Tinnitus Help: The Guide

[Tinnitus Talk]

Chapter listing here and then each chapter is in order beneath.

This thread is locked, only for us to update as we hear your ideas. Put all of your thoughts, comments, suggestions and pearls of wisdom into the appropriate thread in this section. Eventually, we're going to create an eBook, using the crowdsourced content as a base.

Chapter 1: Don't Panic! — Suggest Content

Chapter 2: What Is Tinnitus? — Suggest Content

Chapter 3: Visiting the Doctor — Suggest Content

Chapter 4: Emotion and Reaction — Suggest Content

Chapter 5: Get Some Support — Suggest Content

Chapter 6: Sleep and Relaxation — Suggest Content

Chapter 7: Exercise and Nutrition — Suggest Content

Chapter 8: Treatments — Suggest Content

Chapter 9: Make a Plan — Suggest Content

Chapter 10: Claiming Your Life Back — Suggest Content

Appendix 1: Quick Tips — Suggest Content

 

[Tinnitus Talk]

Chapter 1: Don't Panic! — Suggest Content

1.1: Introduction

That isn't easy, we know. You may be wondering; what is it, what is happening to me, will it get worse, am I going mad, will it ever stop, am I going to go deaf??? HELP!

It can be alarming, but tinnitus is not usually a sign of a serious or on-going medical condition. And it can often be temporary; it could very well go away in a few days or weeks or fade to the point that you rarely notice it. In fact this is what happens for the overwhelming majority of people who get it.

Tinnitus is a symptom, which means that if you can get treatment for the underlying cause then you have an excellent chance of it going. It's important that you get to your Doctor and you make sure you get a referral to a specialist that can help you out. Check out Chapter 3 to find out more.

The first thing you need to do is to stop listening to it. Don't give it attention, don't wonder if it's still there when other noise masks it, try not to think about it and don't panic about it. There are millions of us out here who have felt like you do now but we have got through it, and so can you.

Tinnitus is a perception of an external sound that doesn't exist. It can be a high or low pitched ringing or hum, or a more complicated sound. You're not losing it, believe it or not you share this with around 10% of everybody in the world.

A key to getting over tinnitus is to understand that it can't hurt you. If you are finding the sound distracting or irritating right now you can either play the above masking track or open up our player while you read this (it will open in a separate tab on your browser). Find a sound that you like, get the volume to a level where it just about covers your tinnitus but you can still hear it a little and try to forget it exists whilst you read through this guide.

Now relax.

No matter how you feel right now it's important to know that things are likely get a lot better. Pretty much all of us that contribute to and use this site have been in exactly the same place as you. Although it might not seem like it, there is a high likelihood that your experience of tinnitus will improve. It may not happen as fast as you want it to, but if you understand what helps you and what makes you worse, you can beat this and go back to living a normal life.


1.2 How On Earth Am I Supposed to Not Panic?

One of our members posted that the two most important things are:

1. You MUST relax your body and mind
2. You MUST be able to sleep

Stress is the natural reaction to tinnitus, It is crucial to relax so that your brain doesn't 'learn' to fear the tinnitus sound. For many people it causes extreme stress both mentally and physically in the beginning. Your brain interprets tinnitus as a threat and your body goes into a primitive fight-or-flight state. The physical symptoms of this are for example a high heart rate, increased cortisol (stress hormone) levels in the blood, high blood pressure and many other negative effects.

If you are badly sleep deprived, everything will more or less fall into pieces. Sleep deprivation causes havoc to our body and mind in various ways and it almost always makes the T worse -> more stress -> harder to sleep -> the vicious cycle continues.

Tinnitus can be hard going as the sound invades our lives and quiet times. You can forget what it is like to just sit in a space and listen to absolutely nothing and that thought can set off a chain reaction.

Along with the sound we can experience panic, anxiety and depression and lack of sleep. It can be hard enough trying get through the day as it is, being a parent or holding down a job or dealing with any amount of things that feel so far from your control.

