Tinnitus and Possible Hyperacusis - Concerned about Its Onset/Worsening

Hi all,

I'm in my late 30's, and the last 6 months I've been suffering from anxiety/chronic stress for the first time really in my life. This has been getting better of late but in the meantime I'm concerned about the onset/possible worsening of tinnitus and especially hyperacusis.

Here's the story.

Around March of this year I had a bit of a breakdown for various reasons work and non-work related. I started to get really bad sleep and soon this turned into insomnia. About two months in, I thought initially my central heating system was playing up because I could hear this water trickling sort of sound in each room. I eventually realised when I stayed at my parents that it was my left ear! I also retreated into a really quiet/silence space in the evenings, even though this wasn't because of any ear problems, but my anxiety/stress/breakdown made me lose any interest in music, TV, etc. and I seemed to just want to stay in bed all the time and try to sleep.

Shortly after, pressing on my tragus, I could also hear a dual sound - a consistent tone rather than a ring.

As my anxiety/stress was ongoing, my GP prescribed me Citalopram. I was initially determined I was going to overcome my anxiety/stress without the need for anti-depressants/SSRIs, but after 3 months I decided to do it as I was still having attacks. I only lasted one 10mg tablet as what little bit of sleep I sometimes got (around 1-2 hours sometimes with Zopiclone) collapsed entirely, my appetite which was still mostly good also collapsed. After a few days the side effects including dry heaving wore off again. I had about 4 days worth of teeth pain around this time too which I saw my dentist about. I thought I might be grinding because of the stress/anxiety but the dentist wasn't entirely convinced and having found an infection at the back of my gum - left-hand side too, I was prescribed Amoxcillin and it cleared up. I'm not aware I've had any grinding since or TMJ.

I struggled on, having some better days/weeks and some worse. After one bad panic attack especially, I caved in and took another 10mg Citalopram and 7.5mg Zopiclone (sleeping tablet). I had the same side effects as before (which my GP said to expect). The night after, I accidently took 200mg of Ibuprofen instead of a Paracetamol for such incredible headache. It was the morning after that I realised my voice sounded incredibly loud to myself, and other noises seemed increased in volume. Again, I never took another Citalopram or other tablets.

After a few days, my sensitivity to noise seemed better but my voice still seemed loud to me, and a little distorted/echo-like. I rang my GP in panic as I read that Ibuprofen shouldn't be taken with Citalopram, but my GP assured me this is because of risk of bleeding and is very rare. I'd taken Ibuprofen in the past before and never experienced any problems so presumed it would be ok. At this point, I'd never even heard of ototoxic drugs.

Roll forward another month, my tinnitus hasn't got any worse. It's still only my left ear and it's very changeable - even during the day. Sometimes I hear dual tones, sometimes just a low rumbling/water trickling sound. If I do a sort of breathing exercise (not classic breathing exercises but one where I breathe in only a little, but breathe out more heavily) over about 10 minutes, the tinnitus rumbling often halves in its volume. I sometimes also get squelches, multiple clicking when I swallow. I have no problems with my right ear at all.

The tinnitus itself I think I can live with but its the weird sensation of my own voice and sensitivity to noise that worries me - and possibility of hyperacusis. This seems to change day by day, depending on my anxiety/stress level (the original reasons for anxiety/stress aren't such a factor now, having been replaced my a new anxiety/stress about my ears!) and sleep patterns. For example, I got about 5 hours sleep one night and my sensitivity to noises around me seemed less pronounced. Last night I got very little and today everything seems very loud/irritable around me. It also seems to be the left ear where this is pronounced.

At the moment, I wouldn't say its that bad sensitivity - I notice it mostly on the bus to/from work (engine noise), in our canteen with people talking, and occasionally traffic noise going past. I seem to be tolerating life in general ok, TV, music (which I now listen to at reduced volume than I have in the past!) although seem to have more difficulty in following people's conversations against background noises and after listening to music my left ear sometimes feels more sensitive and 'buzzy' - sometimes it feels like it's 'more open'.. I don't get any pain and I don't seem to see any obvious pattern with my tinnitus volume or sensitivity to noise. Having read articles about hyperacusis, I realised that my retreat into silence when I had my initial breakdown might not help and so I am ensuring I expose myself to everyday noise and music again so as to not worsen things.

