Importance of Behavior in Response to Tinnitus Symptoms

[Peter Q]

This research paper from 1999 is a very interesting study showing how people with hypochondria experience higher levels of tinnitus distress that those without hypochondria.

"Among subjects affected by tinnitus, two groups are distinguished: patients who can cope positively with the symptom and patients who cannot cope with it. These differing attitudes suggest the necessity to study affected patients' "illness behavior" (i.e., a subjective interpretation of symptoms concerning body functioning). Our study considered 125 idiopathic tinnitus sufferers who requested a visit by an otorhinolaryngologist expressly for this symptom. All patients were invited to complete the illness behavior questionnaire (lBQ). lBQ mean score results were lower for affective inhibition and irritability and resulted in higher denial. Patients with more psychological suffering presented higher levels of hypochondria, disease convinction, and dysphoria. Results revealed a correlation between psychological suffering and tinnitus intensity: The group of patients with stronger psychological suffering included more subjects with a higher intensity level. The other group included more subjects with a moderate intensity level. Within the psychological evaluation of tinnitus sufferers, the lBQ results demonstrated particular sensitivity in revealing patients' non adaptation area in coping with the symptom."


https://www.tinnitusjournal.com/articles/importance-of-behavior-in-response-totinnitus-symptoms.pdf

 

[El BUZZ]

I can relate to a certain extent and these days that I am going through a massive spike I consider the following:

My tinnitus has been severe since day one. Nothing masks it. Nothing. However I've had times I have completely ignored it for weeks or even months in a row. Zero psychological impact. Then I start perceiving it as louder and more intrusive, anxiety, depression and suicidal thoughts come back to my daily feelings. I think hypochondria isn't what determines our response to tinnitus but its volume and intrusivenes. Of course certain subjects may feel drowned in despair by just having a completely mild tinnitus but mainly intrusiveness is what makes it harder to cope with.

 

[AfroSnowman]

I can relate to a certain extent and these days that I am going through a massive spike I consider the following:

My tinnitus has been severe since day one. Nothing masks it. Nothing. However I've had times I have completely ignored it for weeks or even months in a row. Zero psychological impact. Then I start perceiving it as louder and more intrusive, anxiety, depression and suicidal thoughts come back to my daily feelings. I think hypochondria isn't what determines our response to tinnitus but its volume and intrusivenes. Of course certain subjects may feel drowned in despair by just having a completely mild tinnitus but mainly intrusiveness is what makes it harder to cope with.

I can't agree more. Even a slight difference in perceived loudness / intrusiveness can make a huge difference in its impact. There are the occasional periods of time where it is just less intrusive, still severe by most measures, but below a certain threshold and my reactions to it really melt away.

 

[El BUZZ]

I can't agree more. Even a slight difference in perceived loudness / intrusiveness can make a huge difference in its impact. There are the occasional periods of time where it is just less intrusive, still severe by most measures, but below a certain threshold and my reactions to it really melt away.

That always took me to consider that auditory system is tightly linked to whatever part of our brain which regulates our mood. One can cry, feel upbeat or nostalgic because of a song... Then I also contemplate the other way 'round; Low mood making tinnitus seemingly louder.

 

[Watasha]

I think a lot of it all comes back to those who tend to be highly neurotic tend to suffer more with this.

 

[AfroSnowman]

I think a lot of it all comes back to those who tend to be highly neurotic tend to suffer more with this.

I promise you I was the least neurotic person you would have ever met before this happened to me. No history of depression. But this condition has messed me up pretty good. I function (though significantly compromised), socialize, continue to live life and do stuff, but I suffer an awful lot and this certainly takes a lot of joy and energy from me. For me the psychological conditions were 100% caused by an endless severe tinnitus. On the very rare day my symptoms are more modest I quickly regain my natural joy.

 

[DimLeb]

When will this clown fiesta of surveys end? This is a seriously outdated one from 1999, when tinnitus was greatly associated with psychological stuff. We don't need any more of those.

For 98% of people with tinnitus, if you remove the tinnitus itself from the equation, they are perfectly normal people. Tinnitus is the reason behind all this and its severity and character of sound dictates how our reaction is. Not the other way around. Just imagine saying "People with hypochondria experience higher levels of -- put any neurological or not disease here like ALS or cancer here -- distress that those without hypochondria". How ridiculous that would sound.

 

[Tau]

I promise you I was the least neurotic person you would have ever met before this happened to me. No history of depression. But this condition has messed me up pretty good. I function (though significantly compromised), socialize, continue to live life and do stuff, but I suffer an awful lot and this certainly takes a lot of joy and energy from me. For me the psychological conditions were 100% caused by an endless severe tinnitus. On the very rare day my symptoms are more modest I quickly regain my natural joy.

I was anxious, but not depressed. I would get anxious and inquisitive at work (science!), so that was actually a benefit.

Now I am severely depressed. I still socialise like you, but I just cannot feel happy at all.

