by Neil Bauman, Ph.D.
A veteran wrote:
My hearing loss and tinnitus is service-connected. I was exposed to constant cannon fire while in the Marine corp. No hearing protection. Marines were expected to tough it out. Now I’m paying for that silly theory with my hearing problems.
I am trying to explain to the VA doctors and audiologists about my severe sensitivity to sound. Some loud sounds hurt my ears really bad. This is causing me to have anxiety and panic attacks secondary to the loud sounds. The VA has said that my problems are psychological so I’m now seeing a psychologist.
I am very depressed because of my inability to hear well, and my tinnitus is extremely loud. I sometimes think that there are mice in my ears scratching to get out. The tinnitus and combined hearing loss is very depressing, but so also is the sensitivity to loud sounds.
Loud sounds cause me to become disoriented and dizzy and I lose my balance. Several times, upon hearing loud sounds, I have fallen. I realize that this is caused by my anxiety reactions and panic reactions to the pain of the loud sounds.
My problem is that I can’t seem to make the VA medical people understand. They just think I have to get over the depression. They think the depression is causing the problem and that when the depression goes away so will the tinnitus and sensitivity to sound.
I also hear phantom sounds, which I know are a part of my hearing loss and tinnitus. But again the VA is saying no. They want to blame it on psychosis? The bottom line is that the depression, anxiety and panic disorder are secondary to my hearing problems.
Fear of sounds is called phonophobia. In your case you perceive the sounds as so loud they hurt. No one wants to be hurt—whether it is loud sounds or anything else.
However, I think that rather than having phonophobia, you have hyperacusis—where you perceive normal sounds as too loud. Hyperacusis is often the result of having your ears damaged by loud noise such as you were exposed to in the Marines.
Living with loud tinnitus day in and day out can lead to depression. Actually, this is sort of a Catch 22 situation. Depression often leads to louder tinnitus—so you want to get your depression under control in order to help control your tinnitus, but on the other hand, loud tinnitus leads to depression, so you want to get your tinnitus under control if at all possible.
You can learn to live and enjoy life even though you have tinnitus and can’t hear much. I don’t hear much at all now, and I’ve had tinnitus day and night for 65 or more years—but I don’t let it affect my happiness. My book, “Take Control of Your Tinnitus—Here’s How” has helped many.
It’s interesting (not nice, but interesting) to note that loud sounds also cause you to lose your balance. I don’t see how it relates to anxiety reactions like your doctors think it does. To me, it seems you have a condition called Tullio’s Phenomenon in which people lose their balance from loud sounds—not from anxiety or panic.
Another name for it is Superior Canal Dehiscence Syndrome. Basically what happens is that you have a hole or thin spot in the bone separating the balance system from the hearing system. Thus when you hear a loud sound, the sound wave travels via the hole to act on the balance system. Since it is a sound signal and not a balance signal it sends false balance information to your brain. This totally confuses your brain and the result is loss of balance.
Some people drop to the floor like they were knocked out. Others have vertigo and some dizziness and imbalance. Sometimes doctors can patch the hole and cure this, but other times not.
If this is what you have, then the psychologist is wrong in trying to treat you for anxiety and panic. Yes, you need to get those under control too, but you also need to have an otologist check you out for things that cause Tullio’s Phenomenon such as Superior Canal Dehiscence Syndrome. You have several ear-related problems and each one needs the proper treatment by the appropriate professional. Blaming it all on you just isn’t going to help!