Help Me Understand What Caused My Tinnitus

[Alvise]

Ok guys, this is my first thread here.
I use to read this forum about success stories because they helped me a lot in these six months (I still have tinnitus since 20/02/2017).

My English is not perfect but I hope you will understand me.

This is my tinnitus story:

I am 36 years old, and when I was 10 I had an acoustic trauma to my right ear after an explosion near me.

I had one day tinnitus after that and then it disappeared, but I lost a little % of my hearing, I'm pretty sure about that. I didn't care so much, it was not a problem. My life went on w/o any problem since December 2012 when I developed pulsatile tinnitus (I hear my heart) in the same ear, but also in that case, I dealt with it in few weeks.

The real problems started last February.

In first day of January I had a little sinus, but I recovered in 1 week w/o any problem.
In first days of February I had back pain and chest pain for few days but they gone in few days. I took fans (oki), half a dose.

On Febrary 12th I bought a PlayStation 4, and while playing I heard an annoying fan noise. I read online that there was few defective units who had that fan noise problem. I used to play with headphones (not with high volume) but often I heard that annoying fan noise and every 10 minutes I removed headphones trying to hear that noise, trying to understand if that ps4 was defective.
After one week like that I decided to sell that ps4. It was 19 February.

The day after, 20th February, I developed tinnitus.

It's almost 6 months now. It faded a bit (it was really higher than now), but I still have it and I see my life worse than before.

I made all exams and I'm ok, a bit hyperacusis in my right ear due the explosion 26 years ago.

Reading my story, in your opinion, what caused my tinnitus?

 

[TuneOut]

Reading my story, in your opinion, what caused my tinnitus?

Good day to you, Alvise. That's good news that the tinnitus has faded to some degree. I think the explosion probably set the stage. You've probably been exposed to other loud things throughout the years, right? Then the headphones may have set off the tinnitus. Was there actually a fan noise or was it your ears?

 

[Bill Bauer]

I took fans (oki), half a dose.

What is "oki"?

 

[Samir]

Hi and welcome to the forum!

After reading your story, I would say it's because of the acoustic trauma, headphone use and degeneration of the cochlea as part of the aging process.

Did you have any emotional problems before this? Like anxiety or depression?

On Febrary 12th I bought a PlayStation 4, and while playing I heard an annoying fan noise. I read online that there was few defective units who had that fan noise problem. I used to play with headphones (not with high volume) but often I heard that annoying fan noise and every 10 minutes I removed headphones trying to hear that noise, trying to understand if that ps4 was defective.
After one week like that I decided to sell that ps4. It was 19 February.

The day after, 20th February, I developed tinnitus.

This sounds all too familiar to me. I was blasted by a very intense noise via headphones due to some technical problem with the sound card. Months after I started noticing like a hiss or static noise in quite places. Which later turned to tonal type of noise. This one day, I did not have my headphones on, I was just sitting by the computer, and I thought I heard my power supply making noise, or the fan in the computer. I started scanning my surroundings just like you describe, and that's when I realized... the noise in my ears/head. I started panicking but as time went on I started to accept it and learn to "live with it", just like they say at ENT clinics.

I do have some minor hearing loss on the left ear, but it doesn't prevent me from hearing conversations clearly. It's the tinnitus that gets to me, not hearing loss. I also had some mild hyperacusis, but that has passed now, I only sometimes feel the hyperacusis and ear pain.

So I think in your case, it is a combination of the things I listed above. Unless your hearing is severely damaged, your hyperacusis should improve over time. The same goes for your tinnitus. Just don't expose yourself anymore to loud sounds, but don't overprotect your ears either. Your ears and your brain needs to hear sounds. Just give them time to recover. Of course, use protection when necessary.

 

[Alvise]

What is "oki"?

It's a ketoprofain for pain and infiammation.

Good day to you, Alvise. That's good news that the tinnitus has faded to some degree. I think the explosion probably set the stage. You've probably been exposed to other loud things throughout the years, right? Then the headphones may have set off the tinnitus. Was there actually a fan noise or was it your ears?

