Mental illness and tinnitus

Hi guys,
Its me again. I'm still doing Audiology and its going well. Anyway, we have to do a year long project starting next year. I want to do something on tinnitus. I was tentitively thinking I would research the connection between mental illness and tinnitus distress. I was thinking, just from reading through your posts, that there is a common mentality of worrying amongst all of you, myself included. I'm definitely not trying to diagnose or presume anything here and I mean no offense. All I was thinking is that there seems to be a common element of obsession among people that perceive their tinnitus to be distressing and I was hypothesising that perhaps if a psychiatrist can control the obsessional thoughts maybe with medication and therapy then maybe the tinnitus distress will decrease. If you think this a silly idea please tell me now before I hand in my ethics proposal. Alternatively if you can think of a more interesting topic in the field of audiology please let me know. If you're interested, here is an article on the comorbitity of mental illness and chronic tinnitus: http://www.tinnitusjournal.com/imagebank/pdf/v16n2a07.pdf

 

Also, some advice, take it or leave it. The day I stopped wishing my tinnitus away was the day it got better. Actually, no. I rephrase. It did NOT get better, my anxiety got better. My tinnitus is still exactly the same and unless you're really lucky your tinnitus will also remain the same. I guess you need to ask yourself, in light of this, do you want to waste the rest of your life worrying and wishing about something you can not change? I dont

 

Hey @Neenie, nice to see you. Glad your studies are going well!

Research has long suggested there is a connection between anxiety and tinnitus. And just browsing this board would lead one to believe the same. In fact, if you search the forum, I think we had a thread discussing exactly this topic a few months ago.

Patients with anxiety seem to fall in two categories: Those who have had chronic anxiety for many years, and those who develop it post-tinnitus, as the limbic system kicks in. It may those who have anxiety after onset, however, have been dealing with anxiety for years but just not known it. I put myself into that category.

It is interesting you mention "obsession;" obsessive compulsive disorder (OCD) is an anxiety disorder, like general anxiety disorder and social anxiety disorder. I have no idea, but I would be willing to bet that OCD people in particular are vulnerable to tinnitus distress.

Doctors and therapists who know their stuff already are treating anxiety in tinnitus patients, exactly for the reason you suggest: it can reduce the distress for some, which in turn reduces loudness perception. Treatments include meds targeting anxiety (like benzos; there is a U.S. study that looks at the affect of aprazolam on tinnitus and found that it helped) and talk therapies like cognitive behavioral therapy. I have tried both. They helped me tremendously. As with you, it made me realize I could not control my tinnitus and I needed to accept it. Which I have. Of course, some people don't need professional help to get to this place. But I did.

What I haven't seen explored: If you had a longstanding anxiety disorder, would advance treatment help ward off tinnitus? Also: Given that there appears to be a strong link between anxiety and tinnitus, and anxiety treatments can ease suffering distressed patient, why the hell aren't ENTs telling their newly diagnosed patients them and handing them a list of qualified mental health professionals in their community who can help them?

My comments don't include other mental health conditions: depression, bipolar disorder, schizophrenia. There may be a link with those as well.

Good luck with your paper!

 

Hi @Neenie I admire you for your studies and wish you every success ! I defo believe that it's out anxiety towards T that feeds it or our attention to it saying that I also respect some people have such intrusive T it's life consuming for them.

I believe my t was a result of stress fed by it I crashed and burned and T anxiety overwhelmed me - I have friends who now confess they have T but it doesn't bother them - r they stronger than me !? No it's just how we react to it - any help I can give to your studies I will be there - I wish you lots of luck xx

 

I agree %100. I felt so depressed for 2 weeks about my tinnitus when it first started. I was crying, getting angry and feeling like life had gotten misserable.
Then something clicked. I came to the conclusion that the tinnitus probably isn't going anywhere. So i either feel sorry for myself for the rest of my life. Or say f"%^%k it, i'll just live with it.
A month or so on and since that day i haven't looked back. Yeah the tinnitus is still the same, no it's not given me a brake since it started and no it's probably never going anywhere. But all it is to me now, is a minor pain in the ass.
When i go to sleep it's a bit annoying. But hey, i can see, i can walk, i can run, hear and ride my bikes. So tinnitus can kiss my ass. I'm gonna be happy.
The ones feeling defeated will not get anywhere. feeling sad wont change a thing. So my advise to anyone going through a hard time with tinnitus, is accept it, stop analysing it, realize it's probaly no going anywhere and tell it that it's not gonna win and you have no time to spend worrying about it anymore.

 

neenie... I can only speak for myself, but I think the last thing you should focus on is the "psychological" angle wherein it hypothesized that a lot of people have tinnitus but only those prone to depression, anxiety, etc suffer from it-- I'm sure that's the case in some instances, but I think that does a big disservive to tinnitus sufferers.

