Tinnitus vs. Tinnitus + Hyperacusis: Some Basic Differences

[RaZaH]

Man...you are strong , I could not deal with anything more than my T .
I'm impressed, hope that is not the wrong thing to say.

 

[Marlene]

I love your postings Michael ,what good answers you place ,you do the homework ,you prove that before posting .,get going on those tips and tricks ,be of great interest to us .Hope your keeping well

 

[Zimichael]

@Marlene ... Not ignoring your request here, just been side-tracked with other issues and recurrence of one of my long puzzling 'medical mysteries' (pain = a drain).
By the way, I don't do any "homework" on stuff like this T and H, etc. I live it, so it's just easy "reporting" so to speak. I have to reserve 'homework' for the intricacies of figuring out neurology and Retigabine!

One of the things I wanted to get clearer in this thread was the "body" v. "mind" aspect of dealing with and understanding sound reactive T/H. Simply speaking, it's easy to talk about mind over body and all that, but decent amounts of chronic pain for instance can have most of us re-evaluating the idea. Sons of God aside, etc.
So when the "body" is reacting in such a radical fashion as it can do with sound reactive T/H then it gets damn hard to overrule that with the mind (habituation, etc.). Kind of like when the doc used to hit one's knee with a rubber hammer (do they still do that these days???) to test reflexes or whatever. As kids we thought it was such a 'kick' that one's leg kicked out every time, no matter how hard we tried to stop it.
Same dealyhick with what I refer to as sound reactive T/H. Makes it somewhat of a "physiological" issue, to me, despite the 'theory' that it's all in your head so your head can get over it, etc. Ahhhhhhhhhhh....not so fast!
I wrote this up in a really badly worded thread a while back but want to simplify it and add it here to make a kind of 'completion reference'. But not today.

Take care, Zimichael

 

[Natalie Roberts]

Billie... Yeah, the lack of 'realization' about hyperacusis riding along with tinnitus (especially at the beginning of T onset) is one I see being missed just about every day in new posts here. UNDERSTANDABLY!!! Like I said, it was only when I got to volume level III in 2006 that I realized what hyperacusis was or that it even existed., and I had had tinnitus for 50 years by then!
But like you, it sure added a lot to the anxiety and suffering as my ignorance of it did not help at all. No TT Forum back then to enlighten me!

Anyhow, for general reference, as this was not in this post, I'd like to clarify a point... My hyperacusis seemed to go down/calm down/ease off, about 10% per year. In retrospect it was pretty darn steady and stable in that rate. This was true irrespective of some inevitable 'spikes' and situations that amped up my tinnitus volume temporarily along the way.

My tinnitus volume however, at any of the "levels" (now at stage IV), has never gone down...Once a baseline is established, it stays there. For me! There is a very high likelihood that this will be different for others.

So this is good news and bad news in a way. Good news in that the hyperacusis seems to be sort of independent from the T and just does it's own easing off thing. Which is great, as for sure it is the tougher of the two to deal with in terms of trying to live a more normal life....That "quality of life" aspect.
The bad news (in my case) is that the T volume has remained at the new higher baselines each time...BUT, and this is a somewhat qualified "but"...The good news is that plain T can eventually become the equivalent of one's own "silence". Which in essence can mean it does not really bother you. It is just "there". Classical habituation. Yeah, even with insanely loud levels internally.
If I stop and actually listen to my tinnitus, I just am in awe of how darn loud it is. My comment to myself is always: "This is just INSANE, who could put up with this?!" (See "Eyes Like Saucers" post if you want an idea of loud baseline volume is). Yet somehow my brain sort of, kind of, maybe most of the time, after a while (years), adapts to it enough that I am not thinking about going into a gun store to end it all.

So back to the Hyperacusis + T, and super common posts that refer to habituation...Getting to where the T does not rule your life any more. Being able to go out and do stuff again. Realizing that the T level/volume comes down after a spike. Maybe changing jobs to a quieter profession but now all is good and don't notice the T hardly at all. And so on.