My own voice loudness/distortion/echo effect varies also, often throughout the day. Sometimes it seems that if I sniff, it goes down a bit in distortion/echo. Certainly it seems better those days I've had some sleep and I'm feeling less anxious/stressed. It's improved since a month or so back when I first had the sensation come on after my panic/Citalopram/Ibruprofen episode.

I've been to my GPs again, and they seem to either think its anxiety related - and that I need to give SSRIs proper chance to work. Although I'm coping really quiet well now with no panic attacks for a month, mostly functioning ok and working. I said I'm scared now that the potential side effects of SSRIs (especially in regards my ears) makes me reluctant to. They seem to think I'm blowing it out of proportion and the amounts I've had of Citalopram/Ibuprofen in only two sporadic occasions wouldn't cause any of the problems with the loudness of voice/sensitivity to sound. I did mention that I'd read that these and other drugs are known to be ototoxic and on one site lots of people claim that they're tinnitus/hyperacusis possibly came on only with a handful of Ibuprofen, etc. I just don't know what to believe.

Perhaps the sensitivity to noise is only anxiety or lack of sleep related? And if I can keep my anxiety/stress down and get some decent sleep back and regularly, then it'll get better. Perhaps my retreat into silence at the height of my breakdown has just made my brain less tolerant for a while and it just needs some re-training/getting used to noise/music again.

My GP thinks the voice loudness/sensitivity is a combination of this, and also Eustachian tube dysfunction. I tried to get a referral to an ENT but they're not being very receptive and they've given me Mometasone nasal spray for a month and Cetrizine anti-histamines before they'll consider anything else.

I've not experienced any ear pain, balance or vertigo so far. I've not been to an audiologist for any tests but I can't detect any obvious hearing loss - if anything, everything seems louder and my hearing seems pretty good still.

As I'm mostly functioning, I'm really reluctant now to attempt SSRIs again even though my GP, another GP, therapist and occupation health nurse at work all seem to sing their praises! I did wonder whether Mirtazapine might be worth a try primarily to get my sleep really properly under control (and its side effects seem much less worse than any other anti-depressant out there). I'm a bit baffled though that some resources regard it as not ototoxic, but other people say that it can cause/make hyperacusis worse?!

Thanks for reading and any thoughts and advice I would be most grateful (even if its that I'm probably over-reacting/overly worrying/am a hypochondriac!)! I'm so scared that one or both are going to get worse, especially as music is such a big part of my life.

Steph

 

For starters you have to get your stress under control. Your cortisol levels sound like theyre off the charts and that can increase T. Start exercising to reduce that stress. Sleep is very important. It will take time. Your T and H should reduce over the next few months.

 

Reading Hyperacusis horror stories that there is a lot of is the worst thing to do right now. Anxiety matters a lot when it comes to H and it´s very easy to almost induce a sensetivity to sound if you obsess over it. Exercise is the best thing to do atm, force yourself out for a run. Better anti d is hard to find.

 

I had the loud voice also in the beginning and my voice sounding like somesort of echo.... little did I know that my eustachian tube was blocked... making my T worse but the voice thing was terrible... When I had to give a presentation I just could not do it and ask someone else to do it because I was hearing my own voice so loud. The doctor gave me Nasonex and said I had to try the valsava manouvre to clear my tube and ears. But warned me not to do the valsava to much cause it can also cause damage. So I tried that and it was becoming less right a way. The voice thing cleared up in a week with Nasonex.

In the beginning the doctor also gave me anti depressive pills but I took one and thought that it was not for me. I felt terrible and made matters worse. I knew I had to pick myself up and get out of this horror story. For some pills work and for others it does not.

I don't know if I got H or am just sensitive for sound. Putting away the dishes or screaming kids make my ears hurt or ... I don't know how to say it.... I feel my ears inside shrink or something..... I have a son of allmost 2 years old and when he screams real loud it realy hurts my ears ....sound that I could stand easly before T. But I do not know if this is H. I still can listen to music , but firework on new years eve is impossible.

I do not think about it to much and do not want to cover my ears everytime so when things are to loud for me I just get out of the way. It will settle eventualy I guess.

