Tinnitus, A Personal View

Tinnitus, A Personal View

This article is for information purposes only and is not intended to substitute the advice from your healthcare professional. I have used medical terms where I thought it necessary and to give clarification. I have tried to keep the content factual and accurate. Please do not consider anything that I have written to be professional medical advice. If you need help with your tinnitus always talk with your healthcare provider.

Michael Leigh

I would like to thank the Doctors and my Hearing Therapist, who have treated me over the years, and have helped to make my life easier, especially at those times when I wasn’t feeling my best.

My experience with tinnitus has enabled me to give advice at Internet forums, on the telephone and by email to people that asked for my help. Some of these people suggested that I write a book about this condition but unfortunately; my abilities do not stretch that far. I hope the information given here will be of help to anyone that is having difficulty coping with tinnitus. I would like to thank the people that gave me the encouragement to write this article; because it was something I never contemplated doing or thought I would be able to complete.

Tinnitus is a sound that is experienced either in the head or the ears but often in both which is not coming from an external sound source. There are two types of tinnitus. The most common is Subjective. The person affected can only hear this. The other is called Objective. A doctor can hear this when examining a patient, by placing a stethoscope on the neck, close to the ear. If a rhythmic heart beat can be heard through the blood vessels of the neck, it is known as objective pulsatile tinnitus.

I will only be dealing with subjective tinnitus and the treatments for it, although people with pulsatile tinnitus have also found them helpful.

The onset of my tinnitus stems back to a time when the Internet wasn’t like it is now. My main source of information about it came from tinnitus organizations and books that I had borrowed from the library or bought at a store. How times have changed. Although I learned a lot from books, I really wanted to meet with people that had experience with tinnitus and would be able to advise me on how best to cope especially in the early days. For all I had been hearing was, there is no cure you will have to learn to live with it. Through one of the tinnitus organizations that I had joined they published a magazine that I found very informative. I was delighted to see they had readers letter pages, where people could write in for advice or ask questions and hopefully they would be answered by more experienced people living with tinnitus.

That was 20 years ago when a video tape recorder was in many homes. I thought my luck was in when I had the opportunity to borrow a VHS tape of a tinnitus seminar held by a Dr, that worked in ENT and was also a tinnitus expert and wrote a book on it. The venue was in a large hall. He stood on a podium behind a lectern with microphone and presided over his seated audience and looked very official. After his introduction he said that he would answer any questions at the end of the evening. At last I thought I was going to learn something and settled down to watch the hour-long tape.

To say I was disappointed at what I had seen would be a polite way of describing it. For one hour I watched and listened to this person say, that everyone gets tinnitus occasionally. It is mostly to do with noisy background activity within the body and it travels up to the auditory system where the signals are transmitted to the brain. Most people can easily ignore these signals was his theory but those with tinnitus, have allowed their brain to focus on them, until they become louder and eventually become a problem. He asked the audience, how many had been for a night out where the music was played loud and at the end of the evening their ears were ringing?

Nearly everyone put their hand up. He walked pompously from behind the lectern and stood at the front of the stage and said “And by the morning the ringing has gone a way right”? Looking very pleased with himself he continued. “But in your case, you have allowed your brain to hold on to the tinnitus and when you don‘t hear it any longer you say”. In disbelief I watched him start to jog up and down the stage shouting out “Where’s my tinnitus, where’s my tinnitus”?

When he eventually stopped he could hardly contain the huge smile that was spread across his face because he looked very pleased with himself. However, the audience looked less than impressed at what they had seen as no one said a word. I watched the tape until the end and sent it back with a letter of thanks and my comments that were not favorable. My letter was printed in that tinnitus magazine to warn other potential readers of what to expect before asking to borrow it.

What I had witnessed all those years ago on that video by this so called tinnitus expert, was nothing short of mocking people that find tinnitus debilitating when it’s severe. It was very clear to me, that Dr had never experienced loud intrusive tinnitus once in his life. Thankfully, times have moved on and there is more understanding and help for people with tinnitus, in the medical field and not everyone thinks it is all in the mind or something that can easily be dismissed because it isn’t.

I am thankful that the Internet, enables people to come together and meet in forums and give help and support to those that need it. I believe these are the people that are the tinnitus experts because they know what it’s like to live with the condition daily.

The ear is a very sophisticated and delicate organ. I think that I am right in saying, many people don’t give this much thought or know the complex things that it does, to enable us to hear and to keep our sense of balance. That is, until something goes wrong with it. The ear consists of three main parts: Outer ear, Middle ear and Inner ear. I want to explain them in a little more detail.

The Outer ear. This is the part that we see attached to the side of our skull and is called the Pinna. Its job is to collect sounds from the outside world and funnel them down the narrow passageway inside our head called the ear canal. It is approximately 26mm long and connects the outer ear to the inner ear. The ear canal is lined with wax, the medical term: cerumen. It protects the skin of the canal and helps prevent bacteria, dirt and other foreign substances from entering.

The Middle ear. This comprises of the eardrum and the three smallest bones in the human body that are connected to it, called: the hammer (malleus) The anvil (incus) and the stirrup (stapes) The sound waves in the ear canal are directed onto the eardrum also known as the Tympanic membrane. It is a thin piece of tissue that is stretched between the outer and middle ear and vibrates when sound waves hits it. As the eardrum moves the malleus, incus and stapes, which are joined together also move and transfer the sound to the cochlea, which is in the inner ear.

The Inner ear. The cochlea is the hearing part of the inner ear and is pushed by the stapes. It is a spiral tube that is filled with fluid. Its coiled structure looks similar in appearance to a snail. The vibrations that are delivered to it are turned into electrical signals by thousands of tiny nerve cells that are attached to it. These nerve cells are also known as ear hairs. As the nerves begin to vibrate to sound, the electrical signal travels directly to the brain via the vestibulocochlear (auditory nerve) known as the eighth cranial nerve. The brain interprets these signals into sound.

The vestibulocochlear nerve transmits sound and balance information and is split into two: The cochlear nerve and vestibular nerve. Whilst sound travels along the cochlear nerve to the brain, the vestibular nerve is connected to the Semicircular canal. There are three semicircular canals or ducts in each ear. These small tubes are interconnected and filled with a fluid called endolymph, which contains motion sensors. The canals are at right angles to each other. When the head moves the fluid in the canals detect it and sends this information to the brain, so it knows how to keep the body in balance.

It may surprise some of you to know that tinnitus is quite a common condition. Mention to a friend or family member that you are experiencing ringing in your ears and it’s causing you no end of distress and you will probably be told: “I get that but just ignore it”. “Mine only bothers me at night when it’s quiet but once asleep I’m fine. Another might say: “It plays a tune, at first it was strange but I’m used to it now”. And so the story goes on.

This casual approach to tinnitus doesn’t stop there for even some healthcare professionals have a cavalier attitude to it as if it’s no problem at all. I have read on Internet forums and been told by people after seeing their family doctor that the advice given was “learn to live with it as there’s no cure.” Telling someone this when they are in distress and seeking help with their tinnitus is the last thing they want to hear, as it can often leave one at a crossroads and not knowing which way to turn. At the other end of the scale someone once told me their GP suspected they were a medical emergency and got them rushed to hospital because of the distress they were in. So it’s reasonable to assume when someone visits their doctor complaining of tinnitus the experience will be unique to them.

All things considered, it must be said the relaxed attitude once shown towards tinnitus is starting to change amongst some healthcare professionals and the way they treat their patients. More understanding is being given as it’s realised when tinnitus is loud and intrusive it can seriously affect a person’s quality of life and their emotions. This hasn’t come to soon and such people whom we reach out to for help are to be commended.

We are all different for no two people experience tinnitus quite the same. Similarly, the condition comes in many forms and intensities: Mild, moderate and severe. It can either be constant or intermittent. It can manifest itself in one or both ears. When in both ears it is known as bilateral tinnitus and with this one can sometimes experience a sensation of the noise coming from within the centre of the head. As if that isn’t enough, tinnitus can fluctuate in intensity daily, which can complicate matters and make habituation more difficult but in most cases still possible.

There is no hard and fast rule for the way tinnitus will affect a person, nor is there, any definitive treatment that will work to make them cope better. However, it is my intention, to try and convey to you that I understand how distressing tinnitus can be when it is severe and the way it can make a person feel having lived with it for many years. At times it hasn’t been easy but like others that have learned to habituate to their tinnitus, I hope to make your path to it a little easier and less stressful.

I want to dispel the doubts and fears that are often associated with tinnitus when it’s loud and intrusive. Remove that wall of negativity that some people find difficult to overcome which can hinder or stop the habituation process. Replace it with positive thinking and in doing so you will be able to move forward and realize there is light at the end of the tunnel. Just because you have tinnitus doesn’t mean your future is mapped out to be one of doom and gloom. With positive thinking a lot can be achieved and I will discuss this later. For now I’ll say this: Once you learn how to harness positivity and incorporate it into your daily living, gradual changes will start to take place both in your mind and thought process about this condition as life will become easier and less problematic.