I was the most laid back person anyone who met me probably ever came across, I didn’t have a life void of cares or problems, life had thrown me some serious curve balls, but I was never really anxious or depressed…ever, even for one day (seriously) that is —BEFORE TINNITUS -—this tinnitus stems from a psychological disposition thing is crap- and I would caution you not to go down that road—that gets into the TRT music of the brain- only those who are bothered by it hear it nonsense- like people's psychological disposition has anything to do with abherent nerve fibers in their auditory cortex ruining their lives... I would try to do something that delved into hard science, not jastebroff like speculation

 

@Mpt Could not agree more . I was having the time of my life when this shitstorm hit me.

 

This is really no great mystery. Anxiety is a behavioral label for a function of the brain whose purpose is to alert the organism (ie. you) to threat. Therefore, anxiety will heighten all senses - to help you better assess the threat. Anxiety therefore makes you more aware of tinnitus and prevents habituation. Reducing anxiety makes you less aware of the tinnitus and assist habituation. Anxiety per se is not a mental disorder. Excessive anxiety when the situation does not warrant this, is a disorder. Obsessive ruminations are a feature of anxiety and hyperarousal. Treatment of this pathological anxiety and depression will reduce the impact of the tinnitus. Psychiatric disorders have no actual pathological effect on the causes of tinnitus. Once your brain learns that tinnitus is not a threat and a damn sight better than active hemorrhoids, the impact of tinnitus fades into the background.

 

Good to hear from you again, Neenie. Thanks for the good update and the great point you make there in the last question. I don't too. I make an argument for my choice on the positivity thread today. Why waste our life with choice B when choice A is much better for us in the long term?

 

I didn't understand what anxiety was before T. People would explain it to me, but really I had no idea. I have worried about things in the past, but never had this feeling of anxiety.

Now with T, I get it! I understand it fully!

 

Perhaps doctors, knowing they can offer no real treatment or cure whatsoever, say things like "the tinnitus is just your anxiety" because at least that sounds better than "Sorry, I can't help you. Next patient."

 

Honestly, the most frustrating part of this journey was the fact that people kept telling me "I was just anxious" and that a lot of people have this and it doesn't bother them.

I really felt like the condition itself was being down played, I was told it was just me, and I was by nature a worrier. Then it was about my history, my child hood. Basically looking for reasons I would act this way to a simple noise in my head.

I believe being treated in this way was was the lead contributor to my anxiety and isolation.

 

I think among a lot of ents thats the case... that's because worrisome tinnitus is a rare complaint and I could tell that the ent I saw didn't understand the second by second suffering resulting from the type of loud t I had, ents should at least be trained to have a standard line regarding tinnitus therapies (as inferior as they are to a real treatment they are still better than nothing and being told to live with it by someone with no clue)... after going through what I did I know not to judge anyone's suffering with this, and the unfortunate truth is that tinnitus can get to a level that is basically unlivable, questioning those poor souls mental health is pathetic given the fact that the medical profession offers no treatment for the condition, as if its not a serious enough a condition to warrant really researching a cure/pallative treatment because the only people who really suffer from it do so because of some mental condition that keeps them from habituating

 

"Once your brain learns that tinnitus is... A damn sight better than active hemorrhoids, the impact of tinnitus fades into the background"... are you kidding me, I've had both and I know which I would rather have, congrats for you on habituating to mild tinnitus, seriously, but as a dr you shouldn't make generalizations about others ability to habituate, try tinnitus that can be heard over a lawn mower on for size, I think your opinion might be different

 

I wonder if people get anxious and suicidal over active hemorrhoids

 

I was recently diagnosed with generalized anxiety disorder and panic attacks (and consequently sleeping issues). Therefore as I tend to be more anxious and worried about most situations in life I of coursed panicked about tinnitus as well. However I was told that in many cases with the help of proper medication and therapy people with a generalized anxiety disorder heal completely. I was also told that the same situations happen to everyone, the reaction to them is simply different. Therefore it would be wise to change my reaction to the problems in my life. This explains how some people deal with very difficult problems and yet have a positive attitude while others become sad or bitter. I believe it goes for a lot of people with tinnitus as well (however of course it is a bit different if one has severe hyperacusis and reactive tinnitus which might actually stop one from engaging in everyday activities).

 

I keep seeing this post and to be honest it really bothers me. I have never had mental illness or any kind of anxiety related problems. I worked in a high presure job that I coped with just fine over many years. There have been many adversities in my life that I have overcome. I have had high successes in all areas of my life and have always been relentless in my pursuits.

Now I have tinnitus and it's becasue of anxiety problems according to the so called experts. My family and doctors are convinced I just had a break down at work, or that I had unresolved issues from my past.

