Tinnitus at 22 — Stress Being the Only Plausible Cause?

Hi,

I have contemplated posting on this forum for a while and finally decided to do it. I will try to describe my situation as briefly as possible; any advice is appreciated

At the end of January this year (2021) I went to bed and noticed I had high pitched ringing/hissing in my head. I was a bit confused as to why this was, as I am only 22 and hadn’t been exposed to loud noise or had any sort of illness/injury. As it persisted for a couple of days, I booked a hearing test to check if it was caused by earwax or an infection. I was told my ears and hearing were fine and was referred to ENT, who performed a more thorough hearing test (and pressure test for the ear drum), again with no obvious hearing loss or visual damage internally. I mentioned to the audiologist that I hadn’t been exposed to loud noise but had been under a lot of stress from November to January with university exams. He suggested stress may have triggered tinnitus due to changes in the nervous system rather than physical damage to the ear, and that as stress diminished it would settle down and eventually not bother me.

It has been a couple of months since my appointment (4 months since onset) and I still have tinnitus at the same volume and pitch but mentally I am at the worst stage so far. I am sure many people with tinnitus feel the same, but I just cannot imagine living the rest of my life like this. I have not had a truly peaceful day since tinnitus started. Even when I am out enjoying myself tinnitus is constantly in the back of my mind (trying to think if I can hear it or not), which I know is the worst thing you can do but I simply cannot control it. I have tried using noise from TV or music throughout the day to distract me from the tinnitus, which can sometimes help but I don’t feel I can live my life constantly avoiding silence (something I used to love). I understand that in order to habituate you have to train your brain to ignore the noise but I just don’t know how to do this. As my mental health has suffered a lot in the past couple of months, I had another ENT appointment (to get a 2nd opinion). Once again there was no sign of hearing loss and was told it is likely stress induced. I am still sceptical of this though, as although stress can exacerbate tinnitus, there does not seem to be a consensus as to if tinnitus can be “caused” by stress.

Has anyone had a similar experience of sudden tinnitus onset with no possible cause other than stress? If so, did tinnitus go away completely after a reduction in stress (and how on earth did you manage to not be stressed with tinnitus) or did you become fully habituated to a point it is not noticeable? I suppose it is less likely to find people on forums that are ‘cured’, as they will probably just get on with their life, but the information online is so mixed, with some saying after 3 months tinnitus is chronic and will not go away, and other saying their tinnitus went away after 9/12/18 months.


I know that there can be hearing damage without detectable hearing loss, but as I developed tinnitus during a period of very little noise exposure (due to COVID-19, bars, concerts, cinemas etc. were all closed) so I don’t understand how it can be caused by damage. For those of you who managed to ‘get rid’ of tinnitus or achieve full habituation, how did you do this? I have seen so many different opinions on drowning out tinnitus with other noise, focusing on it and accepting it (train the brain to relax to the noise), using ear devices to retrain the brain and others who simply ignore it and get on with life. I think the biggest barrier for me is not knowing if it will ever go away or if I will habituate. I never know if I am doing the right thing by trying to mask the tinnitus or actually just listen to it and accept it. Sometimes I feel that I am on a good streak and not noticing tinnitus but then I will fall back into a bad cycle of thinking about it all day. I have also been very sceptical of using headphones, but I find my tinnitus is less noticeable when gaming, so I don’t know if this will help me habituate or just cause damage? In truth I just don’t know what to do with myself. Being 22 I don’t know anyone who has tinnitus and don’t think most people around me understand my situation as I don’t have a visible/physical ailment (surprisingly even the ENT professionals don’t seem very compassionate).

Anyway, thank you for taking the time to read this and I would greatly appreciate any help, advice or personal experiences

 

Many things can cause tinnitus including stress. The most common cause is exposure to loud noise. Although you have said you haven't been exposed to loud noise, you have mentioned using a headset for gaming. People that regularly use headphones, earbuds or a headset, often listen to audio at levels that are too loud without realizing it, so it's something to think about. Since you find some relief using a headset for gaming, try keeping the volume as low as possible.