There is a lot of help and support for you so stay positive. At Tinnitus Talk there are a whole community of people going through the exact same thing and they are here around the clock to support you. Feel free to vent and get it all out, that's an important step in the healing process.


1.3 What About All The Bad Stories I See?

As you read through the forum, you will notice that there are a lot of different stories of how we got here and how we react to the ringing. Your story will be different, your cause, your reaction, your coping will all be unique, because you are unique. Your ringing might go away on its own or continue. Don't let our stories scare you!

It's important to understand that the people who have tinnitus where it is a real problem for their daily lives account for around 1-2% of those who have it.

The human brain has this habit of attaching to the negative, we also have a habit of sharing and venting the negative more than we do the positives. Most of the posts you read on Tinnitus Talk and elsewhere on forums are from people who are in need of support. What you don't notice is that these people have all left and got back to living their lives. A small percentage write their success stories to try and help others but most just improve and drift away.

We are all different! Some may be cured. Some may learn to ignore it. Some of us just live with it. But do know that we care. If we can handle it then so can you. There is hope!

 

[Tinnitus Talk]

Chapter 2: What Is Tinnitus? — Suggest Content

2.1 Introduction

Tinnitus is usually said to be "The perception of a sound where there is no external sound present".



2.2 The Mechanism Of Tinnitus

In most cases this tinnitus is subjective, meaning that only you can hear it. In few cases it can be heard by others listening closely, this is called objective tinnitus. Both types could be heard as any sound. Even in objective tinnitus high frequency continuous tones are a possibility.
In objective tinnitus there is no hearing damage directly involved with the sound, the sound is simply originating somewhere around the ear, like the whistling sound from blood running through a bendy vane. Subjective tinnitus however is not a sound caused by vibrations in the air, which are then sensed as sound in the ear. Rather subjective tinnitus is noise produced in the auditory nervous system directly without external stimuli.

Every one, and every system, has inherent noise. An electric guitar will produce noise, and the amplifier has an input filter which filters out this noise, leaving you with a clean sounding signal. In subjective tinnitus our human input filtering system has malfunctioned.

The human central nervous system filters noise using many methods. Two main ones are relevant here. Neurons wait for multiple signals on the same line before sending a signal through, a form of confirmation. And the central nervous system seems to wait for a certain proportion of signal before interpreting it as external sound instead of internal noise. The loss of proportionally many neurons that never fire by accident all at once may break the filtering. This could be due to the loss of many synaptic connections along the auditory system, because of acoustic trauma and the associated hearing loss, because of drugs that alter the signaling between neurons and/or permanently damage them, or because of a head injury.

The central nervous system filtering relies on a threshold, because of this tinnitus sufferers will often suddenly get tinnitus, instead of gradually. As the threshold volume of noise is reached you will suddenly start to hear the whole noise produced inside the system at that frequency.

Shown below is a map of the auditory pathway, from the cochlea to the Medial geniculate body an internal noise could be produced that may become audible. The graph shown indicates the pulse that travels through all systems, this data was acquired by means of a BERA (Brainstem Evoked Response Audiometry).

Subjective tinnitus can often be accompanied by other issues such as an over-sensitivity to sound, the experience of pain with or without certain sounds, a sensation of fullness in the ear, weird noises when swallowing, dizziness, etc. These afflictions and tinnitus will have the same cause, or will follow naturally at the advent of tinnitus because the body reacts to tinnitus as if it were an externally produced sound.

It is conventionally thought that a problem with the cochlea or dorsal cochlear nucleus is at the root of most subjective tinnitus in occurrence, simply because these parts are first in line for any damage from the outside world.

There is an extensive source about signal noise in this extended article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631351/
Two excellent book chapters to read, which help in the understanding of the whole system is: Neuroanatomical Basis of Clinical Neurology 2ed [2014] Chapter 14 & 15

[insert chart]

2.3 What Causes Tinnitus?

Tinnitus is a symptom, not a disease of its own. There are a lot of things that can cause it and there will often be several causes that a person can identify.

