Tinnitus can sound like any number of annoying tones, including ringing, buzzing, hissing or whizzing. It can be loud, soft, or any volume in between, and the sound can range from a low-pitched roar to a high-pitched squeal. It may occur nearly constantly or come and go.
When tinnitus flares up, it can be difficult
- Symptoms of tinnitus
- Chronic tinnitus: When it won’t go away
- The emotional symptoms of tinnitus
- Track your tinnitus symptoms
- Can tinnitus sound like clicking?
- Get help from an expert
- What is tinnitus?
- What causes tinnitus?
- Why do I have this noise in my ears?
- What should I do if I have tinnitus?
- What if the sounds in my ear do not go away?
- Are there treatments that can help me?
- Can I do anything to prevent tinnitus or keep it from getting worse?
- What are researchers doing to better understand tinnitus?
- Where can I find additional information about tinnitus?
- 4 Signs You Have Tinnitus
- There’s a constant ringing in your ears
- You hear music when none is being played
- You feel a thumping sound in your ears
- Your hearing has changed
- Will Tinnitus Go Away on Its Own?
- So…Will the Ringing in My Ears Go Away?
- Tinnitus tips
- When will my tinnitus go away?
- What can I do about my tinnitus?
- How do I stop the noise from bothering me?
- What is partial masking?
- Does tinnitus deprive you of silence?
- How do I learn not to notice the noise?
- What if I’m already in The Loop?
- Useful resources on tinnitus
- Update (Sep 2011)
- Update – Plasticity (Aug 2012)
- Update – (SEP 2013)
- The 4 Different Types of Tinnitus
- Tinnitus: Common, Constant, Treatable, and Manageable
- The Four Different Types of Tinnitus:
- WHAT YOU NEED TO KNOW:
- What causes or increases my risk for tinnitus?
- How is tinnitus diagnosed?
- How is tinnitus treated?
- How can I help prevent tinnitus?
- Call 911 if:
- When should I contact my healthcare provider?
- Further information
- Learn more about Tinnitus
Symptoms of tinnitus
Common descriptions of tinnitus symptoms include cicadas, wind, crickets, fluorescent lights, running engines, grinding steel or dripping tap water.
It’s important to know that tinnitus can be a symptom itself—it’s linked to many different medical conditions, and even some medications can trigger it. It’s also strongly linked to hearing loss and loud noise exposure.
However, whenever a medical cause can’t be uncovered, tinnitus can be considered a disease in and of itself. In most cases, there is no known cure, though treatments and related alternative relief strategies can help.
Chronic tinnitus: When it won’t go away
Occasional bouts of brief noise that lasts a few seconds is considered “transient” and something most people experience from time to time. A diagnosis of chronic tinnitus usually means a person reports episodes of tinnitus that last for at least five minutes and occur at least twice a week.
It’s possible to have tinnitus in just one or both ears, and it can come and go. Tinnitus can get loud enough to interfere with concentration, and sometimes, it can mask natural sounds. Tinnitus is most commonly experienced by adults, especially those who have hearing loss.
Tinnitus is most commonly experienced by adults who have hearing loss.
In a very large survey of American adults with tinnitus, nearly a third reported having symptoms nearly constantly. About the same number of people noticed tinnitus at bedtime.
Note: If you experience tinnitus and sudden hearing loss, seek prompt treatment.
The emotional symptoms of tinnitus
Having a constant ringing in your ears is not pleasant, and you may have trouble falling asleep or concentrating at work. The constant annoyance, lack of sleep and inability to live your life as you used to may even cause increased anxiety. Anxiety is especially common if tinnitus is getting in the way of work or causing other stressful situations. Many people who have tinnitus often describe a connection between tinnitus perception and stress. You may even suffer from depression or thoughts of suicide in response to the persistent buzzing or ringing that feels inescapable. Along with treatments, behavioral strategies can make tinnitus more manageable.
Track your tinnitus symptoms
Having a good grasp of the tinnitus sounds you hear, when you hear them and how often you hear them may be able to help your hearing care professional or physician determine the best way to treat your tinnitus. Keeping a symptom diary for a few weeks is a good idea.
A tinnitus evaluation from a hearing healthcare practitioner will begin with a series of questions designed to get a clear description of your symptoms such as:
- How long has this been going on?
- Is it regular or constant?
- Are the symptoms worse at certain points of the day?
- Which ear is causing the issue? Both?
- How loud is the noise?
- Is the pitch high or low?
- Is the issue extremely bothersome or just a little irritating?
- Are there certain conditions that make the symptoms worse, such as exposure to noise or caffeine intake?
- Does the sound ever change?
- Do you also suspect you might have hearing loss? Tinnitus can be a symptom of hearing loss.
Can tinnitus sound like clicking?
In most cases, no. Most tinnitus sounds like a ringing, hissing or buzzing sound. If you do hear a persistent clicking sound, it’s worth investigating, though.
For some people, the jarring motion of brisk walking can produce what is called a seismic effect, which causes movement in the small bones and/or contractions in the muscles of the middle ear space. You can experiment to find out if this is the cause by walking slowly and smoothly to see if the clicking is present. Then, try walking quickly and with a lot of motion to see if you hear the clicking. You can also test for the seismic effect by moving your head up and down quickly.