The causes of tinnitus

Many things can cause tinnitus but the most common is exposure to loud noise, and it is this that I will be focusing on. However, I will list a few of the other things that can cause it.

Hearing loss.

Injury to the ears or head

An Ear infection

Disease of the ear- otosclerosis

Side effects of some medication

Emotional stress

TMJ Temporo-mandibular joint

Meniere’s disease

Acoustic neuroma

As I’ve previously mentioned tinnitus is a common condition that many people are able live with quite easily because it is remains relatively mild or moderate and doesn’t impact too much on their daily life. For these kinds of people habituation to tinnitus happens quite quickly and therefore, the need to visit their GP or to be referred to hearing clinic isn’t always necessary. For the less fortunate amongst us that have loud intrusive tinnitus it can become quite a problem. Ranging from sleep deprivation at night to not being able to function properly during the day because of the constant noise that has now become part of our world. The dreaded feeling of being unable to escape from it can become overwhelming. Under these dire circumstances it can become necessary to be referred to a hospital ENT department where tests can be carried out to try and find the cause of this anomaly.

An ENT specialist may have already seen some of you but for those waiting for their appointment, I will try and give an account of what you are likely to expect on the day you arrive at the ear, nose and throat department. I won’t be able to cover everything but hopefully, I will be able to include the most relevant points of what is likely to happen. Your consultant or ENT specialist will usually start off by asking you a series of questions that will probably begin with, how long have you been experiencing tinnitus and when did it start? Is this the first time that you have noticed ringing in your ears? Do you experience the noise in just one ear or is it in both and whether the tinnitus is constant or intermittent? You will probably be asked to explain in detail what the tinnitus sounds like, does the noise change or remain the same? Tinnitus can vary considerably between people from buzzing, whistling, ringing and sometimes musical tones are heard. Some people hear multiple tones.

One of the most common sounds is hissing, which resembles white noise as if a radio has been tuned between two stations. These questions are important so try to remain calm. You will probably be asked when does it bother you the most and how does it affect your quality of life and day to day living and whether you are able to work? A common question is do you have any idea what might have caused the tinnitus, as many things can cause it. Whilst this is going on your doctor will be listening and observing your body language as this can give an indication of how the tinnitus is affecting you physically and emotionally. The questions are necessary for it is you that is experiencing the tinnitus, as no one else can know what you are going through. Notes will be taken about your medical history and whether you are taking any medication. Some medicines, beta-blockers for example can cause ringing in the ears and aspirin has been known to cause it too.


Your occupation could also give an indication as to the cause of your tinnitus, especially if you work in a noisy environment or operate machinery where noise levels are high. You may be off work sick due to your tinnitus which is not uncommon. An important piece of information is what do you like to do socially. Do you attend nightclubs or visit places where music is played loud regularly? Many people enjoy a night out on the town and have experienced ringing in the ears after they have left a club. Going to gigs and clubs and subjecting one’s hearing to high sound levels over a period of time can cause tinnitus to become permanent so it’s something to keep in mind.

We live in a world where most people have a mobile phone on their person the majority of the time. It’s as if these devices have become an integral part of one’s wardrobe and many feel undressed unless first checking that they have their phone to hand before venturing through the front door. I often wonder how did we manage to exist before without them. These devices have much wider uses than mere telephony. They can browse the Internet when we are out and about take photos and communicate on social media websites and do many other things. They are often used to listen to music via headphones.

Walk along any high street or travel on public transport and you will see people listening to their music through headphones attached to their phone or an MP3 player. They are often totally immersed into what they are listening and sometimes oblivious to what is going on around them and to those that can clearly hear their music, which is an indication that what they are listening to is too loud for their ears. Prolonged headphone use and listening to music through them at high volume levels can cause hearing damage and tinnitus.

With noise induced tinnitus it is often the case a person can also experience hyperacusis, this is having a sensitivity to sound or certain sounds that become very irritating to the ears and sometimes even painful. I will be covering hyperacusis in more detail later on as I feel it deserves to be explained in much more detail and how people are able to get it treated since it is closely linked with tinnitus. You will probably be asked if you are sensitive to sounds and if so what are they?

At some point your doctor is likely to look into your ears using an Auriscope to inspect the ear canal and also the eardrum. It is similar in size to a small hand held torch and has a magnifying glass attached. A light shines through this allowing the doctor to see if there is any wax-build up in the ear which is another thing that can cause tinnitus. If everything is fine this part of the consultation will be drawing to a close. The next step is, you will probably be asked to take a hearing test, which will be carried out by an Audiologist in a sound proof room. You will be given a pair of headphones to wear and a selection of audible tones will be played and you will be asked to press a trigger on a hand held device when you hear each one.

Another test that the audiologist might perform is a Tympanometry examination. This will check the condition of the middle ear and mobility of the eardrum (tympanic membrane) and how the three smallest bones in the human body are fuctioning: the Malleus, incus and stapes. The test will measure your ears response to both sound and pressure and can detect things like hearing loss, fluid in the middle ear, otitis media (ear infection) and a perforation or tear in the eardrum and other problems associated with the inner ear. A small plastic bung rests in the ear and seals it. A machine gently changes the pressure in the ear canal and the results will be recorded on a graph called a tympanogram. Afterwards you will wait to see the ENT specialist again who will go through the results of your hearing tests that were plotted on an audiogram. With the onset of tinnitus especially caused by exposure to loud noise, it is not unusual to find there are signs of some hearing loss but not in all cases.

Another procedure that tinnitus patients are likely to have is an MRI scan. Magnetic Resonance Imaging. It will enable the ENT specialist to closely examine the inside of your ear and brain to see if there is an acoustic neuroma present. An acoustic neuroma is a benign slow growing tumour attached to the eighth cranial nerve, also known as the vestibulocochlear nerve. It connects the inner ear to the brain. It can cause problems such as hearing loss, dizziness and tinnitus.

If your hearing test and MRI scan show no abnormalities, then it’s likely your doctor will discuss with you the different treatments that are available to help you manage and cope with your tinnitus better. Most people will be referred to a Hearing Therapist and you will probably be advised to wait for an appointment letter. Tinnitus can play havoc with one’s emotions especially in first few months of having the condition. Therefore, it is not surprising that some people can find this period a little overwhelming and feel stressed out. Try not to be too hard on yourself because this condition isn’t easy to deal with when it’s loud and intrusive and remember, that you are still in the early days but as time goes on you are likely to see improvement.

Your doctor might ask if you are managing to get off to sleep at night or whether the noise is keeping you awake. If you are having problems sleeping then please say so because you are not alone. Many people that are new to tinnitus have some difficulty sleeping and a mild sleeping tablet might be offered to help you through this stressful time. An antidepressant might be prescribed if you haven’t already been given them by your GP. Antidepressants can help prevent a person becoming too down due to their tinnitus because it has a direct affect on a person’s moods. The more stressed one becomes the louder and more intrusive the tinnitus will appear which can result in a person feeling more depressed. Tinnitus feeds stress and stress feeds tinnitus.

When you meet with your Hearing Therapist for the first time you will probably have a lengthy conversation, where you will be able to relay how you have been feeling since the onset of your tinnitus. This is your chance to get it all out there and remember the person you will be talking to is someone that knows a lot about this condition and the way it can affect a person emotionally and physically. Some of the comments that you may have been told by people that play down tinnitus as something minor because theirs is not intrusive won’t be mentioned.

Throughout the consultation you will be listened to and then advised how to look at your situation a little differently which comes with time and adopting a more positive approach to life. Hearing Therapists help their patients by showing them a way forward and demystifying a lot of the negativity that surrounds this condition. Not surprisingly, this level of understanding and empathy doesn’t always come from training and working in an ENT department alone, for some of these people also have tinnitus. Over the years I have met quite a few Hearing Therapists and Audiologists at tinnitus Internet forums helping people. At some point they have relayed to me that they have tinnitus or were born with it as my hearing therapist was.

Treatment and coping strategies


Coping strategies that people have found helpful will be explained, as well as giving you advice on the types of treatments available to you at the clinic. Some are listed below.


TRT (Tinnitus Retraining Therapy)

CBT (Cognitive Behavioural Therapy)

Relaxation exercises

The Sound Machine

Natural environmental sounds

CDs and MP3 downloads

Tinnitus Retraining Therapy

Tinnitus retraining therapy or (TRT) has been around for a while and is one of the most effective treatments for tinnitus. Many patients achieve good results with it but like anything, the benefits will be variable from person to person. It involves using sound enrichment and counselling. Sound enrichment is achieved by wearing white noise generators (wngs). The device closely resembles a hearing aid and fits around the back of the ear, from which a small tube is attached that rests in the entrance to the ear canal. The white noise is adjusted via a small rocker switch on the wngs.

