Reactive Tinnitus Vs. Hyperacusis: Treatment Crossroads

Hello! I am a 26-year-old music producer. I have had tinnitus since sometime in 2020, it was so quiet it didn't bother me.

On 1/1/2023, I had a temporary threshold shift while producing music. The threshold shift subsided the next day, but it came with a louder and reactive form of tinnitus. This tinnitus seems to amp up with external noise input.

A week after onset, I had become so stressed about it that I fainted and was taken to the ER, where they claimed to have found fluid behind my eardrums. I was treated for an Ear Infection. While I didn't have any obvious symptoms, I did notice some infected congestion come up.

I continued to stress into the following week, until I ended up with neurological symptoms resembling a stroke. These symptoms subsided once I got my anxiety under control. The next week, I saw an ENT who confirmed only very mild hearing loss in the upper frequencies, but not enough to be concerned about.

Since then, my tinnitus has remained reactive. I started trying pink noise therapy which seems to have helped reduce the reactivity over the past couple of weeks. I am now noticing a sensitivity to sounds, mainly those very present in the 1.7 kHz - 2.5 kHz range. This became more noticeable in the past two days.

I don't know if this is hyperacusis or not, because I don't have pain (yet).

I want to prevent this from developing further, but the information on how to do that seems to be conflicting.

On the one hand, pink noise therapy is going to be the best thing for me whereas overprotecting my ears will be what brings on sound sensitivity.

On the other hand, those with bad hyperacusis are saying that pink noise is dogma and that the only way for me to fix this is to spend 2 years in absolute silence, giving up my passion for music or any other fun experience involving sound.

I have no idea what to do now. Both of these schools of though conflict with eachother and claim that the opposing viewpoint will cause my condition to collapse into painful, depression-inducing intolerance to sound.

Does anyone have any solid thoughts on this?

 

Everyone’s hyperacusis is different. Including the amount of long-term damage each person has.

I can only tell you my experience. I had hyperacusis when I was 20 from DJ’ing. It lasted 18 months or so. I was even wearing earplugs to drive. This was before I even knew what it was. I continued to make music and DJ despite pain. It still healed. Always wore earplugs.

Maybe it would have been quicker had I stopped DJ’ing? Or maybe it was time that was required to heal. We will never know but it went away for 15 years.

Only recently did it come back on and off. I tend to think the people that don’t get better either have too much damage or they overprotect.

It’s hard to gauge how it will go for you. But you’re in a very anxious state at the moment and may presume the worst. Most of all you need time. I’d maybe suggest not pushing your luck and keeping it easy with loud sounds or long periods of work. Avoiding headphones for a while will help too. But you will likely continue your career.

 

True hyperacusis or not... well, at least you have some sort of sound sensitivity, given your description. Just a little note. Pain doesn't have to be involved at all with hyperacusis. It could be loudness hyperacusis.

As @Benjaminbb states; everyone's hyperacusis is different. The road "to recovery" is very much a trial and error road - one day at a time...

A minimum would be to protect when needed. Sound therapy, if it soothes you and you can find some positive association to it/to the soundscape you prefer (and it doesn't aggravate you a lot), could be a way to go to desensitize.

 

I am less experienced with tinnitus and hyperacusis then @Benjaminbb and @MindOverMatter but I definitely agree with both their posts. The key is to find a balance between protection and exposure, and that is unfortunately something you will have to figure out for yourself as everyone is different.

One thing I've noticed with my struggles is that the "worst" part of the hyperacusis came on a few weeks after my sound trauma, even though I had already begun to protect myself from loud noises at that point. This was stressful and discouraging because I felt I was steadily worsening despite my best efforts. In retrospect, I think it might just have been a form of delayed reaction to the trauma. Now, a bit over 8 months since onset, I have made progress with my pain and sensitivity. I still experience regular pain, but I know my limits better than at onset and that helps a lot. This condition really tests our mental toughness and patience. Hang in there, chances are your condition will improve or at least stabilize.

 

@CRGC, @Benjaminbb and @MindOverMatter:

Thank you all for your replies. It's encouraging to hear your thoughts on this. I am 26, so I would hope that being fairly young may benefit the recovery or stabilization from what I'm going through.

I also have debilitating OCD, so it's hard not to get trapped in this rabbit hole of "what if I develop worse hyperacusis?" "What if I develop pain with this?" Every day I feel like I'm just waiting for the other shoe to drop and my condition begins to collapse into something more terrifying.

At this point, I actually feel habituated and can be comfortable with my condition the way it is as long as it will continue to improve. I have worked hard over the past 6 weeks to become at peace with my reactive tinnitus, so the anxiety is not about what I'm presently experiencing. It's about what could be - I'm afraid that I will make one wrong choice and the whole house of cards comes tumbling down on top of me. My peace, my music career, all gone in a few days with my only option to withdraw from society and sit in silence. Clearly I have read too many hyperacusis horror stories but now I can't get them out of my head.

 

Everyone is different when it comes to improving with this is the best advice one can give imo.

 

What could have been, yes. It's a legitimate question to raise, especially at your age. Many questions arise when one gets hit with this challenging condition. There are many "what ifs". But given you have OCD too, you could easily be stuck in that loop for too long - which in turn makes things harder.

I think you would greatly benefit from counselling with someone that specialize in CBT. If this person has knowledge about hyperacusis and the likes as well, even better.

You need to break this cycle and get out of the rabbit hole.

Personally I believe in acceptance of the situation, for now. Which really applies to so many stages and happenings of life. We can't change whatever happened, but we have a choice, once we are able to, to let go of things.

Letting go doesn't mean there will be no grief or suffering still, but it could make the situation easier to handle. And with some sort of acceptance to the situation, there is (for quite many people I believe) a chance that it will fade out in the background for you.

Time and persistence is key, and not getting stuck in the past.

But, again, every case is different, and every person is different. However, don't measure your journey from all the stories here. Don't get caught up on negativity - focus on what you still have - and that things can improve.

Most people do get better, and many of them are not members here at all. Or they post once or twice, and was never seen again.

 

I also want to add that your perception of the situation can completely change how you feel about it.

This sounds obvious but when you’re in a hole and have read a few horror stories, you start thinking crazy things like you’ve destroyed your ears and that every minor 25 dB tinnitus sound is proof of major damage etc etc.

You’re aware of your OCD and anxiety so you almost have to remind yourself part of what you’re thinking and feeling isn’t real. In the early states of fixating you see minor things as major. You need to continue to ween your brain onto other topics till it stops thinking about ears. I still have periods where I go from 100s of thoughts a day down to only several. It generally moves in waves.

Our brain is trained by what is at the forefront of it. If you have a habit of picking up your phone every 2 minutes, that continues. If you lock your phone away, you very quickly move your mind to other things and that habit stops.

The same occurs when thinking about ears and what can go wrong. Ween off those thoughts.