Protecting? Overprotecting? Not Protecting?

“Suppose I am crazy, and want to experience pain every time, say, I see a black cat. I don't think that my brain can cause me to have pain for weeks or months at a time, following this random cue. Also, many sufferers report getting the spike the next morning. No matter how much I work myself up, my brain is not complex enough to provide me with a pain (in the same part of my body each time) as I wake up the next day. And yet, this is what most of the people who get spikes experience every time they get a spike.”

Do you follow much science, Bill? Have you never heard of Pavlov’s theory? There have been many studies done on this, so again, yes, it’s very possible for this to happen to someone if their response is conditioned. This is exactly what some people on this forum are doing; they are conditioning themselves to have a negative response to non-threatening sounds.


Classical conditioning (also known as Pavlovian conditioning) is learning through association and was discovered by Pavlov, a Russian physiologist. In simple terms two stimuli are linked together to produce a new learned response in a person or animal.

John Watson proposed that the process of classical conditioning (based on Pavlov’s observations) was able to explain all aspects of human psychology.

Everything from speech to emotional responses was simply patterns of stimulus and response.


Saying “all aspects” is going a little far, but we can condition a response to pretty much anything in humans and animals.

I’ve followed science my whole life, and have always had a really inquisitive mind. I’ve read more scientific journals then I care to remember, and have watched far too many scientific documentaries. When I was a kid everyone thought I’d either become a research scientist or an astronomer.

 

How do you know! Did they show you their blood cortisol levels? A conditioned response becomes more of a reflex, anyway, so adding stress to the equation surely heightens the strength of the reaction that’s invoked.

 

I love watching BBC scientific documentaries. The production values are high. Having said this, me watching BBC shows might have to end soon. About a year ago, I remember reading that the managers at BBC are considering a presenter explaining concepts to the audience to be an outdated format...

I read it carefully. It was interesting, but had nothing to do with what I was talking about. I was talking about the cases where the sufferer is not stressed out about the noise and then gets a serious spike anyway. So stress is not relevant, as there was no stress.

If someone's T would spike as a result of a noise that you believe shouldn't bother their ears (and yet the noise sets off their spike), would you advise them to listen to their body and protect their ears against the noise?

Only the sounds that already irritate their ears and give them spikes. I was in that boat, followed my own advice, and now many of the sounds that used to give spikes to me, feel a lot safer.

I receive my own share of messages critical of the kind of advice that you give. I am not going to quote them as I don't have their permission, and some of them actually asked me to not post their stories on here (they knew that I sometimes do that with regular posts).

You call it "positive discussion", I call it promoting recklessness.

I agree. It is important to provide them with the information that they need and to not encourage reckless behaviour.

I couldn't agree more. By the way, the true translation of that Russian saying is "If you get a fool to pray, he will break the skin on his forehead." When one provides people with useful information, a small fraction are bound to be foolish and (in our case) overdo it. This is on them, and it has nothing to do with the original advice.

I asked them. They have the most information and so are the best people to judge this. Also, I am one of them. Like I said, I know exactly what I was feeling and thinking. When I had that loud phone incident, I was a little annoyed, but I told myself that it can't possibly be serious. I spoke to the person who called me. Our conversation lasted for something like an hour. By the time we were done, I had completely forgotten about what had happened. A little later the volume increased slightly, but by that time I knew that most spikes are temporary. The next morning, my T changed from a hiss to a high pitch tone (it stayed that way for months). At first I couldn't think of why that might be...

 

This is true. Jim Al Khalili is a favourite of mine.

I have one question here:

Was the person who had a spike, because he only had earplugs in during a conversation (and didn’t have a chance to grab his ear muffs) right to be terrified? And was this spike because they were under-protected?

I will add that these spikes happen all the time (with totally non-threatening sounds), for various people, and they are already protected. I fear there is a hidden problem on this forum because most of these people don’t speak out on the forum very much.

So you think it’s right that there are people isolating themselves?

What’s that? To protect your ears around dangerous noise? How can anyone be critical of that?

I’m using anonymous examples because there are people who won’t speak up and are suicidal. I’m quite confident that general readers don’t know the extent of what overprotection can lead to.


And at this point I give up. I can’t keep trying to help people who are reading threads like these, so at this point I’m going to give out some tough love:

If you’re reading threads like these and you find that they’re making you change your behaviour, unrecognisably, then stop coming on internet forums and seek professional help. You do not have to live your lives the way you are and it kills me to see your suffering all the time.