There is another type of white noise generator that serves the same purpose but is smaller and more discreet which some people might prefer. The device is inserted into the ear canal and has a small volume control to adjust the white noise. The second part of the treatment involves counselling. It is necessary for the patient to have regular outpatients appointments, with their Hearing Therapist who is trained in the field of tinnitus and the perception of it. Some patients are also affected with Hyperacusis (sensitivity to sound). If it is present at the same time as having tinnitus then the white noise generators will also treat it.

TRT was founded by Professor Pawel Jasterboff and follows a strict protocol, which should be adhered to for the patient to receive maximum benefit. It must be said, the treatment can be expensive and it’s not available at all hospitals and tinnitus clinics. Some that practice it have adapted the treatment to their requirements but good results are still possible. If one chooses, they can do their own research to find a clinic that practices the Jasterboff method. Tinnitus retraining therapy is not a quick treatment and therefore must not be rushed. It requires the patient to wear two white noise generators for up to ten hours a day. They are first put on in the morning and the white noise set to just below the tinnitus, and then left alone. It can be tempting to turn up the volume when out on the street as traffic noise can make it difficult to hear them. Please don’t do this. Constantly adjusting wngs volume will delay the habituation process. Over time the brain habituates to the white noise generator and pushes the tinnitus further into the background where it becomes less noticeable. This cannot be successfully achieved if the wngs is repeatedly adjusted throughout the day.

Tinnitus counselling is a vital part of TRT. Tinnitus can become a problem when the patient starts to believe nothing can be done about the condition. If one isn’t careful anxiety and depression can start to take hold. Through regular counselling sessions with a Hearing Therapist the patient learns not to look at their tinnitus as non life threatening and not to be constantly afraid of it and to be monitoring every little change in its perception. At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. Therefore, it must be stressed and understood, this treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

There are a few misconceptions about this treatment and the way it is administered that some people misunderstand which I want to address. If a patient is given one white noise generator to wear this is not TRT. When two wngs are issued and no tinnitus counselling is offered on a regular basis, it is not TRT. I am not saying that a patient will not gain any benefit from the above treatments; I only want to state they do not follow the proper Tinnitus retraining therapy protocol. White noise generators should not be used when going to sleep at night. When retiring for the night, one should use a sound machine by the bedside and adjusted to a level just below the tinnitus. The sound machine should be set to play throughout the night until morning.

Cognitive Behavioural Therapy for Tinnitus.

Cognitive behavioural therapy (CBT) maybe offered as a treatment for tinnitus. It can teach coping techniques to help a person deal with the negative thinking and thoughts that often accompany the condition when it’s intrusive and for those that are new to it. This treatment can be practiced through a Hearing Therapist or clinical psychologist. Patients are asked to keep a diary of the times they find their tinnitus to be most annoying and distressing. Detailing the nature of the distress and what might have caused it. All this information helps the therapist to make suggestions on how to think and do things differently, which the patient might find helpful. By changing the way one looks at their tinnitus the distress is reduced and the noise becomes less noticeable.

Relaxation exercises

Relaxation exercises can be beneficial and a good way to channel stress. It can take a while to learn the technique. If you are offered the opportunity to attend a class and have the time, then it’s something to consider trying as good results are possible. Anything that a person can do to remain calm and relaxed will help tinnitus.

The Sound machine

When the brain hears tinnitus for the first time it can feel threatened, as it has never heard this strange new noise before and because of this, it latches onto the sound and doesn’t want to let it go. It is similar to someone moving home and relocating to a new area where trains or motorcars might frequently be passing near their home. The brain is not used to hearing this amount of background activity and starts to focus on the sounds and in doing so they are given importance and thus become louder. The brain is capable of doing and adapting to many things. As time goes by, it no longer interprets these sounds as threatening and slowly pushes them into the background of the mind where they are now seen as unimportant.

Tinnitus and the way the brain reacts to it are a little similar. As previously mentioned, most people with mild or moderate tinnitus adjust to it quite quickly. Although, we are all different, it’s natural to expect some people will take longer than others, so there is no definite time frame. However, the outcome will usually be the same for people in this group. After a while the brain will perceive the tinnitus as unimportant and gradually push it into the background where it becomes less noticeable and this is called habituation.

The same does not always apply to anyone with loud intrusive tinnitus. People affected in this way should try to avoid quiet rooms and surroundings during the day and especially at night, as it’s quieter and the tinnitus will appear to be louder and more intrusive. It is a good idea to buy a sound machine that plays nature sounds. They are often recommended to people with tinnitus who find difficulty getting off to sleep. Anyone new to this condition I advise to buy one. The sound machine can be placed by the bedside and also used during the day. For night use some people prefer to connect it to a pillow speaker particularly, if they have a partner that might be disturbed by it; although most people find they can drift off to sleep easily when listening to the soothing sounds of nature. If you decide to use a pillow speaker then make sure the sound machine that you buy has a 3.5 audio output socket fitted that will enable the pillow speaker’s cable to connect to it. The volume of the sound machine should be set just below your tinnitus and not at a level that will completely mask it. The same also applies when a pillow speaker is being used.

When we are asleep, the auditory pathways and brain are still active. If the brain hears silence it has the ability to increase the level of the tinnitus making it louder and more intrusive during waking hours. The sound machine with its low level non intrusive sounds, will gently deliver sound enrichment to the brain while we sleep which will, over time help it to push the tinnitus further into the background of the mind making it less noticeable during the day and helps the habituation process. Anything new that we bring into our lives takes time to get used to. Most people are used to sleeping in their bedroom at night in complete silence. Therefore, please remember the sound machine takes a while to get used to but once the benefits are realised you won’t want to be without it.

Natural environmental sounds

Some people find natural environmental sounds to be very therapeutic for their tinnitus. The opening of a window or the sound of traffic and even the rustling of trees has been mentioned. It’s as if all one has to do is turn to mother nature to find all the answers. A personal favourite is to be by the sea and listening to it lapping against the shoreline for it creates the perfect ambiance for relaxation.

CDs and MP3 downloads

Not only is tinnitus experienced differently by each person, the type of treatment that one uses to get relief from the condition and make life a little easier can be different too. Some people find listening to relaxation CDs through a portable cd/radio player beneficial or downloading MP3 tracks from the Internet and listening via their mobile phone or MP3 Player. Listening to music through a mobile phone or MP3 player is usually fine, as long as they are connected to a docking station that has speakers attached.

The sound therapies mentioned above come under the heading of sound enrichment for tinnitus. My advice is to experiment and see what works best for you, including household items such as a fan or ticking clock. Most people with tinnitus prefer non-intrusive sounds such as white noise, sound machine and environmental sounds. Music on the other hand tends to draw attention to itself and evokes emotions, which probably isn’t the best source to use for sound enrichment.

Headphones and Tinnitus.

The views on whether a person with tinnitus should listen to music through headphones are controversial. Some people show no adverse affects while others do even when the volume level is kept low. As I have already mentioned we are all different so the only way one can know, is to experiment and see what works best. I believe when the tinnitus was caused by exposure to loud noise/music and it has become intrusive - by this I mean a person having to seek help at ENT, then they shouldn’t listen to music through headphones no matter how low the volume is set.

Most music has syncopation throughout its frequency range, so it’s constantly changing in pitch, rhythm and timbre. The beat of the music and volume can also change while listening. This evokes pleasure and can stir our emotions. This happens whether we listen to music loud or soft, although certain types of music does sound better played at a higher volume than others and vice versa. Once the cochlear in the inner ear becomes affected by noise exposure, it is much more sensitive to sound. This is one of the reasons hyperacusis is often experienced with noise-induced tinnitus. I will be covering Hyperacusis and Habituation in more detail later on. The organ of the Corti, which is attached to the cochlea, has approximately 20,000 hair cells. These hair cells move to the vibration of sound and are just one of the components in the auditory system that enable us to hear. Someone that already has a sensitive auditory system due to noise-induced tinnitus and listens to music through headphones at a low volume, risks irritating the cochlear further; this can make the tinnitus louder and more intrusive.

It can be misleading when some health professionals tell tinnitus patients, listening to music through headphones is fine as long as the volume is kept low. These health professionals mean well and know a lot about the anatomy of the ear and are able to treat it medically or surgically. Therefore, it is not my intention to try and undermine their abilities or expertise. It must be said, many of them have never experienced intrusive tinnitus. This leads me to say, one of my ENT consultant’s who is an Audiovestubular physician, and someone that I have a lot of respect for, once told me that I know more about tinnitus than her because she never experienced it. I have spoken to people and corresponded with them by email and at Internet forums, complaining their tinnitus has become worse after listening to music through headphones even though the volume was kept low. My advice to anyone that has tinnitus that was caused by exposure to loud noise, is not to listen to music through headphones, as the auditory system is more sensitive.

White noise generators.

