Tinnitus Increasing in Response to External Sounds

[Paulie87]

Hi All,

Let me start by saying I've been dealing with tinnitus for 15 years. For the most part, it's been more of an annoyance than a life-altering issue, and I've gone long stretches without even noticing it.

Recently, I experienced an extremely stressful few months (unrelated to tinnitus) that led to a hospitalization and a change in my medication to Zoloft. Shortly after, I came down with a bad case of the flu and was congested for a week. After a week on Zoloft, I found the side effects intolerable, so I stopped and switched back to Prozac.

Then, about five days ago, while watching TV, I had a sudden, loud episode of fleeting tinnitus. This incident made me start focusing on my tinnitus again after all these years, and now it seems like I'm hearing it everywhere.

The pitch is extremely high, and honestly, in a quiet room, it's probably not much louder than it's been for years. However, the real issue is that my brain seems to be stuck in a cycle where I hear it constantly, and it intensifies with any external noise.

I went to an audiologist today, and we both agreed that while my tinnitus is a very high pitch, it's relatively low in volume. But as soon as I stepped outside into the shopping center, it felt like the tinnitus was louder than all the surrounding noise, and the same thing happened in the car on the way home.

Now, lying in bed, I'd rate it about a 2-3/10 (annoying but manageable). However, I know that if I get up to watch TV, it will compete with the sound of the TV and jump to a 6-7/10. It's driving me crazy.

Has anyone else experienced this? I feel like walking around with earplugs might help since I've habituated to my normal tinnitus, but it's this "ramping up" that's really getting to me. It feels like my brain is, for some reason, amplifying the tinnitus whenever there are competing sounds. I'm wondering if all the stress, anxiety, and medication changes have triggered a fight-or-flight response, causing my brain to perceive this sound as a threat and amplify it.

I'd really appreciate any advice or insights you might have.

 

[Marcello]

Hello,

One thing we can say for sure is that tinnitus is unpredictable. However, in your case, there may be certain factors contributing to its reactivity.

The stress you mentioned can alter brain chemistry and affect the perception of the auditory pathway. Believe me, tinnitus thrives on stress and tends to react strongly to it for most people. Stress can also impact the muscles in the neck, jaw, and head, which may trigger increased reactivity as well.

Additionally, changing medications—particularly those that affect serotonin—can temporarily disrupt neurotransmitters, potentially leading to some reactivity. This disruption is usually short-lived when stopping or adjusting doses.

The flu you experienced could also have affected your auditory system, either causing or intensifying existing tinnitus to some degree.

In any case, it's important to consult an otorhinolaryngologist to ensure there are no underlying issues. That said, this reactivity is often temporary and tends to subside as you gradually expose yourself to sounds in a gentle and controlled manner. It seems to be more related to how the brain processes sound rather than any actual damage to the auditory system.

Please note, I'm not a doctor—this is just my opinion. Be sure to discuss your situation with a medical professional.

Best wishes to you.

 

[ECP]

I'm really sorry to hear that. Many people on Tinnitus Talk experience the type of tinnitus you're describing. While it may not have an official name, most here refer to it as "reactive tinnitus" because it becomes louder or changes pitch in response to real-world sounds.

I recommend searching for "reactive tinnitus" on Tinnitus Talk. It will lead you to many discussions about how others are managing their symptoms. Best of luck to you!

 

[Paulie87]

Thank you so much, @Marcello and @ECP. I had terrible hyperacusis when I first developed tinnitus, but it settled down after about six months. I've habituated to tinnitus a few times now, so I know I can do it again. However, this new sound is so high-pitched that only crickets or running water can mask it. When I measure it, it's around 12 kHz and cuts through everything.

To be honest, for a long time, I would only notice my tinnitus when it stopped for a few seconds, and I suddenly realized the world was quieter than what I had been hearing.

A year ago, I witnessed my wife have a massive seizure at night, and she was later diagnosed with a low-grade brain tumor, which we now have to monitor constantly after it was removed. About a month ago, I was hospitalized briefly due to stress (not tinnitus), and that's when my medications were changed. A few days later, I contracted a bad influenza A infection, which left me partially deaf for a while. Soon after, this new tinnitus started. Now my hearing is fine, but the loud ringing is constant.

It seems like all the evidence points to this being a spike, but why does it have to be so reactive and high-pitched? It's rare to hear anything this high-pitched in the outside world, so I hear it everywhere. I also have a lot of pressure sensitivity at the moment, so my ENT is planning to put grommets in soon, as they've helped me a lot in the past—especially with the allergy season approaching where I live.

The psychiatrist prescribed me Mirtazapine, which I started last night. While it hasn't reduced my tinnitus yet, it has made a huge difference in alleviating the suicidal feelings I was experiencing. Now, it feels more like a massive annoyance, rather than something that triggers severe nausea and distress.

 

[Nick47]

@Paulie87, reactive tinnitus is a nightmare. It appears to be a subset of pain hyperacusis, which is caused by afferent type 2 nerve fibers following damage to the outer hair cells in the ear. Unfortunately, this condition is often missed by traditional audiograms.

Instead of SSRIs, treatments that target nerve pain—such as tricyclic antidepressants, anticonvulsants, or anti-inflammatories—are more effective options. A low-dose combination of these treatments may also be beneficial.