by Neil Bauman, Ph.D.
January 3, 2016
If you have tinnitus you need to stop focusing on your tinnitus. Constantly and repetitiously mulling over your tinnitus will only make your tinnitus worse. Therefore, you need to consciously choose not to dwell on it.
Instead, focus on living a happy productive life. Get involved in fun activities, productive projects, and the loves of your life. When you are thoroughly wrapped up in something that is exciting or enticing to you, your tinnitus will not be important enough for your brain to even bother decoding it.
As I have said numerous times to people with tinnitus, “Did you ever notice that when you are passionately kissing your spouse, you don’t hear your tinnitus?” They all get a surprised look on their faces, followed by a knowing look as they realize this is true.
Only one person ever said that he could still hear his tinnitus, to which I retorted, “Obviously you weren’t passionately kissing your wife!”
It’s interesting that those of us who spend time helping people deal with their tinnitus find our tinnitus (if we have tinnitus) becomes considerably louder at the same time because we are focusing on tinnitus by talking or writing about it.
One man noted, “My tinnitus comes on whenever I think of it.” I pointed out to him that it is not strange at all, but a good thing because it shows that he is completely habituated to his tinnitus. Thus the only times he really notices his tinnitus is when he thinks about it.
Most of the time I’m the same way. I can go for hours without even realizing I have tinnitus (although it is always there), but then someone phones me or emails me wanting help dealing with their tinnitus and immediately, “there it is”. My tinnitus becomes much louder and more intrusive. It’s ringing away pretty loudly right now as I write this.
Here is a typical example. Let’s say I am working away at my desk and am not aware of my tinnitus at the moment. Then the phone rings. Someone wants help with their tinnitus. Almost immediately I hear my tinnitus louder than I hear my own voice over the phone and that’s pretty loud. (I wear a binaural headset so both ears hear.) This lasts as long as I am on the phone–typically an hour or two. But the good news is that within a few minutes after I hang up the phone and return to what I was doing, my tinnitus drops to its old level and I may no longer be aware of it anymore.
The same thing happens to numbers of us who help people with tinnitus. It’s an occupational hazard of the job. I know my audiologist has a tinnitus clinic. Thus, he works with people with tinnitus a lot. He also has tinnitus himself. He told me he has the same experiences as I do.
This illustrates just how important it is not to focus or think about your tinnitus if you want to bring your tinnitus under control. If this happens to tinnitus professionals who understand, and are thoroughly habituated to, their tinnitus, think how much more it affects people who do not understand tinnitus and are actively worrying about their tinnitus?
That is why we tell people to focus on the loves of their lives and forget about their tinnitus. However, it is hard for me to do this because I am often researching and writing about tinnitus. For example, I am currently updating the 7th edition of my book on tinnitus. So guess who has a problem with their tinnitus at the moment?
Now here’s the good news. Even after hearing my tinnitus most of the day, whenever I focus on other things, my tinnitus calms right down because I am so habituated to my tinnitus.
This can happen to you too. Your tinnitus can seem to disappear, but this only happens if you become truly habituated to your tinnitus. And that only happens if you totally ignore your tinnitus. And that only happens if you do not attach any emotional significance to your tinnitus. And that only happens if you do not see your tinnitus as a threat to your well-being. So that is where you have to begin working on your tinnitus in order to successfully deal with it.
_______________________
The above article is condensed from Chapter 17 in the 7th edition of my book, “Take Control of Your Tinnitus—Here’s How“. (The title used to be “When Your Ears Ring—Cope with Your Tinnitus—Here’s How” in previous editions). I have extensively revised and updated this edition with the latest in tinnitus research and treatment as of January, 2016.
I’m currently considering taking a mindfulness training class, basically meditation class, part of which will require me to focus on my T. I’m also currently seeing a therapist who practices CBT and they are also encouraging me to focus on my T (for about five minutes) as a way of losing the fear of it. Do you think either of these are a good or bad idea?
Hi Ray:
Both Mindfulness and Cognitive Behavioral Therapy (CBT) are highly regarded as tinnitus therapies. Because of the way they work, they can help you with your tinnitus, rather than make your tinnitus worse. Yes, you focus on your tinnitus, but in a good way. It’s not like obsessing over your tinnitus and making it worse–which many people do that do not practice good tinnitus therapies such as Mindfulness or CBT.
Cordially,
Neil
I’m only 11 but I can’t help only to think about so much
Trey your comment made me sad. I was 12 when I got tinnitus first off. Please, no in ear headphones, stay away from loud music and clubs as you get older, and even if it sounds silly, wear ear plugs or headphones to protect yourself in noisy places. That way it won’t get worse and as you get older it’ll ease up.
A VERY DIFFERENT SITUATION!
Very truthfully, if I concentrate on my hissing, several things happen. First though, let me say I agree 100% that it exists only when you think of it. The hissing is a great blessing to me and as well a little peculiar, but It’s a friend, if you will.
1. My hissing is very similar to the noise the TV use to make back when it went of air around 3-4AM with the National Anthem, White Noise it’s referred to as.
2. I purposely listen to when in bed and fall asleep within 1-2 minutes by concentrating only on the hissing.
3. It greatly reduces my Generalized Anxiety Disorder by taking a five minute break and listening to it.
4. Here’s the strange part: If it’s during the day when I’m wide awake and I concentrate so hard that I only hear the hissing no matter what noises are around me, which takes several minutes to get this focused, I find I’ve stopped breathing and my heart has slowed immensely of which finally breaks my concentration. Other symptoms occur but I think they’re related to the lack of oxygen.
I think this is in some way slowing or pausing my ANS (Autonomic Nervous System) but am not sure because I can’t find any mention of these same responses to one concentrating on their “ear noise”. I know others have a different sound and are bothered by it and thus sympathize with you and am in no way minimizing your discomfort, mine I guess is different. At first, many years ago it did bother me but just as the doctor says, I just let it be there, let it calm me until something distracts me from it.
If anyone has ever experienced the ANS slowing or a doctor knows what’s going on, please be sure to let me know, I’d greatly appreciate it.
Blessings to all and thanks for reading!
Glenn T. Kitchen
glennTK@gmail.com
Hi Glenn:
Glad you found something that works for you. Your points 1, 2 and 3 are where you are essentially practicing mindfulness. This is one fairly-new treatment for tinnitus. So in this case, concentrating on your tinnitus in this (good) way is not wrong. You have to be doing it correctly since it is working well for you.
But if you are not practicing mindfulness, then focusing on your tinnitus in a negative way just makes things worse.
You can read more about mindfulness in my tinnitus book, or you can search the Internet for mindfulness and tinnitus and learm more about this technique.
Cordially,
Neil
First off; thank you very much for reading and replying to message!
The first three have become very helpful and appreciate your comment on the mindfulness. The fourth issue I didn’t make clear enough and have enough time to elaborate on but it isn’t done in a way which yields negative results (I see you laughing lol) but instead to investigate very peculiar occurrences that are difficult to describe and require a different venue. Please know I don’t do this on a daily basis and am mindful when I do.
One advantage I yield from this is hyper-concentration abilities. After starting this many years ago I have become able to concentrate on the most difficult topics regardless of my surroundings. It has brought several further advantages that are more on a spiritual level and yielded wonderful benefits, really!
Regarding the breathing; I now subconsciously force myself to breath hence no brain damage has or will occur – 🙂 Thank you again for your comment and any other thoughts or questions are very welcome.
Have a wonderful day!
Glenn T. Kitchen
glennTK@gmail.com
What should I listin to to distract me from my tinnitus.
Hi Patrick:
What you listen to doesn’t really matter–what matters is that it is something that doesn’t annoy you and yet distracts you from your tinnitus. You want to keep the volume down so you can hear it, but still hear your tinnitus. You are not trying to mask your tinnitus so you can’t hear it. You just want some competing sounds for your brain to listen to.
Some people like white, or preferrably pink noise. Others like fractal music. Still others find listening to environmental sounds such as waves lapping on the beach or creek or waterfall sounds work for them. Others like night life sounds in the forest, or rain. Pick what works for you.
The idea is not that you actively listen to these sounds, but they are there passively in the background as you go about the business of daily living. Over time, your brain learns to tune them out, and along with that, tunes out too your tinnitus too.
Cordially,
Neil
First of all, thank you to everyone that has discussed their experience with Tinnitus. It’s now been 2 months that I have this ringing in my left ear. I don’t know if my tinnitus is caused by some hearing loss to my ear or from 2 different medications that I was recently put on.
In December of last year, I was diagnosed with blood clots in my lungs. As such, my pulmonologist put me on Eliquis which is an anticoagulant drug. In January, he also put me on a blood pressure medication called Metoprolol Succ.