Some may question the use of white noise generators since they emit white noise directly into the ear. White noise generators don’t usually irritate the auditory system due to the volume being kept low and its frequency range remains constant, so there is no syncopation within it unlike music. Although white noise generators can be bought privately to treat tinnitus I don’t advise anyone to do so, unless a Hearing Therapist/Audiologist has first tested their auditory system for suitability. A person must also be shown how to use these devices correctly as improper use can make the tinnitus worse. Furthermore, they are normally used in conjunction with tinnitus retraining therapy to get maximum benefit.

The brain cannot habituate to a sound that it cannot hear.

Some people believe totally masking or covering up their tinnitus with another sound so it can’t be heard means they have habituated. This belief is incorrect. The brain cannot habituate to a sound that it cannot hear. As soon as the source masking the tinnitus is removed, the brain will immediately focus on it and in some cases the tinnitus can become louder and more intrusive. Anyone that is seasoned to tinnitus knows that trying to mask it completely so that it can’t be heard is not achievable. A much better way and preferred method that Hearing Therapists advise tinnitus patients, is to use sound enrichment. One can use music or nature sounds from a sound machine and set the volume slightly below the tinnitus. By doing this, the brain over time will learn to no longer see the tinnitus as a threat and gradually push the noise further into the background giving it less importance.

Answers to Hyperacusis and Habituation

Hyperacusis.

Two questions often asked about tinnitus are: How long does it take to habituate and how do I know if I have hyperacusis? One of the main causes of tinnitus is exposure to loud noise. Quite often though hyperacusis, (sensitivity to sounds) accompanies the condition. This is because the nerves in the auditory pathway have been subjected to noise trauma and thus become highly sensitised. Hyperacusis can be extremely painful. It can cause tinnitus to spike sometimes making it last for days until it settles down again. Within this time the person affected can be in a lot of discomfort.

Music that was once pleasurable to listen to through a home music system or radio is now an ordeal so one prefers not to listen to it. The closing of doors, washing up of kitchen plates and cutlery is enough to send a person running for cover, as it can feel like a pneumatic drill is piercing through the head and ears. It can become such a problem that some people are afraid to venture outside their home in fear of road traffic noise, sparking an increase in their tinnitus due to their sensitivity to sound. In severe cases, conversation with someone can be painful to the ears.

One of the best ways to treat hyperacusis is by using “sound enrichment”. This can be achieved in many ways but the most convenient is wearing white noise generators as part of TRT treatment. Alternatively, using a tabletop sound machine for day and night time use can help. A word of caution. Some people use noise reducing earplugs to help suppress external sounds because of their sensitivity to sound. Earplugs are available but should only be used when in noisy surroundings and not to suppress normal every day sounds, as doing so can prevent the healing process of hyperacusis and could make the auditory system more hypersensitive to sound.

Habituating to Tinnitus.

Habituating to tinnitus often seems shrouded in mystery for the more seriously affected people that are in distress and have had to seek help at ENT. It can be particularly difficult for people that are new to tinnitus to comprehend. How does one know when they have habituated to their tinnitus and more importantly what does this actually mean? The following doesn’t apply in every case of tinnitus for there are some people that have large fluctuations with it and every day can be a different experience. This is one of the most severe forms of tinnitus and medications may be required to help cope with the condition. Habituating to this type of tinnitus is still possible to an extent but does present additional problems.

To others I will say this: You will know when you have habituated to your tinnitus, regardless of whatever treatment you are using via ENT, as your brain will over time push it further into the background so it becomes less significant, in a similar way to the people that have mild tinnitus. Although your tinnitus may be present and on occasions it will spike, over time it will cease to be so much of a problem, unless you deliberately focus on it and bring it to the forefront of your mind.

Computers and tinnitus

This topic has caused much discussion on tinnitus forums whenever it is mentioned. Some people refuse to believe that using a computer can make tinnitus worse, while others are more open minded about the issue. Then there are those that agree with me that using a computer can make tinnitus worse for some people, due to the EMF (electro magnetic field) that all computers emit. I believe it would help if I explain the way near field computer use affects me, and the steps I’ve taken to reduce my exposure to computer EMF. IF anyone decides to try my suggestions their life might become a little easier.

In 2008 my tinnitus became increasingly worse for reasons I’m not quite sure, as I’m usually careful about being around loud sounds. One evening I was listening to a favourite symphony on my HI-FI and enjoying it quite a lot turned the volume up but didn’t notice any adverse effects. It wasn’t until the next day that I noticed my tinnitus begin to increase. This continued over the next two weeks and at times the noise became excruciating. I needed help, as there were no signs of it reducing to its previous levels. After various tests at ENT I was referred to a Hearing Therapist and began TRT for the second time in eleven years. I didn’t know at the time that my tinnitus would change so dramatically and affect my life for nearly five years. For two years I was unable to read a book and using a computer was a definite no. Every time I tried within a few minutes my tinnitus increased to unbearable levels that would last for days.

At the time I knew nothing about the effects of EMF from computers but was convinced it was causing my tinnitus to increase every time that I used it. I spoke with two electronic engineers that also have tinnitus and told them about my problem. They mentioned some people with tinnitus are sensitive to EMF that a computer emits. I was advised if possible, to move my PC into another room and use a: wireless keyboard, mouse and external monitor. I was prepared to try anything so bought the relevant cables, wireless keyboard and used a TV as a monitor.

The advice that I had been given worked for I was able to use my computer without my tinnitus becoming louder. Six years on, the computer base unit is still in another room and I use a wireless keyboard, mouse and external monitor. I also have a laptop. On many occasions, I have tried using it in the conventional way to make sure my symptoms were not psychosomatic. Each time my tinnitus becomes worse within an hour or two. I have persisted and the tinnitus reaches such unbearably levels I have to switch it off. I have passed on my experience to others that were having difficulty with their tinnitus and also use a computer. Some people have noticed an improvement after trying my suggestion, or reducing the time they are at the computer.

When I saw my hearing therapist in clinic, I told her what I’d done with my PC, and explained the effects of computers and EMF. That it can make tinnitus worse for some people. I was informed no other patients had mentioned it. I didn’t pursue the matter any further and let it rest. Around four weeks later I returned to clinic as part of my TRT treatment. It was then explained to me that a few of her patients had talked about noticing an increase in their tinnitus whenever using the computer. There will always be people for and against something. The sceptics want scientific proof that near field computer use can make tinnitus worse for some people. My answer to this is: I have none but there is information on the Internet about EMF from computers making tinnitus worse for some people that are hypersensitive to it.

Food, drink and tinnitus

Many years ago when I first got tinnitus, I wanted to learn as much as possible about the condition. I believed acquiring the right knowledge and being proactive was the best way forward in finding a cure. Like many people new to the condition I was desperate and going through a very difficult time. My appointment to be seen at ENT for the first time was six months away and it couldn’t come soon enough. Whenever I could manage it, I read books on tinnitus and it wasn’t long before I learnt certain foods and drinks could make it worse. The advice given was to keep a food diary and over a period of time, slowly omit certain foods from one’s diet to see if there was a reduction of the tinnitus, and if there wasn’t reintroduce them. One of the main concerns was to avoid excessive salt and where possible reduce its intake. Cut down on red meat and avoid dairy products. Limit the use of sugar and abstain from drinking anything containing caffeine. It would mean missing my regular cup of coffee first thing in the morning but it would be worth it since I was on a mission and determined to succeed.

It was advised to avoid alcohol. I wasn’t a regular drinker but enjoyed a glass of wine or brandy occasionally. Surprisingly, with the onset of my tinnitus I found a glass of wine during the evening helped to relax me. Everywhere that I went I had my notebook and pen writing down everything I eat or drank. At first there was a lot of enthusiasm but as the days and weeks passed this began to wane. Constantly reading the ingredients of every food item bought at the weekly shop can get tedious after a while, especially when there was no noticeable reduction in my tinnitus. I began to feel miserable and at times felt life wasn’t worth living. Having to cope with raging tinnitus and hyperacusis on one hand and monitoring every morsel of food and drink that passed my lips on the other just wasn’t a pleasant experience.

I missed my regular cup of coffee and the caffeine free substitutes just didn’t do it for me. After five weeks of endurance I decided enough was enough. I put my notebook and pen away and returned to my normal eating and drinking. I now looked forward to having a sirloin or ribeye steak without thinking is this going to increase my tinnitus, or eating a jam doughnut or having yoghurt. One can easily be drawn into a world of paranoia over such issues if they are not careful. I became less stressed and I was no longer plagued with headaches, which can be a symptom of caffeine withdrawal. The result was no difference in my tinnitus or hyperacusis. Although they were still intrusive I felt life was more tolerable and I wasn’t constantly monitoring them to see if there was any reduction or increase as a result of what I eat or drank.

My advice to anyone that is new to tinnitus and wants to pursue this route, then do so with caution. In the early stages tinnitus can be very stressful and emotionally draining, asked yourself the question do you really want to put more pressure on yourself considering what I’ve mentioned above? I believe life is for living. It is true that some people are allergic to certain foods and drink and the preservatives withing them. Therefore, it’s important they be aware of what they consume. I had taken no such precautions before the onset of my tinnitus other than to eat and drink in moderation.

