I don't believe that depression and stress/anxiety alone causes tinnitus. It doesn't make sense to me. I was depressed for a long time but never got it. I have it from loud noise/acoustic trauma. People are exposed to loud noises all the time and some people here have talked about 'hidden hearing loss.' I discovered that doctors and audiologists (the ones I talked to) have no clue what this is. These are supposed experts not knowing at all?Then it means that the acoustic trauma and other causes of tinnitus has nothing to do with lesion in strutures of the auditory system?
I was treated at a psychiatric clinic for depression and anxiety caused by tinnitus. This clinic with five psychiatrist and many patients, only treat people with depression and anxiety and I was the only person with tinnitus. Many didn't even know what was tinnitus and doctors were treating a person with tinnitus for the first time in more than ten years.
I think people who are depressed and/or stressed/anxious had acoustic trauma along the way and the combined 'brain rewiring' which is assumed to occur with what depression/stress does instigates the tinnitus - in other words, made it worse. Many people have very mild forms of tinnitus - from hearing loss as they age or get exposed to loud noise/sound. As the hair cells are damaged or dying, it comes to a point in which too much damage occurs and the tinnitus worsens. This is just my theory from reading several reports on tinnitus and hearing loss.
I suppose ototoxic drugs also plays a factor but I wish researchers/scientists would also look at prescription drugs and people's mental states as it relates to the formation or presence of tinnitus. It seems to me that the worse forms/cases of tinnitus is due to acoustic trauma combined with hearing loss.
As for protecting ones ears - I realize that the hearing field/community/doctors say that you need exposure to sound and they often encourage tinnitus sufferers not to over protect but acoustic trauma to an already affected tinnitus sufferer is serious and dangerous. I have read posts of people who already had tinnitus being exposed to yet another loud noise and then posting about spikes and changes. I have also had this experience - I was over protecting but then decided to go into a store without plugs after an audiologist insisted that I should allow normal sound experiences. That turned out to be the worst advice possible which I have read on here so I disagree with those who said to not use plugs/muffs. It has ruined my life.
The only reason that plugs/muffs might not be good is that it can cause inflammation - my inner ear canal is inflamed in my left ear from foam plugs. I also worry about what muffs might be doing. I am wondering what ear plugs are good to use that won't cause inflammation - from over use. I am not using them all the time but because random loud noises can happen at any time, anywhere, I wanted to use them at times to avoid potential setbacks and further damage. In this situation, as a tinnitus sufferer, the expression 'damned if you do, damned if you don't' comes to mind. :-(