2.4 What Can Make Tinnitus Better?

There is no straight answer to this. You need to find out what makes your tinnitus better as it seems to be different for everyone.

 

[Tinnitus Talk]

Chapter 3: Visiting the Doctor — Suggest Content

Your next step is to get to the Doctors and arrange an appointment with a specialist. They will check you out and make sure there isn't something that's causing the tinnitus, which can be treated. There are things they can do to help in the early stages so it's important that you are seen by somebody who understands tinnitus - if they tell you "you'll just have to learn to live with it" ditch them, they haven't the knowledge or experience to understand and treat you. See these tips for GP's to help you in your appointments.

Ask them about the full range of things available; make sure you get a proper consultation. There are many different causes of tinnitus so we can't give you a list of things to try here. The right Doctor will explain what you can try.

You may get something to help you, or may be suggested for a follow up with an ENT or audiologist. There are options for you, many things could help you. Have a look through the treatments section of the forum for some advice and support on the various options out there.

 

[Tinnitus Talk]

Chapter 4: Emotion and Reaction — Suggest Content

xxx

 

[Tinnitus Talk]

Chapter 5: Get Some Support — Suggest Content

If you feel like you need to talk to somebody over the phone, there may be a support service to help. In the UK, the BTA helpline is 0800 018 0527 (free of charge - from within the UK only), 0114 250 9922 national rate within the UK, +44 (0)114 250 9922 outside the UK. It's open Monday to Friday, 09.15 - 16.45. You can also e-mail the BTA at info@tinnitus.org.uk. In Australia, you can call (03) 9762 8964 or (03) 9755 2238, more information at http://tinnitus.org.au/Contact.

Support is important. Make sure that the people around you understand what's going on and how they can help. Sometimes people really don't understand what tinnitus is and that can make you feel isolated, we've found that giving them a taste of what you're listening to can be very powerful. Play them this video.

Look for support from others who understand what's going on too; there may be a support group in your area plus you can join our forum to talk to others who understand. Check out the support groups in the UK or in the USA.

 

[Tinnitus Talk]

Chapter 6: Sleep and Relaxation — Suggest Content

6.1 Introduction

The most common thing by far with tinnitus is that we lose our relaxation time. This can make any anxiety worse and it can affect sleep too.


6.2 Getting to sleep

There are a number of medications available but they should only be a short term stopgap if you are really in need. It's an idea to try the natural ways first and then go see your doctor to get the correct sleep medication if it isn't working out for you. The key is in making sure you are ready for bed and able to sleep - if you aren't ready for sleep when you go to bed and you lay awake there is a reasonable chance you will focus on your tinnitus.

There are lots of tips around, the best bet is for you to try them out and see which ones work for you. Then you can develop a routine that works.

Getting tired

Tinnitus can put you on edge and stop you from relaxing, so you may need a little extra help in feeling tired at bed time. Many people find that having a regular exercise routine can help


Sound therapy
A warm relaxing bath
A warm milky drink
Reduce alcohol
Regular bedtime routine
Keep off computers etc two hours before bedtime.
Read a book
Download free relax and sleep apps
Minimize stress
If have reacuring thoughts write them down to off load them and forget about them to help sleep.


6.3 Getting Good Quality Sleep

It's incredibly important to get quality sleep and enough of it. Without sleep we become more irritable and tinnitus inevitably seems worse.

6.4 Learning To Relax



6.5 Relaxation exercises

a

 

[Tinnitus Talk]

Chapter 7: Exercise and Nutrition — Suggest Content

7.1 Introduction

Exercise and nutrition form the basis of so many help guides that you'll see. There are many that promise you a complete cure - which is of course a lie so that you can line their pockets with cash. So what, exactly, can exercise and nutrition do for us?

