Tinnitus Spike from a Recreational Drug After 2.5 Years of Habituation

Hello Dr. Nagler,

I'm writing to you in desperation! I'm a 51 year old healthy male who developed tinnitus in mid 2017 after a surgery gone wrong and depression and anxiety. After the start of an antidepressant, after 2-3 pills, I woke up one day with tinnitus. My ears felt like I was at a rock concert the previous night... I hope you understand my example.

As you can imagine my world was turned upside down in addition to my ongoing depression and anxiety from the surgery gone wrong that I was dealing with. Fast forward after turning upside every possible rock in the "why me" tinnitus world and trying every snake oil cure including acupuncture and downloading Neuromonics on my phone etc... No salt, no sugar, decaf coffee, I finally habituated!!!! THANK GOD!!! Very rarely even thought about it... Lived a totally normal life, no restrictions, however I totally respect my ears when I have to, loud places, parties, spin class, concerts etc. Little orange ear plugs!! I've been drinking as much as I want as well as do other recreational things with no issue!!!!

3 days ago after a TINY bit of something recreational that I used before numerous times from the same batch... I have a spike now!!! And I feel like day 1... It was not acoustic trauma... I'm back in panic mode... What should I expect and what do you think happened?? How long typically can this last??

I know it's been only 3 days but I had SUCH a hard time in the beginning and I worked so hard to achieve normal and now this... Why???

I went to my audiologist today and my hearing is pretty much the same as it was in 2017, a couple decibels less.

I'm desperate, all I'm doing is listening to the increased noise and I can't seem to focus on anything else. It's driving me crazy!! Total panic mode!! Please help. I need to nip this in the butt. I feel the fight or flight situation all over again.

I thank you so much in advance.

 

Hello @ANDREWCHARLES -

Thank you for your inquiry.

I am away taking care of a family matter. I should be back in Atlanta by next week and will respond then. I apologize for not being able to get to it sooner.

Regards -

Stephen M. Nagler, M.D.

 

Hello again, @ANDREWCHARLES -

It might help to view habituation as a process rather than as a state. And in that context, it would be more realistic to say that you had largely habituated rather than saying, "I finally habituated!!!!"

Periods of tinnitus exacerbation (i.e., spikes) are not at all unusual along the habituation highway. Your spike might or might not be related to the recreational drug to which you refer in your post - just like the original onset of your tinnitus might or might not have been related to the two or three antidepressant pills you took in 2017. I suspect that it was all coincidence, but either way for sure you did not damage your cochlea back then or now.

So there is nothing in your post that tells me you are in any sort of long-term trouble. Indeed, more likely than not it is the panic you are experiencing that is itself actually fueling the fires!

As to what to do?

Well, first of all understand clearly that nothing is broken and therefore there is nothing that needs to be fixed. You will want to see an ENT to be certain of that fact - but to me what you are experiencing is rather common, completely understandable, and boringly normal. You are incredibly miserable, of course, which is to be expected under such circumstances. But nothing is wrong. You might take a look at the "What Makes a Sound Sound Loud?" article attached below in that regard. I am also attaching two more articles, "Barriers to Habituation" and "Letter to a Tinnitus Sufferer." The barriers article might give you some insight, and when you said "It's driving me crazy!!" (which is definitely not the case in actuality), I immediately thought of the cognitive distortions in the letter article.

I hope that these few pointers will set the stage for resolution, which will almost certainly happen in its own time, at its own pace, and in its own way.

All the best -

Stephen M. Nagler, M.D.