On February 27th, when I went to sleep, I noticed this loud pitch noise in my left ear. I’ve had that same noise now for 2 months (today being 5/1/19). I’m coming off of Eliquis in 3 weeks and I’m going to ask my family doctor if she can change my blood pressure (Metoprolol) to another.
I am hoping and praying that one of these meds are the cause of my tinnitus. As such, I’ll come back in a few weeks and will give an update.
In the meantime, has anyone or anyone you know experienced tinnitus due to any of these meds?
Thank you for your insights and for being so generous with your time in helping those of us suffering from this condition.
Hi Wilson:
Metoprolol is by far the most ototoxic of the Beta-blocker drugs. I wouldn’t be surprised if it caused your tinnitus. MUCH better choices in relation to tinnitus would be other members of this class such as Betaxolol, Acebutolol, Nadolol, Labetalol or Nebivolol.
I doubt the Eliquis caused you tinnitus although it is remotely possible.
Cordially,
Neil
Hello Dr. Bauman,
Thank you for your response. On Monday, my family doctor changed one of my blood pressure meds. She kept me on Lisinopril (20mg) but changed my Metoprolol to Amlodipine Besylate, 5mg which is the generic for Norvasc.
It’s now been 2 days off of Metoprolol but the ringing is still there. Hoping that within the next couple of weeks as Metoprolol gets out of my system that my tinnitus goes down or goes away for good. I’ll give an update in a few weeks. Fingers crossed.
Thank you,
Wilson
Hi Wilson:
I suggested less ototoxic alternative beta blockers to your Metoprolol which was the most ototoxic beta-blocker. Instead of doing that, your doctor switched you to the most ototoxic calcium channel blocker so you’re still taking a pretty ototoxic drug which may or may not ease your tinnitus. So don’t be surprised if your tinnitus doesn’t change.
Cordially,
Neil
My tinnitus is fluctuating like crazy recently. Some days it is gone entirely. I’ve only had it for 2 months, and it’s been fairly consistent. In the past two weeks, I’m off Benzos and now getting off an antidepressant. Is the fluctuation a sign it’s going away or just a head fake by my T?
Hi John:
I think it is a sign your tinnitus is going to go away eventually once your get off the drugs and your brain and body settle down again, but only time will tell.
Cordially,
Neil
Dr. Bauman,
I successfully tapered off Klonopin a month ago and Buspar about 10 days ago, but I’m still on Celaxa (20 mg/day) and Remeron (30 mg/day). I’ve been on the former for almost 11 years and the latter for almost three. Last August I developed tinnitus, which almost always is in only my left ear (it sounds like cicadas). Recently the tinnitus seems to follow a pattern: two days relatively tinnitus-free (I still hear it in the early morning before I start my morning routine), followed by a day of all-day tinnitus. What could cause this every-third-day tinnitus? Why does it go away on the “good” days after I’m up and about? Does the fact that it’s become cyclical mean that it will eventually go away, or is this my new normal?
Hi John:
I don’t have a clue why your tinnitus is on a 3-day cycle of one on and two off unless you were taking a drug every 3 days. But it seems you are taking the two remaining drugs regularly every day.
Anyway, I always say that if your tinnitus is intermittent, that is a good sign because it shows that your tinnitus doesn’t need to be permanent. So it may eventually go away. You can be hopeful. But only time will tell what will eventually happen. In the meantime, put in a request for it to be 1 day on and 3 days off.
Cordially,
Neil
Dr. Bauman, I have had tinnitus mildly for 15 years, and I barely noticed it most of the time. A couple of weeks ago, I woke up in the middle of the night with my ears screaming, which has NEVER happened before. I actually think the sound woke me up. I got up and walked around, and after about 30 min, it calmed down. It has happened every night since then, an hour to an hour and a half after I fall asleep. Do you have any idea why this would be? My tinnitus seems to be slightly worse during the day than it was before this night time thing started but not intolerable. I also feel like my ears are more sensitive, but it’s hard to say if they actually are or if I’ve been reading too much on tinnitus and Hyperacusis the past couple of days and am having an experience like you mentioned with your tinnitus seeming louder when you’re focused on it. Perhaps sounds just seem louder because I’m hyper aware of them. Anyway, the night time awakening with extra loud tinnitus is what really has me perplexed. I’d love to know if you have any thoughts on this. Thank you!
Hi Jennifer:
Now you’ve got me perplexed too! We need to go back a couple of weeks ago when this first started and see what changed at that point. Had you started or changed any drugs or medications in the weeks before this began?
Did you have any problems with your neck or jaw, bump your head, etc.?
Does it make any difference whether you sleep on one side or the other, or on your back. I’m wondering whether your neck is “out” and pinches a nerve depending on which way you are laying–and that might cause the tinnitus. Since it goes away after you get up, this could be a possibility.
And definitely, thinking about tinnitus can make things worse–at least temporarily.
Cordially,
Neil
Thank you for your reply! I have actually been racking my brain trying to think if anything changed prior to the nighttime tinnitus starting. I honestly can’t think of anything. No loud noise exposure, no new meds, no injuries to my head or neck, no new stressors etc. The only thing that I can come up with is that maybe lugging around a 30 lb toddler all the time has finally put enough stress on my neck and shoulders to start causing issues. I’m also weaning said toddler, so perhaps hormones could have something to do with it. As far as sleeping, I’ve tried sleeping in different positions, even in different rooms, and it doesn’t seem to make a difference. The strange thing is that it only happens after I fall asleep the first time. After it wakes me up and I finally get back to sleep, it doesn’t happen again for the night. Perhaps it has something to do with the cycle of sleep that I’m in. I’m perplexed too! I’d just like to be able to sleep through the night again.
Hi Jennifer:
It looks like you have covered all the bases that I can think of–and nothing makes sense. I don’t know how to help you at this point.
I know you want to get a good night’s sleep. So facetiously, fall asleep the second time first–then you’ll sleep all though the night. LOL
Cordially,
Neil
Hi Doctor Neil,
I had cold cough and fever March 8th that developed into bronchitis!
Just after semi-retirement in nursing.
High blood pressure due to stress started on lercanapine and ramipril
Medication switched to bisoprol but did not like afffects and now off all prescription medication since June 15th.
Commenced on abx for tooth abscess May 19th two teeth extracted during lockdown on May 29th..
Eating on a poor bite after and then developed tinnitus ten days later.
Diagnosed with a TMJ dysfunction today and occlusion denture plate moulded today and being fitted 21st October!
Started with tinnitus June 8th and have been overwhelmed by it!
Self diagnosed general anxiety disorder!
I have just been diagnosed with TMJ dysfunction and will be receiving my splint in 22days!
I also have knots in my neck and back!
Receiving therapy had five sessions now!
My tinnitus appears somatic as it increases with movement of head or neck and eye gaze virtical.
Is it possible to be resolved with the TMJ treatment and physio/Chiropractor ?
Can it be both oxytoxic and somatic?
When standing or engaging in conversation barely noticeable but it is very high when trying to lay down and unable to lay on side due to TMJ discomfort pounding. During a reiki and therapy laying face down barely there?
Hi Jayne:
It is entirely possible to have both tinnitus as a side effect of taking an ototoxic drug, AND having tinnitus from your neck/jaw being out of proper alignment at the same time. When this happens it can be had to determine which is which and what to do.
I’d start with the somatic tinnitus. Since you know your neck and shoulders and jaw are “tight”, you can work on that. You may need both chiropractic to get your vertebrae into proper alignment, and then physiotherapy to get the muscles to relax so they don’t pull your vertebrae out of their proper positions again.
Nothing wrong with having both treatments concurrently. And add in the dentist for your TMJ. Between your chiropractor and dentist you should be able to get it working properly again.
Since your tinnitus is positional, I’ll bet most of your tinnitus is somatic and very little if any is from drugs or hearing loss, etc. So that is the place you need the work. And you need to calm down and get your anxiety under control as anxiety just tightens your muscles up–and then they pull your vertebrae and jaw out of alignment again.
Cordially,
Neil
Dear Dr Bauman,
I read somewhere on your site that you have had tinnitus for 60+ years. How old were you when you got it? Are you completely deaf too?
I ask, because i’m new to tinnitus, am 49, but it is already driving me crazy, and I feel like my life is in ruins. How have you managed to stay sane all this time? Did you have mild tinnitus or in one ear? I simply can’t imagine 60 years of this.
I am a very stressed person in general, so I have no idea how i’m going to enjoy life and cope with this.
Hi Nicole:
Closer to 70 years now. I’ve had tinnitus as far back as I can remember. I called it the “sound of silence” because that is what I heard when I couldn’t hear anything else.
