Tinnitus questions and answers. : The questions... - Tinnitus UK

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Tinnitus questions and answers.

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The questions below are from people that have contacted me for advice about tinnitus. My answers are based on personal experience with “noise induced tinnitus” and hope they will be helpful to someone. Please regard them as information only and not medical advice.

Thank you

Michael Leigh

I am new to tinnitus and finding it hard to cope, what should I do?

Many things can cause tinnitus but the most common is exposure to loud noise. Typically listening to music through headphones at high volume levels or attending places where loud music is played: clubs, concerts and even the cinema. If you haven’t seen your GP about this then I advise that you do so and take things from there. Most probably you will be referred to ENT for tests on your auditory system. If your tinnitus was caused by loud noise, then I advise that you don’t listen to audio through headphones even at low volume. I have written an article titled: Tinnitus, A Personal View. It covers treatment and coping methods for tinnitus, please click on the link below.

My ENT doctor is uncaring and doesn’t understand my tinnitus or what I’m going through.

ENT doctors are physicians. They know all about the anatomy of the ear and able to treat it medically or surgically and they do this well. However, the majority of them know very little about tinnitus and how if affects a person emotionally. The bedside manner of some ENT doctors leaves a lot to be desired and this needs to improve. If there is no underlying medical problem causing your tinnitus, then a referral to a Hearing Therapist or Audiologist, who specialises in the treatment and management of tinnitus is usually recommended. These health professionals are the tinnitus experts and it’s not unusual to find, many of them were either born with tinnitus or acquired it at some time in their life. Their level of understanding and empathy towards tinnitus patients will supersede that of an ENT physician, as it requires a different set of skills, that are not learnt form training alone, but personal experience of the condition.

I was desperate and went to a private tinnitus clinic, as I didn’t want to wait on the NHS. I was fitted with two white noise generators and sent on my way, but haven’t noticed any improvement after nine months. Why is this after costing me so much?

In the UK you will get the best help and long term aftercare for tinnitus under the NHS that no private tinnitus clinic in this country can match. Sadly your story is a familiar one that has been told to me by people that have opted to go private and been left disappointed.

If a person has ordinary tinnitus with no additional symptoms such as: balance problems, pain in the ears, deafness or dizziness. The best treatment is to do nothing and there is a good reason for this. The ear is a very delicate organ. Most ENT doctors prefer to leave it alone for a period of up to six months before starting treatment. Within this time the tinnitus can go away or a person habituates to where the tinnitus reduces to a very low level. Early intervention such as wearing white noise generators without proper guidance and counselling can make the condition worse or a person makes no improvement at all.

The early stages of tinnitus can make one feel like they are riding an emotional roller coaster and this takes time to settle. It is best to talk with your GP on how you feel. If an antidepressant is recommended then I advise taking it as it can help a lot with your mental wellbeing. White noise generators should really be used as part of TRT (Tinnitus Retraining Therapy) it involves regular counselling sessions with a Hearing Therapist or Audiologist trained in tinnitus management. Unless regular counselling is offered wearing white noise generators alone is not likely to be successful and the reason is this:

Through regular counselling sessions there is a gradual retraining of the way a person thinks about tinnitus and to treat it as non life threatening. At first the therapist discusses with the patient how the tinnitus makes them feel and how it has impacted on their life. Often people say they have lost interest in the things they once liked doing, which is perfectly understandable. The main goal here is to gradually help them look at life differently and with a more positive outlook. Over time the negative thinking that is often associated with tinnitus and hyperacusis is gradually dispelled and demystified.

The Hearing Therapist does this in a controlled and precise manner so that the patient feels relaxed and not pressured. In many instances the tinnitus is gradually pushed further into the background making it less prominent. This treatment takes time. To complete a course of TRT takes approximately twelve to twenty four months and in some cases longer. The duration of each counselling session is left to the discretion of the Hearing Therapist. Typically, these can last up to one hour or more. The amount of appointments required will be different for each patient, but it is quality rather than the quantity of the counselling that really matters.

When should TRT be started?

As already mentioned the onset of tinnitus can be quite an emotional roller coaster for a lot of people, and I believe a person needs time for this to settle. Many people habituate within the first 6 months to one year of the onset without any treatment. So as long as there are no additional symptoms, I think a period of six months should elapse before starting a long-term treatment such as TRT. If one decides to go the private route and is offered white noise generators without regular counselling sessions, then I advise them to go elsewhere as the treatment is not likely to work.

