by Neil Bauman, Ph.D.
A lady wrote,
For about 5 years now I have been unable to tolerate 2 sounds (1) meat frying and (2) water running. They honestly absolutely drive me crazy. Until I was diagnosed with, and started learning about, Meniere’s disease, I thought it was due to schizophrenia even though my psychiatrist couldn’t give me a reason that this would happen. Now, I know it is due to my Meniere’s.
In the last few months I’ve had to add loud fans to this list. Most fans I can handle but my parents have a heavy duty fan that, if it is on high, I literally cannot hear anything else and I get angry because I’m literally in pain.
I am lucky as I have a terrific family who believes me when I say it hurts so they try very hard to help keep the sounds low.
Actually, your symptoms are not due to Meniere’s disease as such. Rather they result from hearing loss—whatever cause—which, in your case, is very likely caused by your Meniere’s disease.
There are several different conditions that give somewhat similar symptoms.
First, there is recruitment. Recruitment only occurs in people who have a sensorineural hearing loss. With recruitment, due to your now reduced dynamic range (the range of sounds from the softest sound you can hear to the loudest sound you can stand without pain) as sounds increase in volume, they no longer increase linearly (i.e. a sound that is twice as loud actually sounds exactly twice as loud to you), but exponentially (you may perceive a sound that is twice as loud in actual fact as though it were 8 times as loud, for example.) That is recruitment. Recruitment is generally frequency-dependent meaning that the frequencies near your greatest hearing loss will give you will recruitment the most.
Second, there is hyperacusis. Hyperacusis is typically not frequency dependent. What typically happens is that your internal volume control is “changed” such that you now hear all sounds as too loud. Think of wearing hearing aids that are set properly. You hear soft and loud sounds—but they are all “normal”. Now if you increased the volume to a higher level—all of a sudden the softer sounds are now louder and the loud sounds are now much too loud and hurt.
Two common causes of hyperacusis are from taking certain drugs and from exposing your ears to loud sounds. There are a number of other lesser causes as well.
With hyperacusis you may have a hearing loss or have normal hearing. And if you are really “lucky”, you could have hyperacusis and one or more of these other conditions at the same time.
Third, there is misophonia—where you intensely dislike certain sounds—they drive you buggy. (Sort of sounds like you, doesn’t it?) For example, a “normal” person may get annoyed listening to others chew with their mouths open, while a person with misophonia will have a more extreme reaction—ranging from disgust to rage to panic—and maybe a combination of all three.
Furthermore, if you have longstanding recruitment or hyperacusis, you can easily develop misophonia to certain sounds.
Finally, there is phonophobia—a fear of such “hurtful” sounds. If sounds, whether from recruitment, hyperacusis or misophonia, “hurt” you enough, you may develop a fear of them, and now you can have phonophobia to boot.
As you can see, this is not a simple condition—but can be a complex situation.
It sounds like the heavy-duty fan is causing recruitment. This can happen right out of the blue. For example, I’ve only ever seen my wife react to recruitment once, and that was when we were near the MindBender ride in the West Edmonton Mall in Edmonton, Alberta. For whatever reason, the sound caused her to immediately clap her hands over her ears. To me (with my severe hearing loss) it was noisy, but did not recruit. (My hearing loss causes recruitment to other frequencies of sound. It is also one reason I have a hard time wearing hearing aids in noisy situations—the sounds often recruit and I’m in pain.) Fortunately for me, I don’t notice recruitment when I am not wearing my hearing aids.
You are indeed fortunate to have such an understanding family since it is so hard to understand why a sound at one volume is fine, but just turn the volume up a smidgen and wham—it’s now hurting you! But that is the way it works with recruitment.
Here’s another example. One time I was chatting with a piano tuner while he was working on a piano. As he went up the scale, two keys recruited and I wanted to punch him in the face every time he hit those keys because he was “deliberately” hurting me when he pressed them. Yet to him they were no louder or softer than the adjacent keys—just different in pitch.
This is a fascinating subject, albeit definitely not nice when you experience it in person.