I’m not completely deaf–just functionally deaf. I was born with a severe low frequency hearing loss–and it hasn’t gotten better with age either! Without my hearing aids on, I basically hear nothing, or very faint sounds unless the sound is really loud and very close.
My tinnitus may be in one ear, the other ear, both ears or just in my head–it varies all over the place without rhyme or reason. It also varies in volume from soft to loud. But since I am so habituated to my tinnitus, it doesn’t bother me even when I hear it–and I hear it loud whenever I write or talk about tinnitus (which is quite often). For example, I can go through most of the morning without even being aware I have tinnitus (that’s how completely I ignore it), then someone phones and asks for help with their tinnitus. Almost immediately my tinnitus increases in volume so that I can hear it above the sound of my own voice–and stays that way until I hang up the phone. Then typically within 5 minutes I am no longer aware I have tinnitus although its always there if I listen for it (which you don’t want to do so you stay habituated to it).
I always have a high-pitched hissy-whine kind of tinnitus, but I may also have a low-pitched rumble or my right ear may hear a twittering kind of tinnitus (which I like to think is a flock of birds twittering away in a nearby tree–that way it is a friendly sound and I don’t worry about it.
Stress can cause tinnitus or make tinnitus worse. So can depression. I never think of my tinnitus as something that interferes with my sanity or enjoyment of life. It is just something that is “there”, just like I can’t hear. You just accept it and get on with your life.
You may find chapter 16 in my tinnitus book, “Take Control of Your Tinnitus” will help you properly deal with your tinnitus so you can habituate to it. You can see/get this book at http://hearinglosshelp.com/shop/take-control-of-your-tinnitus-heres-how/ .
Cordially,
Neil
Thank you for the answer. Would you say then that it has been easier for you to habituate to your tinnitus because it started when you were very young?
Surely for a person like myself who for almost 50 years has always known silence it will be much harder to habituate?
Hi Nicole:
I’m sure it is easier to habituate to something you get when very young. You don’t know anything else. But that doesn’t mean the tinnitus is any less loud–just that you have a lot of years to learn how to ignore it. It’s the same as suddenly losing your hearing as opposed to being born with it.
But you can trade off all the years you had tinnitus-free against the greater difficulty in habituating to it as opposed to dealing with tinnitus for an additional 50 years.
For some people habituation isn’t a problem. They don’t make a big deal out of their tinnitus so they habituate quite easily. But if you make a big deal out of your tinnitus it will be very hard to habituate to it.
Cordially,
Neil
I’m making a big deal out of my tinnitus. It’s going to be a learning process.
Can you please tell me if tinnitus can be caused by having an air purifier on your desk next to you? I have had one on my desk, midsize, for about 2.5 months to clean the air and help with air circulation. About 2 days ago, pretty much non-stop tinnitus started and it has not gone away.
I have been known to get it for a night a time or two a year or the passing of a louder high-pitched squealing sound in my left ear that would subside within a minute or so. But this long is really concerning me. It does seem to lighten at times, but will not totally leave me. Esp when I try to lie down for the night lately.
I have also been taking the odd Benadryl for my allergies, so I wonder if that and Advil for occasional headaches could be causing this suddenly. It did start after my anxiety revved up and I was dealing with a very derealized mood, which is usually caused by my hormones. My anxiety has been really high for quite some time.
I hope you can help me out here. I have dealt with some tinnitus, but this has been horrible. I need some relief before my OCD gets worse from this…which it already has begun to.
Thanks in advance,
Lisa
Hi Lisa:
I don’t really think the air purifier is the cause of your tinnitus. If anything, I’d think it would distract you from any tinnitus, not cause it.
Diphenhydramine (Benadryl) can and does cause tinnitus in some people, but I don’t think it too likely in your case.
Ibuprofen (Advil) could be the culprit. I’ve had more reports of tinnitus from taking Ibuprofen than from almost any other drug.
However, anxiety is a well-known trigger of tinnitus, so I wouldn’t be at all surprised if this wasn’t your prime trigger, and possibly helped along by the Ibuprofen and possibly Diphenhydramine.
You need to learn how to get your anxiety under control–I’d suggest a counselor who can help you, rather than trying to drug it into submission–which is basically an exercise in futility.
Cordially,
Neil
I find it hard to sleep at night after a worsening of my tinnitus which was due to really loud noise from vechicles driving on board a ferry. Therefore I’ve been taking sleeping pills for a couple of weeks. My fear is whether they are ototoxic. I an from Norway, and here the name of these pills is Imovane. I would be very grateful for your answer.
Hi Wenche:
Zopiclone (Imovane) is mildly ototoxic. Some people do report hearing loss and tinnitus from taking this drug. So if you take it and your tinnitus gets worse I’d stop taking it.
However, note that this drug is dependence-forming, so if you take it for any length of time and form a dependence on it, it will be very hard to get off it. Consequently, the better part of valor is not to get hooked on this drug in the first place.
Cordially,
Neil
Hi Dr. Bauman,
I noticed noise in my head and ears about 9 months ago. Before that I was dealing with severe anxiety and started seeing particles in the air. I went online and came across some information on visual snow (or snow vision) and how tinnitus often accompanies this disorder. My mom has tinnitus and that scared me a bit. A few months later I noticed sounds coming from my ears. I’m not sure if I mentally brought it on. I read about a study by Heller and Bergman where a large percent of people put in a soundproof room heard sounds mimicking tinnitus. Is it possible that people without tinnitus also perceive ear noise in a quiet, 30dbish room if they focused intently on their hearing?
Hi Olivia:
Yes, I’ve read the same–that visual snow and tinnitus can occur together. However, I don’t know the exact connection between the two.
If the room is quiet enough, and you sit there long enough and strain to listen for tinnitus, you’ll probably hear it. Note: I don’t recommend this as you might then have problems NOT hearing it. No one I know WANTS to hear tinnitus.
Anxiety and worry and stress can also bring on tinnitus. If that is your problem, then getting your anxiety under control can let your tinnitus fade away.
One good way to help prevent/ameliorate tinnitus is to have soft sounds playing in the background to give your ears/brain real sounds to listen to, so they don’t have to manufacture their own sounds (tinnitus).
Cordially,
Neil
Thank you! My ENT said that tinnitus is typically caused by hearing loss, but I have perfect hearing. He also said that anxiety can make it louder. I know that a lot of people report getting it after a bout of anxiety. Do you know what might be going on in the body for anxiety to bring on tinnitus?
Hi Olivia:
When you are anxious, you are in fight or flight mode. When that occurs, your hearing (and other senses) actually are more acute. Thus, if you had very faint tinnitus that you didn’t even notice you had, when in fight or flight mode, you now hear it as it is louder. And because you are on “high alert”, your ears are tuned to any new sound. Thus you zero in on this new tinnitus sound. You worry about it–and thus your limbic system turns up its internal volume control so you can hear it better (it must be important since you are worrying about it) and thus begins a vicious circle. That is why you need to calm down and get your body out of fight or flight mode.
Cordially,
Neil
Hi Dr. Bauman. Thanks for the information. What if I didn’t have faint tinnitus before, is it possible that anxiety can generate tinnitus sounds without preexisting tinnitus?
Hi Olivia:
As I understand it, yes. But there could be a number of factors that all conspire together to cause your tinnitus–anxiety would be one.
Cordially,
Neil
I have had tinnitus for over ten years and until about a week ago was completely habituated to it. Recently, I started have a problem with insomnia. And about two weeks in I became hyper aware of my tinnitus. Either that or it suddenly got louder. My stress level is extremely high especially because I think it is due to lithium and my doctor insists that lithium doesn’t cause tinnitus. I am worried that it is just going to get louder and louder. I started an 8 week MBSR course. I am aware of the fact that it is my fear, not the tinnitus causing the stress. Is there anything I can do in the meantime to reduce my stress level.
Hi Alicia:
What happened a couple of weeks ago? Did you start the lithium then? Or had you been taking if for years?
Obviously your doctor doesn’t know much about the drugs he prescribes or else he’d know that some people DO get tinnitus from taking lithium–not all that many–but some people do. You could be one of them.
I’d get off the lithium (run it by your doctor of course) and see how your stress levels go down. Maybe that is all it will take. If you need a drug, see if your doctor has another suggestion besides lithium. That seems to be the best solution as I see it, unless the lithium is really helping you. But from what you say, it is just making things worse.
Cordially,
Neil
Hi Dr Neil Bauman
Will valium cause tinnitus to worsen like i read in tinnitus forum? I do take valium on and off.
thanks
victor
Hi Cheong:
Diazepam (Valium) can certainly cause tinnitus.There have been hundreds and hundreds of such reports to the FDA. However, not everyone gets tinnitus from taking Valium by any means. Since you have taken it before (and presumably nothing happened), so taking it now and again probbly won’t affect your tinnitus in the future either.
