I found a research paper (though 14 years-old) that I thought explained the cause and response to tinnitus quite well. I can account for the treatment discussed in the paper to some extend, as I use Sound Therapy although I also take Sertraline for the anxiety and to help with insomnia. I digress! I wanted to at least share the explanation, as in my experience _acceptance is key_ and _understanding is the key to acceptance_, even alongside other treatments. Of course, our tinnitus is different depending on the types and causes of tinnitus, which for most it is likely to be subjective tinnitus, as a result of hearing loss or noise exposure (temporary or permanent - for me it's the latter).
"Following peripheral hearing damage, for example, through noise insult or ototoxic drugs, there are changes in activity levels in the auditory nerves that appear to be centrally mediated (Eggermont & Roberts, 2004; Gerken, Saunders, & Paul, 1984; Kaltenbach, 2006)."
"the cortex detects the amplified background neurological activity and interprets it as the sounds, such as ringing or buzzing, perceived in tinnitus."
"for those with clinically significant tinnitus, the perception becomes reinforced and more intrusive as a result of the involvement of attentional and emotional processes."
"In the case of clinically significant tinnitus, these filters determine that attention should be applied to the specific patterns of neural activity associated with the tinnitus percept, such that it is constantly brought to the patient's conscious attention (Jastreboff, 2004; Searchfield, Morrison-Low, & Wise, 2007)."
"The limbic system of the forebrain (and the amygdala, in particular), certain sublimbic structures in the brainstem, and the autonomic nervous system (responsible for the “fight or flight” response) are involved in the control and expression of emotional states. In patients with clinically significant tinnitus, these systems become engaged in response to the awareness of tinnitus (Cacace, 2004; Kaltenbach, 2006; Lockwood et al., 1998; Muhlau et al., 2006). At its worst, this causes a stressful state of high arousal and anxiety in response to the tinnitus awareness, and this state has a significant effect on quality of life and general well-being"
"Similar processes involving neuroplastic change in the auditory system and emotional centers of the brain are also believed to be involved in the development of conditions of reduced sound tolerance, such as hyperacusis and misophonia, which are commonly associated with tinnitus. "
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daverussell
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Thanks for sharing this, Dave. Explains T in medical language. Just because it’s published a while ago doesn’t mean it isn’t true, and I doubt if more recent research has improved this explanation. Though in my case i don’t think there was a specific cause, everyone in my close family had it and I thought everyone else did, too, all part of growing up!
Thanks daverussell A very good explanation. I couldn't agree with you more. Understanding is the key to acceptance. I've found great solace in reading about T & hearing loss. The more I read the better I feel 🙂
Brilliant post , spot on information and thank you . I remember when you posted sometime ago thinking that you were very good .. I do hope others on here will read and digest some of what you’ve said and that it will help them understand T better.
Hi Dave, Yes I agree with everything in your post, Acceptence is the key to living with Tinnitus, hope a lot of people see your post and it helps them.
Thanks this is very interesting.I would say that after a virus gave me ‘clinically significant tinnitus’ (2015 ish) while at the same time taking away my sense of smell and taste, I now am anxious and depressed for sure. I know I always feel like I’m stuck in fight or flight mode and am constantly stressed from walking to collapsing to and exhausted broken sleep.
Each day repeating the same pattern of the day before. Like a living nightmare.
Sorry maybe I became upset but what was the result of the paper please?
"By simultaneously addressing the auditory, attentional, and emotional processes implicated in clinically significant tinnitus, the Neuromonics Tinnitus Treatment aims to achieve consistent, rapid, and efficient results for suitable tinnitus patients. The intended clinical objective is, in the early stages of treatment, for patients to experience relief from their tinnitus and a sense of control, as well as improved relaxation and sleep in cases where relaxation and sleep have been problematic. Then, progressively over the course of treatment, it is intended that patients experience reduced awareness of their tinnitus, reduced tinnitus-related disturbance, and reduced effect from the tinnitus on their general well-being and quality of life."
"Based on this assessment, the best candidates for treatment are adults who display the following characteristics:
1. clinically significant level of tinnitus disturbance, which may be defined as a score of at least 17 on the TRQ (Tinnitus Reactive Questionnaire) ***which is mild and above as I understand)***
2. normal hearing or some hearing loss, but sufficient residual hearing loss
3. normal or reduced tolerance of loud sounds
4. any psychological disturbance, such as anxiety or depression
5. any psychological disturbance, such as anxiety or depression, is no worse than mild or moderate
6. tinnitus is not reactive in nature
7. patient is not subject to continuing exposure to high levels of noise
Among patients who fall outside of the profile defined by the above-mentioned characteristics, many achieve positive outcomes with treatment.