If you do detect the seismic effect, it is likely nothing that indicates a serious medical condition. However, if it is a constant annoyance, by all means discuss it with your hearing care professional.
Get help from an expert
Not all hearing care professionals specialize in tinnitus diagnosis and treatment. Seek our a hearing healthcare practitioner in your area who advertises this expertise. Before your first appointment, take note of your specific symptoms, when they occur and what environments make them better or worse. This work ahead of time will prepare you for the first questions asked by the practitioner and ensure you get the most out of your evaluation.
Joy Victory, managing editor, Healthy Hearing
Joy Victory has extensive experience editing consumer health information. Her training in particular has focused on how to best communicate evidence-based medical guidelines and clinical trial results to the public. She strives to make health content accurate, accessible and engaging to the public. Read more about Joy.
What is tinnitus?
Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Roughly 10 percent of the adult population of the United States has experienced tinnitus lasting at least five minutes in the past year. This amounts to nearly 25 million Americans.
What causes tinnitus?
Tinnitus (pronounced tin-NY-tus or TIN-u-tus) is not a disease. It is a symptom that something is wrong in the auditory system, which includes the ear, the auditory nerve that connects the inner ear to the brain, and the parts of the brain that process sound. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. But it can also be the result of a number of health conditions, such as:
- Noise-induced hearing loss
- Ear and sinus infections
- Diseases of the heart or blood vessels
- Ménière’s disease
- Brain tumors
- Hormonal changes in women
- Thyroid abnormalities
Tinnitus is sometimes the first sign of hearing loss in older people. It also can be a side effect of medications. More than 200 drugs are known to cause tinnitus when you start or stop taking them.
People who work in noisy environments—such as factory or construction workers, road crews, or even musicians—can develop tinnitus over time when ongoing exposure to noise damages tiny sensory hair cells in the inner ear that help transmit sound to the brain. This is called noise-induced hearing loss.
Service members exposed to bomb blasts can develop tinnitus if the shock wave of the explosion squeezes the skull and damages brain tissue in areas that help process sound. In fact, tinnitus is one of the most common service-related disabilities among veterans returning from Iraq and Afghanistan.
Pulsatile tinnitus is a rare type of tinnitus that sounds like a rhythmic pulsing in the ear, usually in time with your heartbeat. A doctor may be able to hear it by pressing a stethoscope against your neck or by placing a tiny microphone inside the ear canal. This kind of tinnitus is most often caused by problems with blood flow in the head or neck. Pulsatile tinnitus also may be caused by brain tumors or abnormalities in brain structure.
Even with all of these associated conditions and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For some, tinnitus can be a source of real mental and emotional anguish.
Why do I have this noise in my ears?
Although we hear tinnitus in our ears, its source is really in the networks of brain cells (what scientists call neural circuits) that make sense of the sounds our ears hear. A way to think about tinnitus is that it often begins in the ear, but it continues in the brain.
Scientists still haven’t agreed upon what happens in the brain to create the illusion of sound when there is none. Some think that tinnitus is similar to chronic pain syndrome, in which the pain persists even after a wound or broken bone has healed.
Tinnitus could be the result of the brain’s neural circuits trying to adapt to the loss of sensory hair cells by turning up the sensitivity to sound. This would explain why some people with tinnitus are oversensitive to loud noise.
Tinnitus also could be the result of neural circuits thrown out of balance when damage in the inner ear changes signaling activity in the auditory cortex, the part of the brain that processes sound. Or it could be the result of abnormal interactions between neural circuits. The neural circuits involved in hearing aren’t solely dedicated to processing sound. They also communicate with other parts of the brain, such as the limbic region, which regulates mood and emotion.
What should I do if I have tinnitus?
The first thing is to see your primary care doctor, who will check if anything, such as ear wax, is blocking the ear canal. Your doctor will ask you about your current health, medical conditions, and medications to find out if an underlying condition is causing your tinnitus.
If your doctor cannot find any medical condition responsible for your tinnitus, you may be referred to an otolaryngologist (commonly called an ear, nose, and throat doctor, or an ENT). The ENT will physically examine your head, neck, and ears and test your hearing to determine whether you have any hearing loss along with the tinnitus. You might also be referred to an audiologist who can also measure your hearing and evaluate your tinnitus.
What if the sounds in my ear do not go away?
Some people find their tinnitus doesn’t go away or it gets worse. In some cases it may become so severe that you find it difficult to hear, concentrate, or even sleep. Your doctor will work with you to help find ways to reduce the severity of the noise and its impact on your life.
Are there treatments that can help me?
Tinnitus does not have a cure yet, but treatments that help many people cope better with the condition are available. Most doctors will offer a combination of the treatments below, depending on the severity of your tinnitus and the areas of your life it affects the most.
- Hearing aids often are helpful for people who have hearing loss along with tinnitus. Using a hearing aid adjusted to carefully control outside sound levels may make it easier for you to hear. The better you hear, the less you may notice your tinnitus. Read the NIDCD fact sheet Hearing Aids for more information.
- Counseling helps you learn how to live with your tinnitus. Most counseling programs have an educational component to help you understand what goes on in the brain to cause tinnitus. Some counseling programs also will help you change the way you think about and react to your tinnitus. You might learn some things to do on your own to make the noise less noticeable, to help you relax during the day, or to fall asleep at night.