Believe me...do not watch youtube movies about horror storiers regarding T and H.... I watched one just when I got T and a guy said... "THIS IS WHAT I HEAR ALL THE TIME" so he filmed himself talking to his childeren and playing in a swimmingpool and than with the sound of his T through the film. I got so depressed and scared it would be as bad for me 2 that I nearly broke down.

You better read the succes stories.... you brain is a strong thing that can do things you don't even know right now. It can make you or brake you depending on which side you are going to be (positive or negative)
If you stay negative and scared you brain will focus on that ....if you try to stay positive.... eventualy you feel better.

Today I woke up......was hearing my T.... and I said ...f$ck it .....out loud.... I did some shopping , played with my son, watched a movie , did not go to this forum *laugh* , and hardly noticed my T today....only when my son cried loud I got a spike....so again I said f#ck it..... no stress ...the spike will go down.....and it did.

But if I have a negative day with bad feelings...my T screams.....well it does not realy ...the tone is almost the same every time when i stick my fingers in my ears.....but like I said the more negative I am ....the more I'm aware of my T. I know it's hard to ignore, but even when you hear it......it's the way it is at that moment. What can you do about it....nothing....only mask it. That is what is is for you at that moment.
You can panic...or you do not panic....T is still there....so why panic if it does not change the situation?
Crying won't help....praying won't help....dear lord why me.... I think we all said that to our selfs a lot.
You can listen to your T ....but since it is endless....why bother. I know it sounds hard and I did not follow my own advice I gave now when I first had it but I wish I knew what I know now. I can feel sorry for my self but it just won't help me...it makes matters worse.

During sparring I broke a finger ...and my students said...."your finger looks weird"... I said "What ever...lets fight"... so at the end I thought ...yes it looks very weird because the top of my pink was 90 degrees backwards".....
It hurt but I did not care.... i broke a lot of stuff in the passed so I was used to the pain. Somebody else might not take the pain and would go in panic mode. I went to the hospital ...they spalked it and I went home..... next day I was sparring with a spalked finger....didn't feel the pain cause I did not care only when I looked at my finger and thought about it I could feel the pain.

Knowing that I try to have the same attitude about T.... I already posted it in an other thread your brain is capable of ignoring it ....my girlfriend has T and she can hear it when she is focussing on it and it's louder than my T. But she can block it in a second cause she does not care and does not want to think about it ....her priorities are our son and me. She says why bother with things I cannot change. Her sister was born with T ....very loud...she doesn't care less and only hears it when she is focusing on it. The impact our brain got with T brought our brain in a very defensive mode and is trying to fight it. We need to adapt to it and that takes time.
But you and you alone can pick yourself up and walk forward.

We all do not want to be alone with T but in the end we are alone with T. It's you and T. We talke about it with others who have T ...and we feel less alone...... Even when you hear a horrorstory....you sometimes can say.....pfewww glad mine is just a eeeeeeeeeeee and not 20 sounds at ones. Some people feel better when others have it worse than you. But than again..... there you are with your T .... some posts give you a good feeling ...some make you scared.....etc .....T is still there...... So you know that ...and you must be selfaware that it's the way things are for you for now. If you loose two arms...you never get them back and you need to adapt.

T...can be ignored or can be lived with.....but it's up to you which path you are gone take. You can fight it or you can undergo it and try to makes peace with it. That does not mean you hate it less, but you have accepted it that it is the way it is for now. Take a lot of sleep.....eat healthy....try to stay social (I need to work on that myself ). We all (i guess) have/had the times we do not want to do anything anymore. I thought I could never have sex again because this damn T all the time. I am very open about this....but if I have a bad T day....nothing can make me feel to be intimid with my girlfriend....and I realy love her...so when that feeling is gone (not the love...cause that is always there) for that day..... I know I have to pick myself up. You cannot lie to yourself ....you know when you have a bad day or a good day.....but you have to be strong.

Sorry for my long reply....but I know a lot of us are having ups and downs .... and I just refuse to feel down anymore....life is to short.....to beautiful. Nobody said life was easy.....but it's easy to give up on life....but to live with T or don't hear our T anymore....life challenge you to get a grip of yourself. And you alone can get control of your life.....

