The Complexities of Tinnitus and Hyperacusis

The complexities of Tinnitus and hyperacusis.

This post is based on my experience with tinnitus and hyperacusis, caused by “exposure to loud noise”. I have also corresponded with people affected by these conditions and their experiences have helped me to write this piece. Please read it as information only. It is not a substitute for medical advice as each person’s circumstances will be different.

Thank you
Michael Leigh

Tinnitus is a common condition that many people are able to cope with without it causing too much difficulty in their life. Therefore, it is often treated as a minor inconvenience because it rarely requires being under the care of an ENT clinic. Please ask members of your family, friends or co-workers whether they have experienced it or have the condition and you’ll probably be told: “I get that but just ignore it”. “I only hear mine when it’s quiet but it’s nothing”. “It plays a tune and then it’s gone”. These are just a few examples of what you are likely to hear by those that are not aware or have any inclination of the effects tinnitus can have on a person when it is loud and intrusive. If this intensity is sustained for long periods it can become very debilitating. Fortunately, with time and in some cases with treatment, many people are able to habituate and go on to lead a fulfilling life doing all the things that they want to.

With most things there are exceptions and tinnitus is no different. If a person also has hyperacusis, which isn’t uncommon with loud noise exposure, it can complicate matters. If the hyperacusis doesn’t improve by itself or is left untreated further problems may result. This can manifest itself in a variety of ways that I touched on in my post: Hyperacusis, as I see it.

Some people regard earplugs and earmuffs a necessary requirement to protect themselves from any potential loud noise and will even use them to suppress normal everyday sounds. They will go further and choose not to leave their home unless it’s absolutely necessary. This is done because of their hypersensitivity to sound and believe, their condition it will be made worse by environmental sounds that will cause spikes in the tinnitus. Spikes can be distressing and typically last a few hours but are known to last days. However, if one isn’t careful the problem can be made worse and this is well documented in the medical field, as a lowering of the loudness threshold of the auditory system often results with the overuse of hearing protection making it more sensitive to sound.

If this is practice is continued, one not only has tinnitus and hyperacusis to deal with and the emotional stress that comes with them. They also risk developing other psychological problems that are associated with intolerance to sound. The hypersensitivity to everyday sounds caused by hyperacusis and the overuse of hearing protection instils negative thinking and can lead to Phonophobia - an overwhelming fear of sound. Often an affected person will spend a lot time monitoring sound levels in their immediate environment and even use sound level meters as their concerns for intolerance to sound grows. They will use earplugs or earmuffs sometimes both to protect themselves even from low level sounds they believe will cause harm to their auditory system. Unfortunately, this can become an obsession and a vicious cycle of overprotection of hyperacusis and phonophobia develops and can become a big problem if one isn’t careful.

If this situation isn’t addressed and some form of help is not sought, then things can become more problematic. Some people with tinnitus, hyperacusis and phonophobia can develop a condition called: Misophonia. It is having an extreme emotional reaction to typically occurring sounds. This does not mean hating sounds in general. It is having a dislike for specific sounds known as “trigger” sounds. It is also known as: selective sound sensitivity syndrome. Misophonia does not mean one is sensitive to how loud the sound is or its volume as with hyperacusis. Neither is it having a fear of the sound, which is phonophobia.

Some people that are highly sensitive may be irritated or get very upset to be around continual intrusive sounds. Their level of tolerance to deal with these obnoxious situations is not as high as with other people. For instance, a highly sensitive person might hear a car drive by and isn’t bothered by it. However, if they know they are going to be hearing that sound all day long and it’s going to be intrusive in their life then they start becoming very upset. This is not misophonia. By contrast, a person that is highly sensitive can also have misophonia. Meaning they can be sensitive to certain sounds but they are not misophonic sounds (trigger sounds). Misophonia is not adversely reacting to fingernails being dragged on a chalkboard, a baby crying, a knife being scored along a bottle or the sound of a disc grinder. These are classed as normal sounds that one might not like and find them bothersome.