I had aoucustic trauma in 1991. But since then never had any other trauma. Yea I went to disco from 2000 to 2005, but anyway , zero problems. To be honest I thought is very strange that a trauma stay silent for 26 years and shows damages only now.
Anyway, the noise I was trying to hear was this one:

I was obsessed to figure out if my ps4 was a defective unit and countinued playing removing and putting my headphone (low volume) many many times. I know that sounds stupid but I was stressed by this I'm sure.

So I think in your case, it is a combination of the things I listed above. Unless your hearing is severely damaged, your hyperacusis should improve over time. The same goes for your tinnitus. Just don't expose yourself anymore to loud sounds, but don't overprotect your ears either. Your ears and your brain needs to hear sounds. Just give them time to recover. Of course, use protection when necessary.

My tinnitus imrpoved a bit in this six months, same hyperacusis, you right.
But I still have a 1/10 - 2/10 tittnitus in the morning and h;
6/10 after lunch;
7/10 after driving coming back from work (it's only 20 min driving)
4/10 in the evening, and very important thing, it turn to 2/10 when i lie on bed going to sleep (I guess I'm lucky about this).
No idea about why it is so fluctuating.

 

[Fangen]

My boyfriend had a defective PS4 unit that made a lot of fan noises as well, and as I don't play with headphones since my T, I heard it all the time. It was really annoying but not harmful. I sit like 1,5-2 meter from it so it wasn't right beside my ears or so. We both both a Pro a few months later so thankfully I don't have to deal with that fan noise. He had the old one for 2 years (before we lived together) and it has not damaged or worsen his T at all (he also have T), and he sits much closer to it than I ever did. The fans is very unlikely the cause of it. However, like others have said, your T was probably caused early on by the explosion but your hearing got repaired as you were pretty young, the T faded and you didn't think more about it. But as one grow older and also get more exposed to noise over time, that is when the ears get damaged. I blasted music through headphones and went party at nightclubs a lot before when I was younger (early 20s) and never had any problems until I attended an indoor concert that was really loud and that was the last drop for my hearing as I developed permanent T. All those years of damage has accumulated so it is not a real surprise in hindsight that I got T.

 

[Samir]

It's a ketoprofain for pain and infiammation.

According to these two sources, it can cause hearing loss.

https://renewhearing.net/reNew_Hearing_Ototoxic.html

http://www.keesdevries.eu/Documenten/Ototoxic_Drug_Packet_Oct12.pdf

To be honest I thought is very strange that a trauma stay silent for 26 years and shows damages only now.

Any damage may have already been done, it just took time for the cells to deteriorate. Ketoprofen may have been the last straw that caused further damage and the result is tinnitus. I am of course speculating, but you did say you were exposed to an explosion in your close proximity at young age, and you did say you took Ketoprofen which according to the sources above is damaging to the ear. There are many drugs that cause damage to the ear. Just look at that list... I am quite surprised myself that there are so many.

I was obsessed to figure out if my ps4 was a defective unit and countinued playing removing and putting my headphone (low volume) many many times. I know that sounds stupid but I was stressed by this I'm sure.

I'm not sure what to make of this. That fan noise is not harmful in any way. You had to come in real close with the microphone to even pick it up. But I don't know what it means from a psychological point of view... It may be that this noise was somehow interfering with your hearing, and this searching for the noise caused the tinnitus to set in. I think I have seen this referred to as some sort of memory theory of tinnitus, where once you realize you have it, it sets in and you can't shake it off and becomes permanent. Just speculations! But ultimately, I think there is something physiological going on that both triggers and causes tinnitus to set in.

My tinnitus imrpoved a bit in this six months, same hyperacusis, you right.

No idea about why it is so fluctuating.

It is like that by its nature. Most of us here will have some bad days, some good days. It depends on how well rested you are, stress in your life, even some foods and beverages can cause it to go up or down.

Try not to beat yourself up over this as that may only aggravate it further. Hopefully your tinnitus will come down to a bearable low baseline. It may even fade away completely, you are still early into this.

