Severe Hyperacusis and Reactive Tinnitus: How to Treat & Cope?

[mandyc]

Just wondering how best to treat hyperacusis. I've had it quite severely for about five months now, along with bad reactive tinnitus. The tinnitus is very loud and I'm struggling to sleep. I'm scared to take medications in case they make things worse.

I've had all the tests from ENT and audiology, and nothing is wrong. No hearing loss. I'm wondering if I should start exposure therapy to deal with the hyperacusis or if I should hold off and rest my ears for a few more months.

My tinnitus started suddenly overnight in one ear and then progressed to the other. After five months, it is fluctuating between ears. I take a Zopiclone once a week, which gives me about three or four hours of sleep, but I still struggle to fall asleep and stay asleep since this began. Whether I get sleep or not doesn't seem to affect the tinnitus. In fact, some days when I haven't slept at all, the tinnitus is a bit better—maybe because my brain is too exhausted to produce the sound?

I don't want to make the hyperacusis worse, and I worry that exposure therapy might do that, leaving me with no way back. I'm wondering what other people have done.

I'm not wearing earplugs around the house, but I can't stay in the kitchen when the kettle is boiling or the washing machine is running. Even the fridge sound is loud and irritating. I can't stand running water, and the wind is often strong here, so I can only get outside in the garden on still days. Going in a car is impossible because of the sound of the tyres on the road.

I usually start the morning with barely any tinnitus at all, but it comes on around 11 a.m. and gets worse as the day goes on. Any advice from anyone who has been through this or is going through it now?

 

[MindOverMatter]

I'm not wearing earplugs around the house, but I can't stay in the kitchen when the kettle is boiling or the washing machine is running. Even the fridge sound is loud and irritating. I can't stand running water, and the wind is often strong here, so I can only get outside in the garden on still days. Going in a car is impossible because of the sound of the tyres on the road.

I usually start the morning with barely any tinnitus at all, but it comes on around 11 a.m. and gets worse as the day goes on. Any advice from anyone who has been through this or is going through it now?

Luckily, or unfortunately, five months is still a very short time for this kind of sound sensitivity and reactive tinnitus.

There is plenty of time for you to improve. What will work best for you is almost impossible to know for sure, since this is very much a trial-and-error process.

Personally, I have been to hell and back with this, but I am in a much better place now than I was in 2019 when I first experienced a major worsening. Luckily, I sought professional help early on and was fortunate to get counseling from an audiologist after a few months, someone who specialized in tinnitus, hyperacusis, and CBT.

It probably took me at least a year before I could see real changes in how I responded. The tinnitus was by no means gone, but my negative emotions toward it became less intense with acceptance, counseling, and time.

I am not here to tell anyone to simply push through, but I chose not to give up my life. I stopped going to the obviously loud events such as concerts, cinemas, and clubs, but I still went to weddings, birthday parties, and restaurants. I kept working full time, driving, exercising, traveling, and so on, even during the most difficult period of my life.

Nothing is impossible, but I will not deny that it was hard. I did all of these things with some level of ear protection, despite the constant cacophony in my head. For me, the alternative—total isolation—would have been worse. Staying engaged with life helped keep me sane and prevented me from spiraling into a deeper depression.

I reacted to almost everything you mentioned, and more: road noise, wind, voices, running water, rain, frying, kettles, air conditioning. Pretty much everything triggered me at one point.

Still, I kept going. I was careful not to overdo it, and I stepped back when necessary. I rested a lot in between and spent much of my time hiking, being physically active, practicing photography, and staying in nature. That was my healer. Although natural sounds were overwhelming at first, they eventually gave back more than they took. Nature helped me rewire my brain because I wasn't exposed to harmful levels of artificial noise. It calmed my mind and body once I allowed myself to "lower my guard" and accept the reactions. Over time, the emotional charge attached to the sounds faded.

Slowly, things improved. At first I might get only one good day, followed by two or three difficult ones. It was a rollercoaster, non-linear. But as the months went by, the good days became more frequent. It's hard to remember the exact timeline now, but I can see the bigger picture.

Spikes and setbacks will happen. They are unavoidable, and progress is hard to measure. This is not something you can evaluate day by day or even week by week—you need to look at it over longer periods.

In these six years, I have had many moments where I thought I was back to square one after a setback: an MRI, fireworks, a grinding machine, or something else unexpected. There has been a lot, but I survived it all. And the truth is, I was never really back at square one. Even when a setback lasted close to six months, progress eventually returned.

I have noticed that the less tense I become in soundscapes that once caused huge problems, the less spiking there is, if any. It is all connected.

I could probably write a whole book about this.

As for what you should do—only you will know in time. My advice is to go slow and steady. Stay active, but don't overdo it. As you gain confidence, you can gradually do more. It is not impossible to drive again. I know what you mean, but you will get there. Give it a couple of months and start small. Use proper custom musician's earplugs in the car for six to twelve months, and use them when you feel you need them. Choose the filter that feels right for you, but don't overprotect.