What to do about tinnitus?

Tinnitus (i.e., ear or head noises not caused by external sounds) is common among the general population across the world. Tinnitus can be experienced as a “ringing in the ears.” It can also sound like a hissing, sizzling, or roaring noise. It can be rhythmic or pulsating. Tinnitus can be a non-stop, constant sound or an intermittent sound that disappears and returns without a pattern. It can occur in one or both ears.

Tinnitus may be caused by trauma to the head (e.g., blast exposure, such as bombs or other explosive devices, or injuries to the head, such as traumatic brain injuries). It also can be caused by acoustical trauma (e.g., loud noises from earsplitting concerts, listening to music too loud). While tinnitus is different than hearing loss, individuals may have to deal with both conditions.

Tinnitus is a symptom of neural damage and thus reflects that an injury occurred. As a “phantom sensation” or subjective symptom, it indicates neural damage. Currently, there is no cure for subjective tinnitus. Objective tinnitus differs than the more commonly experienced subjective tinnitus; objective tinnitus can be attributed to an internal sound source, such as a pulsating blood vessel that is adjacent to the auditory nerve. Thus, surgery may improve objective tinnitus, but not subjective tinnitus.

Scientists may find a cure for subjective tinnitus someday. Until a cure is found, extreme caution should be taken about internet promises about pills or techniques to cure tinnitus. We know from decades of research and clinical trials that there are some things that can help reduce suffering while having tinnitus. The following three steps can help you self-manage your tinnitus until a cure is found.

The first step that a person should take when experiencing tinnitus is to get a screening of the outer and inner ear and of one’s medical history by a physician or ear, nose, and throat (ENT) specialist to make sure there are no underlying medical issues that need to be treated (e.g., auditory lesions or vascular tumors).

A second step to take if you have tinnitus is undergo an audiological assessment. If you have a hearing impairment and tinnitus, using hearing aids can help in several ways. Hearings aids can amplify sounds from the environment, which help people pay less attention to the ‘internal noise’ created by tinnitus. Modern hearing aids also offer features of providing ‘white noise’ or other sounds that helps people pay less attention to their tinnitus. In general, it is helpful for people to add to their ‘sound environments’ because they will pay more attention to their tinnitus in quiet environments. This includes turning on a radio, listening to music or a podcast, turning on a fan, or using a sound generator when trying to fall asleep at night or when trying to concentrate, such as during work or school tasks.

A third step to take when having tinnitus is to learn stress-management techniques. Tinnitus can be incredibly annoying, frustrating, and for some people, scary when it first occurs. Psychologically-based approaches, such as mindfulness-based stress reduction and other approaches such as Acceptance and Commitment Therapy (ACT), help individuals manage the stress created by experiencing tinnitus. These can be learned from a counselor or psychologist, a tinnitus specialist, or from a variety of books and internet resources. For some people, stress may be a trigger for a reoccurrence of tinnitus. For others, high levels of stress can reduce their patience and increase their frustration with conditions like tinnitus. Programs like Coping Effectiveness Training (CET) teach people how to identify changeable and unchangeable stressors and how to match coping strategies with the type of stressor. For unchangeable conditions like tinnitus, people are taught that while they cannot ‘solve’ or get rid of the problem of tinnitus (given the current state of tinnitus research), they have control over their reactions to tinnitus. When people are less angry and reactive to tinnitus, they have more mental and cognitive space for the things that give them pleasure and satisfaction in life, like focusing on the goals that they want to accomplish or interacting with and helping others.

While subjective tinnitus can be annoying, distressing, and irritating, it is not life-threatening. Our brains will pay less attention to tinnitus when we embed ourselves in rich sound environments and get involved in tasks and events that capture our interest. Further, individuals can learn how to use numerous self-management techniques to increase their quality of life with subjective tinnitus until a cure is found.

Featured image: Buddhist Bells by Igor Ovsyannykov. Public Domain via Unsplash.