Tinnitus and it’s Sidekick, Mental Distress

We’ve all heard stories about the aging process bringing on new aches and pains. We’ve also heard about events that have had a profound effect on someone’s hearing such as an explosion or an auto accident that leaves them with hearing loss.
What we don’t often learn about until it happens to us or someone we know is a condition called tinnitus. According to the American Tinnitus Association, its often described as a ringing in the ears, though it’s also occasionally characterized as one of the following:

  • Buzzing
  • Clicking
  • Hissing
  • Insect chirping
  • Occasionally described as music
  • Ringing
  • Whistling
  • Whirring
  • Whooshing

Since these sounds are not normally heard by those around the person suffering, it’s difficult for others to understand the struggles. This incurable condition can cause a lot of stress and anxiety for the person dealing with it, both mental as well as physical.
A good portion of the mental unease is often brought on by the fact that while there is no cure, there’s also no exact cause for this condition. It can be caused by any number of situations such as exposure to noise, infection or problems of the inner ear, injuries of the head or neck, certain medications, or even wax buildup.
More reasons include the ingestion of toxic substances, the natural process of aging, ototoxicity, as well as vascular or viral diseases. There are also varying timeframes of reaction that can affect the mental state of the person. Some people live with it for many years, while others adapt to the sound and it eventually becomes less noticeable, or it may even go away completely.
Many people report that they have more physical issues while suffering from the effects of the disorder. Problems sleeping range from an inability to easily fall asleep, or to stay asleep all the way to complete insomnia. This can cause problems with concentration, depression, frustration, irritation, mood swings, and there have even been reports of physical pain.
According to the Centers for Disease Control (CDC), there are approximately 15 percent or more than 50 million Americans who have experience with some type of tinnitus. Upwards of 20 million people live with chronic tinnitus, while another two million suffer from extreme, debilitating symptoms of the disorder.
Even with such a varying range of symptoms and severity, one thing is common. It has an effect on the mental health of the person living with the condition. If there is a history of mental illness, it could compound the effects. Suicide and self-harm are very real secondary concerns for people who develop tinnitus.
There is surprisingly little research into the mental considerations of these patients, though recently it’s garnered more attention. Audiologists and hearing health professionals need to be aware of the potential for symptoms of self-harm.
“It needs to be something audiologists aren’t afraid of. Mental health is not a taboo subject,” said Melissa Wikoff, AuD, the owner of Peachtree Hearing in Atlanta, GA. “Sometimes we think the practice of audiology is not life or death. But sometimes with tinnitus, it really can be.”
“I pay attention to what they are saying. I don’t look down at a clipboard or my computer and write notes. I look at the patient,” she said. “You need to demonstrate empathy, and let them know they’re not alone, they are not the only person who has had this, and they came to the right place. There are treatment options available, and it’s going to be OK.”
Hearing health professionals need to be prepared to listen to their patients and ask questions, to probe a bit into the delicate mental state. While some are not as bothered by the symptoms, tinnitus can be a life-changing experience for many. The fear of the unknown, feelings that their body or mind has turned against them, the worry that the condition might be permanent are all very real considerations.
“Audiologists should be aware that patients with tinnitus are potentially fragile emotionally, especially during the early months following onset of tinnitus,” advised Caroline J. Schmidt, PhD, a clinical psychologist at Yale Medicine in New Haven, CT, who helped develop the progressive tinnitus management program used nationwide by the Veterans Health Administration. “The impact of tinnitus differs among people. Some people have no emotional response to it at all. Other people find it to be very distressing.”
Professionals that treat tinnitus patients are one of the first lines of defense for those in this sensitive state of mind, and also one of the best chances to intervene and refer someone who needs special services to help improve their quality of life.
“I believe every audiologist, every general practitioner, and every ENT should know enough about tinnitus and tinnitus management to be able to listen, give hope, and refer to an audiologist or a mental health professional educated in proper tinnitus management,” says audiologist Jeannie Karlovitz, AuD, CCC-A, F-AAA. Karlovitz is a member of the ATA’s Tinnitus Advisors Program.
By following a few strategies for mental health, the overwhelming impact of tinnitus can be eased. Acceptance of the condition can be achieved through education and understanding of the condition. By restructuring the thought process, negative thoughts can be neutralized, and patients can suffer fewer occurrences of anxiety, depression, and stress.
Teaching patient’s self-help tips for relaxation can aid in the process of falling and staying asleep. Making use of white noise apps or machines, deep breathing techniques, and progressive muscle relaxation as well as cutting back on alcohol, caffeine, and electronic device screen time before bed can be a big help.
Lastly, continuing hobbies or enjoyable activities is important for both the physical health and mental well-being of patients. By encouraging them to remain active and seek joy in things they find comfort in, tinnitus sufferers can retain a better quality of life while they learn the ins and outs of the condition.

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