I only have the best intentions with every post I make but I’ve tried to help and it’s a losing battle.

 

Or would you refer to that as "overprotecting"?

I got a spike (not just louder volume, but the change in pitch) from a loud phone.
And what about

If he were to visit that restaurant again (that's not particularly noisy) and wear protection, would you call that overprotection?!

 

He is great. So is Michael Mosley...

 

Have you been reading my posts? He was NOT terrified. He didn't think twice about the noise. And yet he got a Serious spike (mine involved a change in pitch and lasted for over 3 months).

If they are isolating themselves from the noises that cause problems for them, I am happy for them. If they are doing the "giraffes can't possibly have long necks" thing and just keep exposing themselves to the sounds that clearly harm them until the damage is permanent, I feel sorry for them.

People are complaining that people like you advised them to "not let T drive their bus" and that they are paying Dearly for being foolish and listening to you.

I am quite confident that general readers don't know the extent of what Underprotection can lead to. I am also confident that they are not aware that if their vacuum cleaner seems to hurt their ears, they should take it seriously and stop using the vacuum (despite the fact that the noise of vacuum is, without a doubt, safe for the vast majority of the healthy people, and that they have used the vacuum countless times before they got T and had always been ok afterwards).

 

There is such a thing as "a case study." They get published in peer reviewed journals, including medical journals. The goal of those studies is not to estimate probabilities, it is to make the readers aware of something that is possible. Another goal is to get other researchers to study the phenomena in more detail. Here is one example of a case study:
https://journals.sagepub.com/doi/abs/10.1177/0269881107082126
You can read a description of that case in
https://journals.sagepub.com/doi/abs/10.1177/0269881109106929

Here is another example
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357564/

 

I am also getting tired of this debate.

I like you as a person and wish the best for you. I can see this issue from your point of view and even when I make what seems to me to be a good point, I don't enjoy it as I don't like that I am upsetting you (another T sufferer). The next time I advise someone to protect their ears, I will try to remember to also warn them about overprotection. Unless Elfin objects, I will quote his post below.

This debate has been won by Friendship

 

What? I can tell you for a fact he was and how do you know who I’m talking about? Once you condition this physiological response it becomes a reflex.

You’re happy for them? That comment makes me feel sick in all honesty.

You are projecting your own fears and anxieties on here and trying to justify them. I don’t call living in isolation for 8 months something to be happy about. People really need to stay away from threads like these when they are vulnerable and anxious.

 

I was talking about the person that I quoted.

 

Why? I asked you to answer my question and you came up with some random answer.

 

I was replying to

which was your reply to

In this post, I was talking about myself and the guy I quoted.

 

I wasn’t replying to anything in particular. The question I asked was a general one.

 

Relative newbies to tinnitus are likely to find all the information/opinions above quite confusing. So here are a few common-sense rules to follow:

1. The best protection of all is avoidance. Even the best earplugs can't guarantee complete hearing protection so those relatively new to tinnitus are best advised to avoid prolonged loud noise exposure - especially amplified sound at for example live concerts and sports events. This may involve lifestyle changes.

2. When in doubt, use hearing protection. In the many tasks we all do through the week, some will inevitably involve exposure to noise - which may be at higher levels than we at first realise - so using hearing protection for many of these is only sensible.

3. Build quiet into your day. It's not a good idea to be wearing hearing protection all the time - so you need to give your ears a break by ensuring that there will be quieter times during your day when hearing protection isn't necessary.This may involve changing your routine. Use soft masking noise and light music (not using headphones) to avoid "silence" where tinnitus is most noticeable.

4. Don't stress about stress. Tinnitus newbies are forever being told that the thing which makes tinnitus worse is stress. But while it's true that how you are feeling at a particular moment can make tinnitus temporarily louder, it won't have a lasting effect. But prolonged loud noise exposure can make tinnitus permanently louder. So don't stress about stress - but do be concerned about noise.

 

Thank you for sharing your own experience and the support you provide @Starthrower I agree, at this point it is very confusing for anyone who's interested in this topic. Imo, the most important info remains on the page 4 & 5.

I don't think it's meant to be interpreted in a way that sounds 3 dB(A) louder automatically equal NIHL. I'm taking into an account the possibility that we may be vulnerable to another noise damage now so following the strickest of the noise dosage guidelines makes sense to me. At least it helps me to rationalize when I hear smth unexpected.