 

[Watasha]

I promise you I was the least neurotic person you would have ever met before this happened to me. No history of depression. But this condition has messed me up pretty good. I function (though significantly compromised), socialize, continue to live life and do stuff, but I suffer an awful lot and this certainly takes a lot of joy and energy from me. For me the psychological conditions were 100% caused by an endless severe tinnitus. On the very rare day my symptoms are more modest I quickly regain my natural joy.

There's a lot more to neuroticism than just depression. I was the same way as you, never depressed, honestly I thought about how lucky I'd be in life to that point. The fact that I didn't have much to worry about I think played a role, now all of a sudden I have something to worry about it, and I can't change it! In fact, I've dealt with many not so great things but none of them affected me like tinnitus. It's almost as if a lever or switch was flipped in my brain.

I've always had a bit of "sticky" brain that gets fixated on things, I think that has played a significant role in the distress.

 

[Uklawyer]

I do think that there is a correlation between stress and tinnitus in a great number of people (onset and management). But pathology varies greatly, and depression, anxiety and the like are natural responses to this thing. It seems to me, however, that there are a large number of intelligent, analytical people on here. Maybe sensitive too and, of course, people with pre-existing anxiety, depression etc. There may be a subset of people who either are at higher risk of getting this thing in the first place, or may find it a bit harder in managing it without assistance, due to the way their brain works/responds to stressors such as this.

 

[Joeseph Stope]

When will this clown fiesta of surveys end? This is a seriously outdated one from 1999, when tinnitus was greatly associated with psychological stuff. We don't need any more of those.

For 98% of people with tinnitus, if you remove the tinnitus itself from the equation, they are perfectly normal people. Tinnitus is the reason behind all this and its severity and character of sound dictates how our reaction is. Not the other way around. Just imagine saying "People with hypochondria experience higher levels of -- put any neurological or not disease here like ALS or cancer here -- distress that those without hypochondria". How ridiculous that would sound.

When I was in my mid-teens -- way back at the dawn of history, I can recall cycling into the city on my push-bike to the central library to find information about the causes of asthma. At that time I was suffering real bad from it. Unfortunately the library then had only two books on Asthma and the one I got dealt with the psychological triggers of asthmatic attacks by some American author. I peddled back home thinking my asthma attacks were due to some subconscious feelings of hating my father.

Them was the days.

FYI: Asthma either you got it or you ain't, but an attack can be triggered by: Allergy, Infection or Psychological factors + Stress... or some combo of these.

 

[DimLeb]

@Joeseph Stope, well, my best friend has asthma and I know a bit of that. What I can say is that it's at least hopeful that the medical science keeps progressing and blames "stress" or whatever less and less, whenever it doesn't have the answers... I'm not surprised that they could blame the feelings of hate if you asked a doctor back then!

Not saying that psychological pathologies cannot trigger stuff, but our understanding of those mechanisms is still so limited that it cannot justify and correlate to things solidly, in my opinion. From my own case with mild tinnitus, it worsened (still mild though) on a period when I was creative, happy and generally well with myself. So yeah...

 

[Gb3]

I was at the happiest time of my life. Just got hired at the job that I will stay until I retire, expecting my second child, everything was awesome until suddenly one day I lost my hearing in one ear for no reason and along came this thing from Hell called tinnitus!

It has changed my life in so many ways, I'm frustrated, depressed and exhausted. I was one of the most happy go lucky people out there and now I'm stuck with this madness. It's not because I'm a hypochondriac. It's because I have a high pitched tone in my head that physically hurts to listen to sometimes!

Only people who have tinnitus bad know what it's like and if I saw the person who wrote this in person I would kick their ass!

 

[antonio77]

When I was in my mid-teens -- way back at the dawn of history, I can recall cycling into the city on my push-bike to the central library to find information about the causes of asthma. At that time I was suffering real bad from it. Unfortunately the library then had only two books on Asthma and the one I got dealt with the psychological triggers of asthmatic attacks by some American author. I peddled back home thinking my asthma attacks were due to some subconscious feelings of hating my father.

Them was the days.

FYI: Asthma either you got it or you ain't, but an attack can be triggered by: Allergy, Infection or Psychological factors + Stress... or some combo of these.

When doctors are arrogant and when they cannot respond to a disease, they invent that it is above all a psychological problem.

The problem is that they do not learn, you just have to look back in history and see when real diseases were considered psychological.

 

[Watasha]

I was at the happiest time of my life. Just got hired at the job that I will stay until I retire, expecting my second child, everything was awesome until suddenly one day I lost my hearing in one ear for no reason and along came this thing from Hell called tinnitus!

It has changed my life in so many ways, I'm frustrated, depressed and exhausted. I was one of the most happy go lucky people out there and now I'm stuck with this madness. It's not because I'm a hypochondriac. It's because I have a high pitched tone in my head that physically hurts to listen to sometimes!

Only people who have tinnitus bad know what it's like and if I saw the person who wrote this in person I would kick their ass!

Hang in there, and for goodness sake's don't donate to the ATA if you want the money to go all to research.

 

[DaveFromChicago]

To antonio77:

I could not have said it any better.

1) I recall that until 1973 the American Psychiatric Association regarded being gay as a psychological disorder and would urge gay clients to utilize all of their coping mechanisms to simply change into heterosexuals.