In some cases, concurrent treatment with other treatment modalities may be beneficial. For instance, concurrent psychological intervention for patients with high levels of psychological disturbance may be advisable. Concurrent use of hearing aids should be recommended for patients whose hearing loss is sufficiently severe that communication is impaired and they regularly strain to hear.
The Neuromonics Tinnitus Treatment is the subject of ongoing and planned further research. Clinical studies are under way and planned to investigate the relative efficacy of the treatment for various patient subcategories, including patients whose tinnitus is the result of military service and sufferers of hyperacusis."
This is interesting in as far the criteria rule out a fair few people with T . I think the bottom line is it's not easy - and perhaps not possible - to ease T distress for everyone .
One has to accept there is no off-switch and if there is it's an internal mechanism.
My stress levels determine how well I cope but I'm also lucky to have found Sertraline to relieves the anxiety, but it doesn't cure it. I also accept it's temporary. Also it not only helps me cope, but it is there for my partner who has to put up with my moods on bad days. Luckily I have more good days than others.
Same here daverussell I'm learning to dial down the stress and - as a result - the anxiety. Both seem to have a knock on effect on T . Good news that sertraline brings you some relief. I think it's trial & error until you find what works for you.
Thank you for all the positive feedback I do hope it helps or brings solace to even a few.
Incidentally, I came across this research when looking into why acoustic background sound appears to work better for me that digital background sound. Among a few other points, this paper drew my attention initially as the treatment described reflects advise I've read about the use of sound therapy/masking, that the noise should be at a level which is not above the volume of the tinnitus. It also mentions that it reflects the authors experience that to achieve relief that "regular (noncustomised) music" needs to be turned up to an uncomfortably loud volume --- In my experience some meditation music/variants of white noise that I listen to has a better effect than others. Of course, it known with tinnitus that we experience and respond to treatment differently and subjectively. This naturally makes measurement of the success of treatments difficult to determine.
I developed tinnitus whilst i was pregnant 20 years ago. Initially it took me a long time to adjust to the orchestra of sounds in my head and i was depressed and and anxious about it. Following the birth of my son i battled postnatal depression also. I have often wondered whether tinnitus can be induced by an imbalance of hormones. As i recovered from my depression through taking medication it definitely reduced my anxiety in respect to the tinnitus.
Thanks Dave, I'm particularly interested in the mention of "neuroplastic change in the auditory system". If there is some kind of solution for mitigating the symptoms of tinnitus, I think some kind of reverse neuroplasticity might be the key - though how that's achieved, I don't know...
As defined by the American Psychological Association habituation involves "growing accustomed to a situation or stimulus,"
For those experiencing Tinnitus through hearing loss, damage to the hair cells in the cochlea, changes how we receive sound, or effectively create new sounds (through auditory nerves that project to the brain). It changes our environment. As with other external stimuli, such as smell, we may become accustomed to it or tolerate the change differently to others. I'll use s crude example (sorry it's the first thing that came to mind):
Whilst watching a film with my partner the other night, the dog passed wind. My partner noticed it before I did, but once our attention was drawn to it we both struggled to concentrate on the film. Out of annoyance I grabbed and sprayed the air freshener to create a more pleasant smell. This simply masked the unpleasant smell. Though for some time the scents converged. It may have taken a few moments, but the air freshener created a different perception to make it tolerable to focus on the film.
The alternative to air freshener might be to tolerate the smell. After some time, or the next time the dog passes wind, overtime we may become habituated and tolerate the smell or not notice it at all. Equally, one of us may never become accustomed or tolerable to the stimuli.
This is excellent. I agree it is difficult to separate stress and tinnitus. The stress is both a symptom and a trigger. That is also relevant about the link with tinnitus and infections or medication toxicity. I have anxiety and inner ear damage.
Yes, understanding what we're dealing with and the processes involved definitely helps. Your analogy with the dog is funny...🐕 It seems a high level of self-awareness helps with managing tinnitus and finding a balance. We are certainly a resilient bunch.
Unbelievable the level of resilience of everyone who has "T", I confess that sometimes I think I'm going to go crazy because there's nothing to do to turn off the "T", it's there tormenting and putting us to the test at all times. Just when we thought it couldn't get any worse, we wake up the next day and the "T" is there, louder than the days before...God bless us all !!
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