I am masking my tinnitus but it seems to make it worse why is this?

For some reason the term “masking” is still used a lot in tinnitus forums and it can be very misleading because tinnitus should not be masked or covered up so that it can’t be heard. Anyone that has habituated knows that trying to mask tinnitus completely so that it can’t be heard is not achievable. A much better way and preferred method that Hearing Therapists advise patients, is to use sound enrichment. One can use music or nature sounds from a sound machine and set the volume slightly below the tinnitus. By doing this, the brain over time will learn to no longer see the tinnitus as a threat and gradually push the noise further into the background giving it less importance, which is called habituation. Trying to mask or completely cover up the tinnitus so that it can’t be heard can irritate the ear and make the noise more intrusive.

I look at people and think, how lucky they are to not have tinnitus and hyperacusis. I feel upset and resentful that I have this condition. I am jealous of others because they have a life and I haven’t. When will this nightmare end?

Jealousy and resentment often affects people and they don't have to be sick to experience it. We live in a very materialistic world and it's easy to focus on oneself instead of appreciating what we have and looking at the bigger picture. Life is problematic and everyone has and goes through problems. If we accentuate the positives in our life and appreciate what we have, which is often more than what someone else might have, then usually we become less self-centered and a more loving and considerate person.

I have no doubt that you are suffering as many people do with severe tinnitus and hyperacusis. My tinnitus and hyperacusis were once so severe I didn't think getting better was a possibility. However, in the mist of all this adversity, thankfully I never stopped believing or was resentful for what had befallen upon me. I'm nothing special but looked at the positives in my life. Imagine for a moment you woke up tomorrow morning and opened your eyes and all you saw was darkness?

Some people live like this everyday and I wonder sometimes how they cope but hope I never have to find out. I saw a young man a few days go coming out of a store with a long white stick tapping on the ground as he walked towards a van. When he got there he used both hands feeling his way along the side of the vehicle until he held the passenger side door handle and then got in. It was a bright sunny day without a cloud in the sky.

Think of the positive things in your life and focus on them. Try not to be jealous of what another person has or the life that they lead. You don’t know what they have gone through to get where they are or the circumstances they are in, so why envy them for it?

My doctor has prescribed me an antidepressant but I haven’t taken it because I read they can make tinnitus worse?

I understand some people do not want to take an antidepressant to help cope with tinnitus and in an ideal world no-one wants to take medicine. However, tinnitus is an integral part our emotional well-being and cannot be separated from it. The more stressed or depressed a person becomes the more intrusive the tinnitus will appear to be. The calmer we are the tinnitus will usually be less intrusive. An antidepressant can sometimes make tinnitus worse for some people but this is usually temporary. They can be beneficial and act as safety net, helping to prevent a person from becoming too down. Please keep in mind that they don’t have to be taken long term.

An alternative to prescription antidepressant is St John’s Wort. It is herbal and used to treat stress and mild depression. Please talk with your doctor if you consider trying it.

My partner has tinnitus and is not bothered by it, but is supportive whenever I complain about my tinnitus. I feel guilty for being so weak and a failure.

Tinnitus comes in many forms and intensities and no two people experience it the same. It is a very common condition that many people habituate to and are able to carry on with their life doing everything that they want to. Some people find it: intrusive, problematic and at times difficult to cope with. There is nothing for you to feel guilty about or think that you are a failure because nothing could be further from the truth. I assure, if your partner had tinnitus severe enough then he or she would probably be visiting a tinnitus forum or seeking help at ENT.

You talk about being positive with tinnitus but there are times when I find it difficult. Are you positive all the time?

I believe one of the best ways to cope with tinnitus is to have a positive outlook on life but this doesn’t mean that one should never feel negative when tinnitus might be intrusive. Just try not to let negativity become all consuming. Focusing on the positive things in your life even in the downtimes can help prevent you from feeling too down. Please read my post titled: Positivity and tinnitus, in my aticle: Tinnitus, A Personal View.

Michael

Tinnitus, A Personal View

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Michael that's as long as a toilet roll...

Nice one...Love glynis

in reply to

lol...Glynis. Hope you didn't fall asleep reading it!

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