Never was my tinnitus talked about. In fact it is pushed to the side becasue of this type of thinking. As if I was using tinnitus as a excuse for my life falling appart. My job which I loved comes up as a problem, it was a lot of stress, you just had a breakdown, it's ok, it happens all the time.

Here I have a physical issue that is being completely ignoired, like it's not even a real condition.

For me, I felt like I was living an episode of the twilite zone. The isolation and ignorance on the part of just about anyone I talked to was incredible. It was/is one of the most terrifying parts of this horrendous condition.

I'm sure people with underlying anxiety issues makes tinnitus harder to deal with, but let's not forget about the problem at hand.

Thank god I found this community, I lived with tinnitus for the first few months with not a single person that would address tinnitus as a real problem.

 

Hi Neenie.
I'm like Telis, I didn't know what anxiety was til T. It used to get on my nerves in high school in '75, it was so bad in the quiet classroom I thought I'd pass out or there was something wrong with my mind.

 

...Not forgetting that hemorrhoids can actually be treated.

 

This sounds exactly like my own story.

 

Without spending too many words, I think your thesis is likely to fall outside the scope of audiology.

 

I am so glad you're doing better! And I think your thesis project has merit--though I prefer analyses that explore what biochemical changes or genetic markers coexist in tinnitus and psychiatric disorders (e.g., depression and anxiety), for I believe this type of inquiry will lead to interventions that might actually cure tinnitus. Such analyses, of course, are different from audiological ones.

That accepting your tinnitus will improve your distress is obviously true. If I am obsessing about my tinnitus 24/7 or am developing severe depression, it is useful for me to address these psychological issues--whether pharmacologically or through a behavioral intervention like CBT or TRT.

But psychological issues are only one component of tinnitus. Many people are no longer distressed by their tinnitus, yet still struggle in their personal and professional life. I, for example, no longer respond consciously to my tinnitus. And I consider it "just a noise." And yet my tinnitus cycles. And when it is loud I do have difficulty focusing and functioning at a level necessary for my profession.

Obviously, people like me are not relevant to your dissertation, which like I noted above does have merit. But it's too simplistic to tell people that accepting their tinnitus will improve their symptoms. Addressing emotional issues differ from solving cognitive ones.

Acceptance is a necessary but not a sufficient component to habituation.

Good luck and keep us posted!

 

I know this is a delicate topic. First, let me say that I respect everyone's experience as unique to them. And I in no way think tinnitus is a "mental illness" or something you should be able to "get over." Also, like others here have commented: I, too, had no history of anxiety prior to my tinnitus onset. I was totally blindsided by rolling panic attacks. I deeply sympathize with everyone here who has dealt/is dealing with anxiety of any sort. It's crippling.

But I decided to post once more on this thread because @jazz said what I meant, only much better:

I prefer analyses that explore what biochemical changes or genetic markers coexist in tinnitus and psychiatric disorders (e.g., depression and anxiety), for I believe this type of inquiry will lead to interventions that might actually cure tinnitus.

I think it's important to acknowledge that in SOME cases, there is a connection between anxiety and tinnitus. No one knows for certain, at this point, if the anxiety comes first or the tinnitus. My guess is it can happen either way, depending on the individual. I also think (and this is just my own theroy, no proof): that prolonged stress or a life crisis, even if anxiety is absent, can make SOME people more vulnerable to tinnitus when a trigger event happens, like intense noise exposure, taking ototoxic drugs, barotrauma, etc.

I fear that patients with co-existing anxiety and tinntius, regardless of which came first, will not seek appropriate help for their anxiety because they fear the "mental health" stigma. It's really hard to habituate to T when you also have to deal with A. I would hate to see tinnitus research sweep anxiety under the rug.

I am sorry you have not found your doctors more sympathetic, @Telis. As I have said before, if you have tinnitus and anxiety, you have two problems: an ear/auditory neurological problem and an imbalanced brain chemistry/anxiety problem. You need separate doctors/therapists to help you with both. Even the best ENT is no substitute for a good cognitive behavioral therapist.

I also am sorry your family has not been more supportive. Mine wasn't very supportive, either, because like you, I never had anxiety before. My mom kept asking me why I just couldn't calm down, I always had been so together, etc etc. Even people who love you don't understand that your limbic system, egged on by your T, has kicked your brain into high alert and all the willpower in the world won't make that stop.

However, you can conquer your anxiety. And getting your anxiety under control will help you greatly in working on the tinnitus. This comes from someone who has been there. Best wishes.

 

Oh and one other thing, regarding those of us who have tinnitus and struggled with it vs those who have tinnitus and have not:

We are not weaker vs stronger, emotional vs stoic, undisciplined vs organized. Much regarding severe, chronic tinnitus is a mystery but one thing is certain: T does not discriminate.