Please click on the links below and read my posts that you might find helpful.

All the best
Michael

New to Tinnitus, What to Do? | Tinnitus Talk Support Forum
Tinnitus, A Personal View | Tinnitus Talk Support Forum

 

Hi Michael,

Thanks for the reply, I will check out those links you sent.

With regards to headset use, this has been another thing which confuses me. During the period of November to January, due to demanding exam deadlines, I did not have the time to play games so my headphone use was very minimal (perhaps a couple of hours a week). Do you think this would be enough to cause permanent damage? For 2-3 weeks after onset I stopped using headphones completely.

But I feel like if a couple of hours use a week could cause tinnitus, then it was surely going to happen at some point anyway?

 

I understand your reasons for thinking the tinnitus would of happened anyway but this isn't usually the case. Ruling out stress, the most common cause of tinnitus is exposure to loud noise. Prior to the onset of the tinnitus, if you regularly used a headset or headphones then it's likely it was noise induced. It would have been there for quite some time but remained at a low level enabling your brain to comfortably ignore it. This happens to a lot of people until eventually they become aware of it. This is just my opinion as I could be wrong.

Whether your tinnitus is caused by stress or as I believe is noise induced, with time I am sure you will improve and make a good recovery. Tests at ENT have shown that your ears are not damaged so try not to think this way. I agree with your decision not to use headphones and if possible, I advise that you never use them again even at low volume. Use low level sound enrichment as mentioned in my posts especially at night. Click on the links below and take your time to read my articles. Try not to worry things will get better.

Michael

Will My Tinnitus Get Worse? | Tinnitus Talk Support Forum
The Habituation Process | Tinnitus Talk Support Forum

 

I'm so sorry you are going through this. I am not sure if stress caused mine in conjunction with an acoustic trauma. Mine could have also been related to medication. I do know a few weeks before mine happened I started having heart palpitations and was very stressed about the pandemic. I also had some close relationships that were very strained at the time when the acoustic trauma occurred. I think stress played a role.

About the recovery timeline, you are young still and the good thing is that if you take care of your body and ears you have a very good chance of healing. I started really feeling better after about 5-6 months. Give yourself some grace and allow your body and mind to recover.

Best in your recovery,
twa

 

You are young so you have have a very good chance of recovering. Be careful and protect your ears from loud noises. I was in a terrible shape at the beginning mentally and emotionally and started to feel better after one year plus.

 

That's interesting and may be the cause of my tinnitus. I have previously (prior to onset) noticed very mild tinnitus a few times in my life when in a completely silent environment. For example during Christmas 2020 my mum and I were in the living room and she said it was completely silent whereas I heard a very quiet ringing. I thought about it that night but it didn't cause me any distress and by the time I woke up I didn't hear it again until the actual tinnitus onset.

Regarding the sound enrichment. After my ENT appointment I was given a sound device to help with sleep. I sometimes use it but put it on the 30 minute timer. Will this be more effective if it is left on continuously throughout the night? Will the brain continue the habituation process even if I'm not awake? I'm usually tired enough to fall asleep at night even though the tinnitus annoys me but I have great difficulty falling back asleep if I wake up. I feel like I wake up in an 'alert' state.

Also would you recommend using the sound device throughout the day or other noise (currently I leave the TV on). I read your posts about the in-ear device for TRT being used for 10 hours a day but that the volume etc should not be altered. Is this the same case with the external sound enrichment?

Thanks again for the reply and links. Your posts are very in depth and interesting.

 

Thank you

If you don't mind me asking, how long have you had tinnitus for? And how is it now?

Also, during your 5-6 month timeline in which you noticed improvements did you do anything specifically which you found helpful?

 

I think the constant mental battle is the hardest part of tinnitus. I know tinnitus isn't going to kill me but I can't stop thinking about it. Feels silly to worry about a noise but it's so debilitating.

I have always been a very calm person so dealing with the anxiety which came along with my tinnitus has been a huge struggle.