Cordially,
Neil
Dr. Bauman
Can foods you cause tinnitus.
Also yesterday I fell and hit my head on the ice. Today my tinnitus spiked terrible that I can’t take it anymore. Do you think this spike is permanent.
Hi Jim:
Some spices can cause tinnitus in some people. So can salt or sugar or caffeine or alcohol. I’m not aware of any food as such that causes tinnitus by itself without some other underlying condition.
Head trauma can certainly cause tinnitus. I’d expect your tinnitus to fade away or at least drop in volume as your “head” returns to normal. This can take time–from a few days to a few weeks. So be patient. It’s early days at this point, so don’t give up hope.
Cordially,
Neil
Hi Dr Neil Bauman
I’m 40 years old and have had Tinnitus for the last 20 or so years but very mild and I’ve hardly noticed it until now (Mild to Moderate hearing loss in the 6K-8K range the whole time). I also suffer from Insomnia and have taken Ambien 5mg for the last 5 years. In November I was having a pretty bad eustachian tube dysfunction that was not clearing up. Finally around Christmas my primary prescribed prednisone to help clear up the eustachian tubes, the prednisone did not work but also threw me into some strange emotional state where I was having panic attacks at work (Frist time ever). I was then prescribed Clonazepam and Lexapro in addition to the Ambien because I could not sleep. I could not get past the first two days on the Lexapro and stopped taking it and slowly stopped the Clonazepam. Tried a myriad of other drugs for sleep and anxiety (Trazadone, Buspar, Seroquel) but nothing worked and I noticed my Tinnitus getting louder or more noticeable. Fast forward a month after multiple visits to the ENT, and MRI (nothing found) and finally a Psychiatrist who again prescribe .5Mg of clonazepam and 300mg of gabapentin. Well I can say I’ve finally found sleep but the Tinnitus is still here, maybe worst 8/10 some nights when I stress about it. On a recent visit the Psychiatrist he wants me to try the Lexapro again because he feels I’m anxious and obsessing over the preexisting condition. I don’t know what to do as I’m very concerned about all of these medications. Could the Gabapentin or Clonazepam be making things worse? What are your thoughts on SSRI’s like Lexapro would that cause more damage than good since I’m obviously uber focused on the Tinnitus right now? Any alternative recommendations for antianxiety/depression related to Tinnitus?
Hi Kevin:
All of the drugs you are taking/have taken can worsen your tinnitus, and some can worsen your anxiety, believe it or not. As you know, I’m not a fan of drugs since they always have side effects that ar often worse than the condition they are supposed to fix. And adding drug to drug just compounds things.
You need to get your anxiety under control–there is no doubt about it. Uncontrolled anxiety over tinnitus just makes things worse and makes it almost impossible to get rid of tinnitus.
This is because when you feel your tinnitus is a threat to your well-being in any way, your limbic system is involved and part of its job is to make sure you HEAR any threat so you can act on it. Thus your limbic system is doing its job of making your tinnitus loud and intrusive. Just the opposite of what you want to happen.
Therefore, you need to learn to treat your tinnitus as a totally unimportant, background sound that is NOT a threat to you in any way. This gives your limbic system permission to not bring it to your attention and thus it will slowly fade into the background and not bother you.
As you can appreciate, the trick is to change your mindset. To do this, I’d go to a good counselor that specializes in both anxiety and tinnitus. Learn how to effectively deal with your anxiety so you can let go of your tinnitus.
To make things easier, you may want to also use sound therapy to partially mask your tinnitus. This helps make it easier to ignore your tinnitus. Good sound therapy sounds include pink noise, fractal music or environmental sounds such as running water, waves lapping on the shore, waterfall sounds, babbling brook sounds, rainfall, etc. These water sounds are also naturally relaxing which also helps calm your anxiety.
In addition, exercise and breathing exercises also help with anxiety. So do taking certain vitamins and minerals. I’d makes sure you magnesium is up there and ditto for vitamin D3. Your blood levels of D3 should be up around 70 ng/ml for optimum health. And don’t forget the B vitamins.
So there are a lot of natural things you can do to help your anxiety. You don’t have to take drugs–which is all your doctors think about obviously.
Cordially,
Neil
Hi Dr. Neil,
Thanks for the reply. Fortunately I should have some blood test results tomorrow from vitamin and hormone testing that may point to any deficiency. It sounds like you are not a fan of SSRIs to help control anxiety either? I just feel like I’m in a little bit of a spiral at the moment.
Hi Kevin:
No I’m not a fan of SSRIs at all. They are all ototoxic among other things. I think typically anxiety can be better handled without drugs.
Cordially,
Neil
When you say SSRIs are ototoxic, do you believe they cause actual damage to the hair sensory cells in the inner ear cochlea? Or is it by some other mechanism? I am suffering from SSRI-induced tinnitus and would appreciate your professional input on this. Thank you.
Hi Eric:
Your question is deceptively simple, but the answer is anything but simple. Ototoxicity is the property of being injurious to the ear according to Stedman’s medical dictionary. Some define ototoxicity very narrowly it only some inner ear side effects, but I don’t. So for example, if a drug caused your eardrum to rupture, or your eyes to bounce (oscillopsia), or your ears to hurt, those would all be ototoxic according to Stedman–and I agree. If a drug caused hearing loss or tinnitus, those would also be ototoxic.
If a drug caused temporary hearing loss, that would also be ototoxic. A side effect could be temporary or permanent, and it could be a primary cause or a secondary cause. For example, your tinnitus could be a primary cause–taking a drug caused your tinnitus and nothing else. Or it could be a secondary cause–it may have caused hearing loss (hair cell damage) and the hearing loss resulted in the tinnitus.
Since SSRIs can cause hearing loss, I believe they do ultimately kill hair cells. Do they kill them directly? I don’t know. But ultimately they die. For example, if taking a drug causes an excess of free radicals in your inner ears (a common occurrence), and the free radicals zap the hair cells and mortally wound them so they program themselves to die is that a primary, or secondary or tertiary cause?
Or does the drug break some of the synapses connecting the nerves in the spiral ganglion to hair cells. Your body tries to repair this damage, sometimes it works and sometimes it sort-of works. If it ultimately doesn’t work properly, the neuron connected to the synapse dies and when that happens eventually the associated hair cell dies which could be several months later and you are left with a permanent hearing loss (and typically the associated tinnitus).
What I am saying is that as far as I’m concerned, it doesn’t matter the exact cause–but yes, SSRIs can cause tinnitus and hearing loss (and 28 other ototoxic side effects) one way or another.
The big thing is properly dealing with your tinnitus now that you have it.
Cordially,
Neil
Hi Neil
Thank you so much for your wonderful blog and positive advice.
I truly appreciate it as it has lifted me through some dark times.
I’ve had Tinnitus for a few months now due to moving to a new house and being in a quiet room, the brain has generated some noise which I have latched onto as I am extremely sensitive and anxious due to my OCD. It has caused me panic attacks and loss of appetite and sleep.
Right now my current fear is that I can’t habituate to the tinnitus sound as I am fearing that I can hear the sound even when I’m outside or watching tv, its like I am anticipating or subconciously trying to search for the noise and fearing that it will there. Is this my anxious mind playing tricks on me? Is it possible for me to habituate eventually if I do the right lifestyle changes such as changing my diet, lowering my anxiety, getting more physical exercise and getting counselling as well which I have booked in for.
I am just so worried as my OCD fear is that it is too late for me to habituate as the sound is stuck in my brain now and that it is always going to affect me and I can’t break out of the fear that the sound is going to be there (even if its not).
I just need your guidance and advice that this is normal and I am able to habituate?
I keep having this intense fear that nothing can help me and even CBT won’t be able to solve me as I am one of the “special cases” where I can’t habituate to the sound – I just don’t like the uncertainty. It fuels my OCD like crazy and makes me feel so ashamed.
Hi Mandy:
You can set your fears at rest. Yes, you can habituate to your tinnitus if you do all the things you mentioned above.
The biggie is to get your anxiety under control, and to realize that tinnitus is NOT a threat to your well-being. When you consider tinnitus the same as you do any other unimportant background noise and ignore it, you will begin to habituate to it. As long as you consider it an important sound, then your limbic system won’t let your habituate to it.
So concentrate on doing these two things–not worrying about it, and treating it as a totally unimportant sound–so you don’t even bother listening for it. Deliberately listening for it is another way of telling your brain that it is an important sound that it must not ignore.
It’s never too late to habituate to tinnitus. It may just take longer, the more entrenched it is–but it is certainly doable.
