Tinnitus is Driving Me to Despair

Vincent Van Gogh is said to have cut off his ear during an excruciating bout of tinnitus. Tinnitus is a disorder that can strike anyone, regardless of age or sex, and affects men and women of all ages. In fact; a recent study in Canada stated that more than 360,000 Canadians suffer from tinnitus, and 150,000 of those are severely affected.

The real extent of the tinnitus problem has for a long time been hidden because people were afraid to tell their doctors they heard sounds that others did not. Simply put people were very scared that because of the errant auditory effects and aberrations that their tinnitus caused they might be considered to be suffering from some “mental” disorder which could lead to institutionalization. “Only crazy people hear things that aren’t there” this is how they feared the rest of the “sane” world would regard them.

Tinnitus Symptoms

Tinnitus has no singularly specific types of sound or noise that is experienced by all patients rather there are a range of auditory aberrations that may or may not be indicative of a person’s being diagnosable as a tinnitus sufferer. For example there may be noises very much akin to buzzing, whistling, humming, ringing, hissing, even the sound of a waterfall.

The sound may be heard in one ear or in both, or it may seem to come from somewhere inside the head. It may appear suddenly or progressively, remain permanent or be intermittent, and can vary in intensity. It may also simply disappear.

Complex Systems

In order to understand tinnitus one must first appreciate just how complex the auditory system truly is. Sound waves stimulate hair cells in the inner ear, causing electrical impulses to travel along the auditory nerve to the brain. Once in the brain, these impulses are then interpreted by the brain and brought to our consciousness as the perception of sound.

Causes of Tinnitus

Tinnitus is often an indication that there is a problem affecting the auditory system that may be directly related to a head injury, muscular contractions or a dysfunction related to the joints involving the jaw, head or neck. There may be other “physical” causes such as a buildup of wax lying against the eardrum resulting in abnormal transmission of sound waves. These can often be in the form of a muting of hearing.

The tinnitus resulting from this type of causative is partially the result of an over compensatory effect due to sensory deprivation and in some part due to the bio-mechanical aspects of the underlying causative factors.

It may also include the results of years of exposure to specific sound levels of high intensity and usually within a very limited frequency range that damage the tympanic membrane (ear drum), the ossicles of the middle ear (the Malleus, the Incus and the Stapes see Figure 1 below) or the little hairs located in the cochlea.

Image Source: http://en.wikipedia.org/wiki/Malleus This is a file from the Wikimedia Commons and is in the public domain in the United States because it is a work of the United States Federal Government under the terms of Title 17, Chapter 1, Section 105 of the US Code. See Copyright.

Other causes of tinnitus include high doses of medications such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), noise exposure, age, high blood pressure, diabetes and even high cholesterol.

Treating Tinnitus

Whenever a patient presents stating that they can persistently hear noises other people around them can’t the first thing medical science will do is to take a detailed case history and then a thorough physical examination.

Once drug side-effects and bio-mechanical causatives have been ruled out doctors are pretty much left with treating what they call subjective tinnitus. This recognizes that while there may be no obvious physical, environmental or chemical causative for your tinnitus the tinnitus is never-the-less very real to the patient (the subject hence the name subjective tinnitus).

Unfortunately when the doctor cannot find an organic or mechanical reason for the sound, he may be unable to eliminate it. The treatment for tinnitus may then require the services of not only an ENT specialist but also an audiologist and sometimes a psychologist or psychiatrist.

Masking Therapies

Numerous different therapies and approaches have been taken over the years in the treatment of tinnitus with some being more effective for different patients than others. It is therefore recognized that if one therapy fails then try another. Here are some of the more common and generally very effective treatment therapies that are currently used in treating tinnitus today:

Masking Therapies – One way to bring tinnitus under control is to mask the noise with another. A masker is a device that looks like a hearing aid and produces a static hiss-like sound that may be easier to tolerate than the tinnitus. Masking has up until recently been the treatment of choice but newer therapies such as Tinnitus Retraining Therapy (TRT) are now available.

Tinnitus Retraining Therapy (TRT) – In essence TRT consists of retraining the brain through counseling to be either unaware of or untroubled by the tinnitus. That is to say that the brain is retrained through therapy to subconsciously block the consciousness from becoming aware of the tinnitus related sensory information or to permit the consciousness to become no longer troubled by it.

Combination Therapies – Frequently, patients will be fitted with a noise generator that is worn about eight hours a day and set at a very low sound level. Positive results of the combined therapy may appear within just a few months, and most patients report significant improvement after 18 to 24 months.

Relaxation Therapies – One thing most experts do agree upon is that tinnitus sufferers should practice relaxation methods to help them cope. Relaxation CDs with sounds of waves or the jungle can help induce sleep. Antidepressants can improve the well-being of some patients, but all drugs have side effects.

For more information regarding tinnitus follow these links:

Tinnitus Association of Canada
Canadian Hard of Hearing Association
American Tinnitus Association