- Wearable sound generators are small electronic devices that fit in the ear and use a soft, pleasant sound to help mask the tinnitus. Some people want the masking sound to totally cover up their tinnitus, but most prefer a masking level that is just a bit louder than their tinnitus. The masking sound can be a soft “shhhhhhhhhhh,” random tones, or music.
- Tabletop sound generators are used as an aid for relaxation or sleep. Placed near your bed, you can program a generator to play pleasant sounds such as waves, waterfalls, rain, or the sounds of a summer night. If your tinnitus is mild, this might be all you need to help you fall asleep.
- Acoustic neural stimulation is a relatively new technique for people whose tinnitus is very loud or won’t go away. It uses a palm-sized device and headphones to deliver a broadband acoustic signal embedded in music. The treatment helps stimulate change in the neural circuits in the brain, which eventually desensitizes you to the tinnitus. The device has been shown to be effective in reducing or eliminating tinnitus in a significant number of study volunteers.
- Cochlear implants are sometimes used in people who have tinnitus along with severe hearing loss. A cochlear implant bypasses the damaged portion of the inner ear and sends electrical signals that directly stimulate the auditory nerve. The device brings in outside sounds that help mask tinnitus and stimulate change in the neural circuits. Read the NIDCD fact sheet Cochlear Implants for more information.
- Antidepressants and antianxiety drugs might be prescribed by your doctor to improve your mood and help you sleep.
- Other medications may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none of these preparations has been proved effective in clinical trials.
Can I do anything to prevent tinnitus or keep it from getting worse?
Noise-induced hearing loss, the result of damage to the sensory hair cells of the inner ear, is one of the most common causes of tinnitus. Anything you can do to limit your exposure to loud noise—by moving away from the sound, turning down the volume, or wearing earplugs or earmuffs—will help prevent tinnitus or keep it from getting worse.
What are researchers doing to better understand tinnitus?
Along the path a hearing signal travels to get from the inner ear to the brain, there are many places where things can go wrong to cause tinnitus. If scientists can understand what goes on in the brain to start tinnitus and cause it to persist, they can look for those places in the system where a therapeutic intervention could stop tinnitus in its tracks.
In 2009, the National Institute on Deafness and Other Communication Disorders (NIDCD) sponsored a workshop that brought together tinnitus researchers to talk about the condition and develop fresh ideas for potential cures. During the course of the workshop, participants discussed a number of promising research directions, including:
- Electrical or magnetic stimulation of brain areas involved in hearing. Implantable devices already exist to reduce the trembling of Parkinson’s disease and the anxieties of obsessive-compulsive disorder. Similar devices could be developed to normalize the neural circuits involved in tinnitus.
- Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed on the scalp to generate short magnetic pulses, is already being used to normalize electrical activity in the brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping researchers pinpoint the best places in the brain to stimulate in order to suppress tinnitus. Researchers are also looking for ways to identify which people are most likely to respond well to stimulation devices.
- Hyperactivity and deep brain stimulation. Researchers have observed hyperactivity in neural networks after exposing the ear to intense noise. Understanding specifically where in the brain this hyperactivity begins and how it spreads to other areas could lead to treatments that use deep brain stimulation to calm the neural networks and reduce tinnitus.
- Resetting the tonotopic map. Researchers are exploring how to take advantage of the tonotopic map, which organizes neurons in the auditory cortex according to the frequency of the sound to which they respond. Previous research has shown a change in the organization of the tonotopic map after exposing the ear to intense noise. By understanding how these changes happen, researchers could develop techniques to bring the map back to normal and relieve tinnitus.
Where can I find additional information about tinnitus?
The NIDCD maintains a directory of organizations that provide information on the normal and disordered processes of hearing, balance, taste, smell, voice, speech, and language.
Use the following keywords to help you find organizations that can answer questions and provide information on tinnitus:
- Noise-induced hearing loss
4 Signs You Have Tinnitus
Over 50 million people in the US suffer from tinnitus. It’s such a common condition and is caused by a plethora of different things. Most people suffer from tinnitus after being around loud noises for a long period of time – for example, attending a concert or working around loud machinery. However, it can also occur randomly, or be the result of an ear infection.
Tinnitus isn’t a serious medical condition, but it’s well worth seeing an audiologist if you have it. They can diagnose the type of tinnitus you have, and assess whether or not it’s permanent. In this blog post, we will be talking about four telltale signs you have tinnitus. If you spot any of these signs on yourself, then book an appointment with your audiologist today.
There’s a constant ringing in your ears
A major symptom of tinnitus is this persistent ringing sound in your ears. Most people describe this sound as a ringing one, but it can also be more of a whistling or buzzing sound. This can often happen after you’ve been exposed to loud noise, and the important thing to note is that other people can’t hear the same sound. If you’re the only one hearing it, then it’s happening inside your head.
You hear music when none is being played
This is a sign of a specific type of tinnitus often referred to as musical hallucinations. Essentially, you keep hearing little bits of music even though none is being played at all. If you’re watching TV or walking around a mall, then it can be easy to assume you just hear background music. So, check when you’re home alone and have no music playing. If the tunes persist, then it’s a telltale tinnitus sign.