And you might want to have soft background sounds on in your house so you are not in quiet–that way your brain has some real sounds to listen to–even if it is just a fan running. This reduces the contrast between your tinnitus and silence and thus you don’t notice it so much. And this helps you habituate to it.
You can do it!
Cordially,
Neil
Hi Neil – I took amityrpline for 20days,10 mg everyday. I stopped the course around Jan 10th and I felt clogged ears around Jan 20th time frame. May be
Eustachian Tube Dysfunction. I went to the doctor, she couldn’t figure out the reason and said may be allergies clogged your ear. And on Feb 10th I got tinnitus. And I got my wax removed. I am not sure if the tinitus is due to the wax or ETD or Amytrypline. If the ETD is due to amytrypline, does it have a chance to get fixed? Should I show a doctor and that will control my ear ringing? Or do you think it is due to ear wax? Either way can I hope that my tinitus can go away?
Hi Anusha:
If your tinnitus was due to ear wax, getting your ears cleaned out should resolve your tinnitus at the same time.
If your Eustachian tube dysfunction was a result of Amitriptyline, I’d think it would have resolved itself by now since it is now 5 weeks later.
If your tinnitus is a result of taking the Amitriptyline, then your tinnitus should have gone away by now or dropped to a much lower level. So yes, I am hopeful that your tinnitus will go away or fade to a low level.
Cordially,
Neil
Dr. Bauman:
I have drastically cut down on my Prozac and Valium. But my tinnitus has spiked even worse every day.
I can not figure this out. I thought by
Decreasing most of my SSRIs and
Valium my tinnitus would decrease.
Please advise
Hi Jim:
If you have been on psychotropic drugs for a fair period of time, you can’t just stop taking them “cold turkey” and not expect to have bad tinnitus develop as a result.
To come off such drugs safely, you have to do a very slow taper–for 300 or more days.
Furthermore, just because a drug or drugs cause your tinnitus in the first place doesn’t mean that stopping taking the drug will cause the tinnitus to go away. It does for some drugs, but not for others.
Also, a lot depends on your psychological make-up at the time–how you see your tinnitus–whether as a threat to your well-being, or just an unimportant background sound that you can safely ignore.
Cordially,
Neil
Dr Batman: Thank you for your help.I have an important question. On my I pad I have come across many masking apps. White noise, pink noise ETC. There are many reply’s from people with tinnitus about how good they work, however temporary. they do not work for me unless I turn up the volume loud, The relief is temporary. I am now reading many Articles that this masking noise can make your tinnitus worse in the. Long run. I have a hearing aid that diminishes the tinnitus a little. I am hesitant to use the masking device on the hearing aid please advise.
Thanks- Jim
Hi Jim:
First, how about spelling my name correctly. It’s Bauman.
Second, you have to be careful when talking about tinnitus masking. Too many people use it wrongly, and if you use it wrongly, my answers won’t be what you really want to know.
Tinnitus masking is drowning out your tinnitus with sounds louder than your tinnitus. This is NOT the way to get rid of tinnitus–but it can give you temporary relief IF your tinnitus is not too loud. If you have loud tinnitus, masking it would require sounds so loud they would be deafening, and that would make your tinnitus even worse. So normally, masking your tinnitus is not a good idea.
PARTIAL masking is where you set the level of the “masking” sound to some point BELOW the level of your tinnitus to reduce the contrast between your tinnitus and silence. This is what you want to do.
If you want to habituate to your tinnitus, you set the sound level to the “mixing point” which is the point where the “masking” sound and your tinnitus begin to blend together. This point is always somewhat below the level of your tinnitus. Hopefully, this is what you really mean by masking–but it is partial masking.
Third, you need to choose a sound that does not bother you. If the sound annoys you in the least, then it will help perpetuate your tinnitus, and you will not habituate to your tinnitus. So choose a sound that you are neutral to or is mildly pleasant.
For example, I don’t like white or pink noise as it grates on my nerves so to speak, so it would never be a good choice for me.
Fourth, researchers have discovered that using constant white or pink noise (and kindred sounds) can cause the stochastic effect where your tinnitus gets louder (at least temporarily).
The answer to this is to use RANDOM MODULATED sounds such as fractal music (sounds much like wind chimes) or water sounds such as waves lapping or pounding on the beach, waterfall sounds, fountain sounds, babbling brook sounds, rainfall sounds, etc.
Water sounds are particularly good in that they are random, modulated and meaningless, and yet are naturally soothing and you habituate to them easily. So that would be my choice for partially masking your tinnitus.
The reason you want to choose a neutral or just mildly pleasant is that you don’t want to focus on it or you’ll be actively listening to it and thus also your tinnitus. You want a sound that is random and soothing so it is easy to ignore and in the process you will ignore your tinnitus.
Cordially,
Neil
Dr. Bauman:
Thank you for your reply. You answered my question. Sorry for the typo in your name.
DR. Bauman :
I was hit in the head by an automatic metal door a few days ago. I had to go to the emergency room where I was given a Cat Scan , which was negative.
The doctors were not 100% shure wether I have a concussion or not. My
Tinnitus has spiked terrible and I am concerned that it decrease iintensity.
Secondly I have been reading about CBT for tinnitus.
Please advise on both questions.
Thanks Jim
Hi Jim:
I assume the door whacked you on the side of your head and that caused the tinnitus to spike more on that side. Is this what happened?
You may find that your tinnitus goes down as any inflammation due to the “whack” goes away. This can take a couple of weeks or longer. In the meantime, don’t think of this tinnitus as a threat to your well-being, but just as an unimportant background sound that is safe to ignore. When you do this, it gives your limbic system permission to ignore this sound and thus you will habituate to it. If you focus on your tinnitus in a negative sense, this will (and cannot) happen as your limbic system is not allowed to ignore any threats to your well-being and will thus keep your attention focused on it.
CBT specifically tailored to tinnitus can help you get started on the right path in dealing with your tinnitus, but you have to do all the work in order for it to be successful.
Cordially,
Neil
Dr. Bauman: Thank you for your concern regarding my head injury. The headaches went away after four days. As far as the tinnitus goes, I am tryin to ignore it! But I am having an extremely hard time ignoring it when it spikes which seems to be happening more and more lately.I am shure this has nothing to do with my head accident. As with some of your other readers! I also suffer from severe anxiety and OCD.
Any advice would be appreciated.
Thanks Jim
Hi Jim:
Your tinnitus certainly could be related to your high levels of anxiety, but why are you discounting it being a result from the whack on your head? That is still a possibility. Or both could be contributing factors.
If your severe anxiety is the culprit, then obviously getting your anxiety under control will help you bring your tinnitus under control at the same time.
When you have trouble ignoring your tinnitus, sound therapy often helps. Have constant background sounds playing to reduce the contrast between your tinnitus and silence. Good background sounds are various water sounds–waves on the beach, babbling brook sounds, waterfall sounds, rainfall, water fountain sounds, etc.
These sounds don’t have to be loud–just loud enough for you to hear. You can download such sounds from the Internet. Another good choice is fractal music which sounds much like wind chimes. Learn to ignore (habituate to) these sounds and in the process you learn to ignore and habituate to your tinnitus at the same time.
Cordially,
Neil
Dr. Bauman: Thank you for your help.I am trying like hell to ignore my tinnitus. When it first started six months ago it was off and on.It would decrease by 90% for a few days at a time. It has spiked the last three weeks non stop. I am have been seeing a psychiatrist for the last thirty years. He has put me on Prozac and Valium. I am taking small dosages. 20 mg of Prozac a day and 5 mg of valium daily. I am now reading that Prozac and valium can cause tinnitus or make it worse. My Dr disagrees. My main problem like other tinnitus patients is that when my tinnitus spikes it will be for ever. This thought is driving me crazy.
I would appreciate your thoughts on my meds worsening or causing my tinnitus and how I can decrease my fears of spiking tinnitus lasting for ever.
Thanks Jim
Hi Jim:
You can’t ignore your tinnitus by trying to ignore it. It doesn’t work because in order to tell yourself to ignore something, you first have to being it into your consciousness and now you are focusing on what you are supposed to be ignoring.
The way you truly ignore something is to focus all your attention on something else–and by default, you ignore everything else including your tinnitus. That is why I tell people to focus on the loves of their lives and let their tinnitus fade into the background. When you have OCD, it’s hard to not keep being drawn to your tinnitus instead of ignoring it.
It is true that both Fluoxetine (Prozac) and Diazepam (Valium) can cause tinnitus/make tinnitus worse in some people, but that is by no means true for the majority of people that use these drugs. If your tinnitus spiked after taking these drugs, then that is one thing, but if you’ve been on these drugs for many years, then probably your tinnitus is due to other factors, although you can’t completely rule out these drugs.