Finding a cure for tinnitus

One of the most asked questions by people that have difficulty coping with tinnitus is, when will a cure be found? Many years ago when I first got tinnitus the same question was always at the forefront of my mind and on the tip of my tongue whenever talking to someone that had the condition and was prepared to listen to my outpourings, because I believed they would understand what I was going through. This belief was short lived and I was soon brought back to reality when told: “Mine doesn’t bother me at all” or, “I just ignore it” “It only affects me at night”. “ It plays a funny tune and then it’s gone”. I would see a smile creep a across their face. I remember thinking what can possibly be wrong with me? There I was living in torment daily with this cacophony of noise for company swirling around in my head and ears and these people are dismissing it as nothing. I thought, what I’m going through has to be completely different and indeed it was.

I researched the condition from my books, and learned from more experienced people at the tinnitus forum I hand joined, that this condition comes in different levels of intensity and no two people experienced it the same. While it was comforting to know that I was experiencing something unique and totally different to what my friends and family had, it didn’t stop me asking that question, when will a cure for tinnitus be found? Whilst I was going through my treatment this didn’t stop my search for finding a cure. I was going to prove the medical profession and the tinnitus books wrong that said there wasn’t one at that time. I tried alternative medicines that some of you may know of and even tried and will be mentioning them later.

I found Youtube to be a good source for information and sat listening to a Physician in a white coat that seemed to know what he was talking about when talking about tinnitus, and for a price my condition could be cured with his treatment plan or send off for medications specifically designed to treat it. All that I had been going through was a learning curve and I thank my Doctors and mentors at tinnitus forums for helping me to stay on track and not parting with huge sums of money for medications that were supposedly the silver bullet to cure my ails. At best they would probably do nothing and the worst-case scenario I don’t want to think of now, since they were probably unregulated but at the time I was prepared to try anything but glad I didn’t. Type into any Internet search engine “a cure for tinnitus” and you’ll get over 4000 hits. Youtube is saturated with over 50,000 videos giving advice on treatments and cures. And not surprisingly this is can be done for a price. It seems over the years nothing much has changed. There will always be people ready to claim they can cure a condition that the medical profession has none for at this moment.

I read a newspaper article many years ago that helped change my perception of tinnitus and looking for a cure. It read: 19 out of 20 medical conditions cannot be cured. That statement brought home a reality. My GP told me when I asked him about pursuing private medical healthcare, as I was so desperate. He explained that I would get the best help and long term aftercare by staying on my current medical programme. I have to say, in the twenty years that I have had tinnitus I have been treated very well by my healthcare providers and have no complaints.

Everyone’s situation is different. Where one lives in the world plays an important part and their access to medical treatment and what this might cost, will also have some bearing on how they are able to be treated. My advice is to pursue the route of going to your GP and getting referred to a tinnitus clinic or hospital and have tests done. This is usually a hearing test and MRI scan. If the results come back normal the next step is to be referred to a Hearing Therapist or Audiologist to learn tinnitus management.

Ear Protection

A few people have asked for my opinion on using earplugs. Is it necessary to use them after habituating to tinnitus and whether they should be used if hyperacusis is present? Whilst I’m on the subject of ear protection, I’d like to say to anyone that uses electric power tools for those DIY jobs around the home, or out in the garden with a petrol lawn mower, it’s a good idea to wear ear defenders. Because tinnitus comes in many forms and intensities and no two people experience it the same. The advice that I give, is based on personal experience and what I’ve learned from others over the years that have this condition. If someone wants to try any of my suggestions, please keep in mind that your experiences may be entirely different to mine so they should be used for guidance only.

My tinnitus was caused by exposure to loud noise. I believe after one has habituated to their tinnitus, they need to be more careful whenever around loud sounds as the auditory system is more sensitive. Ear protection should be worn at: cinemas, music concerts and large sporting events, as sound levels above 85decibels can easily be reached, and is considered the start of becoming unsafe for most peoples’ hearing. However, another important factor is the length of time (duration )a person is exposed to such sound levels as we are all different. My advice to anyone that has noise induced tinnitus the above figure of 85db should be viewed with caution. With noise induced tinnitus, there is usually some damage to the thousands of tiny hair cells that are attached to the cochlear in the inner ear. This can result in some hearing loss and a patient might be told this after a hearing test has been carried out at an ENT. Not everyone will show signs of hearing loss on their Audiogram - but having the tinnitus is an indication that the hair cells around the cochlea have been adversely affected.

It is better to be safe than sorry by taking the necessary precautions rather than throwing caution to the wind and risk making your tinnitus worse. If a person wants to go to clubs or a bar where music is being played, noise-reducing earplugs can be used. Many types are available and some are small and discrete. They are easily available and affordable. You can have them on your person and use them if sound levels start to become uncomfortable. They won’t impair sound quality but will reduce ambient sound to more tolerable and safe levels, bearing in mind what I’ve said about the auditory system being more sensitive for those of us with noise induced tinnitus. Some people are quite blasé and will scoff at the mention of wearing ear protection at a rock concert for instance. A friend said to me some years ago, that when she leaves a gig and her ears are ringing it’s sign that she’s had a good night. Ignorance is bliss I thought and then said: yes, until the day the ringing doesn’t stop! The look of bewilderment was clear to see when she realized I was serious. It had the desired effect because shortly afterwards she bought a pair of noise reducing earplugs.


Positivity and tinnitus

For some people tinnitus can be very stressful and at times debilitating. This can sometimes lead to depression and a person may need to go on a course of antidepressants. I have often been asked in tinnitus forums and via email “It is great if you’re able to be positive, but simply telling someone to be more positive about tinnitus isn’t going to change anything”. I want to clarify here and now, that isn’t what I mean. Thinking more positive about tinnitus and bringing positivity into your life takes time it isn’t achieved overnight or by simply thinking to yourself “I must be positive about my life”.

If a person wants to improve the quality of their life, then they have to be prepared to try and help themselves, because there is no wonder drug or operation that can cure tinnitus at this time. Unless a person faces these facts they will forever be trawling the Internet going from forum to forum complaining why there is no treatment for tinnitus when actually many of these people want a complete cure. Someone once told me “I don’t want to be positive about tinnitus, I hate it. Being positive wont make it go away. This is true, however, thinking more positive and bringing positivity into your life will reduce the perception of how you relate to tinnitus. CBT and TRT are based on having a positive attitude, without that these treatments aren’t effective.

Long before these treatments and the Internet came on the scene Doctors have been telling tinnitus patients, there’s no cure you’ll have to learn to live with it. Most of us know this is easier said than done. So how does one start to think more positive about their tinnitus and to bring positivity into their life? The fact that someone with tinnitus is reading this page suggests to me their tinnitus for today at least isn’t so intrusive that they are unable to function, for that I’m pleased because this is something positive, instead of lying in bed on medication doing nothing. If you are able to work that’s even better as your tinnitus isn’t so severe you’re incapacitated. I see this as something positive in a person’s life. Being able to earn a living and support yourself. Therefore, you’re able to do all the daily tasks one needs to survive in this world. You may have some difficulty granted, but you’re still achieving and that's progress.

It is still better than someone that is visually impaired or severely disabled and unable to earn a living. Or, people with such severe tinnitus they are depressed, on medication and unable to work. So by looking at our own circumstances and seeing what we’re able to do and achieve we can think more positively about ourselves. There is nothing more satisfying than being independent and I suggest you hold onto those thoughts. If you live by yourself consider getting a cat or a dog so your home environment won’t feel so lonely. If you have a partner and family think about spending some quality time with them, as this can help reinforce your sense of belonging, and the love that binds you together, then your tinnitus won’t make you feel so isolated. Sometimes opening up sharing your thoughts and how you feel can help immensely and keep negativity at bay.

I have just given a synopsis of what I believe can help a person’s quality of life improve with positive thinking. It doesn’t happen overnight but a lot can be achieved when one is prepared to try. By moving forwards and taking one day at a time you can occasionally look back and see how far you have come.

I would rather be happy than right.

Many people with tinnitus experience anxiety, depression and low moods. With time they often improve and some with the help of medications eventually habituate. Others may experience spikes in their tinnitus that can make them prone to mood swings. These people still manage to find a way through it with determination and inner strength. There are others that will accept nothing less than a complete cure and therefore, will find it difficult to habituate even if they had the best treatment in the world. My experience as a Tinnitus support contact, has involved talking to many people on the telephone and communicating with them at tinnitus forums and via email. Unfortunately, some of these people with their negative mindset unknowingly inflict their pessimism on others and this isn’t usually helpful.

Just as there are positive thinking people that are prepared to try and make a life with tinnitus, negative ones prefer to sit and do nothing and choose to feel sorry for themselves. I believe this is an unfortunate waste of time and energy. Some blame the world and every health professional and medical organisation for their misfortune in life and it can be difficult for them to change.