Exercise is cited in so many places as improving health conditions that we would fill a separate book with references alone. There is study that shows a correlation between those who exercised more and a lower tinnitus severity [1] although it needs further work to confirm the findings. The anecdotal evidence on Tinnitus Talk seems to support it, people just feel better when they exercise. It could be because of the increased tryptophan availability, which stimulates serotonin and makes us feel generally better.

Many people report that certain foodstuffs can make their tinnitus better or worse. It's all on the individual level though, there are no rules that food X is bad for tinnitus because life doesn't work like that. One thing we can say is that certain foods do seem to have an effect on a group of people. The biggest culprits are salt, caffeine, sugar, MSG, chocolate and alcohol [2]. Caffeine is always talked about, even if it doesn't make your tinnitus worse you should think about your intake and how it may disrupt your sleep patterns, something you just don't need.


7.2 What Exercise Should I Do?

We can't cite any research for this but what we can do is give you a feel for what other people with tinnitus experience and how their experience with exercise has effected their tinnitus.

Cardio seems to


7.3 Which Dietary Items Can Affect Me?

The 2015 Tinnitus Hub survey showed that 40% of tinnitus patients are affected by Dietary Items.


7.4 Supplements and Herbs

You will no doubt have heard of a few things that can either get rid of or reduce tinnitus. There is a lot of


7.5 Testing Yourself For Reactions

Keeping a diary can be very helpful. You can note what you eat and drink and when you have quiet and loud times with your tinnitus. You'll need to do it for a while so that you can gather plenty of information to confirm your findings - you will effectively be conducting your own research project!



References

[1] Physical Activity, Tinnitus Severity, and Improved Quality of Life. Carpenter-Thompson JR1, McAuley E, Husain FT.
[2] Tinnitus Hub Survey 2015. Harrison,Vesala

 

[Tinnitus Talk]

Chapter 8: Treatments — Suggest Content

8.1 Caring For You Ears

It may not seem like a treatment but one important that you can do is look after your ears. Once the hair cells in your ears are damaged beyond repair they won't grow again. You can think of think of tinnitus after noise exposure as a warning sign that there has been damage.

Nearly everyone has had the experience of being somewhere really loud, like a concert or club, then woken up with ringing ears the next day. There is guidance on what level of noise is safe over a certain time period but it is only a guide. The European Guidance on noise exposure at work tells us that over an 8 hour period if the noise is on average 85dB then we need to protect our ears.

The dB scale is different to how you expect it to be, each increase of 3dB represents a doubling of the sound power. 85dB to 88dB may not sound like much but it is quite a large jump. 6dB increase is a doubling of sound pressure and a 10dB increase is where we perceive a sound to be twice as loud.

You will hear people telling you that a certain dB level is safe but there is no "safe level" to rely on, you need to understand how long you will be exposed to the sound and make sure you take breaks and rest your ears.

[Chart to go here]

You don't need to be over-protect your ears, just be aware of how loud places are and make sure you either limit your exposure or protect your ears where necessary. There is evidence to show that over=protection of the ears can cause or worsen hyperacusis.

8.2 How To Spot Scams, Charlatans and Pseudoscience

You search the internet and come across something that seems to cure your tinnitus and sounds a bit like the thought process you had. It must work; there are loads of testimonials, a money-back guarantee and the science behind it sounds about right.

8.3 Being Mindful



References

[1]

 

[Tinnitus Talk]

Chapter 9: Make a Plan — Suggest Content

9.1 Introduction

An important step is to find out what makes you worse and what makes you better, as part of a plan to learn to beat this. If you're finding tinnitus hard to cope with, maybe alongside hyperacusis, anxiety, stress and depression the plan can help you to make improvements across your life.

You'll see a lot of reports that this food makes it better or that food makes it worse, that a certain activity improves things. The reality is that you need to work it out for yourself, there is no one-size-fits-all. The only way you can do this is by being aware of your triggers.

Take on board advice you get and go about the plan logically but do be aware of getting correct information; most things can work for one person and not for another. We don't recommend obsessing over tinnitus but it's helpful to be aware of things that make you better and things that make you worse - this will allow you to take back control. A plan will help you learn more about what you can do to get on track and get back to living life to the fullest.