 

[Alvise]

My boyfriend had a defective PS4 unit that made a lot of fan noises as well, and as I don't play with headphones since my T, I heard it all the time. It was really annoying but not harmful. I sit like 1,5-2 meter from it so it wasn't right beside my ears or so. We both both a Pro a few months later so thankfully I don't have to deal with that fan noise. He had the old one for 2 years (before we lived together) and it has not damaged or worsen his T at all (he also have T), and he sits much closer to it than I ever did. The fans is very unlikely the cause of it. However, like others have said, your T was probably caused early on by the explosion but your hearing got repaired as you were pretty young, the T faded and you didn't think more about it. But as one grow older and also get more exposed to noise over time, that is when the ears get damaged. I blasted music through headphones and went party at nightclubs a lot before when I was younger (early 20s) and never had any problems until I attended an indoor concert that was really loud and that was the last drop for my hearing as I developed permanent T. All those years of damage has accumulated so it is not a real surprise in hindsight that I got T.

I understood but really, I wasn't exposed to any loud noise after 2005, when I quit discoclub (because I didn't like it anymore).

About my "ps4 problem", for a little period I thought that I always had this T but, trying for a week to hear that fan noise I taught my ear and my brain to "hear more" and now I hear my T. I know it sounds stupid....

And I can't understand too why the first week Tinnitus was so loud (incredible loud, it was louder than white noise I tryed to use for sleeping) and now is so lower (but still noticeable in particular moments of the day) and why I feel pressure on the other ear,

My boyfriend had a defective PS4 unit that made a lot of fan noises as well, and as I don't play with headphones since my T, I heard it all the time. It was really annoying but not harmful. I sit like 1,5-2 meter from it so it wasn't right beside my ears or so. We both both a Pro a few months later so thankfully I don't have to deal with that fan noise. He had the old one for 2 years (before we lived together) and it has not damaged or worsen his T at all (he also have T), and he sits much closer to it than I ever did. The fans is very unlikely the cause of it. However, like others have said, your T was probably caused early on by the explosion but your hearing got repaired as you were pretty young, the T faded and you didn't think more about it. But as one grow older and also get more exposed to noise over time, that is when the ears get damaged. I blasted music through headphones and went party at nightclubs a lot before when I was younger (early 20s) and never had any problems until I attended an indoor concert that was really loud and that was the last drop for my hearing as I developed permanent T. All those years of damage has accumulated so it is not a real surprise in hindsight that I got T.

I understood but really, I wasn't exposed to any loud noise after 2005, when I quit discoclub (because I didn't like it anymore).

About my "ps4 problem", for a little period I thought that I always had this T but, trying for a week to hear that fan noise I taught my ear and my brain to "hear more" and now I hear my T. I know it sounds stupid....

And I can't understand too why the first week Tinnitus was so loud (incredible loud, it was louder than white noise I tryed to use for sleeping) and now is so lower (but still noticeable in particular moments of the day) and why I feel pressure on the other ear,

According to these two sources, it can cause hearing loss.

https://renewhearing.net/reNew_Hearing_Ototoxic.html

http://www.keesdevries.eu/Documenten/Ototoxic_Drug_Packet_Oct12.pdf


Any damage may have already been done, it just took time for the cells to deteriorate. Ketoprofen may have been the last straw that caused further damage and the result is tinnitus. I am of course speculating, but you did say you were exposed to an explosion in your close proximity at young age, and you did say you took Ketoprofen which according to the sources above is damaging to the ear. There are many drugs that cause damage to the ear. Just look at that list... I am quite surprised myself that there are so many.


I'm not sure what to make of this. That fan noise is not harmful in any way. You had to come in real close with the microphone to even pick it up. But I don't know what it means from a psychological point of view... It may be that this noise was somehow interfering with your hearing, and this searching for the noise caused the tinnitus to set in. I think I have seen this referred to as some sort of memory theory of tinnitus, where once you realize you have it, it sets in and you can't shake it off and becomes permanent. Just speculations! But ultimately, I think there is something physiological going on that both triggers and causes tinnitus to set in.