2) Before Prozac, (released in 1987) depression was regarded as being no more than the inability to have a correct, more optimistic interpretation about life.

3) Up until the late 60's many physicians in the US still believed that masturbation caused blindness, and would lecture adolescents about the necessity to suppress sexual ideation.

4) In the 50's many mothers of autistic children were so unfairly upbraided for being allegedly, psychologically alienated and cold towards them, which led to such fearful withdrawals.

 

[AfroSnowman]

I was at the happiest time of my life. Just got hired at the job that I will stay until I retire, expecting my second child, everything was awesome until suddenly one day I lost my hearing in one ear for no reason and along came this thing from Hell called tinnitus!

It has changed my life in so many ways, I'm frustrated, depressed and exhausted. I was one of the most happy go lucky people out there and now I'm stuck with this madness. It's not because I'm a hypochondriac. It's because I have a high pitched tone in my head that physically hurts to listen to sometimes!

Only people who have tinnitus bad know what it's like and if I saw the person who wrote this in person I would kick their ass!

I'm with you brother. The one thing that I try and fail but then try again and again is to push forward. If I fail in keeping a positive headspace or I realize that my patience or attention is less than it needs to be (this is the piece that recently has really got me spiraling) I try to remember not to blame myself but then pick myself up and try again. There is no cure, there is no treatment there is only how much we can grow to compensate for the additional burden.

It really does suck, but for me and I think this is an argument for it being driven by the symptoms not the mental state is I have a clear threshold to emotion response. When it is less intrusive or less loud (super rare event), I can completely shrug it off.

I would say that the long term impact of this pain has changed my thought patterns in ways that feel more like depression, anxiety, or neuroticism. Hell why else am I constantly on this site?

 

[Peter Q]

There's a lot more to neuroticism than just depression. I was the same way as you, never depressed, honestly I thought about how lucky I'd be in life to that point. The fact that I didn't have much to worry about I think played a role, now all of a sudden I have something to worry about it, and I can't change it! In fact, I've dealt with many not so great things but none of them affected me like tinnitus. It's almost as if a lever or switch was flipped in my brain.

I've always had a bit of "sticky" brain that gets fixated on things, I think that has played a significant role in the distress.

@Watasha, when you say you've always had a "sticky" brain that gets fixated on things, do you mean that you are obsessive-compulsive? It's interesting that you write: "The fact that I didn't have much to worry about I think played a role, now all of a sudden I have something to worry about". There is a very good book by the psychologist Tony Humphreys called 'Compassionate Intentions of Illness'. In it he describes how illness and distress is often a means whereby the psyche is calling our attention to some form of self neglect. A physical symptom can indicate that we are not meeting our true emotional needs.

 

[Watasha]

I have never been diagnosed with OCD, but have definitely had tendencies that I've talked about with professionals. For instance, it can take me a couple years to get over breakups. Or if I had a bad conversation that I'm afraid hurt someone's feelings, I'll ruminate about it on and off for the rest of the day, etc.

I'm most certain that I'm not meeting my true emotional needs, haha.

Does the book prescribe a solution?

 

[Peter Q]

I have never been diagnosed with OCD, but have definitely had tendencies that I've talked about with professionals. For instance, it can take me a couple years to get over breakups. Or if I had a bad conversation that I'm afraid hurt someone's feelings, I'll ruminate about it on and off for the rest of the day, etc.

I'm most certain that I'm not meeting my true emotional needs, haha.

Does the book prescribe a solution?

@Watasha, basically the solution would be to reclaim for yourself a sense of your own inner security and fullness. He sees tinnitus as being a metaphor for a sort of inner void and the noise of tinnitus being the sound of self criticism and harshness. Tinnitus becomes like the reverberations one hears in a large, empty metallic container. The only way to stop it is to become more full in your own sense of self and well-being by thinking about how to meet your real real emotional needs. For example, by not looking to the world for approval or to meet your needs.

 

[Watasha]

@Watasha, basically the solution would be to reclaim for yourself a sense of your own inner security and fullness. He sees tinnitus as being a metaphor for a sort of inner void and the noise of tinnitus being the sound of self criticism and harshness. Tinnitus becomes like the reverberations one hears in a large, empty metallic container. The only way to stop it is to become more full in your own sense of self and well-being by thinking about how to meet your real real emotional needs. For example, by not looking to the world for approval or to meet your needs.

It's a nice thought but I find it hard to believe. I'll check out the book if I make the time. Thank you for sharing.

 

[CDNThailand]

I promise you I was the least neurotic person you would have ever met before this happened to me. No history of depression. But this condition has messed me up pretty good. I function (though significantly compromised), socialize, continue to live life and do stuff, but I suffer an awful lot and this certainly takes a lot of joy and energy from me. For me the psychological conditions were 100% caused by an endless severe tinnitus. On the very rare day my symptoms are more modest I quickly regain my natural joy.

This is sadly my case also. I'm a jovialist, happy go lucky, party animal, womanizer, heavy metal guitarist.

Now I feel like a weak coward with no confidence... I was ok before my last worsening, I hope I can be myself again in the future...