There is nothing wrong with being occasionally negative especially with a condition such as tinnitus. However, everything must be kept in balance, so one must try not to let negativity become all-consuming. My advice to anyone that visits tinnitus forums, just to post negative and vitriolic comments about their government and the medical profession for not finding a cure for tinnitus, is to please think before hand about what you are doing. Your messages are in the public domain and will be read by people that are seeking help and constructive advice on how to cope with this condition. Negative thinking never produces anything good. So ask yourself what have you achieved? Even if you are right it doesn’t make for a fulfilling life and it is possible with tinnitus. Perhaps it’s time to change your strategy to one of positivity.

Tinnitus, a way forward

Outside the realms of a tinnitus forum or a support group many people do not realize that tinnitus can be a very debilitating condition. Someone that has loud intrusive tinnitus there is usually no outward bodily signs indicating their discomfort. Unlike a person with a broken leg, on crutches and wears a cast. Neither can the severity of tinnitus be measured on any medical equipment. So the sufferer endures this torment alone.

The fact that tinnitus comes in many forms and intensities compounds the issue and just for good measure it can be variable on a daily basis: mild, moderate, severe or very severe. As previously mentioned, many people with mild tinnitus are able to live perfectly normal lives doing everything they want but to people reading this page I ask, how many times have you mentioned to someone that you have tinnitus and you hear those familiar words my friend, Father, Mother has that but they just ignore it and get along with their life?

These comments can be crushing to someone that is distressed by tinnitus. It can make one feel terribly guilty for even mentioning the word. You might feel a failure. That old adage: pull yourself together is still alive and well. There might be times you feel it necessary to confide in someone how your tinnitus makes you feel, there is nothing wrong in this, a problem shared is often a problem halved. Just choose carefully with whom you talk to, as you need support, understanding and a good listening ear. Thankfully, there are people at tinnitus forums and support groups that have understanding and won’t judge you or think that you are complaining about something that other people think is a minor irritant.

Over the years I have read in tinnitus books that the condition is not life threatening, I have heard people say it isn’t comparable to any serious medical condition and therefore one should be thankful. With respect to all those people I would like to say this: you have to walk in a person’s shoes to know what they are going through, because I believe those statements are incorrect. Once you have been there and done that, then you are able to voice an opinion. It is true, by itself tinnitus is not life threatening but that’s not the end of the story. Anyone suffering with severe intrusive tinnitus, I believe it is comparable to any acute medical condition, simply because of what it is able to do to a person’s state of mind. Anti-depressants are sometimes prescribed as treatment for tinnitus. These drugs will not necessarily stop the tinnitus but can help prevent a person from becoming too depressed because of the noise in their head and ears.

It is not often talked about, but people mustn’t be under any misconceptions about the depths that this condition can take one to. If tinnitus is left unchecked it has the ability to make a person think and do something irrational that otherwise they wouldn’t contemplate if they weren’t in such a distressed state. One only has to do a search on Google to find this out. So there lies the paradox.

However, we can move forward and help ourselves by using different coping strategies in addition to such things as anti-depressants, tinnitus retraining therapy, cognitive behavioural therapy and Relaxation exercises. I have talked about the importance of having a positive outlook on life and how negative thoughts about this condition shouldn’t be allowed to take a hold. Acquiring a positive attitude to tinnitus isn’t something that happens overnight but we must start somewhere. Our mind and thought processes are very powerful.

There is a saying: belief can kill and it can cure. When my tinnitus is particularly troublesome I try to take away my attention from it by first thinking inwards and acknowledging the positive things in my life and holding on to them. I encourage you to do the same. Secondly, I project my thoughts outwards away from myself and into the world and look at what is happening with other people. First in and around my neighbourhood then further afield. How other people’s lives are being affected and the circumstances they are going through. It is often said no matter what our circumstances are there is always someone worse off. I am in no way trying to play down the severity of tinnitus but it is my way of trying to be positive in hope of restoring some equilibrium in my life in order for me to carry on.

Staying positive with tinnitus

Most of us know that tinnitus is not an easy condition to cope with when it is severe. Some people manage to maintain a positive outlook on life, even when their tinnitus is troublesome. There are times when it can be difficult to stop those negative thoughts creeping into the mind and taking away our focus, that a corner has been turned and there will be no going back.

I want to try and reassure you that there is nothing wrong with feeling occasionally negative about your tinnitus, for even the most positive thinking amongst us will be adversely affected by it now and again. The thing to do is not to let it take hold for too long. Allow yourself a moment of negativity and let those thoughts wash over you and then, calmly tell them to push off. You are not going to allow all that you’ve worked towards to slip away from you.

By focusing on the positive things no matter how small will help us through the difficult times and restore balance and order in our life. I often go out for an early morning walk. On one occasion I noticed a young man of approximately 20 years walking on the opposite side of the street. He had one arm stretched out in front of him and his hand was feeling its way as if he were in complete darkness. This drew my attention but parked cars obstructed my view until all became clear. In his other hand he held a leash attached to a guide dog walking beside him. I wanted to go over and offer some assistance but remembered that some people might get offended - such a thing happened to my late father, when he offered to help a visually impaired person and was rebuffed quite severely. I watched for a while just to make sure this person was all right and then continued on my walk.

Life Is Problematic

As a tinnitus support contact, I have had the opportunity to talk to all kinds of people from all walks of life and backgrounds. I remember one particular gentleman that was having a lot of difficultly accepting and coping with his tinnitus and as a result telephoned me quite often. My life is over I remember him saying and why can’t a cure be found. It was one particular comment that he made which has stuck firmly in my mind and is probably the reason why I shan’t forget him. I hadn’t heard anyone say something like that to me before, and I did have a lot of sympathy for him for I knew he was in a lot of distress. Every time I go out on the street he said, I can’t stop looking at people’s ears and wondering what my world would be like to have silence again instead of hearing this roaring tinnitus.

I sat listening to his outpourings because sometimes a person needs that. Once everything was off his chest, I began to try and make him look at his situation a little differently. I explained that even the most optimistic and successful people have down times and they don’t necessarily have tinnitus, for life is problematic and few of us go through it without problems. We have no idea what another person is going through so be careful what you wish for. I know tinnitus isn’t easy especially when it’s severe but hold on to the thought that it will improve.

I continued by saying: life can be challenging and obstacles come our way and we have to take them on board and deal with them. Perhaps if everything came easily then we would never grow and develop and in some cases not reach our full potential without some struggle, or appreciate the good things that we have in life. He was a maths teacher, married with two children and also had a business with his brother. He agreed that things hadn’t always gone smoothly but overcoming certain problems and issues in his life seemed to make everything worthwhile, that was until he got tinnitus. I understood where he was coming from, but at the same time trying to reassure him that things would improve although it may take a little time.

His doctor prescribed an antidepressant but he didn’t want to take them and asked for my opinion. It wasn’t my place to advise but I told him of my experience with medications for my tinnitus and the help I had received at ENT. When I first had tinnitus I had taken antidepressants for a while, which helped me not to become too down. In later years I took clonazapam when my tinnitus was severely intrusive. It helped a lot. I was advised of its addictive nature and was closely monitored by my GP. I would only take it when my tinnitus was very severe.

This gentleman kept in touch for a while and eventually decided to take the anti-depressant. A few months passed and I hadn’t heard anything until one evening I got a phone call from him. Telling me his tinnitus had reduced and was improving all the time. He had returned to work and was very pleased with how his life was going.

What happens after habituation?


People that have had tinnitus for while, usually under a year, have often asked me this question as they look forward to the day they will habituate. Some wonder will they habituate to the point where they no longer hear the tinnitus? Will they be able to do everything as they did before the onset of the condition? Going to the movies, the gym or attending a nightclub. Listening to music through headphones and whether it’s necessary to continue using sound enrichment at night? There are many questions surrounding tinnitus and habituation, hopefully, I’ll be to able answer some of them.

Some people believe habituation means they will no longer hear the tinnitus but this is necessarily the case. It is true that for some people their tinnitus has reduced to such a low level they hardly ever hear it. By contrast, others hear their tinnitus in the background and can live quite contently doing all the things they want to because their brain has learned to ignore it, and that’s what habituation is, learning to live with something. It takes time but can be achieved by most people even when the tinnitus spikes occasionally.

I see no reason why a person can’t go out and enjoy themselves at a nightclub or the movies providing they take the necessary precautions and wear noise-reducing earplugs. They won’t impair sound quality but will reduce external sounds to a safe level when in a noisy environment.

Quite a few people have contacted me saying their tinnitus has become worse during and after running, and over time noticed it become more intrusive so have had to stop. I believe this to more than just coincidence. My theory is, running on hard ground or on the treadmill causes impact underfoot and this travels up through the body towards the head and auditory system. The vibrations might be irritating the cochlear in the inner ear and making the tinnitus worse. I have no doubt not everyone will be affected in this way but it’s something to consider if you notice your tinnitus getting worse after a run.