 

Thanks for your replies, I really appreciate it.

Got a referral to an ENT today so we'll see how goes. My GP did a tuning fork test in, behind my ears and my head. This seemed to be ok and I didn't find myself particularly sensitive to the tone either.

As I made my way into work this morning, the bus journey and traffic driving by as I walk the rest of the journey up a main road seemed particularly sensitive and loud - it builds up gradually. It then feels like my left ear gets more sensitive to other noises it picks up - a squeal from a van's breaks, voices sometimes a bit more trebly. When I'm sensitive, I'm not so much sure my hearing is really much louder at times (it certainly is to a degree), but it's the top end that seems to stick out especially.

When I walked into the office, which is rather quiet environment, for a few minutes my left ear still seemed sensitive (a rushing sound more noticeable, but no pain or vibration). One colleagues voice sounded louder I talked to and felt uncomfortable initially, but after a few minutes, it seemed to die down again and by the end of the conversation, his voice didn't seem quite so harsh on the top end.

At the same time, my own voice (including if I hum to myself) was louder/more distorted/harsh after the exposure to the loud noise, but typing this now at my desk (30 mins after getting into the office), it's gone much quieter again! The autophony seems to be limited to my voice/humming - and eating as I'd normally expect with certain foodstuffs which are noisy to eat! I don't hear my breathing (unless I deep breathe which I'd expect), nor my pulse, or eyeballs, etc. I do notice that when my voice gets louder/harsher, my nose sometimes seems like it has opened up wide and I notice the air much more in/out.

It seems so 'up and down', during the day let alone day by day! I listened to some music yesterday on a hi-fi and that didn't bother me at all, but walking down the street it made the crowd in the town I live sound like a city thoroughfare!

Does this sound like a possible onset of hyperacusis, or more likely its an anxiety related reaction?

Steph

 

Anyone?

I started a low dose on Mirtazapine on Monday night, least now I'm getting some decent sleep again!

Tuesday was a great day. The loudness/sensitivity of my hearing/own voice was much improved. I was focusing less on all manner of sounds/noise around me and was able to hear/focus better on those I was with. Filtering out background noise is definitely much to do with it. I didn't notice the bus journey, traffic, etc.

And yet today, its bad again! Not neccessarily always loud noises/sound. One persons voice in a meeting today was really harsh, and in a doctors waiting room earlier, certain sounds I really noticed and was irritated by, and others less so.

 

By the time I got the bus last night and home, my ears were in such discomfort. I got really down about it all. Sleep wasn't as good as the previous two nights on Mirtazapine.

This morning, however, things don't seem quite so bad. On the bus right now. There's a guy behind me, and a girl sitting in front of me, and their earphones are incredibly loud - I want to say to them 'dont do it!'.

Can it really fluctuate this much day by day?

 

Just had an odd sensation a minute ago - a feeling of pressure change in my left ear, sinuses, nose. Just for a few minutes, my own voice loudness/distortion seemed a bit different/less harsh. Hearing sensitivity/loudness is still less this afternoon than it was yesterday (about the same as Tuesday).

So, physical ear problem? Anxiety? I just don't know. Perhaps I'll find out more when I get to see an ENT (or looking at some people's experiences, perhaps not!).

If anyone can give me some feedback on whether this sounds like hyperacusis? Or not? Or even a combination of things going on I'd be grateful. Do others hear their own voice really weird (loud/harsh top end/distortion) with their hyperacusis? Do you find when the hearing loudness/sensitivity is worse, your nose/sinuses also seem to seem really 'open' too?

 

Feel I'm talking to myself a bit here! but could Patulous Eustachian tube fit the bill?

 

Hi Steph, I have H and T and ues sometimes experience that with my voice..I think my ears are just messed and.most likely it all stems from TMJD..however they now react to noise as well..my H is bad atm..too much exposure again...just try to relax and do what you can to not freak out..see what your ENT says though not many will touch on H and will most likely tell you anxiety brought it.on...however some have done well with antidepressants there is an H section in the board, might consider posting there as well

 

Yes @Steph mine does flucuate alot!!

 

Thanks Lynn.