You feel a thumping sound in your ears
Another sign of tinnitus is when there’s a constant thumping sound in your ears. It’s almost like the sound of a bass guitar repeating over and over again. You’ll find that the thumping goes along to the same rhythm as your heartbeat as well. This is a sign of pulsatile tinnitus, which is something of a rare breed.
Your hearing has changed
Finally, a change in your hearing ability is another sign of tinnitus. Many people with this condition complain that they can’t hear as well as they used to, or that their ears are overly sensitive – particularly to loud or high-pitched sounds. While tinnitus doesn’t cause hearing loss and isn’t always an indication that you’re losing your hearing, it can still cause temporary issues inside your ears. So, if your hearing feels strange for a week or two, then it’s best to get checked out as you may have tinnitus.
Generally speaking, your symptoms will go away by themselves with time. Some cases of tinnitus last a couple of days, some last a few months. If you’re diagnosed with permanent tinnitus, then your audiologist will set you on a treatment plan to help calm the symptoms and make it less aggravating for you.
Will Tinnitus Go Away on Its Own?
Something like 5-15% of people around the world have reported indications of chronic tinnitus. While there are some known close associations (such as hearing loss, for example), the causes of tinnitus aren’t yet well understood.
When the causes of your tinnitus aren’t clear, it usually means that a quick “cure” will be elusive. If your ears have been buzzing for over three months and there’s no identifiable cause, there’s a good chance that the sound will not go away on its own. In those cases, there are treatment options available (such as cognitive behavioral therapy or noise-canceling devices) that can help you manage symptoms and maintain your quality of life.
The Cause of Your Tinnitus Is Important
When you can identify the underlying cause of your tinnitus, mitigating the condition suddenly becomes a lot easier. For example, if your tinnitus is produced by a stubborn, bacterial ear infection, treatment with an antibiotic will tend to solve both problems, leading to a healthy ear and crystal clear hearing.
Some causes of acute tinnitus could include:
- Chronic ear infections
- A blockage in the ear or ear canal
- Meniere’s disease (this is often associated with chronic tinnitus, as Meniere’s has no cure)
- Hearing loss (again, this is often associated with chronic tinnitus)
- Damage to the eardrum (such as a perforated eardrum)
So…Will the Ringing in My Ears Go Away?
The bottom line is that in almost all cases, yes, your tinnitus will go away on its own. But the longer it lingers–the longer you hear reverberations or humming or whatever the sound happens to be–the more likely it becomes that you’re dealing with chronic tinnitus.
You can convince yourself there’s nothing wrong and hope that the ringing will just go away. But there may come a point where your tinnitus starts to become uncomfortable–where it’s hard to concentrate because the sound is too distracting. And in those cases, you might want a treatment plan more comprehensive than crossing your fingers.
In most cases, though–in fact, throughout most of your life–your tinnitus will often go away on its own, a normal response to a loud environment (and your body’s way of telling you to avoid that environment in the future). Whether that’s acute or chronic tinnitus, well–only time will tell.
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On November 23, I developed mild tinnitus. I’ve been hearing a constant sound in my head. The sound is a mid-pitched whistle or whine similar to what you hear through the wall when your neighbor is vacuuming. The principal frequency seems to be about 1.1 kHz. Here’s the closest I could get when trying to generate the sound in Cool Edit Pro.
The volume is not high – the sound is overpowered by the refrigerator in my kitchen, the sound of water flowing in the pipes in the bathroom. I can often hear it over my PC (several very quiet fans + quiet 7200 rpm hard drive) or during a conversation in a quiet room when nobody is talking.
As I’ve spent a lot of time reading and thinking about tinnitus, I want to share some tips that helped me get over the initial shock and go back to living normally. Much of the advice in this FAQ is based on what I’ve read about Tinnitus Retraining Therapy (TRT), the leading clinically proven tinnitus treatment.
Sometimes tinnitus has an easily identifiable cause, such as earwax buildup, certain drugs, hypertension, temporomandibular joint (TMJ) disorder, or acoustic neuroma. (The Tinnitus FAQ has a catalogue of possible causes.)
Most cases of tinnitus, however, are “unexplained”. That is, they result from changes in the brain that are still poorly understood. Dr James Kaltenbach has written a good scientific introduction (PDF) to the current theories on the causes of tinnitus.
One thing that is known about this type of tinnitus is that it is associated with hearing loss. Between 60 and 90% (depending on the source) of tinnitus patients have some degree of hearing loss. This is, however, not a true explanation of tinnitus because the majority of hearing-impaired people don’t have tinnitus, and a significant percentage of tinnitus patients have normal hearing (especially among younger people).
When will my tinnitus go away?
If your tinnitus is of the unexplained kind, the question is difficult to answer. If you were recently exposed to loud noise (for example, you went to a concert), you may just have temporary tinnitus that will go away in a few days. In many other cases, tinnitus goes away on its own within 2-3 months. In still others, it takes 2-3 years. On the other hand, there are people who have had tinnitus for over 20 years. Unfortunately, I am not aware of any reliable statistics that would show what percentage of cases resolve within a few months. The best I could find was this informal survey.
What can I do about my tinnitus?
You can go to a doctor in case your tinnitus is due to something that can be fixed or treated easily.