There are documented cases of people who ended up hospitalized with severe hearing loss where immense stress levels were to blaim (not acu trauma). Upon release their hearing was back to normal.

100%. No one is arquing here that we must not protect ourselves. The keyword here remains: reasonable protection. Not overprotecting, no drastic lifestyle changes (a social isolation e.g.), or using Prednisone irresponsibly.

This may, or may not be true.

"Research shows that there is a strong link between tinnitus and stress."

"There is no conclusive evidence that stress causes tinnitus. However, there is evidence to support the idea that, for a substantial number of people, tinnitus follows or coincides with a period of stress."
​

Source: Factsheet Tinnitus by Action on Hearing Loss

 

Nobody really knows this. Stress is often indicated as a necessary precursor to tinnitus becoming perceived in the brain. This is why it’s really common to see tinnitus start after the death of a loved one or after childbirth. It’s also common amongst people working in high stress environments and/or people who are burning the candle at both ends and are burned out.

Here’s an excerpt which is worth reading:

The project “Influence of emotional stress on auditory functions” (for short: “Tinnitus and Stress”) is contributing to remedying this lack. It draws on research done by the molecular biology research laboratory of the ENT Clinic and the Tinnitus Center Charité.

It is established that chronic stress can in general induce and exacerbate changes to the auditory system. They include above all the hypersensitization of auditory perception (hyperacusis), tinnitus, and Menière's disease, a disorder of the inner ear that leads to attacks of rotatory vertigo, one-sided hearing loss, and ringing in the ears.

But how does stress arise? As a rule it develops when people cannot cope with the growing and/or unexpected demands of their environment. They live under constant emotional pressure. The most frequent reaction is to deny any physical risk in an effort to enhance one's own achievement potential and staying power.

The physical effects of stress include increased production of the stress hormone cortisol. This raises the blood sugar level (gluconeogenesis) and intensifies the breakdown of stored fat (lipolysis), as well as protein breakdown (proteolysis), making more energy available. Higher blood pressure, a high pulse rate, and constipation are the result. But the immune system also suffers. Many patients complain of sleeplessness and a lack of appetite, psychomotor disturbances, and growing feelings of anxiety.

According to Professor Birgit Mazurek, “All these stress-induced mental changes can also influence auditory phenomena, leading, for example to the development of tinnitus or the exacerbation of an existing tinnitus. In the ear, cortisol causes a massive release of glutamate into the neurons. This ultimately leads to a greater accumulation of calcium, which damages auditory sensory cells and nerve cells in the ear.”

http://www.deutsche-tinnitus-stiftung-charite.de/en/projects/tinnitus_and_stress/

 

The best advice for newbies who have obsessive tendencies, and/or perfectionist traits, is to stay well away from the internet!

 

Then it means that the acoustic trauma and other causes of tinnitus has nothing to do with lesion in strutures of the auditory system?
I was treated at a psychiatric clinic for depression and anxiety caused by tinnitus. This clinic with five psychiatrist and many patients, only treat people with depression and anxiety and I was the only person with tinnitus. Many didn't even know what was tinnitus and doctors were treating a person with tinnitus for the first time in more than ten years.

 

In response to the comment that "The best advice for newbies who have obsessive tendencies, and/or perfectionist traits, is to stay well away from the internet!" I would say:

Actually, given the lack of help/information from GPs/doctors for most first-time tinnitus sufferers, online resources can provide much needed information to any new tinnitus sufferer -which is why forums such as tinnitus talk are so important.

It does mean though that we have a real responsibility to make sure that online information on major tinnitus websites for example the ATA, BTA and (in the UK) the NHS is reliable and evidence-based and to call it out when it's not. I'm glad that I have been able to ensure that inaccurate information on two of these websites was corrected.

 

That’s all well and good, but some of the information online is appalling, and most of it leads to scaremongering. Vulnerable people who are already in a state of anxiety should not be spending hours of their time reading horror stories.

It’s better to let your system settle and to speak to real people for a while. Find a local support group, if needed, and talk face to face. It’s much better to try and improve your overall health by exercising; talking to family members; using one’s imagination to create new things, etc. Festering in other people’s paranoia and anxieties will not calm anyone down, and this is quite a big problem.

