So question................ why would you need to fix your WNGs if you are habituated???
I have a severe and unusual form of tinnitus so my ENT consultant and hearing therapist have told me. It is extremely variable. From complete silence, mild, moderate, severe and can reach extreme severe levels. It took 4 years for me to habituate for the 2nd time. Habituation can mean many things. No two people will experience it the same. Just because a person habituates it doesn't mean devices such as white noise generators, sound machines medications such as clonazepam (which I occasionally take) or antidepressants cannot be of use to help a person when they feel the need for them. Please read the posts below.
Michael
What does habituation to tinnitus mean?
Although I have written a post titled: Answers to hyperacusis and habituation, I would like to give my opinion of it again. I have read some posts where people believe when habituation is reached, the tinnitus is no longer heard but this is incorrect.
Put simply, habituation to tinnitus means one can live with the tinnitus and not be bothered by it. Although it may still be heard, the brain is not troubled by it. On the other hand, each person will experience habituation differently. For some, the tinnitus will reduce to a level where it is hardly heard and for others the tinnitus might be moderate, or even severe at times and the person is is able to cope and not be troubled by the noise. Habituation is about the brain accepting the tinnitus.
However, in my opinion, habituation does have its limitations. If tinnitus is severe and intrusive enough and this level is sustained for a period of time, the level of intensity can become too much for a person and they may need medication like Clonazapam (which I take) and is sometimes prescribed for people that have severe tinnitus. Clonazapam might not help everyone and if taken regularly, the body quickly habituates and more needs to be taken to get the same relief. Unfortunately, this drug can be addictive with unpleasant side effects, so monitoring by a GP is advised.
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.
Is habituation possible?
I have often been asked this question by many people that are new to tinnitus and those that have habituated for some time but have noticed a resurgence in it's severity, which hasn't calmed down and cast some doubt on whether it will return to it's manageable levels. I believe it is possible to habituate but it does depend on certain criteria. We are all different so no two people will experience tinnitus the same. It also comes in different forms and intensities, which will affect how a person relates to it and what their expectations are for the future, can make or break the habituation process.
It is not unusual for the newbie to want a complete cure from the cacophony of noise that has suddenly invaded their life like an unwanted interloper. Perhaps their Doctor has said those familiar words: There is no cure you'll have to get used to it. As far as the patient is concerned they're out to prove otherwise and will throw everything at it that they possibly can. The Internet is a vast source of information and they will endeavour to research tinnitus to the hilt leaving no stone unturned. Depending on where one lives in the world and the accessibility for suitable treatment is another factor.
Many people don't realize how complex and delicate the ear is until something goes wrong with it. Tinnitus is just one of many conditions that can affect the auditory system. It is for this reason, some ENT Drs are reluctant to intervene too early and prefer to wait for up to six months before offering treatment like TRT, CBT and white noise generators. Unless a person is experiencing additional symptoms such as dizziness, balance problems or deafness which could be an indication of another problem associated with the ear. Therefore, the most a person might be offered in the form of treatment is antidepressants, a sleeping draft or some counselling.
On the positive front: Tinnitus has been known to go away within six months sometimes a little longer and many people do habituate within this time and therefore, it's no longer seen so much of problem. The early stages of tinnitus can cause a lot of upheaval in a person's life, often making them emotionally unequipped to take on the treatments that I've mentioned, because they do require some calm, positive approach and the willingness to be patient.
By all means research tinnitus and gain as much knowledge about it as possible if that is your choice, but try not to put too much pressure on yourself or setting goals that at the moment might not be achievable. In the early stages, tinnitus can feel like you're riding a rollercoaster. One day you're up and the next day down. Enthusiasm can quickly turn into disappointment and despair. It is advisable in this instance to take things slow and easy.
To the person that has habituated for a while and noticed a tinnitus spike is lasting longer than usual and is showing no signs of settling down as it would normally. Try not to panic. As you know stress can cause this, for life is problematic and few of us go through it without having problems. On the other hand some people habituate to the point where their tinnitus is hardly heard. Under these circumstances it's easy to forget and throw caution to the wind. Have you been attending clubs, bars or gigs where music has been played loud and you haven't been using noise reducing earplugs? It is something to consider.
Have you been listening to music through headphones? Although the tinnitus hasn't bothered you passed, there's no guarantee that you wont be affected now even when played at low volume. Whilst it's good that a person habituates and carries on to lead a fulfilling life, it would be prudent to remember to protect one's hearing at all times or at least be conscious of it. I have been contacted by many people having habituated for a while and stopped using sound enrichment at night and noticed their tinnitus becoming intrusive again over a period of time. Others attending venues where music is played loud, and those using headphones.
My advice is to be careful in whatever you decided to do. If the tinnitus doesn't calm down after three weeks then I think it's time to ask your Doctor to refer you to ENT. Hopefully, you'll be put on a treatment plan. Since you have the experience of habituation and what this entails, it wont be long before you'll feel like yourself again.
I have habituated twice in the twenty years that I've had tinnitus, although the second time was more difficult and took longer it was still possible.
Michael
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