All these are great! It's the goal. The: "Don't react to the T instead work on your reaction to your T"...100% valid. Totally relevant. Totally true. But at the risk of sounding like a stuck record...For those with hyperacusis along with their tinnitus, in a way you are dealing with two conditions. Definitely intertwined. Definitely subject to similar 'laws' (for want of a better word). However, if you realize you have two conditions not just one, my strong belief (and experience) is that it will make the road ahead a lot easier to navigate, reduce the inevitable anxiety and setbacks that accompany that, and increase the ability to believe in regaining a "quality of life" that feels totally elusive at the onset of this darn condition.
Educate yourself about hyperacusis if your tinnitus seems to be overly "reactive". All the info you need is on this site. You can debate with yourself and your own experience as to whether you go with the "over protection" route (rest the ears) v. the "stimulate with sound" route. You sure as hell will find out soon enough which one you can tolerate in the early stages. Then take it from there.

Hope this helps. Best... Zimichael

I'm not sure if I have hyperacusis with my T or if it's just reactive T. How do I know the difference? My T prefers being in quiet rooms or with soft music playing, no electronic sounds etc. usually when I watch tv or listen to my car radio my T gets louder as if it's trying to compete with the external noise. It doesn't hurt my ears, it's just very annoying and makes me want to avoid watching tv. I only watch a little tv now in the evenings with my partner we maybe watch an hour or two and I just put up with the extra ringing noise. I don't listen to music in my car or I turn the volume very low. I have been advised to use a sound machine at night but found it irritating as my T reacted and was louder with that also. I do plan to turn it on low volume and try again.. Any suggestions with my type of T? Is it hyperacusis?

 

[PaulBe]

Sounds like very reactive tinnitus Natalie.

 

[Natalie Roberts]

Sounds like very reactive tinnitus Natalie.

Thanks for your input

 

[Mark Beehre]

I'm not sure if I have hyperacusis with my T or if it's just reactive T. How do I know the difference? My T prefers being in quiet rooms or with soft music playing, no electronic sounds etc. usually when I watch tv or listen to my car radio my T gets louder as if it's trying to compete with the external noise. It doesn't hurt my ears, it's just very annoying and makes me want to avoid watching tv. I only watch a little tv now in the evenings with my partner we maybe watch an hour or two and I just put up with the extra ringing noise. I don't listen to music in my car or I turn the volume very low. I have been advised to use a sound machine at night but found it irritating as my T reacted and was louder with that also. I do plan to turn it on low volume and try again.. Any suggestions with my type of T? Is it hyperacusis?

Tinnitus is quite dramatic in its first months. Any number of things can happen from a change in pitch, a change in loudness or complete silence. Your hearing pathways are reacting to outside stimulus and sending messages to the brain generating the tinnitus sensation. Tinnitus that reacts to sound is quite common and often happens in the first year of having tinnitus. As time passes your brain tends to reorganize the stimulus being sent by your ears and the unusual reactions start to happen less and less eventually disappearing. In saying that the original tinnitus generally remains.

Your desire for a diagnosis is not uncommon, but finding the answer is unlikely to make your tinnitus any better. Because you are only one-two months into your initial outbreak of tinnitus I would recommend you give it time. For most people reactions and habituation come after the 12 to 18 month mark.

 

[Natalie Roberts]

Your desire for a diagnosis is not uncommon, but finding the answer is unlikely to make your tinnitus any better. Because you are only one-two months into your initial outbreak of tinnitus I would recommend you give it time. For most people reactions and habituation come after the 12 to 18 month mark.

Thank you for the information. The ups/downs/silents of this are super frustrating as is the reactiveness but I'm hoping it will improve with time. My ENT said it may go away after pregnancy is over (8 more weeks) or after breastfeeding if it was pregnancy induced since they just aren't sure (as in many cases) so I am trying to remain hopeful that that is the case. She said there are known cases of pregnancy inducing this but can't say for sure since my audiogram also showed very mild hearing loss in the upper ranges, which I was completely unaware of.