It is like that by its nature. Most of us here will have some bad days, some good days. It depends on how well rested you are, stress in your life, even some foods and beverages can cause it to go up or down.

Try not to beat yourself up over this as that may only aggravate it further. Hopefully your tinnitus will come down to a bearable low baseline. It may even fade away completely, you are still early into this.

I took Ketoprofen many times in my 20's and never had a single problem.
The week before my T I took just an half a dose. It's strange that a so little dose could create a damage. And can't understand why the damage is repairing (my tinnitus is lower) since the choclea cells can't be repaired.

Thanks for your post. I thought that 6 months was the dead end about T but I'm happy to know that there's still hope.


About the psycho T I have same thought. But I think that this is the classic T that could disappear if I find the strenght to do not care about it. But is not easy.

 

[Samir]

I don't play with headphones since my T

Good call! I also stay away from headphones now completely.

It was really annoying but not harmful.

Yeah it seems like some of these sounds interfere with our hearing somehow. Now that we have tinnitus. I for example had to stop using my wireless mouse because it was making this tinny, high pitched noise. I can barely hear it, but it's there, and it seemed to aggravate my tinnitus. So I stopped using it.

The fans is very unlikely the cause of it.

Agreed!

your hearing got repaired as you were pretty young

Not very likely, since he was 10 years old. That's way past the time window where the body can heal any damage to the inner ears.

But as one grow older and also get more exposed to noise over time, that is when the ears get damaged.

Agreed!

All those years of damage has accumulated so it is not a real surprise in hindsight that I got T.

Agreed! All these insults to the ears over the years accumulate, and then you need just that one last drop of water to cause the cup to overflow.

He did also take Ketoprofen. This appears to be ototoxic. Maybe that was that last drop in his case.

 

[Alvise]

The ketoprofain dose I took was really little. I took the kid dose.
In the past, many years ago I took rly more with only benefits.
I'm sure I had stress period just before the T, not only for that stupid ps4 fan problem but also at work. I had neck injury in 1996 and still have a little pain in the right part of my neck if I press a bit in a certain point. Dunno if it is related or not.
Still can't understand why it appeared (but your posts are teaching me a lot, really appreciate) and why my T in going down a bit with volume every month. Of course the improvements are slow. really really slow. Sometimes I think there are not improvement but it's only me who are trying to not listen.
I also forgot to say that I have bad teeth occlusion (my superior teeth hide the inferior teeth when I close my mouth) and I'm using a bite since 2 months when I go sleep.

 

[Samir]

About my "ps4 problem", for a little period I thought that I always had this T but, trying for a week to hear that fan noise I taught my ear and my brain to "hear more" and now I hear my T. I know it sounds stupid....

Absolutely not stupid!

As you described it, "I taught my ear and my brain to 'hear more'", I had the same idea.

You can see that I have put in December 2016 as the starting point for my tinnitus. But this is only when my tinnitus turned into a tonal kind of sound. Before that, it was more like hiss or static that I heard sometimes in quite places, like in bedroom or in the toilet. I did not think of it much at the time. This was about 12 months earlier, before December 2016, perhaps even more than that.

So like you said, I think... no, I know!... I know now in hindsight that I had it before. But I only realized that I have it when it changed in character. So when did it become tonal for me? It was when I was listening in to my CPU/GPU/PSU fan to see where that noise was coming from. That's when I realized I had a noise in my head! Weird thing for sure! I don't know if it's this scanning for the noise that turns up the volume inside the head, or if that's turned up first, which maybe interferes with the noise of the fan, and makes us go out and see where it's coming from... But as you can see, I had a similar experience.

but still noticeable in particular moments of the day

It could be that some sounds are aggravating it. This is referred to as reactive tinnitus.

I feel pressure on the other ear

Do you hear well on that ear? Do you feel like your hearing is muffled on that ear?

I took Ketoprofen many times in my 20's and never had a single problem.
The week before my T I took just an half a dose. It's strange that a so little dose could create a damage.