9.2 Tracking Your Tinnitus

You will hear a lot of advice telling you not to monitor your tinnitus. It's very good advice. You shouldn't give it attention.

Tracking your tinnitus however is a different prospect. Tracking is the process of noting a change, be it good or bad. The nature of tinnitus means that a change will grab your attention anyway, you will most definitely notice when it gets louder and after a time you will realise that it has been quiet. Think of it as mindfulness, note the change but don't give it attention.

There are tools to help you to do this, notably the Track Your Tinnitus App from the Tinnitus Research Initiative. If you aren't keen on using apps there is the alternative of using a diary.

Fortunately we have conducted a little research here at Tinnitus Talk and we also have a lot of information so we can give you some guidance on the things that may affect your tinnitus.

[to go in a document, need to work up a layout]

Triggers

1. Ventilation system. Constant noise source.
2. Church. High decibel levels during the service.
3. My car. The constant sound of the engine.
4. Fans and air conditioning. Again, constant noise source.
5. Screaming and laughing children
6. Chocolate
7. Red Wine
8. Concerts

9.3 Analysing the Results and Making Change

Once you've done your tracking


9.4 Turning the Plan Into Action

It's a fantastic motivation to kick this stupid noise out of your head. It may take time though so you need to make sure you can stick to your plan.

 

[Tinnitus Talk]

Chapter 10: Claiming Your Life Back — Suggest Content

10.1 How do I get back to normal?

xxx

10.2 Success Stories

You can read other peoples success stories here and find out how they turned things around and carried on living (almost) normally. It's so important that you understand there is hope; when you read a forum or see comments, you're usually hearing from people who are hurting. One key thing to remember: We've been running a forum for years, do you know how long people stick around for? On average up to 3 months. They come on board, often scared and in pain, share their stories and pick up advice. Then they gradually come to terms with it and move on with their lives.

So when you browse our forum (and any others) just remember that you are seeing the small proportion of people who are suffering. You don't see the ones who have got better and moved on with their lives.

Try these threads out: Positivity Thread, Sleep Thread, Success Stories

You don't have to join in the forum if you're not ready, just have a look. It can be inspiring and supportive to see just what other people like you are thinking and doing about this. You are not alone; we're here to help you and support you.

If you don't want to share publicly then you can reach out to one of the moderators here, we will do our best to help you.

 

[Tinnitus Talk]

Appendix 1: Quick Tips — Suggest Content

From us and sourced from the community, these quick tips should be a handy reference for you.

Your Ears

• Avoid really loud places or wear earplugs that reduce the volume to a safe level.
  • Most people find that their tinnitus can become worse after loud noise.
• Earplugs don't reduce the level of noise exactly as to the value claimed. The reduction is based on laboratory testing, in reality it depends how well they are fitted.
  • 3M, a major manufacturer, say to subtract 7 from the dB value then divide by 2.
  • For example for plugs at 25dB - 7 / 2 = 9dB reduction guaranteed.
  • The get more protection it's up to you fit them really well.

Relaxing

• Reduce stress
  • You probably already feel stressed, like anything else stress will make you feel worse. Take out big sources of stress in your life.
• Learn to relax
  • One thing that a lot of us in the modern world forget to do is relax, we don't often make time to sit down, tune out and forget everything.
  • Find something that you can relax doing and make some time for it in your daily routine.
• Do what you love
  • If you really absorb yourself in a task you will find that you don't listen to your tinnitus and you can completely forget it's there.

• Don't let tinnitus stop you
  • You might feel like your life is over but it isn't.
  • If you have a struggle with something, find a way around it. If you're a musician there is a lot more you can explore (the writer moved to making more chilled out music which gives just as much pleasure).

Find help and inspiration

• Have a look at these great resources for more information that might help you out
  • British Tinnitus Association
  • American Tinnitus Association