Misophonia is an immediate reaction to a “trigger sound” that promotes an involuntary emotional response. An affected person can be overcome with rage, anger and even hate towards a sound or someone making a sound they are acutely intolerant to. Not only do they hear it but feel the distress the trigger sound is causing them. For example, the sound of someone eating an apple, the popping of chewing gum or the slurping of a drink or soup, can affect someone with this condition quite severely. They will immediately want to get away and run for cover or feel the need to confront the offensive source. Often this is just a feeling and actual physical intervention is not usually carried out.

I have only touched the surface of phonophobia and misophonia. These are separate conditions that can affect a person that does not have tinnitus or hyperacusis.

Tinnitus and hyperacusis can be complex and each person will experience them differently. A lot depends on the make up of a person. Whether they are positive or negative thinking can affect the way they look at life and the goals they want to reach. If a person has had one or both of these conditions for a while, typically over a year and have not habituated or noticed some improvement, or feel their symptoms are getting worse. I advise them to try and seek professional help with a Hearing Therapist or Audiologist that specialises in the treatment and management of tinnitus and hyperacusis. Counselling is usually helpful and medication maybe suggested too. This can help prevent conditions like phonophobia and misophonia taking hold.

Michael

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

This post is so informative! I regret that I ever resorted to earplugs. I have been trying to play music and listen to several sound that will help me but they only sound so digital that I am ordering the Oasis sound machine you recommended earlier. I really want to have this gone by the early next year... I will keep posting about my progress and thank you.

 

HI @victoria9273

I am pleased that you found this post helpful. Please give yourself plenty of time to heal because tinnitus and hyperacusis are not easy to deal with. As you are a musician, I can understand and appreciate your love of listening to music and the enjoyment you get playing the violin. I am an Audiophile and enjoy listening to the violin which happens to be one of my favourite instruments as well as the cello.

If it is possible for you to get some counselling with a Hearing Therapist or Audiologist whose trained in tinnitus and hyperacusis, I feel this will be beneficial. If you can’t, I suggest that you print some of my positivity posts on my “started threads” to help you reinforce positivity. Please read them often. This is important in the healing process of tinnitus and hyperacusis and to reduce negative thinking as much as possible, which I refer to in my post above and Hyperacusis as I see it. Print some of the success stories from members on the “positivity thread” in this forum. Try not to associate with negative thinking people, as their beliefs can interfere or stop your healing process.

I also advise that you start practicing relaxation exercises three to five times a week. These only last 30mins. There are plenty of videos on Youtube with narration to get you started. Please click on the link below for additional information.

All the best
Michael

https://www.tinnitustalk.com/threads/acquiring-a-positive-mindset.23969/

 

@Michael Leigh
As always, thanks. These days my hyperacusis is more dramatically fluctuating. This is a new phase and I hope I can somehow treat it well, or at least have some peace of mind.

I'm not a musician myself but the thought of it is really great. I only play the piano as my hobby and that's why I want to get better and play it well.

 

@Michael Leigh

I get what you're saying of not avoiding noise too much.

But: what i have a really terrible attention span. i really need silence, or white noise or very specific non-distracting music. Those would add so much to my quality of life, at work(music is always on, at medium volume) especially.

And btw, i'm relatively habituated to my tinnitus.

So noise-cancelling earphones or earmuffs would really help.

But i don't want more problems.

So what if i use noise cancelling/isolation earphones, but ALWAYS put on some music, or white noise, at low levels - say just below my tinnitus , or just a bit above it ?

Would that cause further problems ?

Or is there another strategy to solve this problem ?

 

It is good that you have habituated to your tinnitus. If you want it to stay that way I advise you not to listen to any kind of audio through any type of headphones even at low volume, as you risk making your tinnitus worse. Some people do not believe that headphones can make tinnitus worse even at low volume, so it's up to you. I have written many posts about Headphones and Tinnitus. Please read my article: Tinnitus, A Personal View. There is a piece in it about Headphones and Tinnitus : https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

I strongly advise you not to use noise cancelling headphones or any other type especially if your tinnitus was caused by exposure to loud noise. Even if it wasn't I still advise caution using any type of headphone.