It's probably not the single dose that one day that caused it. You just revealed that you have been taking this for a long time. I am not a scientist, and I know nothing about Ketoprofen. But assuming it is ototoxic (damaging to the ear), then you have to count in all the times you have taken it. As you said, and rightfully so, cochlear sensory cells do not repair on their own. That's the whole reason that many of us are here today. So even a small damage, repeated many times, can add up to a big total.

And can't understand why the damage is repairing (my tinnitus is lower) since the choclea cells can't be repaired.

No, they don't repair on their own. They sometimes spring back, but if the damaging events are repeated many times they no longer spring back.

What is likely happening is that your brain is turning the gain back down. Assuming it had increased it, maybe as a result of synaptic loss as a result of the drug, or when you were trying to listen in on that fan. But honestly, I don't think that listening in on the fan is what causes the gain to increase. It's probably more likely that it's this gain increase that makes you think that the fan is loud. You notice the fan more that way. So in order of occurrence, I would put it like this: damage to the cells, gain increase in the brain, you notice the fan noise as disturbing. Perhaps the fan noise was even at a similar frequency.

 

[Alvise]

Do you hear well on that ear? Do you feel like your hearing is muffled on that ear?

in that ear I hear perfectly, often better than many other ppl. I hear everything, even very low sounds.

maybe

1- that ear is trying to compensate the hearing loss in the other ear
2- my hearing in general is still overstimulated

 

[Alvise]

By the way, soon I'll go in vacation on the beach. Can I, in your opinion, go to swim (sometimes under water)?

 

[Apocalypse77]

attended an indoor concert that was really loud and that was the last drop for my hearing as I developed permanent T

@Fangen did you wear earplugs on this concert?

 

[Apocalypse77]

@Alvise I asked something like thid in the past read this thread.

https://www.tinnitustalk.com/thread...-the-sauna-and-go-swimming.22964/#post-266273

 

[Alvise]

@Alvise I asked something like thid in the past read this thread.

https://www.tinnitustalk.com/thread...-the-sauna-and-go-swimming.22964/#post-266273

thanks mate

 

[Fangen]

@Fangen did you wear earplugs on this concert?

No I did not, I never used earplugs before I got T. So that is why I am here today

 

[Alvise]

Little update. Talking with a doctor, I learnt that many tinnitus are caused by liquid in inner ear, and in many hospital doctors use to give diuretics. So this weekend I started to drink a lot of water, and T is going better. Keep it in mind guys

 

[Alvise]

My 7th month is going to end. I still have tinnitus, maybe is a bit lower and still flictuating.
Some doctors told me I could have choclear hydrops, but they're not sure.
The hearing loss I have show that is not a hearing loss from acustic trauma but it is caused by this hydrops or could be otosclerosis too (but in this case the fluctuating is very strange).

Any advice about what to do?
I'm not desperate to be honest, just a bit sad.

 

[vermillion]

Hello @Alvise could you please inform me about hydrops symptoms. And what the doctors told you for this condition.

 

[Alvise]

Hello @Alvise could you please inform me about hydrops symptoms. And what the doctors told you for this condition.

hydrops can give vertigo (which I don't have thanks god), fullness and tinnitus,
doctors told me to drink a lot of water and avoid salt.

 

[vermillion]

Thank you @Alvise for your response. I am intrested in information on this, especially on early symptomatology where hydrops can be under diagnosed.

 

[Alvise]

another thing: any doctor told me that a fluctuating tinnitus menas that there's not a permanent damage.

 

[Bill Bauer]

another thing: any doctor told me that a fluctuating tinnitus means that there's not a permanent damage.

Interesting! Thank you for mentioning this here.

 

[Dana]

@vermillion

http://vestibular.org/secondary-endolymphatic-hydrops-seh

 

[Alvise]

@vermillion

http://vestibular.org/secondary-endolymphatic-hydrops-seh

according to this, surgery is possible

 

[Alvise]

today I saw another doctor.

this time it was a specialist in tinnitus.

he said I will never recover the hearing loss, but the said also that the tinnitus will go away. even if I'm atm at the 8th month, it will go away.