If you are cruising the Internet looking at various tinnitus boards where they scare you silly with all their horror stories, that is the first thing you need to stop doing. These sites just make your situation worse.
You may have tinnitus “forever”, but so what? I’ve had tinnitus for more than 70 years and to me it’s a non-issue. It’s no big deal because I have habituated to it. Thus whether I hear my tinnitus, or am not even aware of it makes no difference to me.
Where the problem comes is when you think of your tinnitus as a threat to your well-being. When you do this, your limbic system cannot simply ignore your tinnitus as it HAS to bring all threats to your conscious attention in order to protect your life. Thus you cannot ignore your tinnitus.
That is why you have to think of and treat your tinnitus as a totally unimportant, useless background sound that is NOT a threat to your well-being, and thus can be safely ignored. Only then can you habituate to your tinnitus–like I have done.
Cordially,
Neil
Dr. Bauman: Regarding my e- mail to you at3:36 AM.
I forgot to mention the reason for my visits to the psychiatrist is severe anxiety and ocd.I have read that several tinnitus patients are taking Hemp oil and are seeing large decreases in their tinitus.
Do you think Hemp oil will help.
Thanks Jim
Hi Jim:
I’ve heard good things about taking CBD oil. In your case, it may be worth trying it to see if it affects your tinnitus in a good way. It should help you relax and not worry and focus on your tinnitus. Just be sure whatever you take has almost NO THC in it because that component can make your tinnitus worse.
Cordially,
Neil
Dr. Bauman: Thank you for your advice. It appears the main point is to accept tinnitus and not fear it. I recently purchased a few bottles of CBD neon cubes 500 MG. The bottle states it contains pure hemp cbd ectract. Also 25MG of
Phytocannabinoid Hemp oil. My doctor told me I was wasting my$$$ and was scammed. I did not see any mention of THC on the bottle. Since I am taking small doses of Prozac and Valium why not give this a try. The dosage is one a day.
What do you think.
Thanks Jim.
Hi Jim:
You got it. It is NOT a threat to your well-being, so you don’t need to fear it (or even pay any attention to it).
I don’t see any real red flags concerning the CBD cubes you are proposing taking, but in any case, keep your eyes open and be cautious as you try them out and see if it helps you or not.
Cordially,
Neil
Dr: Bauman:
Thank you so much.
Jim
Dr. Bauman: I have been doing better lately until I got a Phizer booster a few days ago. My tinnitus has spiked very high. I went on the Internet and found out that tinnitus isa side affect of the Covid 19 vaccine. Especially Phizer. I wish I had read this before my booster. I am driving myself crazy for even getting the booster. I hope this spike doesn’t. Last for ever. I am in a bad place.
Hi Jim:
Actually, tinnitus is one of the more common side effects of the Covid jab. Another good reason not to get this so-called “vaccine”.
There is no point in beating yourself up anymore. It’s not going to help matters. What’s done is done. Now you need to focus on effectively dealing with your louder tinnitus.
Basically, the program is the same. Don’t think of it as a threat to your well-being, but instead treat it as you would any other totally useless, meaningless, background sound by ignoring it and focusing on the loves of your life. And if you need to, use sound therapy to take the edge off it to make it easier to ignore. Sound therapy helps in the process of habituation.
Cordially,
Neil
Dr. Bauman: Thank you. At least you think I can still habituate. This makes me feel better.
Jim
Dr. Bauman: I was doing some heavy weight lifting yesterday, my tinnitus spiked terrible. Do you think I have plf perilymphatic fistula. I don’t seem to have any of the symptoms except hike spike in tinnitus.
Please advise
Hi Jim:
How is the tinnitus doing now? Has it calmed down in the past 6 days?
I rather doubt you have a perilymphatic fistula as you only have tinnitus and no other symptoms, but it is always possible.
Was there are detectable change in your hearing following this weight-lifting episode?
Cordially,
Neil
Dr. Bauman: Thank you for your reply.
I do not have any symptoms of a
Fistula, and there has been no hearing changes. Unfortunately because some anxiety problems my Dr. Increased my Prozac intake. My
Tinnitus has spiked since the increase
Of Prozac and has not calmed down.
Hi Jim:
Taking drugs to try to calm down tinnitus is often an exercise in futility and can just make your tinnitus worse as you have found.
I’d say that the solution is to get off the Prozac, and learn other ways of reducing your anxiety issues.
Cordially,
Neil
Dr. Bauman. Thank you for your reply. I do not have a fistula, no symptoms. Because my anxiety has increased mr Dr. Increased my Prozac and my tinnitus. Has not calmed down.
Hi Jim:
It’s hard for tinnitus to calm down when you are taking a drug that causes tinnitus in the first place. Drugging tinnitus into submission seldom works.
Cordially,
Neil
Dr. Bauman : my last comment I sent las week has disappeared. What does
Your comment is awaiting moderation mean
Hi Jim:
It just means that I haven’t had time to release the comment. Sometimes I’m too busy to deal with all the comments I receive so they are held until I release them.
This keeps trash from being posted here.
Cordially,
Neil
Hi Neil,
I really appreciate all the comments you make trying to help others with this condition that can be so troublesome to people. I was reading one comment you made about someone’s tinnitus and how it might be a pinched nerve. I don’t know if this might be the case with mine but my tinnitus does have a mind of it’s own. When I sit down to relax it gets loud and when I walk after a mile or so it shuts off. Also I have to lay on my right side to sleep cause my left side it makes it louder. Not only that it ramps up when I eat as well. My tinnitus gets extremely loud and I am having a very hard time habituating as it sets off my limbic system on its own just from when it hits a certain level. I could be sleeping and it will wake me up and be causing all kinds of havik, like fast heartbeat, tight chest, overhearing body temp, panic attacks etc.. The other thing that’s making this hard is my tinnitus is intermittent where it’s on for 3 days and off for 1-2 days. Thanks for reading all this, I know it’s a lot. Any ideas or comments I would appreciate it cause you are the most knowledgeable and experienced person I have ever found with tinnitus. Thank you
Hi Michael:
Your tinnitus can have more that one cause, and be of more than one type. This makes chasing down what is causing your tinnitus more of a challenge. You have to eliminate ALL cause of tinnitus in order to get it to stop. Eliminating one cause may reduce the volume of your tinnitus, or it may not.
You could have a pinched nerve or a nerve that is otherwise hypervigilant and thus hyperactivated.
When you sit down is your tinnitus louder because you are freeing your mind from all the things that you usually think about/do so you now notice you tinnitus more, or is it because of the way you sit that “pinches” a nerve? Or is it the quiet surroundings that let you notice your tinnitus more? Or a combination of all three?
When you walk for a while and your tinnitus stops, is it because you have relaxed your body, or your mind, or is it because the nerve is not pinched/aggravated so much?
If you have to sleep on your right side, is it because laying that way pinches the nerve more and results in louder tinnitus, or is it because your right ear has a degree of hearing loss and when you sleep with your left ear down not as much sound gets to your brain, with the result you hear louder tinnitus?
When it ramps up when eating, is in the fact you are chewing and opening and closing your mouth and thus aggravating your TMJ/nerve and thus making the tinnitus worse, or is it a result of the foods you are eating–some can cause tinnitus in some people?
As you can see, there can be a lot of causes you have to look into. You can observe and experiment to see exactly which things make your tinnitus worse and which let it fade away.
Basically, your limbic system isn’t just “set off”. It observes how you are reacting to various stimuli and acts accordingly. So if you are allowing yourself to become upset, anxious or depressed over your tinnitus because you see it as a threat to your well-being then your limbic system responds and makes it louder because one of its jobs is to bring all threats to your conscious attention.
That is why it is so important to treat your tinnitus as an unimportant background sound that is safe to ignore–and then ignore it. Your limbic system will take its cue from you and again act accordingly and eventually turn the volume down.
When you tinnitus comes and goes, carefully consider all the above possibilities and see whether any of them fit the pattern.
The good news is that if you tinnitus can go for 2 or 3 days, then you know it doesn’t have to be permanent, and by doing the right things, you can have more and more good days and fewer bad days until they are almost all good days.
Hopefully, the above will give you ideas so you can pin down more what makes your tinnitus behave the way it does. Then I can help you work out a plan to get it under control.
Cordially,
Neil
Wow you are such a good guy, I appreciate your reply. Im thinking my best road is to continue trying to habituate so I can go on either way things go with my tinnitus. I guess my biggest concern is if I will be able to habituate you this level of noise I have. It’s very close to the alarm that’s on your ceiling in your house and the only way I have been able to sleep is knocking myself out with remeron. I won’t sleep but maybe an hour or so without it.