The same applies when at the gym, see how you feel on the equipment that you use and adjust your workout accordingly. I use an elliptical/cross trainer machine and haven’t noticed any adverse affects. The reason might be, while using it my feet don’t make contact with the ground so no impact is felt or transferred up through my body. I don’t believe headphones should be worn because I have counseled too many people that habituated to tinnitus, returned to using headphones and noticed their tinnitus becoming worse even when the volume is kept low.

What is Reactive Tinnitus?
A word often used in tinnitus forums these days is: “Reactive” tinnitus. People affected will say something like: “ I have habituated but my tinnitus is reactive to certain sounds” or “ I have reactive tinnitus”. I believe there is some confusion here and will explain.

Someone that has tinnitus, especially when it was caused by loud noise exposure hyperacusis is often present. If it hasn’t been treated the auditory system will always be sensitive to certain sounds even after habituation has been reached. It is for this reason the use of white noise generators is recommended to help desensitize it. When a person says they have reactive tinnitus, I believe they are not aware they have hyperacusis, which is causing their tinnitus to spike when they hear certain sounds. Although hyperacusis can improve by itself with time, without treatment there is no guarantee. For this reason I often recommend a person to use sound enrichment (sound therapy) as it helps to desensitize the auditory system.

Are spikes from loud noise permanent?

I have often been asked: are spikes from loud noise permanent? I don’t think there is a definitive answer, because tinnitus is a complex condition and if hyperacusis is also present it can complicate matters further. Some people habituate to tinnitus but their hyperacusis hasn’t fully cured and this can cause tinnitus to spike. When a person first develops tinnitus and it was caused by loud noise they have to be careful in future. Tinnitus can and does spike for many people and this is not necessarily caused by loud noise or sounds. After a while it usually returns to baseline or into its normal rhythm.

Danger can sometimes present itself after a person habituates and the tinnitus has reduced to mild or moderate levels for most of the time. If one isn’t careful, it can be easy to forget and slip back into the old lifestyle of: listening to music through headphones. Attending clubs, concerts and the cinema where sound levels can be quite high. I believe a person with tinnitus should attend clubs, concerts and the cinema if they want to, providing they use noise-reducing earplugs to protect themselves. One should remember that nothing is one hundred percent safe. My advice is to stay clear of large standing floor speakers and if you’re at a concert don’t go to near the front stage where the music is likely to be booming out at high sound levels.

In many instances people will get a warning when visiting these places. If the decibel levels are too high their tinnitus might spike. Usually the tinnitus will return to baseline. However, some people do not pay attention to these warnings and continue to subject their ears to loud sounds and think they are perfectly safe because they are wearing earplugs. Under these circumstances the tinnitus might spike again and this time it might become permanent. I am saying might because nothing is for certain. In my opinion a person with tinnitus needs to follow the warnings their auditory system and tinnitus is telling them.

Regarding headphones. Many people have contacted me after they have habituated to tinnitus and returned to using headphones and listened to music through them at low volume. All of them have noticed an increase in their tinnitus. Some of them noticed their tinnitus spiked but carried on listening to music through headphones and then the tinnitus increased to a higher and more permanent level. It must be said that some people with tinnitus use headphones and have no adverse effects and that is perfectly fine.

It saddens me to have to say, if a person doesn’t heed the warning signs their auditory system and tinnitus is telling them then the condition could get worse, because tinnitus is very unforgiving. I have seen people posting messages at tinnitus forums telling others what they want to hear. It is perfectly fine to listen to music through headphones because life is for living. Go to the nightclubs as often as possible as long as you have earplugs you will be safe. I want people to consider this before going down this path. If your tinnitus increases you will be the one that will be in the suffering. I have read on Internet forums where people had habituated and the tinnitus is low. They returned to listening to music through headphones and go clubbing during the week and weekends. Some are now regretting this because their tinnitus has increased and they are in distress.

Just because a person habituates doesn't mean they should forget everything and carry on in some instances recklessly. You can of course do this but my advice is to do things in moderation and not to excess, because the end result is often returning to ENT for help and visiting tinnitus forums because you are unable to cope.

Complementary therapy for tinnitus

Many people at one time or another will turn to complementary therapy to help treat their tinnitus. Below are a few of those treatments.

Gingko Biloba I first heard about this Chinese plant (herb) when I first got tinnitus and have taken it periodically over the years. Some people have reported it helped to lower their tinnitus while others have said it made no difference. There have been studies carried out by various organisations to check its effectiveness at reducing tinnitus or whether it is purely a placebo effect by individuals that say it works.

It is said to increase blood circulation to the extremities of the body: feet, hands and head, including the auditory pathways. I cannot say for certain whether it has helped lower my tinnitus but I believe it has improved my hearing and for this reason I continue taking it. Taken as a tincture (liquid) is considered to be the best as it enters the blood stream quicker. Some call it the memory tree as studies have suggested that it may help Alzheimer disease and improve thinking and learning. Anyone that decides to try it, please be advised, that it takes about three months to build up in the body to reach full effect.

Acupuncture Most people know of this ancient Chinese medicine in which fine needles are inserted into the skin at certain points on the body. I have spoken to a few people that have tried it for various ailments with good success but as yet, I haven’t spoken anyone with tinnitus that has had success with it. However, we are all different so it might help you.


Magnesium This mineral is found in green leafy vegetables such as spinach. It is said to help repair nerves. Since the auditory pathways are all made up of nerves, it might seem a good idea to take as a magnesium supplement especially if the tinnitus was caused by exposure to loud noise. I took magnesium for quite a while with the onset of my tinnitus and believed it helped.


St John’s Wort (Hypericum perforatum) is a herb and can help to treat mild depression. It can be a good alternative to prescription anti-depressants, that are sometimes used by people with tinnitus, to help them not get too down. It is usually safe without having any side effects. It is best to have a word with your doctor before taking. Please note that it needs to be taken for at least six weeks to start noticing its effect.

Helping yourself and putting it all together

Tinnitus retraining therapy (TRT)

Counselling

Wearing white noise generators (for sound enrichment)

Using a sound machine for sound enrichment. Or listening to music tracks via mp3 player

Relaxation exercises

Hearing aid. Improves hearing loss and can lower tinnitus

Anti-depressants and other medications like: clonazepam

Neuromodulation

Mindfulness therapy

The above treatments may help some people manage their tinnitus and hopefully go on to lead a fulfilling life. However, none of these treatments will work if a person is looking for a "complete cure". One must face the facts. Nineteen out of twenty medical conditions cannot be cured and at present tinnitus is one of them. You may be living on this mortal plane for some time. Try and help yourself because no one else can do it better. Try to get the best treatment that you can and adopt a more positive approach to life for that is the only way forward with this condition.

 

Well written Michael,
Your knowledge and understanding about tinnitus is outstanding and I know your article will help so many people....lots of love glynis

 

Michael,
A transcendent abridged resource that touches on all the important facets of this disorder.

Only thing missing is when a cure will be available, so I will add that.
A cure for tinnitus will occur on February, 202o. There is more good news on the horizon as well.
The fountain of youth aka reverse to aging will be available to the public in 2027 or just over 10 years from now.
No word on whether we can transform our looks or be able to swim like Michael Phelps...will see.

Happy Thanksgiving everybody and thanks again Michael.

 

Thank you @stophiss Good to see your usual brand of humour, and now you tell predictions. Can't be bad. Happy Thanks Giving. Wish I was State side tucking into a turkey dinner later....

 

While I believe positivity is indeed crucial, I think too much of it can overshadow real suffering. E.g. "I'm glad I got tinnitus because it taught me about life, etc." Or "habituation is easy once you let go, etc." That's all well and good but the squeaky oil gets the grease as they say. If outsiders think that we just need to get used to it, habituate, and be positive then we'll never make any progress.

 

I thought it was the squeaky wheel that gets the grease...which is somewhat true.
But, believe if you took a poll here, nobody would say tinnitus is a good thing. It is a scourge of mankind and probably a few animals that just can't tell us about it. We choose positively for no other reason but to cope...in the face of being told, "just get used to it"...which is hard but we do the best we can.

I don't share the view that tinnitus is flying under the radar from a research standpoint. A lot of brilliant people working on it...and further trying to demystify the whole mechanism of hearing...tinnitus being a part.

 

Haha you're completely right. Typo on my part there.

As to tinnitus research, I do agree there is more now than ever before. However, I personally think a real breakthrough won't be made until it can be objectively measured. Right now they are just shooting in the dark based on speculation in the aim of providing a treatment. What I want is a way to measure it accurately without relying on the patient himself/herself. Then the trial and error method will truly work.

