuck out.

 

I agree on the TTTS being partially caused by anxiety. I got the TTTS spams about 3-4 months into my tinnitus/hyperacusis journey. This was around mid-end of February. I was doing terrible - mentally, due to spending weekends alone at home spending all day on forums, being stressed out at work because I hate my job in general, and also my office was super loud (people yelling over one another all day long, radio playing, loud sounds in general, and lots of room for a huge setback).

I have been home with my parents for a month and a half now and haven't really experienced the spasms. I'm not sure if it's because I'm not in a loud office for 8 hours a day around people I hate, or because I'm at a place I feel a bit more peaceful and less lonely with my parents around. I definitely do struggle with anxiety on the daily due to the general nature of this condition and all my other symptoms, but at least ONE has gotten a tiny bit better

I've posted this before, but ear spasms are thought to be related to the tensor tympani muscle. The tensor tympani is controlled by your trigeminal nerve, and "fight-or-flight response involves activation of the trigeminal nerve", so it would make sense that if you're constantly on edge and your entire nervous system is out of whack on top of already somehow damaged ears that more unfavorable symptoms will appear

I know there are many on these forums who are sick of hearing that anxiety is causing all of our issues (myself included) but I do believe anxiety does play a role in at least some of the things we experience.

 

Oh how I wish there was some magic bandaid quote I could pass out for everyone to have, I wish I had one myself.
I'm not trying to fix it, these are only tips.
I just take it one day at a time and never imagine my future in a negative light in any way, shape, or form. The only way we fight these battles is one day at a time - as soon as we start thinking about fighting a month's, year's, or lifetime's worth of battles we're going to lose every single time. I've learned I just have to stay in today and do my best with what I have today and leave tomorrow for tomorrow. If all you end up doing today is taking care of yourself and the house is a mess and you haven't showered or eaten, that's ok! Of course you wouldn't want to do that every day, but we're not talking about every day, we're talking about today. Today we're going to do our best.
Another thing that keeps me sane is looking at my strengths as a person. I am an extremely kind person because I have been treated very badly during my life. I had an abusive sister growing up, and that was really hard. It was hard growing up with a bully, someone I was really scared of. But I am kind. I am so kind that during a summer camp the councilors all thought of and voted for me unanimously to be the one they would ask to befriend and watch out for a girl being bullied behind closed doors. I'm not making a ran't of 'look at me, I'm so special,' but I'm trying to make a point that sometimes people go through some pretty tough crap. I grew up being bullied, and I turned out to be a good person. I'm not minimizing any of it, what we're going through is awful - I can't believe any of us are surviving like this. What keeps me going is knowing that who I am becoming is someone that is going to be made of steel. Someone that can make it through anything. I don't know if you're religious, and if you're not I respect that, but I survive knowing that someone out there knows that I'm hurting and He went through it too.
This isn't supposed to make you feel better, but I tell these thing to myself every single day, actually today I've gone over them so many times I've lost count.
But something I know will definitely make you feel better is when you see motorcyclists. They think they're so big and bad with their nasty mustaches, bandanas, leather jackets, and too tall handle bars. Just know they're a bunch of pansies compared to you, you're surviving the noise they're making.

 

It's definitely triggered by something, however I am unsure what it is Perhaps it is a delayed response to artificial noises as I'm not really exposed to anything remotely loud at home.

 

It's also interesting because Myriam Westcott has had success using a stellate ganglion block for a patient who had severe TTTS pain. It's only been tried on this one patient so far but after multiple treatments it basically eliminated much of her pain. Interesting because it achieves its effects by blocking the sympathetic nervous system.

Also, for me laptop speakers were what originally worsened my setback so I honestly wouldn't be surprised if there's maybe a psychological element to it like my nervous system fearing damage if I am exposed to sound from my laptop or something idk.

 

@Juan

Would really appreciate if you could elaborate on this. Wondering if there is anything to hope for.

"I wouldn't say exactly that it improves. It is more like it changes..."

What do you mean by "it changes..."

Two months after my tinnitus was improving (only H to certain sounds) I experienced burning ear pain/searing pain in head and muffled hearing for about 5 days after exposing myself to everyday sounds when I did some errands. Lost tolerance to other sounds. Two days ago a bowl fell on the granite countertop in the kitchen and I'm back in hell again and so scared if this could be permanent. I cannot tolerate any sounds right now. As I sit in silence... my ears and my head burn. Muffled hearing comes and goes.

I am going to see my ENT next Tuesday for the first time since this all started (3 months ago).
What medication should I be asking for?
​

 

There is like a trade-off among hyperacusis, tinnitus and hearing loss, and maybe the particular development of this process is different for each person.

Some people are prone to develop hyperacusis, others develop early hearing loss, for other tinnitus spikes and recedes, or there is a combination of these things. It is impossible to generalise with this. So only time will tell you in which category you fall.

That's why I am skeptical about "progress" meaning healing. For me progress means changing. Obviously when hearing starts playing up there is a problem. Hearing is complex and unless a particular case fits very closely a medical book description of some medical problem that can be fixed, we fall into the unknown (which is a lot, regarding hearing). If we fall into the gray area, then you have to listen to your body and figure out by yourself. Going to doctors and using medication becomes a trial and error game, there's not much more to it...