You can try one or more remedies recommended by tinnitus patients – vitamin B12, magnesium, ginkgo biloba, caffeine withdrawal and paracetamol – for each of these, you will find people who swear it reduces their tinnitus. And you can certainly avoid wasting your money on the countless “tinnitus cure” scams ran by unscrupulous assholes all over the Web.
Other than that, there is currently no proven method of rewiring your brain to make “unexplained” tinnitus disappear completely and permanently. There are therapies that can lessen tinnitus or even make it disappear (Xanax, notched music therapy), but their effect is temporary, i.e. they must be continued indefinitely if the effect is to be maintained.
However, you can do two very important things:
- You can stop the noise from bothering you.
- You can learn not to notice the noise.
If you achieve these two goals, tinnitus will be no more of a problem for you than the color of the walls in your apartment. It will still be noticeable, if you choose to notice it, but it will not be an issue.
Dr Stephen M. Nagler describes this beautifully in his introduction to Tinnitus Retraining Therapy (TRT):
TRT is not a cure for tinnitus. It is a treatment approach designed with the goal of tinnitus ceasing to be an issue in the patient’s life. It is designed with the goal of making tinnitus into a pair of pants. Ninety percent of the time, people are unaware of their pants. The 10% of the time they are aware, they do not “cope” with their pants, they do not “deal” with their pants, they do not “learn to live” with their pants, and they most certainly do not spend any time worrying whether the following day will be a “good pants day” or a “bad pants day.” They simply wear their pants; and when the goal of TRT has been met, tinnitus should be just like that!
How do I stop the noise from bothering me?
The first thing you must realize is that the sound itself is not that much of a problem. Unless your tinnitus is uncommonly severe, the noise in your head probably does not interfere with your hearing in a significant way.
The real problem is that (1) you are paying attention to the noise and (2) you are reacting to it in an emotional way. In neurological terms, the auditory stimulus leads to a stress response. You find the sound disturbing, you can’t think about anything else, your heart is racing, you can’t fall asleep at night – all these problems are not due to tinnitus; they are due to your emotional reaction to tinnitus.
Does it have to be this way? No. You are probably surrounded by many sounds that are objectively louder than your tinnitus, yet you don’t give them a second thought. Every day, you sit in front of a computer that has noisy fans and hard drives, but you don’t obsess over it. While driving, you’re exposed to the sound of traffic and your own car, sometimes for hours, but that does not make you miserable. Airline pilots spend half their lives in the noise of jet engines, but they don’t make a big deal out of it. The only difference between tinnitus and those “everyday sounds” is that you interpret those other sounds as “normal background noise”.
As I sit in front of my computer writing this post, I am surrounded by potentially annoying stimuli. I hear the drone of the washing machine that’s running in the bathroom, the whirr of the hard drives in my computer, and some sounds of traffic outside the window. I am wearing eyeglasses that put constant pressure on my nose and ears; worse still, their rims impose themselves on my field of vision, putting a useless blurry border around whatever I’m looking at. To the right of my screen, there is a network router with bright LEDs blinking at irregular intervals. And whenever I move in my chair, it makes a fairly loud squeak. All of these things can be seen as irritating, yet none of them bothers me in the least bit.
There is no objective reason why I should be completely indifferent to all these stimuli, yet be disturbed by tinnitus. After all, tinnitus is just another sound I can’t do anything about.
Your emotional reaction to tinnitus is a matter of attitude. And attitudes to stimuli can change. I remember very clearly that I used to be annoyed by the ticking of the wall clock in my room, to the point that I had to take it down. Guess what? I recently hung it again and now I kind of like it. To take another example, there are people who are annoyed by the noise made by children playing in the playground. Often, the same people will find it much less annoying (or even pleasant) once they have their own children and begin to associate the sound with something pleasant.
It is helpful to realize that most of your negative attitude to tinnitus comes from the initial shock. If you had been born with tinnitus, would you worry about it? Certainly not. For you, it would be the way the world works – much like the fact that you have to blink every 20 seconds or so. Some people who have had tinnitus since childhood are indifferent to it to the point that they believe it is completely normal.
Finally, here are some positive thinking tricks to “become friends” with your tinnitus:
- think of it as the “dial tone of the universe” (not everyone can hear it, you’re among the chosen ones!)
- think of it as a noise that your brain makes when it’s working (it’s good to know your brain is working, isn’t it?)
- think “my invisible force field is on and is protecting me” (this one was suggested by Thomas Tang in the comments here, I think it’s great)
What is partial masking?
Partial masking is a good technique that can help you stop reacting emotionally to tinnitus. Surround yourself with some sort of noise that blends with the sound of tinnitus without obscuring it completely. Good sources of noise include computer-generated noise, recordings with sounds of nature (rain, ocean, mountain stream, etc.), fans, radio static, air humidifiers, etc. There is a good free online noise generator over at SimplyNoise.com. Remember that if your goal is to reduce your emotional response to tinnitus, the tinnitus should still be partially audible over the masking noise. The reason is that you cannot get used to something you don’t hear. You can then gradually decrease the volume of the masking noise until your tinnitus becomes as boring and unworthy of attention as the buzz of the refrigerator in your kitchen.
Does tinnitus deprive you of silence?