 

@stophiss I was discussing @The Red Viper comments with a friend of mine that also has tinnitus. She has been in a lot of distress with it lately and said " You just can't please everyone " We both started laughing

 

And what a great laugh you have Michael . ......lots of love glynis

 

@Michael Leigh True, not everyone can be pleased. However it is those who fought against the grain that achieved great things. Those who refused to accept that their fate could be resigned as so. Remember when mainstream medicine thought ulcers were caused by stress?

 

Very true @The Red Viper couldn't agree more. Tinnitus has made me a stronger person that is for sure....

 

Ain't that the truth!

 

@Michael Leigh . Wow that took sometime to read. Excellently put together better then any book I've read on tinnitus. A must read if you are suffering from tinnitus.

 

Not sure what you desire is plausible. I also believe that the hearing apparatus does not have to be fully repaired to extinguish tinnitus. Just like some without perfect hearing don't have tinnitus. I believe its possible some day, a device maybe implanted that will be like tinnitus noise canceling to the brain. An interface to the auditory cortex that removes the electrical stimulus aka neural pathways that create a given person's tinnitus. This is somewhat independent of creating perfect hearing in people.
I have no doubt solutions will come....just hope they aren't 20 years out.

 

@stophiss, I see no reason why an objective measurement tool is implausible, especially if you believe that a tinnitus noise cancelling implant is possible. For the implant to work, it would have to measure the tinnitus objectively in some way. So in a sense you agree with me.

 

While it would certainly be very useful to be able to measure T objectively, I don't think it's a necessary condition for an implant (or any treatment really) to "work".
When you have a headache and take acetaminophen and the headache goes away, you can tell "it works" without having objectively measured your headache.
I'd be happy to regain my pre-T quality of life, even if I can't confirm that my T is "gone" through an objective measurement. I'm pretty sure I'm not alone.

 

Not to quibble as we are discussing a hypothetical
But...I see that it could stay in the subjective realm.
An implant to the brain would be provided. Then based upon patient feedback, the implant could be tuned to tune out the unwanted sound known as tinnitus. This would be independent of any objective measure and extinguishing the tinnitus sound which is a bit different for each of us would in effect be trial and error by collaborating with patient to see if the right frequency(s) are targeted which would include volume level as well.

 

I see what you're saying. I was imagining an implant that would work independent of patient feedback, i.e. it "knows" your T sound and automatically cancels it out.

 

Yeah I wouldn't mind that as well, but the certainty of knowing why would be a real breakthrough. As to acetaminophen, no one really knows how it works, which is crazy considering how many years it has been around. I believe a breakthrough in the mechanism of action of acetaminophen would lead to an understanding of what actually happens when people have headaches and could lead to a permanent cure for migraines.

 

Thank you for this post...it touched my heart.

With all respect....i disagree with wearing ear protection i went to around 10 music events....with out any issues ... not even a fleeting T ever.... then one fine day i read about tinnitus and decided to wear 20db musicians ear plugs to what would be my final music event which caused my T and H. I suspect the ear plugs inflammed my ears and made them more succeptable to noise damage.

I think the best thing to do is buy a professional sound meter by paying 200£ or more and if it shows anything above 75db ..... run for your life!!!

 

Dangerous advice klaxon! I think i got t on arous my 30th concert without protection. It will get you at some point as i now know!

 

@Hopeful1

Thank you Hopeful1. No two people experience tinnitus and hyperacusis the same because we are all different. So I agree with you about not wearing earplugs if that is right for you. You know your auditory system better than anyone else. I would like to touch on your comment “reading about tinnitus” then you noticed the tinnitus one fine day. A similar thing happened to me. I am a HI-FI enthusiast and used to listen to music through headphones a lot. I was reading a hi-fi magazine one-day and they were reviewing a pair of high quality headphones so this interested me.

In the article, the writer mentioned the risks of hearing damage and tinnitus when listening to music through headphones at too high a volume, because many people may not realise it. He said tinnitus manifests itself as “ringing in the ears”. He went on to say: the start of tinnitus is usually noticeable late at night when it is very quiet. If you hear any ringing it is a warning that you should lower the volume on the headphones or stop using them.

Thinking back, prior to reading that article, I remember hearing ringing in the night but in the morning it would be gone. At the time I didn’t realise sounds during the day was masking my tinnitus that I didn’t know I had because it was at a low level. My point is, I believe that article planted a seed (a thought) in my mind. I carried on listening to music through my headphones then one “day” similar to you, I noticed the loud intrusive ringing when I took off my headphones.

Your last comment made me smile and you are right. Anything-above 75db run for your life.

In the summer I went onto the Brighton Pier. As you probably know they have a large amusement arcade there with slot machines of every description to entice people. I had my sound level meter with me and my earplugs just in case things got too loud. I wanted to test my tinnitus and whether I had any hyperacusis which I was sure I didn’t as it was completely healed. The sound levels in that arcade was around 100 decibels with music playing in the background and the noise from people as the place was full. My ears didn’t hurt once nor did my tinnitus spike. I stayed there for just over 30mins. The next day I woke up my tinnitus was silent and no sign of any hyperacusis. This was just a test and not something I normally do or advise anyone to try.

My tinnitus ranges from: silent, mild, moderate, severe and very severe.
Michael

 

Well if i do go to another concert i will certainly be using ear plugs!

@Michael Leigh

I am amazed by the variations on your tinnitus, must be such a pain to deal with. If i was to think of mine in terms of a graph then it is just one one long line as it were going on and on and on.

 

I agree with you @Sam Bridge, earplugs is the sensible things to have when around loud sounds. You are correct the variations in my tinnitus has caused me a lot of difficulty and frustration at times. As I type I am in a room with my sound machine gently playing in the background. I only hear it at this moment because I'm focusing on it. However, my tinnitus is completely silent. Tomorrow who knows what I will encounter, but that's my life and I have habituated to that...

 

Michael,
You wrote your tinnitus varies perhaps more than most if not all on this forum...from silent to very severe.
Variation in tinnitus intrusion is so very common and one of the mysteries of this disorder.

Do you have any theory(s) on why your tinnitus varies so greatly? As discussed, mine varies from a 4-5 to about 0.5 or so (subjective). Any idea why your range is so broad? Do you believe the range of tinnitus people have correlates to the type aka cause of their particular tinnitus?
Thanks

 

Hi @stophiss
My tinnitus changed when it got worse in 2008. Prior to that is was silent to mild most of the time. That is the danger when you habituate to such a low level because I forgot that I had tinnitus. It happened one evening listening to my HI-FI. I turned up the volume but everything was okay. Went to bed and in the morning the tinnitus increased and got louder over the following days and weeks and I had to go back to ENT. It changed my life for nearly 5 years.

My hearing therapist and consultant have said I am a rare case, because they haven’t met anyone with my type of tinnitus. That goes from complete silence, to mild, moderate severe and very severe. From 2008 to 2012, when my tinntius reached very severe levels it was different from the severe level I get now. It was excruciatingly loud is the only way to describe it. Over the course of one to three days it would gradually calm down but till this day I don’t know how I coped. I can only put it down to my will power and determination and the belief that things would get better. It took 4 years to habituate.

In 2011, by chance I was surfing the Internet and wasn’t looking for anything in particular and happened to visit a website where Tiex, tinnitus therapy device was sold. I was so desperate I ordered it and the rest is history because it helped me. In addition to my TRT and clonazepam . I use the Tiex device every day morning and evening. This is the first time I have mentioned it in a tinnitus forum. I have always been reluctant because it is expensive and might not work for everyone but now I have decided to mention it. http://www.tinnitus.cc/en/index.php It can be rented or bought outright.

I wish I had an explanation as to why my tinnitus is so variable but I haven’t. It is silent at the moment and I’m wearing white noise generators as I’m so used to using sound enrichment.

Michael

 

Are you serious guys? Some lecture theatres are almost as loud as that lol.

 

Tinnitus and hyperacusis are complex. As I previously explained. I went onto the Brighton Pier and into the amusement arcade and had my earplugs and sound level meter. I didn't use the earplugs and sound levels were 100db and I had no problems. It is not something I would do every day or advise anyone else to try.
Michael

 

@Michael Leigh ,
Thanks for the warning .
Better bring my plugs to Brighton and my hearing aids and glasses.

All the better to see you with ,hear you with and plugs when laughing our head off....lots of love glynis

 

Quite an odyssey Michael. Thanks for sharing your story. Lesson for all of us...don't temp our tinnitus with a loud night out without protection. As mentioned Michael because of you I have suspended my earphone usage which as it turns out is safer out on the bike anyway...many cyclists denounce earbud usage because hearing is directionally correct to surviving on the roads...hearing others...upcoming cars etc.
I, for no good reason am getting a reprieve from my tinnitus today....mine presently is about a 1-2. I woke up this morning to lower tinnitus for no reason I can surmise. Yesterday I woke up to pretty loud T which always surprises me a bit. Patience and hopefulness are a virtue with this disorder...always hoping for better days ahead when having a bad day. Worse than a dramatic change in weather.
Congrats on your silence today and hoping it hangs around brother!