Michael

 

Very well written and balanced message. I think especially for hyperacusis it is important that people should realize that improvement, and often (near) full recovery, is very well possible, provided the hyperacusis is addressed in the right way. Message boards are often flooded by people who have just gotten the condition or have not yet had meaningful improvement. Those who recover do not stick around usually. This creates a very one-sided and negative picture, that fuels fear and avoidance behavior, which paradoxically make hyperacusis worse!

And with tinnitus, millions have it but many of those successfully learn to deal with it (I recently found out more than half of the people in my office have some form of tinnitus or other hearing issues - can you imaging? I never knew!)

Thank you for sticking around and providing well-thought, realistic information. I try to do the same now that I am doing better but I admit that it is tempting to avoid the negativity and just get on with life.

 

Thank you for your kind comments @Coffeebean they are much appreciated. I have read a number of your posts and they are informative and well written. Hope you are able to stay around too.

All the best
Michael

 

When you say audio do you mean only music or do you also think that an earpiece can also worsen it?

 

@Michael Leigh – I have not read your lengthy essay as what you have to say is at best unimportant, but most often just plain annoying. However, I would appreciate you didn't use terms such as "complexities" as in the title of this thread – because if there is one thing your one-track simplistic regurgitative mind doesn't cater for, then it's complexity...

Thank you for your understanding.

 

I do not understand what you mean by "earpiece"? If you mean a hearing aid? These are perfectly fine and using white noise generators providing they are used correctly they will not usually spike tinnitus or make it worse.

I do not recommend anyone that has "noise induced" tinnitus to use any type of headphones including earbuds to listen to any type of audio including speech even at low volume. My advice is for guidance only and therefore, it is up to the individual to make up their own mind regarding the use of headphones. I am making people aware of the risks. If the tinnitus should spike from using headphones, it is unlikely that it will return to its previous level.

Michael

 

So would ear tests also be dangerous.

 

I have no way of knowing if ear tests or hearing tests are dangerous. As far as I am concerned they are essential for determining problems within the ear and auditory system for such conditions as tinnitus. I have had many hearing tests in the 22 years that I have had tinnitus and never had a problem. I have had microsuction 3 times and ear irrigation the same and had no problem. My tinnitus can reach very severe levels.

Michael

 

I used an earpiece like this for work. Is it dangerous? I am scared now.

 

Please look at your questions to me. They are "one line" statements from which you are expecting me to give you answers. Please write a post giving information what you are using the earpiece for, the duration of use and what type of audio you are listening to.

With respect @dpdx I know you are able to do much better than this.
Michael

 

Perhaps you could enlighten the forum with the reason for posting the above comments. Personally, I haven't found this comment to be helpful to this thread... Please don't post statements like this without explaining yourself

 

Wow, I'm deeply shocked - I would have expected better from you Michael Leigh - but then perhaps you're having a bad day...

Perhaps it wasn't clear, but if you care to read the name included in my quote, it was directed @attheageofscience

It would be nice to read things properly before jumping to conclusions. I am very disappointed considering I always find you to be a friendly face on the forum

I look forward to your humble apology...

 

I am as shocked as you are @dingaling I have looked at your post again and see no reference to attheageofscience. I will delete my post since you have made it clear your post wasn't intended for me.

I do apologise unreservedly for my comments towards you but please understand, on my computer screen I see no reference to your post addressed to attheageofscience.

I wish you well.
Michael

 

Hi Michael

Very strange as I see it at the top of the box in Post 16. In hindsight, perhaps I should have deleted your name.

No worries, apology accepted - keep up the good work

 

Well... I guess your own subsequent line explains everything doesn't it...?