I have been working very hard for about a year, meeting with audiologist and reading books and using sound therapy with my hearing aids (I use waterfall masking) and the only time I ever felt the habituation was the week I was using ativan. But I jumped off that road cause I seen where the tolerance and addiction issues would be coming into play. It kinda made me think that maybe my anxiety issue needs to get under control as it might be blocking my habituation? I am making progress on breaking my emotional attachment and fears and all but ya it’s slow as I have had some very very extreme loudness times that totally freaked me out. One other thing when I got tinnitus a year ago I also got 6 detached retina surgeries. It was right after having TMS done, I think they did a poor job cause I never had any issues with my eyes or hearing. Anyways the loud tinnitus and all those eye surgeries (everytime I had a surgery it would follow with about a 2 weeks to a month or extreme spiking). So I think I have some ptsd from all that, I would have panick attacks on the operating table watching them dig in my eyeballs. It’s been a tough year forsure.
Hi Michael:
You can habituate to any level of tinnitus if you follow the rules for habituation.
First, you have to determine that you will do whatever it takes and will not give up–that you will win in the end.
Second, you must stay off benzodiazepines and kindred drugs as they can prevent habituation.
Third, you need to believe and treat your tinnitus as an totally unimportant, useless, background sound that is NOT a threat to your well-being in any way.
You basically do this by not focusing on your tinnitus, but on the loves of your life, thereby basically ignoring your tinnitus because it is not important to you.
Along with this, don’t constantly “check in” with your tinnitus to see if it is getting softer or not. Every time to “check in”, you are telling your brain it is important to you and thus your limbic system cooperates and brings it more to your attention–exactly the opposite that you want in order for habituation to take place. If you have to check in, just do it once a week or once a month so you can see your progress and be encouraged.
You are right about your anxiety issues. You see, if something is totally unimportant to you (like tinnitus should be), you are not anxious about it. So you can only habituate to something that is unimportant to you. That is why it is so critical to learn to get your anxiety/stress/depression under control.
And having 6 eye surgeries sure didn’t help! Your tinnitus could have spiked because of the drugs they gave you with each of the surgeries, making even more of a problem.
Just take it slow–habituating to tinnitus is a slow process and can take anywheres from a few months to 3 years or so when you are doing all the right things. So you also need patience.
Cordially,
Neil
I got it and truly appreciate you helping me. I will go to work and report back! You can be sure I am a fighter and will not stop until I get this! It’s been 1.5 years but I know I am making some progress but will keep going.
Hi Neil,
I was wondering about what to play on my hearing aids for background sounds? I read one of your reply’s that said fractal music and I’m not sure what that means. I have been playing an assortment of my favorite music. Is this not a good idea?
Hi Michael:
It depends on why you are listening to music–for enjoyment/to take your mind off your tinnitus, or to habituate to your tinnitus.
For the former, listen to music you enjoy. But for the latter, you want random sounds so you don’t focus on the music/lyrics. In other words you passively listen to it, not actively listen to it. Thus basically you learn to ignore it and in the process you learn to ignore your tinnitus and habituate to it.
For this to happen you need constant random sounds so fractal music which is random, yet pleasant–sort of like wind chimes, or water sounds–waves on the beach, waterfalls, babbling brook, rainfall, etc. are good choices–especially if you don’t like white or pink noise.
Whatever sounds you choose must not annoy or irritate you, or you will focus on them and thus prevent habituation. So random neutral sounds are the best. Water sounds are ideal.
Cordially,
Neil
One more question I hope you don’t mind.
Will I have to keep busy at all times all my life in order to stay habituated? I am realizing I am going to need to keep myself busy constantly to keep my brain occupied so it don’t focus on the noise?
Hi Michael:
When you habituate to your tinnitus, you WON’T focus on the noise.
We are always doing something (call it busy if you will). It could be reading a book or watching TV or taking a walk on the beach or whatever. All these things occupy your mind so you don’t have to focus on your tinnitus. Just sitting and watching a sunset is being “busy”.
Cordially,
Neil
So if my tinnitus fluctuates and has several different tones and pitches then it will need to habituate to each one which might take longer?
Hi Michael:
It’s possible that you will have to habituate to each different tinnitus sound to some degree, but with proper tinnitus treatment protocols, I think you will habituate to all of them more or less at the same time because you are learning to ignore ALL of them, not just one of them at a time.
Cordially,
Neil
Okay now I am kinda baffled. As I said before my tinnitus is very affected by when I sit down, walk or certain sleeping positions. So just a few minutes ago I came home from dinner and went to my bed and sat down. I immediately noticed the tinnitus went up. Then I straightener my posture out and it went off. What do you think, should I see some type of doctor? Seems strange to me.
Hi Michael:
If your tinnitus is affected by your body motion/position, then you have the somatosensory kind of tinnitus. This can be caused by hyperactive nerves and this can be due to your vertebrae being out of proper alignment, which can also cause muscle problems such as a tight neck and shoulders, facial pain and TMJ.
If I was in your position, I’d go to an upper cervical chiropractor and get the top vertebrae properly aligned. Then I’d see what is happening with my tinnitus.
Cordially,
Neil
Good morning Neil.
I am feeling the habituation starting as my noise is behind my head now which is great it’s not so bothersome. Does it continue to get even better or is that pretty much what it will stay like. Still loud but not really in my face and so annoying?
Hi Michael:
Habituation is a two step process. First you habituate to the annoyance of your tinnitus. This is what you are doing now. Second, you habituate to the volume of your tinnitus. That will soon be happening if all goes well. So not only will it not annoy you, you won’t hear it as much and hours may go by without your even being aware you have tinnitus.
Cordially,
Neil
That sounds wonderful! I look forward to this.
Thanks Neil
Hi Neil,
Is viagra a bad idea with this condition?
I have a feeling it might be? I just take alot of medication and it affects that pretty badly.
Hi Michael:
Many, many drugs, including Sildenafil (Viagra) can cause tinnitus. Every time you add another drug, the chances of increasing your tinnitus also increase. So by taking another drug that is known to cause tinnitus and hearing loss, you are increasing your risk.
Thus, you should carefully consider whether you need all the drugs you are currently taking.
Cordially,
Neil
Hi Neil,
I have a good one for you. So, I am moseying along with this habituation and kinda coming into a stumbling block. You see I have pretty serious depression and have been needing to get some relief from a medication but every single medication I take makes my tinnitus absolutely go crazy once they start to work (typically after 2-3 weeks) and I have tried about 90% of all the medications out there. I mean when this happens the tinnitus goes so loud I can’t even imagine I could habituate you that and my mind will not ignore it for anything. I know this is a hard one and probably no answer, I am just super frustrated and thought I would run it by you.
Thank you so much for your time,
-Michael
Hi Michael:
How did St. John’s Wort work for you? Many people find it works as well as prescription drugs without the side effects although a few people find they get tinnitus from taking it. If you haven’t tried it, that’s one thing I’d do.
Second, have you done the non-drug things you can do such as proper diet including getting your gut bacteria normalized, getting adequate exercise, getting adequate sleep, taking care of your emotional and spiritual needs, seeking counseling and so on. These factors can make a tremendous difference.
Have you gone to one of Dr. Amen’s clinics. If you need professional help, that is the first place I’d go and have SPECT imaging done so you know exactly what parts of your brain are not working properly and learn how to get those parts working properly again. They use holistic methods–don’t just push drugs at you.
Also, remember that if you take any of the benzodiazepine drugs, it is difficult if not impossible to habituate to your tinnitus.
There is hope for you and you have not exhausted all avenues of help until you have done all of the above.
Cordially,
Neil
Neil, you brought me to tears as you are so great of a person to take the time to help me like this. I tried John’s wort when I was in my 20’s but not since then or cleaning my gut but I did receently go to the amen clinic and had the spect scan, currently waiting until November to get the final results. I am nervous as I am hoping the results are not to bad.. what happened is 1.5 years ago I had TMS done and the technician was applying the magnet on the wrong spot as ever since then my life has been turned upside down. At least this is what I believe since he was sloppy not giving me ear plugs and would quickly set me up and leave the room until I was done, then after about 25 sessions he got replaced and I figure my wife was complaining to the doctor about me not being the same person and when she checked his work she realized he was doing it wrong. I am not 100% sure on this but nothing else I did that could of caused all of this. After the tms was done…First it was major anxiety and brain fog which I never had before, then the tinnitus started and then the retinal tears (retina tear in my left eye)and detachments started in my right eye which I am still dealing with (my right eye has had 4 detachment surgeries to try and repair the retina). It’s been a nightmare but I am defiantly going to try the things you said but I take several mood stabilizers that I’m not sure I could get off right away. (Gabapantin for anxiety, lithium and lamictal for mood stabilization and remeron for sleep) many nights my tinnitus is so loud I could never sleep without a sleep aid. I have noticed the Gabapantin helps anxiety go down which helps me habituate I notice. I just hope that’s not real habituation cause I have been trying so hard but this noise can get so loud sometimes. Anyways, thank you again for all your help, it’s so appreciated.