Among tinnitus patients, there is a tendency to think “I will never hear silence again”, but it is worth noting that humans are incapable of hearing complete silence anyway. In a well-known study by Heller and Bergman (1953), out of 100 tinnitus-free university students placed in an anechoic chamber , 93% reported hearing a buzzing, pulsing or whistling sound. (Here’s another, more recent study of the same phenomenon.)
How do I learn not to notice the noise?
At the core of tinnitus is The Loop. The Loop is my own term for the positive feedback loop created by the following two mechanisms:
- The more attention you give to your tinnitus, the louder it gets. (What happens is, you are telling your brain “This sound is important/threatening, I need to hear it more clearly”.)
- The louder your tinnitus is, the more it attracts your attention, which in turn makes it even louder, and so on.
This is a vicious circle that can be extremely hard to break out of. In the first few days after my tinnitus appeared, I gave it so much of my attention that eventually I could hear it even while watching TV.
The loop starts when you focus your attention on the noise. Once you let yourself do that, the noise will get louder, making it much harder to get your mind off it. So Rule Number One is: don’t start The Loop. Whenever you find your attention wandering towards the noise, use your will to immediately focus on something else. Get busy. Slap yourself on the face. If you’re trying to fall asleep, try counting. Remember how miserable you felt the last time you let yourself focus on the noise. Do whatever it takes to take your mind off the tinnitus. If all else fails, mask it with music or some noise. But whatever you do, don’t start The Loop.
Learning to take your attention away from tinnitus takes training. One technique that helps with this is having a loud ticking clock in your room. The moment your attention wanders towards the tinnitus, focus on the tick-tock instead. Counting tick-tocks is also a good way to fall asleep.
Tinnitus gets louder when you are anxious about it, so anything that reduces your overall anxiety level is helpful. There’s medication like Xanax that is known to help, but exercise works great, too. If you make yourself feel so tired that you can barely move, it’s really hard to think about tinnitus – when your body is aching, all you can think of is how good it feels to lie down and rest. I would also recommend experimenting with cold showers. In general, anything that causes (safe) pain is good because once the pain is gone, you experience the opposite feeling: bliss, warmth, energy.
If you haven’t heard your tinnitus for some time, don’t listen for it. Don’t ask yourself: “Do I hear the noise now?” or “Has it really gone away or is it just temporarily masked by ambient noise?”. In the first weeks after I got tinnitus, whenever it stopped being noticeable, I would go to a quiet room and put on my isolating headphones to see if it really went away. I did this many times a day and all it did was make me notice my tinnitus again. In the end, I had to set a rule: I am allowed one “tinnitus test” per day, when I get up in the morning. For the rest of the day, no checking.
Remember: If you listen for tinnitus, you are just training your brain to hear it better. Don’t do it. Focus on other things in your surroundings and your life.
What if I’m already in The Loop?
Ah, yes. When you’re in The Loop, your tinnitus seems so loud that it’s like a tiger in your room – it seems damn near impossible not to pay attention to it. In addition, the stress you are probably experiencing does not make it any easier to exercise mental control.
Still, you have to help yourself. You have to get out of The Loop somehow. Here’s a method that worked for me: Mask the hell out of it and go to sleep. When you wake up the next morning, use every ounce of self-control you have to focus your attention on things other than the tinnitus. Keep telling yourself: if I let myself focus on it, it will just get bigger and even harder to ignore. Whenever your thoughts start wandering toward the tinnitus, slap yourself on the face or pinch the back of your forearm (this serves as negative reinforcement). The goal is to develop a mental habit to distract yourself every time you start thinking about your tinnitus. As time passes, it will get easier and easier to distract yourself when tinnitus becomes noticeable.
It can be hard to keep this up for the whole day, especially in the beginning, so use masking liberally. (Full masking is not recommended in Tinnitus Retraining Therapy because it removes the noise completely rather than letting you get comfortable with it, but my experience is that when you’re going crazy from listening to your tinnitus, masking it partially doesn’t make you any calmer. There are times when you need emergency measures.)
When you cannot help but pay attention to your tinnitus and it’s beginning to stress you out, you can try the following mental technique that I’ve found very effective. I call it the Refrigerator Trick. The trick is to imagine that the sound of tinnitus is made by an actual device in the room, perhaps a small refrigerator. It’s amazing that simply having that thought brings about instant stress relief. As soon as the sound is associated with an everyday object, it seems the brain no longer has any reason for alarm. Once the tinnitus is classified as an “everyday noise”, it is much easier to take your mind off it. To make this visualization more convincing, you can picture what the refrigerator looks like, where it’s standing, etc.
Useful resources on tinnitus
- – a very well-written site with tinnitus information and support, by Dr Stephen Nagler, who is a tinnitus patient himself
- Tinnitus Retraining Therapy (TRT) “uses a combination of low level, broad-band noise and counseling to achieve the habituation of tinnitus, that is the patient is no longer aware of their tinnitus, except when they focus their attention on it, and even then tinnitus is not annoying or bothersome”. The author of TRT, Dr Pawel Jastreboff also wrote a book about it.