"just wait and stay quiet, avoid strong noises but do not avoid natural sounds. it could take years, but ur tinnitus will subside. there is not any terapy to follow. just wait and be quiet. live ur life normally".

what do you think?

 

[Michael Leigh]

today I saw another doctor.

this time it was a specialist in tinnitus.

he said I will never recover the hearing loss, but the said also that the tinnitus will go away. even if I'm atm at the 8th month, it will go away.

"just wait and stay quiet, avoid strong noises but do not avoid natural sounds. it could take years, but ur tinnitus will subside. there is not any terapy to follow. just wait and be quiet. live ur life normally".

what do you think?

Hi @Alvise

Although the doctor that you saw may call himself a tinnitus specialist, and I'm not trying to refute that but is he really? By this, I mean is he an ENT consultant that patients first see to find out why they have ringing in their ears? If this is the case, then in my opinion he is not a tinnitus specialist. ENT doctors are physicians and know about the anatomy of the ear. They can treat it medically or surgically and this I believe they do well. However, if there is no underlying medical problem that is causing your tinnitus. For instance, if your tinnitus was caused by "loud noise" then the right thing to do is to refer you to a Hearing Therapist or Audiologist that specialises in the treatment and management of tinnitus.

These health professionals are the true tinnitus specialists. It is not unusual to find some of them have tinnitus. They were either born with it or acquired it at some time in their life. They will have a depth of understanding and to be able to empathize with a tinnitus patient that most ENT doctors are unable to do. There are various treatments that a Hearing Therapist or Audiologist will be able to explain to treat your tinnitus. I have covered these in my article: Tinnitus, A Personal View and Hyperacusis, As I see it. You haven't had tinnitus very long and it's likely to improve and could go away. I strongly advise you not to use headphones even at low volume. Please click on the links below to read my articles. Try to read them in full and not skim through them. I suggest you use a sound machine at night.

All the best
Michael

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

 

[Alvise]

Hi @Alvise

Although the doctor that you saw may call himself a tinnitus specialist, and I'm not trying to refute that but is he really? By this, I mean is he an ENT consultant that patients first see to find out why they have ringing in their ears? If this is the case, then in my opinion he is not a tinnitus specialist. ENT doctors are physicians and know about the anatomy of the ear. They can treat it medically or surgically and this I believe they do well. However, if there is no underlying medical problem that is causing your tinnitus. For instance, if your tinnitus was caused by "loud noise" then the right thing to do is to refer you to a Hearing Therapist or Audiologist that specialises in the treatment and management of tinnitus.

These health professionals are the true tinnitus specialists. It is not unusual to find some of them have tinnitus. They were either born with it or acquired it at some time in their life. They will have a depth of understanding and to be able to empathize with a tinnitus patient that most ENT doctors are unable to do. There are various treatments that a Hearing Therapist or Audiologist will be able to explain to treat your tinnitus. I have covered these in my article: Tinnitus, A Personal View and Hyperacusis, As I see it. You haven't had tinnitus very long and it's likely to improve and could go away. I strongly advise you not to use headphones even at low volume. Please click on the links below to read my articles. Try to read them in full and not skim through them. I suggest you use a sound machine at night.

All the best
Michael

https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/

https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/

thanks a lot for ur help.
I read everything carefully. My english is not perfect so probably I missed the way to habituate to fluctuating tinnitus. You mentioned it, but I didn't find an answer.

 

[Michael Leigh]

thanks a lot for ur help.
I read everything carefully. My english is not perfect so probably I missed the way to habituate to fluctuating tinnitus. You mentioned it, but I didn't find an answer.

Hi @Alvise

Tinnitus can fluctuate a lot this is not uncommon especially in the early stages which you are still in. Please do not worry about this. Please read my post below on the habituation process that you might find helpful.


The habituation process.

Habituation is frequently talked about in tinnitus forums and probably comes in at second place to the popular question: when will a cure be found? It seems some people have become quite taken with this word and believe it is the most important thing to strive for when dealing with this condition. Everyone wants to habituate as soon as possible and carry on living their life doing everything that they want to and putting tinnitus firmly behind them.