I'm glad to hear you found improvements! Do you have any tips or things that helped you improve your mental health?

 

I'm so sorry of what happened to you. Especially since you are so young and you really didn't do anything harmful to cause this. I have tinnitus too, from an intense breathing exercise, the Wim Hof Method. Did you try this by any chance? For me and many others this was the cause.

I think to deal with this situation you'll have to see this from a different side, a positive one is possible. You mentioned stress and that the doctors think it caused the ringing. So you'll have to make changes to your lifestyle, and learn how to put yourself in a relaxed state. Gentle relaxing breathing, exercise, healthier diet, these can help you to ease on the stress and take your mind of the ringing.

That is what I'm trying to do and I can tell you it is much more bearable. After sometime it won't bother you that much. But first you'll have to distress yourself.

I don't know if this was any help, but I hope so! It will get better, trust me!

 

Many people hear tinnitus in quiet surroundings. This doesn't mean they have noise induced tinnitus, or an underlying medical problem within the auditory system is responsible for it. The internal workings of the human body is a noisy place. Quiet surroundings can allow the brain to focus on this and tinnitus is often heard. If you regularly used headphones for gaming or listening to music, you may have been listening at high levels without realizing it. This is something only you will know but is a strong indication the tinnitus was noise induced.

I suggest that you use sound enrichment throughout the night until morning, keeping the sounds slightly below the tinnitus. The volume should be set at a level that it's not drawing attention to itself. More about the benefits of sound enrichment is covered in my posts that I have given you.

During the day try to avoid being in a quiet room. This doesn't mean you have to be constantly immersed in sound enrichment. Have some low level relaxing music playing in the background, set at a level that it's not drawing your attention too much. Mix things up by using nature sounds or classical music. TRT and using White Noise Generators is a specialist treatment, at this stage I don't think you should concern yourself with it. Habituation takes time so take each day as it comes and I suggest reading my articles again.

Thank you for your kind comments.

All the best,
Michael

 

Exercising and being more in the outdoors were some ways that really helped me. I also spent a lot of time with my loved ones and volunteered myself for all sorts of work.

 

Thanks for the positive comments

I had never really tried breathing techniques prior to tinnitus so I don't think that would have been a cause. I had always been quite calm and relaxed even during tough times in my life.

Now with tinnitus I am trying to control my anxiety and change my mindset. I have found it quite difficult but I'm trying my best. Trying to stay active and will give the relaxing breathing a try! Hopefully it will get better with time!

 

It's quite difficult to know. I have always been careful with headphone use and exposure to loud noise in general so I can't say for sure but it is possible.

I will give the sound enrichment a try throughout the night and have some low volume noise in the background throughout the day

After my ENT appointment I was told I'll have a follow up in a few weeks to discuss potentially getting the in-ear noise generator but hopefully this won't be necessary.

Do you think this is more effective than trying to habituate naturally with sound enrichment?

 

You are new to tinnitus so give yourself plenty of time to recover. It takes about six to eight weeks to get used to using sound enrichment at night. Patience is key and I suggest that you go to my started threads and read my posts: Tinnitus and the Negative Mindset, Acquiring a Positive Mindset.

I do not recommend the wearing of white noise generators, until six months has elapsed for someone with tinnitus. They should also be used with counselling and introduced to the auditory system slowly, otherwise they might cause irritation and make the tinnitus spike. My TRT posts explain this in more detail.

Some people habituate without the need for white noise generators, counselling or medication. There are no set rules because we are all different. It all depends how the tinnitus is affecting you emotionally. If you feel you need to talk things over with your doctor or an audiologist that specialises in tinnitus, then this might help you.

Alternatively, you can try engaging in the things that you like to do and this will help reinforce positive thinking. The posts I have mentioned explains how to incorporate positivity into your life.

Best of luck,
Michael

 

I can see from your posts the importance of positive thinking. I try to stay positive but find it difficult, hopefully this is something I can work on and improve using the strategies you recommended. Sometimes I will be keeping busy and not think much about tinnitus but then when I'm at home and there's not much going on it consumes my thoughts and it's very easy to enter a state of despair.