- Tinnitus Support Message Board – the largest and best forum for tinnitus patients
- Tinnitus success stories from real people
- Tinnitus FAQ
- SimplyNoise.com – a free online noise generator
- Plasticity – a free brain training game that may change your perception of tinnitus (Firefox only) – see below
Update (Sep 2011)
I still have tinnitus, but have become indifferent to it to a degree I would never have thought possible. Basically, now it’s like the sound of the hard drive in my laptop. Sure, I notice it sometimes, but I don’t focus on it; I just go back to whatever I was doing. I’m certainly not sitting there writing an e-mail on my laptop and thinking “OMG, here’s the damn hard drive noise again, why won’t it stop?”. Needless to say, I don’t check the intensity of my tinnitus every day anymore. In fact, I’ve gone weeks without noticing it.
I used to be scared of going to sleep without masking sounds, as the silence at night brings the tinnitus out. Now it’s no big deal: I don’t pay attention to it, and on the rare occasion that I do, it doesn’t bother me; it’s just “that familiar sound” to me.
Update – Plasticity (Aug 2012)
In April 2011, I wrote an HTML5 game (Firefox only) called Plasticity with the objective of rewiring my auditory cortex and thus reducing my tinnitus. The idea was simple:
- Some neurons are firing in my auditory cortex (since I hear the tinnitus).
- The cortex can reorganize in response to training.
- Conclusion: I’m going to train my auditory cortex and see how that changes the perception of tinnitus.
Did it work? It’s hard to say. I was of course hoping for a dramatic, unmistakable result – a total cure. That didn’t happen. I thought I noticed some improvement in the course of my training, but that could have easily been simple placebo effect. After a month of using Plasticity every day, I went on a short foreign trip. During that trip, I noticed that I was able to fall asleep without masking noise for the first time since I got tinnitus. When I got back home, I decided to stop using masking at home as well. I also stopped using Plasticity. In the following months, my tinnitus gradually became a non-issue for me. I would still hear it, but only if I tried to. It would no longer hijack my whole brain. Since the auditory training was effective (I did get better at recognizing sounds, as evidenced by better scores), I think it’s possible that the training somehow changed my brain’s neurological response to tinnitus. I wouldn’t bet money on it, though.
Anyway, I have now made Plasticity available to everyone on the Web, so you are free to try it if you wish. (Here’s some more information on the scientific justification and tips on how to use Plasticity.) It’s totally unproven, but, unlike the countless fake cures on the Internet, it’s also totally free (though I’d be really grateful for your donations if you can afford to spare some money).
Update – (SEP 2013)
Well, OK. The bad news is that my tinnitus got worse. The good news is that it didn’t really upset me. It only bothered me a bit for 2-3 days, then I quickly forgot about it.
How did it get worse? Well, there was a loud concert that I went to with a friend. My friend wanted to get closer to the stage, and, like an idiot, I followed her, even though the music was already uncomfortably loud where I was standing. In other words, there was a red light but I ignored it. Needless to say, I won’t be attending any loud concerts anytime soon. Which is fine with me, I’m more of a home listener anyway.
The concert left me with a threshold shift (reduced hearing) and a whistling sound in my left ear that persisted for about 3 days. My hearing came back to normal (for a while I was worried that it would stay that way), but the whistling never went away. It is much louder than the tinnitus I have in my right ear.
Now I am 90% sure that my original tinnitus was caused by noise as well (another super-loud concert). So here’s a public service announcement: If you have tinnitus, avoid loud noises, such as concerts in enclosed spaces like clubs.
How did I get over it? Same as before, only 100 times faster. (I’m getting good at this!) I used a bit of masking, Plasticity, plus exercise to relax, but mostly it was just the familiar “don’t let yourself think about it” technique. Initially, I felt pretty bad – mainly because I hated myself for making such a stupid mistake and because I was afraid my hearing would be permanently impaired. After a couple days, though, I started paying less and less attention to it, and now I don’t think about it as an issue anymore. Actually, I am quite proud of how quickly I stopped caring about it.
Good luck! Remember to post your comments here.
The 4 Different Types of Tinnitus
Tinnitus: Common, Constant, Treatable, and Manageable
Tinnitus sounds different to everyone, so it makes sense that there are four different types: subjective, objective, neurological, and somatic. Tinnitus is a fairly common medical malady that presents in a variety of ways. Simply defined, it is a phantom ringing, whooshing, or buzzing noise in your ear that only you can hear.
Hearing Things? No, You’re Not Crazy.
People experience tinnitus in a variety of ways: in some, a simple head shake will make the annoyance vanish; others, however, describe the condition as debilitating. Though research is ongoing, currently there is no cure. But relief can comes from a variety of treatments.
What Causes Tinnitus?
Typically the cause of tinnitus is uncertain. If there is no damage to the auditory system, your provider will look into these possible causes:
- Jaw joint dysfunction (TMJ)
- Chronic neck muscle strain
- Excessive noise exposure
- Certain medications
- Wax buildup
- Cardiovascular disease
- A (generally benign) tumor that creates a strain on the arteries in the neck and head
The Four Different Types of Tinnitus:
- Subjective tinnitus: The most common form of tinnitus. Subjective symptoms can only be heard by the affected individual are usually caused by exposure to excessive noise. This type of tinnitus can appear and disappear suddenly, and may last 3–12 months at a time. In some severe cases, it may never stop.
- Neurological tinnitus: Usually caused by a disorder, such as Meniere’s disease, that primarily affects the brain’s auditory functions.