I can honestly say that I see nothing wrong with that, but wanting something in the speed that we would like it isn't always achievable, especially with something like tinnitus. A few people that have had tinnitus for a while, have contacted me to discuss just that. They have concerns about the length of time it's taking to habituate. Similarly, I have heard from those new to this condition that want the habitation process to start as quickly as possible. Both groups tell me they are doing all the right things but it seems patience is giving way to despondency and despair and some are starting to believe habituation might never happen for them.

It is of little comfort to these people when they hear family and friends say, tinnitus is just a minor irritant and something that can easily be ignored. Occasionally, it might be intrusive but this is never more than temporary and they are still able to carry on with their life unperturbed. I often sense the frustration a person is under when they are relaying this to me. Whether I'm talking to them on the telephone, private messenger or answering an email. It is then that I'm often asked: why is it that the habituation process doesn't seem to be happening for them?

Answering such a question isn't easy because there is no single answer that I can provide but I will say this. Tinnitus is a common condition that comes in many forms and intensities and no two people experience it the same. It can be very troublesome especially in the early stages of onset, but gradually this gives way and the condition settles down and in time many manage to cope with it when it's mild or moderate. Sometimes this may involve treatment via a hearing therapist or a person achieves this naturally without being referred to a clinic.

It should be noted that tinnitus can be a complex condition, depending on how loud and intrusive it is for the individual? So what I've just outlined won't apply to everyone. There are other factors that also come into play. A person's make-up or rather their outlook on life. Whether they are positive or negative thinking can help or delay the habitation process. In addition to this, stress and anxiety are often associated with tinnitus and a person might be taking medication such as an antidepressant to help cope with it. There are a myriad of scenarios that I could relay to you on how tinnitus can affect someone's quality of life, their well-being and the habituation process. For now I will say this:

When a person habituates to tinnitus it means they are able cope with it but this doesn't mean they will never hear it. Although some people habituate to a level where the tinnitus is rarely heard or stays at a very low level. Whether the tinnitus is silent for periods of time or remains low, mild, moderate or is occasionally intrusive, it doesn't really matter, because it all means the same thing. When habituation is reached a person will know, because whatever the level it will not bother you. However, like everything there are exceptions and tinnitus is no different. I believe there are some limitations to habituation. As I have previously said the condition comes in many forms and intensities. Some people have variable tinnitus that can fluctuate from silent, mild, moderate and severe. When it is loud and intrusive (severe) and this level is sustained for long periods it can become very debilitating and a person might have to take medication to cope with it, which is usually supplied by their doctor. This level of sustained intrusiveness shouldn't be confused with a tinnitus spike, which usually returns to baseline within a short period of time.

I want to say that I believe habituation is achievable for most people with time. In some instances a person might need the professional help of a Hearing Therapist or Audiologist, as there are a variety of treatment options available to help one in the habituation process. One should also try to be realistic. There are some people that will accept nothing less than a complete cure from their tinnitus and this is unfortunate, because they could waste a lot of time being miserable.

I have corresponded with people that have said, their tinnitus is very low and is only heard occasionally or in a quiet room, at night for instance. Yet these people are not satisfied because they want a complete cure and will deliberately seek out quiet surroundings to monitor their tinnitus, checking to see if it has increased or not. It's as if they have become obsessed with this condition and to the point where is starts to affect their relationship with those that are close to them, and I don't think this is healthy.

In summing up I want to say one last thing. Those that are having treatment with a Hearing Therapist, Audiologist, or finding that their tinnitus is becoming less intrusive and they are in the habituation process. Try not to read negative posts or associate with negative thinking people who are not in the same place that you are, as their beliefs can prevent your advancement, if you are not careful.

I wish you well
Michael

PS: further reading on habituation:
https://www.tinnitustalk.com/threads/tinnitus-a-personal-view.18668/
https://www.tinnitustalk.com/threads/hyperacusis-as-i-see-it.19174/
https://www.tinnitustalk.com/threads/answers-to-hyperacusis-and-habituation.12058/