Immediately after onset I was very distressed but got accustomed to tinnitus after a few weeks, however, I reached a stage where my mindset changed thinking my tinnitus will never improve (as it has been constant for so long) and have not been able to bounce back since.

During my ENT appointment last week I asked about CBT but was told the waiting list was 9 months. Then they mentioned TRT and I was told white noise generators would be given to me in the follow up but they didn't mention anything about counselling.

In your posts you seem to have found TRT effective. How often did you have counseling sessions? Ideally I'd rather not have to wear WNGs every day but by the time I have my follow up it will be 5/6 months from onset, so not sure if I should consider it? I understand everyone is different but obviously want to utilise the most effective treatment available.

 

Noise exposure is only one of the possible causes for hearing damage. "Invisible" diseases are another one. Some physiological changes may have happened to your hearing apparatus, due to a variety of factors. Figuring out what happened is often quite challenging.

Good luck!

 

I suspect that you are reading my posts on a computer screen or on a phone. If you are doing this I suggest that you print them and refer to them often. Reading the posts on a screen is fine but you will not absorb the information in it's entirety because they are a form of counselling. I know they are long, so you need to play some low level relaxing music and take your time and read the articles slowly.

Tinnitus changes a lot within the first six to twelve months of onset.This can affect a person's mental and emotional well-being considerably. All that you are going through is the typical way tinnitus behaves. Positivity comes with time and patience. You may have a few good days and think that you've turned a corner, only to awake one morning to notice the tinnitus seems more intrusive. This happens and is quite normal. You have to dust yourself down and carry on.

I know some people are given white noise generators without counselling but it's something I don't recommend. I am not saying a person will not find any benefit because some do. However, white noise generators are usually used with counselling.

I had TRT for 2 years with regular counselling. At first every two weeks, each session lasting one hour. Over time my hearing therapist would see me every three or four weeks. Then return to two week intervals. Sometimes counselling would go over one hour.

Take things easy and don't be too hard on yourself.

Michael

 

Sorry to hear of your tinnitus onset. I think you have been given good advice regarding the cause of your tinnitus. Stress can make tinnitus worse but it is very unusual for stress to cause tinnitus on its own without any other causes. Therefore it is much more likely that your use of headphones in gaming was the principal cause of your tinnitus and stress is understandably making it worse.

More importantly though - what do you do now? I think you are doing the right things in terms of using sound enrichment at night etc. The main thing I would say is that over a period of time tinnitus can "improve" as people start to habituate more to the tinnitus. But unfortunately it can also get worse and the main thing that can make it worse is more loud noise exposure to already highly sensitive ears.

Therefore my main advice is to be very careful around loud noise exposure, in situations where you absolutely cannot avoid loud noise use hearing protection (and make sure the duration of noise exposure is as limited as possible) and avoid using headphones at all in the future. Hopefully, if you follow this advice and take things slowly things should slowly start to improve.

 

Yeah, I had been reading on my phone. I will get some physical copies printed!

I am not sure what my ENT has planned for my follow up appointment but will see how that goes and continue with the sound enrichment just now

 

Yeah, it is possible that previous headphone use caused my tinnitus and stress aggravated it. Although I find it difficult to understand why we don’t have a huge proportion of young people with tinnitus? Considering such a large number of younger adults and kids using headphones for gaming and in general (hard to go out and not see people using AirPods etc.). Additionally, as I mentioned previously, I developed tinnitus at a point in which my use of headphones was very minimal and with the pandemic I had not been exposed to excessively loud noise at clubs, concerts, cinemas etc. or even using earphones while commuting from work/university as this was done from home.

Obviously, I may just be unlucky, but I have always been much more conscious than most people I know around my age regarding exposure to noise. I suppose if damage has been done then there’s not much I can about it but I will continue to be extra careful with exposure to loud noise and will keep away from headphones!