CHANGING BELIEFS ABOUT TINNITUS

Tinnitus may be viewed as a stimulus to which a person responds with a number of thoughts, some of which are conscious but others are automatic. Many of the emotional problems which occur with tinnitus, such as depression and anxiety, are a result of your reaction to the sounds. The source of distress is therefore not the tinnitus itself, but rather the way in which you view and think about the tinnitus.

Cognitive-behaviour therapy is a way of identifying and changing negative thoughts and emotions about tinnitus. The aim is not to ‘cure’ the tinnitus but to help you to find effective ways to manage the problem and your reaction to it. First, you need to make sure that you are not harbouring any incorrect, negative thoughts about the tinnitus, so you need to learn as much about tinnitus as you can.

Frequently Asked Questions

What causes tinnitus?

Any activity in, or damage to, the auditory system can produce tinnitus. Major causes of tinnitus are long-term or sudden exposure to very loud noise, and ageing. Specific problems with the ears which cause tinnitus include otosclerosis (fixation of the tiny stirrup bone in the middle ear) and Meniere's disease, which also affects balance and hearing. Tinnitus also occurs in normal ears – it’s the sound of the auditory system at work – and can be heard by most people in a very quiet room. This attention can be increased during periods of stress, anxiety or depression, leading to tinnitus annoyance.

Could the drugs I take be causing tinnitus?

Many drugs list tinnitus as a side-effect, but this doesn’t mean that every person who takes them will get tinnitus, or that it will persist. The main drugs in which tinnitus is a recognised side-effect for some users are the ‘-mycin’ antibiotics (which are not used routinely in general medical practice), some diuretics (‘water pills’), aspirin in high doses (not the small, daily dose for your heart), some anti-inflammatories, some anti-cancer agents and the antidepressant Imipramin (Tofranil). For more information, discuss the matter with your doctor and do not stop taking any prescribed medication without advice.

Can tinnitus get out of control?

Most people find that they get used to the tinnitus sounds over time and they do not notice them as much. Although there can times when the tinnitus seems very annoying, generally these periods are short lived and the loudness or annoyance do not keep getting worse.

Does tinnitus lead to deafness?

No, but some conditions which cause tinnitus can also cause hearing loss - e.g. long-term exposure to loud noise - so it’s a good idea to have your hearing checked. If you already have a hearing loss, the tinnitus will not make your hearing deteriorate any more rapidly.

Do hearing aids make tinnitus worse?

Generally, people find that wearing a hearing aid reduces their attention to the tinnitus sounds because they are receiving natural sounds more clearly. In rare cases, some people find that loud sounds heard through a hearing aid may aggravate their tinnitus for a short time, but this does not cause an overall increase in the tinnitus problem over time.

If I go deaf, will I stop hearing the tinnitus?

Is there an effective drug or operation for tinnitus?

Tinnitus has many different causes, some of which we do not fully understand, therefore there cannot be one single drug or surgical procedure which can be effective for everyone with tinnitus. Some people find that they get relief by using a prescription drug or vitamin/mineral supplement, but this depends upon the source of the tinnitus. There is no operation specifically for tinnitus, but if it is caused by a condition which can be operated on, e.g. otosclerosis, it may be relieved by the operation. This should be discussed with your doctor, but there are no guaranteed medical treatments.

Will the tinnitus get louder and louder?

Generally, no. In 8/10 people the tinnitus loudness remains the same or becomes less over time.  Most people find that the tinnitus loudness varies from time to time, due to their general health, intermittent ear or respiratory problems, or stress, depression or anxiety.

Does grinding my teeth cause tinnitus?

Some people clench or grind their teeth, especially in their sleep, and experience jaw and ear pain, clicking or locking in the jaw, and tinnitus. Correcting a poor bite and managing muscular tension in the jaw and face can give some relief to these symptoms, so it is worth seeing a dentist and/or specialist physiotherapist if you have these symptoms. In some people, tinnitus and jaw problems are both caused by stress and anxiety, so relaxation is an important part of the management of both conditions.

Why is tinnitus bad at night?

Tinnitus is often more noticeable when there are no other sounds to distract your attention from it, hence it can be more noticeable at night. Also, when we are tired we are generally less resilient and less able to think positively so feel more anxious or worried. If you have particular worries or preoccupations – work-related stress, the illness of a family member, you are planning a major event – you may find that you are sleeping less well and you notice your tinnitus more when you are lying awake.

Why is the tinnitus loud when I wake up in the morning?

The most likely explanation is that your ears have become slightly blocked over-night, when you haven’t been swallowing regularly to refresh the air in the middle ears. This blockage causes a slight hearing loss and increases your attention to internal sounds instead of external sounds. As your ears unblock, the loudness of the tinnitus may decrease.

THINKING ABOUT TINNITUS

“Consider what options are open to us when we actually encounter a particular problem. At one extreme, we can allow ourselves to be overwhelmed. At the other, we can simply go on a picnic or take a holiday and ignore it. The third possibility is to face up to the situation directly. This involves examining it, determining its causes and finding out how to deal with them” (the Dalai Lama, 1999)

We have a constant stream of self-talk -  thoughts and images which go through our minds during waking hours. For example, you might be stuck in traffic. Your thoughts might be:
Neutral    (“I wonder what’s happening at the intersection ahead?”)             
Negative (“I can’t stand all this traffic. Why is it always so busy when I’m in a hurry?”)
Positive   (“I have a chance to hear the end of this interesting radio program”)

Tinnitus Self-talk

Thoughts can be automatic. We are often unaware of the contents of our thoughts until we deliberately stop and listen to what is going through our heads.  Thoughts flow fairly constantly – we rarely pay attention to them.  We tend to believe our thoughts without questioning their basis. However, thoughts might be logical, that is based in fact -  or illogical, not based in fact.  Thoughts can also become stuck, repeating the same sequence.

next page>>

home