- Somatic tinnitus: Related to the sensory system. This form is caused, worsened, or otherwise related to the sensory system.
- Objective tinnitus: A rare form of tinnitus that may be caused by involuntary muscle contractions or vascular deformities. When the cause is treated, the tinnitus usually stops entirely. This is the only form of tinnitus that can be heard by an outside observer, and the only type that has the potential for a permanent fix.
- Musical tinnitus: Also called musical hallucinations or auditory imagery, this type is less common. Simple tones or layers of tones come together to recreate a melody or composition. Musical tinnitus tends to occur in people who have had hearing loss and tinnitus for some time, though people with normal hearing or increased sensitivity to sound can also have musical hallucinations.
- Pulsatile tinnitus: A rhythmic tinnitus that aligns with the beat of the heart. It usually indicates a change of blood flow to the vessels near the ear or an increase in awareness of the blood flow to the ear.
- Low-frequency tinnitus: Perhaps the most confusing type of tinnitus because sufferers aren’t sure whether the sound is being produced internally or externally. Often, the tones correspond to the two lowest octaves on a piano and are described as a humming, murmuring, rumbling, or deep droning. This type of noise seems to affect people most strongly.
Tinnitus can be managed through strategies that make it less bothersome. No single approach works for everyone, and there is no FDA-approved drug treatment, supplement, or herb proven to be any more effective than a placebo. Behavioral strategies and sound-generating devices often offer the best treatment results — this is partially why distracting the individual’s attention from these sounds can prevent a chronic manifestation.
Some of the most effective methods of tinnitus management are:
- Cognitive behavioral therapy (CBT)
- Tinnitus retraining therapy
There are countless treatment options, but they vary in effectiveness depending upon the type of tinnitus. More than 50 percent of those who experience tinnitus have an inner-ear hearing impairment, meaning that a connection between tinnitus and hearing loss is likely. Though wearing hearing aids helps ease tinnitus (they amplify the sounds outside, making the “inside” sounds less frequent), they are not the only method: careful diagnosis by a professional with years of experience creating solutions for tinnitus sufferers is essential.
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WHAT YOU NEED TO KNOW:
Tinnitus is when you hear ringing, clicking, buzzing, or hissing in one or both ears. You may also hear whistling, chirping, or pulsing. It may be soft or loud, and at a low or high pitch. Tinnitus that lasts longer than 6 months is considered chronic.
What causes or increases my risk for tinnitus?
Tinnitus may be caused by problems with your hearing system, including the parts of your brain that sort out sounds. Tinnitus may also be caused by a health condition, such as Ménière disease. The following may increase your risk:
- Age older than 60 years
- Exposure to loud noise
- Hearing loss or abnormal bone structure in the ear
- Ear and sinus infections, or wax buildup
- Hormone changes in women
- Diseases of the heart and blood vessels, or brain tumors
- Certain medicines, such as aspirin, NSAIDs, methotrexate, and erythromycin
- Anxiety, sleep problems, or depression
How is tinnitus diagnosed?
Your healthcare provider will ask about your symptoms and examine your ears, jaw, and neck. Tell him if you have tinnitus all the time or if it comes and goes. He may ask if anything makes it worse, such as stress or anxiety. You may need any of the following tests:
- A hearing test may show problems with your ear. Your eardrum and middle ear may also be examined and tested.
- An ultrasound, CT, MRI, or MRA may show the cause of your tinnitus. You may be given contrast liquid to help the parts of your ear show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.
How is tinnitus treated?
You may not need treatment. Your symptoms may only appear when you are anxious or stressed. Your healthcare provider may stop certain medicines that may be causing your tinnitus. You may also need medicines to help decrease your symptoms. The following can help treat or manage tinnitus:
- Counseling can help you learn ways to relax, decrease stress, and make your tinnitus less noticeable.
- Cognitive behavioral therapy helps you understand your condition. Your therapist will help you learn to cope with tinnitus. You may also learn new ways to relax and retrain your behavior to decrease your symptoms.
- Sound therapy, such as white noise machines, may help cover your tinnitus with a pleasant sound. Sound therapy devices can help you fall asleep or help you relax. These devices can be worn in your ear or placed next to your bed at night.
- Hearing aids or cochlear implants may help if you have hearing loss.
- Surgery may be needed if your tinnitus is caused by abnormal blood vessels or a mass.
- Do not smoke. Nicotine decreases blood flow to your ear and can make your tinnitus worse. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
- Decrease how much alcohol and caffeine you drink. Alcohol and caffeine can make your tinnitus worse.
How can I help prevent tinnitus?
- Avoid exposure to loud noise, such as loud music or power tools. Occasional exposure can still cause tinnitus. Move away from the noise or turn down the volume.
- Wear ear protection when you are exposed to loud noises. Good ear protection includes ear plugs or headphones that reduce noise.
Call 911 if:
- You feel like hurting yourself or others because of the constant noise.
When should I contact my healthcare provider?
- You have headaches.
- You are tired and have trouble concentrating or remembering things.
- You have more anxiety or stress than usual.
- You have deep sadness or depression.
- You have trouble falling asleep or staying asleep.
- Your symptoms do not go away or they get worse.
- You have questions or concerns about your condition or care.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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