Hi Michael:
I assume you really mean you had repetitive transcranial magnetic stimulation (rTMS). It is used for a number of different ailments, including tinnitus. However, for tinnitus, it needs to be run at a slow rate–1 Hz to slow down tinnitus. At a higher rate–3 Hz it revs up your brain and thus can make tinnitus worse. I know you weren’t having it for tinnitus, but if it was run at a higher rate than 1 Hz, then it’s possible it could have caused your tinnitus, especially since the electromagnets weren’t place properly.
Do you have any idea what rate your TMS was run at?
Unfortunately, if the rTMS was the culprit, it can take months to undo the “damage” and get your tinnitus on track. And this could well be complicated by all the drugs you are taking.
I hope you realize that all four drugs you are taking can cause tinnitus in their own right, and who knows how they affect tinnitus when taken at the same time.
Many hundreds of people have reported Gabapentin caused their tinnitus.
Compared to Gabapentin, few people report lithium as causing their tinnitus, but it still occurs.
Lamotrigine (Lamictal) and Mirtazapine (Remeron) fall in the middle between Gabapentin and Lithium for ototoxicity related to tinnitus.
Ideally, you’d get off all these drugs, but you can’t do it all at once, that’s for sure. Let’s see what the Amen clinic’s results show. Hopefully, they will have a personalized plan to get you back to normal again.
Cordially,
Neil
Hi Neil,
Thank you for your reply. The tms I had was for major depression and I don’t know forsure what speed they were running but it must have been the high one cause I got seriously rev’d up as my wife was absolutely freaked out how I was acting all over the place. She was really upset in that doctors office telling her “what did you do to my husband he has never been the same” I was really manic and at the same time felt like I was in a fog like my memory was really bad, clumsy and I couldn’t find words etc. the fog has got alot better but I still have the memory issues.
I have been trying several meds to try and get some depression relief which I never got from the tms at all. I do excersize and always have enjoyed that but since all of this I notice now I don’t get any endorphin rush or feel good from it at all. I just hope they didn’t severely damage my brain and feel good area of it to where I cannot enjoy life anymore. That’s what worry’s me the most. The antidepressant that has worked for me the most in my years has been Wellbutrin but I know you say it’s not good at all for tinnitus. The problem I am having is that the only antidepressant that doesn’t work on the seratonin in Wellbutrin that I know of anyway. Every single antidepressant that works on the seratonin absolutely makes my tinnitus scream when it starts stimulating seratonin (about 2 weeks after I start) to where I cannot take it, I mean it’s painful. So I have been trying Wellbutrin at 150mg. I just am really desperate for some bit of relief. I will be getting the briefing from amen clinic early November, so you think if I have damage that it will come out in from the scan results?
Hi Michael:
If Wellbutrin works for you and the side effects don’t outweigh the benefits as you see them, then maybe you want to stay on it until you find something better. Note that by keeping the dosage low, you reduce the chances that you will experience ototoxic side effects. In other words, the higher the dose, the higher the risk.
I’m interested in knowing what your Amen SPECT scan reveals. Hopefully, they will be able to do something positive to help you get back on track.
Cordially,
Neil
One other question I had was do you know if they did speed up my brain really fast as it feels that way, will it eventually slow back down? It’s been 1.5 years since the tms and the anxiety and tinnitus are very ramped up.
Hi Michael:
I don’t have any information on how long it takes your brain to slow down again, but studies show that it can slow your brain down (slow down tinnitus) from several weeks to 6 months or more. Thus you might assume from this that if it revved your brain up, it could take up to six month or more to calm down again. Since you had it a year and a half ago, I would have expected that your brain would have slowed down by now, based on the above.
Cordially,
Neil
I sincerely appreciate all your reply’s and support Neil! 🙏
Hi Neil,
I got the brain scan results back and there report and was wondering if there was anyway you could look at it and tell me if you see anything interesting. They indicate very milf brain scalloping which is on the surface if the brain and I wonder if that it the TMS being put in the wrong part of my head. Just really trying to make sense of all of this.
Hi Michael:
What kind of brain scan did you have? A SPECT scan, an MRI, an Xray or what?
Sorry, I can’t help you with reading brain scans. Not an area of my expertise.
Cordially,
Neil
I had a spect scan at amen clinics. However I understand and knew it was a lot to ask. I’m just a little confused by all of it. Thanks so much though you have been a lot of help to me along my journey. -Michael
Hi Michael:
Are the Amen Clinics going to be able to help you? I sure hope so.
Cordially,
Neil
Dr. Bauman : I am stretching my neck
Because of neck pain, I am taking 400 mg of ibuprofen a day and I have increased by valium a little my tinnitus has spiked quite a bit. Can the neck stretches cause your tinnitus to spike. I am also going to aP.T.
Please advise.
Hi James:
You have 3 sources of your tinnitus. First, you could have somatosensory tinnitus spiking because certain nerves are inflamed from the stretching, etc. This would typically go away when things return to normal.
Second, taking Ibuprofen causes tinnitus in many people. I have received more reports of Ibuprofen causing tinnitus than for almost any other drug. So that would be my most likely choice for your tinnitus spikes.
Third, Diazepam (Valium) can also cause tinnitus.
My money is on the Ibuprofen as the most likely culprit and somatosensory tinnitus second with the Valium a distant third.
Thus, if it were me, I’d stop taking the Ibuprofen.
Cordially,
Neil
Dr. Bauman: Thank you for your reply..
I stopped the ibuprofen three days ago, The. Tinnitus is still spiking. I am
Concerned that the stretching of my
Neck is causing the spike. Somatosensory tinnitus and when I cut down on the stretching the spike will never get better.
Please advise.
Hi James:
Ibuprofen is one of those drugs that can cause permanent tinnitus in some people from the very first (and only) pill. So, if your tinnitus is a result of taking the Ibuprofen, it may or may not go away. Only time will tell.
If you tinnitus is somatosensory in nature and is caused by your neck stretching, once the treatment is over and things calm down again, I’d expect that any somatosensory tinnitus would fade away.
Cordially,
Neil
Dr. Bauman:
Thank you for your help
Jim smallis
Dr. Bauman. You are such a help to so many people. You are doing wonderful work to help the tinnitus community. I am a doctor myself working in the ICU. After a stress full time of a few years starting 2018 and then COVID and losing both my parents during the last 4 years. I suddenly one day started to have tinnitus in my both ears a month ago. It was very bad in the beginning and sent me down that vicious circle of anxiety, fear and depression. I lost 7 kgs in 12 days. I think I have habituated to it over tha last two weeks as my appetite has improved and my sleep is slightly better. My question is that my tinnitus is always worst on waking up and also that if somebody startles me or wakes me up by shouting or shaking me, my tinnitus can literally go out of control. Then it can take hours to even a day for it to come to baseline. This has put a fear of sleeping in me. After habituation I would say I am at a 4 or 5 in the morning and a 3 or 4 in the evening. I have had a few days where I might have been even near 2. But this sleep and waking pattern is something I am unable to predict or control. Please shed some light as to what you think I should be doing more.
Hi Salman:
Thanks for the kind words. With all the stress you have been through recently, not to mention a stressful job in the ICU, what has happened is that you have kicked your anxiety reflex into high gear. That is why, when someone wakes you up suddenly,your fight or flight reflex kicks in which causes your tinnitus to instantly spike. Your tinnitus calms down again as you calm down.
I assume that you try to get some sleep between patients in the ICU. And when someone wants you, it is an emergency so they shout or shake you violently to get your attention. What you need to do is teach them how to wake you up. For example, maybe by putting a hand on your shoulder and if that is not enough–gently shake you a bit–to give you a few seconds to wake up calmly. For me, never, ever bang on the mattress or touch my feet. That is too startling for me. Find what works for you yet keeps you calm. Then instruct your staff. That should help a lot in getting your stress reflex under control in such situations.
Some people find that their tinnitus is worse as they wake up. This is because when your brain is waking up, it doesn’t know exactly what is going on yet–so is more on high alert–and thus so is your tinnitus. As it gets oriented and realizes there is no “emergency”, then things calm down and so does your tinnitus.
You may find practicing breathing exercises first thing as you wake up will help calm you down so your tinnitus doesn’t take off. This should only take you a couple of minutes.
Relax as much as is possible so you calm your body down overall. This is important in calming down your fight or flight reflex that is causing you these problems.
Cordially,
Neil