What is Tinnitus?
Tinnitus is a perception of sound. It originates inside the head. It is real. It is involuntary. It cannot be produced intentionally. Some people perceive it has a ringing, a hissing, a hum, or a pulsing. It varies from individual to individual.
The causes of tinnitus are varied ranging from hearing loss, noise exposure, head trauma, side effects from medication, dietary issues, and other medical issues. In most cases, the cause of tinnitus is harmless. Seeking medical advice is important especially if you have persistent tinnitus, tinnitus in one ear only, your tinnitus is accompanied by dizziness and/or balance issues, or your unilateral tinnitus has a vascular or pulsatile cause.
A well-accepted theory on tinnitus generation is that of spontaneous activity in the hearing system. When the outer hair cells in the inner ear get damaged, they do not function normally. Outer hair cells are supposed to keep the inner hair cells from sending signals to the brain when there is no sound to be heard. When the outer cells aren’t working properly, the inner hair cells can spontaneously send signals to the brain that are amplified. These spontaneously amplified signals are perceived as a ringing sensation.
Many people experience tinnitus. For some people, it comes and goes. It is not bothersome. For others, tinnitus can have negative effects on day-to-day life. These negative effects can create a vicious cycle that affects other areas in the brain; namely, the limbic system (having to do with emotions) and the autonomic nervous system (having to do with physical/bodily reactions).
For most tinnitus patients, there is no known cure. However, there are treatment options that can help provide significant relief from tinnitus.
Why Wait? You don’t have to live with ringing in your ears.
Why Wait? You don’t have to live with ringing in your ears.
How is tinnitus treated?
People react very differently to their tinnitus. Some people find it a little bothersome but mostly ignore it. Others are distressed by their tinnitus. Research studies have indicated that troublesome tinnitus affects people in four main areas: thoughts and emotions, hearing and communication, sleep, and concentration. Once medically cleared, there are several treatment options that can help people cope with their tinnitus.
Depending on how tinnitus affects you, one or more of the following treatment options may help:
Tinnitus Testing and Extensive Interview
Our Doctors of Audiology are interested in how your tinnitus affects you. They will spend time listening to your story. After the extensive interview, they will conduct tests that match the pitch of your tinnitus, the loudness of your tinnitus, and discover if there is a level of white noise that suppresses your tinnitus. Depending on the results of the questionnaires and the interview, they will assign you to a treatment category and recommend one or more of the following treatment options:
All people who are negatively affected by their tinnitus can benefit greatly from educational counseling about tinnitus. People with brand new tinnitus or mildly disturbing tinnitus may only need one counseling session on how and why tinnitus becomes bothersome.
The psychological principle that a known danger causes less stress than does an unknown danger plays a role. In the initial counseling session, you will learn about possible mechanisms of tinnitus perception and why tinnitus causes negative emotional reactions. Thoroughly understanding these concepts has helped some tinnitus sufferers reduce the level of stress caused by their tinnitus.
Learning how tinnitus can be the result of normal compensation in the auditory pathways has helped some people feel less stress about their tinnitus thereby reducing the negative effects of tinnitus on their lives.
If you have a hearing loss and you feel that your tinnitus affects your hearing and communication, you will benefit greatly from hearing aids. Hearing aids provide sound enrichment. They make environmental sounds audible. They facilitate easier listening and lessen the strain to hear which reduces effort and reduces stress. Many people with hearing loss and tinnitus report less awareness of their tinnitus with the use of hearing aids alone.
People with more troublesome tinnitus may benefit greatly from the use of tinnitus sound generators (TSG). TSGs can be sound generators alone, or they can be combination instruments which are hearing aids and TSGs in one unit. With TSGs, you hear a background sound below the level of your tinnitus. The background sound has no emotional importance; therefore, it promotes passive listening. Your brain detects the tinnitus, and it detects the noise from the sound generator. Over time, with proper counseling, your brain learns to re-categorize your tinnitus as an insignificant signal. Many tinnitus sufferers experience less negative effects from their tinnitus with the use of TSGs and some experience less awareness of their tinnitus over time.
Cognitive Behavioral Intervention (CBI)
People whose tinnitus has caused moderate to severe distress in their lives have benefited greatly from Cognitive Behavioral Intervention. It has been known to lessen negative emotional reactions related to tinnitus, help improve concentration abilities, and promote positive sleep habits.
Cognitive Behavioral Therapy represents a very important advancement in psychological approaches to the treatment of tinnitus. It incorporates a specific set of techniques to help tinnitus sufferers change the way they think about their tinnitus. This type of therapy assists tinnitus sufferers in successfully managing the negative effects of tinnitus which often leads to less awareness of the tinnitus. Cognitive Behavioral Intervention can also be used to help people with sound sensitivity issues.
Some techniques include cognitive restructuring, thought stopping, attention control, imagery training, and self-instructional statements. Also included in cognitive therapy are various forms of relaxation therapy.
Cognitive restructuring enables tinnitus sufferers to identify the content of thought that goes through their minds when reacting to their tinnitus. They will learn ways to challenge the accuracy or usefulness of these thoughts as well as learn to substitute more constructive thoughts for the negative thoughts.
Thought stopping techniques teach a person with tinnitus to interpret and control negative thoughts about their tinnitus thereby preventing the deleterious effects of ongoing negative cognitions.
Attention control teaches tinnitus sufferers how to shift focus away from their tinnitus and onto a different sensation or object thereby empowering them with a greater sense of control over their tinnitus.
Imagery training teaches people with tinnitus a method for using the imagination to evoke sensations that compete with the tinnitus thereby reducing some negative effects of tinnitus.
Relaxation training helps to reduce stress. Tinnitus often is perceived as worse when under stress. Additionally, relaxation training activates the parasympathetic part of the autonomic nervous system counteracting the sympathetic part of the autonomic nervous system (which often is activated in the vicious cycle that reactions to tinnitus can create). Forms of relaxation therapy include deep breathing, progressive muscle relaxation, and guided imagery.
The Psychological Management of Tinnitus: A Cognitive-Behavioral Approach by: Jane L. and Henry and Peter H. Wilson
Please Note: Cognitive Behavioral Intervention at Advanced Hearing Solutions does not replace the need for professional psychological therapy when indicated.