Maybe one could take a walk somewhere that’s beautiful and breathe in some nature for a while. Take a vacation or two if money allows. The worst thing anyone can do, in the early days, is to allow their tinnitus to dominate their life. Precautions can be made for loud noise, but it’s blown out of all proportion on internet forums and this is where a lot of people’s anxiety takes over.

 

Getting support from family is sensible - but very often they may know very little about tinnitus themselves and be in need of reliable online information to support their family member with tinnitus. When advice from doctors and ENTs is so frequently lacking ensuring that there is good quality information online is perhaps the most important thing we can all be doing.

The biggest problem with much online information - and here unsurprisingly the BTA is one of the worst offenders - is the "nothing or almost nothing needs to change" lifestyle advice it provides. In fact, as with most health conditions, sensible lifestyle changes are the best way to make sure that the condition improves rather than worsens and with tinnitus reducing exposure to very noisy environments is key.

 

Sounds like you are advocating the "live and learn" approach over learning from others' mistakes:

 

This is absolutely true , I got tinnitus during a very stressful period in my life, my father for tinnitus while going through a divorce, my collegue for tinnitus while under stress because he got news his son had autism.
I read dozens of stories on this board of people who got tinnitus while being anxious or having a hard time with a lot of stress.
It doesn't mean that even if you were not stressed when hearing the sound that caused your tinnitus that you're not going through a stressful period.

 

hmm so there's two basic schools of thought, "people who argue about this concept on the internet for hours" and "people who ignore it and just use rarplugs for stuff that hurts without them, and otherwise tries have as normal a life as possible"......

that said, we're all different, and if noise I can easily tolerate today with plugs became painful tomorrow, then I'd have to recalibrate my lifestyle.

 

A link does not mean causation. Stress certainly makes T worse, and just about every other disease as well. I find that in my case also.

However, I do not believe that stress causes T on its own, and have not seen any evidence supporting that. Also, many folks here have taken anti anxiety drugs, but it has not cured their T.

The danger in my mind is that we relegate T to a "mental problem," but not deal with the underlying cause, like the noise that induced it in my case.

 

It sounds like you're equating severe stress with a mental problem. Whether or not that's the case, I view the resiliency of a given individual's stress response to be primarily affected by a fairly wide variety of "non-mental" factors. That would include factors like genetics, lifestyle, nutrition, emf exposure(s), environmental factors affecting the air we breathe, and the water we drink, etc.

Just one example, the highest concentration of Vitamin C in the body is stored in the adrenal glands. If a person has even a minor Vit. C deficiency, it's likely going to affect how well a person deals with stress, and in turn, how well they deal with tinnitus. -- It doesn't help that even minor oral and gum infections can rapidly deplete Vit. C reserves in the body. I myself try to get 5 grams of Vit. C into my body daily.

 

So there is causality. Furthermore, if you look at the Dr. Rauschecker TEDx talk he clearly mentions somewhere around 3:50 min in the vid that a lot of people who get tinnitus following acoustic trauma are also experiencing a lot of stress during that time period (which correlates with the information that’s provided in the document I shared above). That could explain why some have just hearing loss and no tinnitus whilst the other group gets hearing loss and tinnitus.

Tinnitus: Ringing in the Brain | Josef...

What some of us are providing here are our believes based on evidence other than relying heavily or entirely on personal testimony. What some of you are providing here are your own opinions, oftentimes backed up by anecdotal evidence from this forum (world population cca 7.5 billion, possibly hundreds of millions tinnitus sufferers, a couple quoted posts mostly from TT should suffice as an argument?). Factual evidence vs circumstanstial evidence.

I hate when someone relegates T to just a "mental problem" too. On that note, there is also not just one type of tinnitus. They’re looking into subtyping t now. So who has the answers?

Anyway, this is getting a little off topic now.

I don’t want to go this route. I argue that we should protect ourselves reasonably. What some members promote here is reckless and should be moderated.

 

https://ods.od.nih.gov/factsheets/vitaminc-consumer/

The upper limit for Vit C daily is 2 g, with a recommended dose of 90 mg for adult men and 75 mg for women. The dose you are taking is more likely to cause complications than help anything.

https://medlineplus.gov/ency/article/002404.htm

Vitamin C is a water soluble vitamin, that is not stored in the body, and any extra gets excreted in the urine.

 

As I recall, Linus Pauling (2-time nobel prize winner) took about 15 grams of Vit. C/day for the last several decades of his life, and enjoyed good health during most of that time. He died at age 93. I trust his research and recommendations over that of the NIH.