Yesterday more sensitive/loud, today not so bad again! I could understand it fluctuating over time, but daily?!

 

Yeah, mine can also fluctutate over the day. It's always at its worse in the morning, then at its best in the middle of the day to get a little worse during the evening.

 

Well, a week later from my first post.

I still seem to be getting better day, followed by worse day, and repeat, with the hyperacusis and autophony symptoms. On the whole I'd say things are improved (or perhaps I'm learning to cope better?) than a few weeks ago.

The first key change has been getting some really good sleep through taking Mirtazapine. Although I've not managed an unbroken nights sleep yet, I'm getting mostly 7-8 hours in two chunks of 3-5 hours each. This has really improved my mood, general health and tolerance to noise I think as soon as I start the day. I'm currently taking 7.5mg each night (I've actually been prescribed 15mg per day for anxiety), so using it as a sleep aid primarily. I'm wondering whether to now increase to 15mg as the GP recommended but I'm pleased that my anxiety/stress has already dropped a bit purely because I'm not suffering insomnia!

The tinnitus is still centred on the left ear, mild and mainly a rushing sound. The tones only noticeable at certain times or if I press my tragus.

 

Well, I saw the ENT yesterday. He examined my ears and I had a hearing test - to which he described the results as 'interesting'.

Hearing in the high end is very good (with a bit of a dip in the left ear around the 4khz area which I expected and to which he puts down to both problems with that ear specifically when I was younger (multiple infections/eardrum perforations) and some noise-induced loss.

What was 'interesting' is that both ears stuggled with the lower end frequencies, response improving gradually as the frequency increased.

At the moment he doesn't think there is anything too untoward, and has recommended I persist with the nasal spray. I questioned whether Eustachian tube dysfunction/blocked Eutachian tubes would cause the loudness/sensitivity of hearing/own voice and he said it certainly can.

So, looks like persisting a bit longer as I am doing and then he asked me to get back in touch if I'm still not improving.

Anyone else had a hearing test where the low-end was the problem rather than the high?

 

Been a week or so since my last post.

The loudness/sensitivty of hearing is improving steadily - as is the autophony/loudness of my own voice. Hoping this is result of the steroid spray, and perhaps also the improved sleep and general lowering of my anxiety/stress levels.

The rushing/hissing in my left ear is pretty noticeable, but the last few days I've been experiencing an hour or so where it dies down to almost silence before slowly turning up again. Anyone else get this? It seems to be happening around 5-7pm so far and I can't relate it to anything I am doing/not doing other than it's about 30 mins after having my evening nasal spray.

I've also been getting a second sound of late in my left - a louder, clear high pitch tone, but which usually only lasts a few minutes before going again.

 

Your T is cycling. Why? Know one really knows but change is good and better than a solid tone. Some forum members on here say their T has been cycling for years. I have a constant "eee" tone in my right but my left has a buzzing tone and it has been cycling up and down every other day for 5 months, one week after starting. I have had random 2 to 4 day breaks so that's positive. However for me the good days are getting better and the bad days are not as bad. My sensitivity has improved but is still not the same.

 

Been a while since I posted so thought I should update.

Well, I got my stress/anxiety down with the help of Mirtazipine - which also helped to get my sleep back on track again.

The loudness of my own voice/autophony and sensitivity/loudness to sound have both decreased massively. Still some days it's not so good. This does seem to have been caused by chronic eustachian tube problems made worse when my anxiety was high (and which sometimes became a vicious circle).

I've still got constant clicking and popping with both ears (especially the left), and have to regularly do a careful valseuver manouvre to adjust them. The ENT was wanting to do myringotomies but especially given my history of perforated ear drums and problems with my left ear, have been reluctant in case it made things worse. Instead, I've persisted with Mometasone.

Still got this rushing/whistle in my left ear that often goes quiet or changes noise/loudness during the day. From my reading on the net, chronic eustachian tube dysfunction can be incredibly slow to clear.

Doing much better though!

 

Hi Steph, I'll responding to a very old post but hopefully this will get to you somehow.
I have had tinnitus for 3 weeks now and I'm struggling with hypercausis too now. Your story is very similar to my situation and I just wondered how you got on considering this was posted 2 years ago. Do you have any pointers?

Thanks
Si