 

[Zimichael]

@Natalie Roberts ... Just to add a little more here regarding your:

I'm not sure if I have hyperacusis with my T or if it's just reactive T. How do I know the difference?

A lot of this is covered in my posts in this thread as it gets a bit "complex" to figure it out. Maybe go over those four descriptions in post # 27 again and you will see the differences in what I have managed to figure out/discern are the differences in T, and H, and T + H.

However, before a kind of summary for you specifically, I want to get a little 'pedantic' about the reference to "Reactive Tinnitus"...Reason being, that some time back, Nagler created a whole Broadway drama production based on this choice of words, as he reported that he got "reactive tinnitus" from eating Thai food, every time. But, because he was such a superhero (or whatever) he absolutely refused to let that stop him not living life to the full with tinnitus and enjoying Thai food...Code for this, from my interpretation, was: "Reactive T is no big deal...get over it!"
Well, I agree if:
1. One has a choice in the matter in relation to 'getting' a reaction.
2. Said reaction goes back down as you poop out the Thai food, and it is thus TEMPORARY...and consistently so.
This becomes a whole different ball of wax if such 'reactive increases' say, did not go down, and T volume increased permanently with every 'event'. I would postulate that seeing Thai restaurants may even cause some phobia, or angst, and trips to Thailand would be in the: "Never!" category.

OK, so most of us here consider "Reactive T" to be from exposure to sound that triggers more or increased T, be it short lived (once removed from the sound, or after a good nights' sleep, or whatever)...or permanent. And I assure you that "permanent" increases in T are possible. *[Just look at my Profile/Information tab].

So...to avoid theater productions over semantics, I adopted the more accurate term "SR-T" = "Sound Reactive Tinnitus" to describe jumps in T volume ascribed to sound. Increases in T from Thai food; coffee; MSG; chocolate; sex; etc., etc., etc. do not count as "SRT".

Hence what you are inquiring about in your situation is "SRT".....Fair enough???

From your description it sounds like you have somewhat sensitized "SRT" and maybe some H along with it. (Read those earlier breakdowns in post # 27). Your T volume goes up when you are in certain sound environments...thus QED, proves the SRT equation.

My suggestion is: Don't push it! You could end up with permanently louder T. It is possible, though fortunately not the norm.

With regard to H...I have described somewhere much better than I am going to do now (I have too many past posts on all this and can't find it), what "H feels like" versus SRT.
For me...it is akin to a kind of "bruising" feeling inside the ear area 'somewhere in there'. A sort of dull, aching, semi-nerve-ouch-ugggghh-uncomfortable feeling trauma vibe. The "discomfort" is not like a sharp pain for me. Not like sticking a knife point into my arm. It's more like getting punched in the gut with the after-bruise sensation, as against the in initial "punch-ouch!" part.
There is a strong correlation with an almost intuitive sense of: ALERT! ALERT! Damage is happening, or may start to happen!!!...But, and this is a very cruel "But"...This H damage can happen to me without this 'alert', or even knowing it is happening - if my consciousness was elsewhere (involved in the conversation or sound medium) or it was just too darn subtle to pick up at the time as "Volume" was not loud enough to warn of it. The damage to the H came, as I have previously stated,...from "Exposure Time Accumulation" to the sound source.
And yes, permanent damage. (See 2102 and 2015). Permanent and long lasting loss of prior sound threshold tolerances.

Indeed, like I explained above, this H damage need not be permanent...but what if it is???!!! How will you know until after the fact...Then let me tell you the: "If only I had not...." remorse is a killer.

My advice, is be careful. Go slow. There is NO RUSH when there is potential to lose YEARS of very painfully gained ground, or future loss, of that final yardstick with all with this T/H stuff...Quality of Life.

Take care, Zimichael

 

[Natalie Roberts]

Zimichael,

Thank you for your post. Sound reactive t does sound like what I am dealing with for sure. I will take your advise and continue easing into things. Like I said, I do use ear plugs on occasion and just purchased noise reducing ear plugs for loud things where I still need to what conversation and what not. I will listen to my body and try to do things that do not make my T worse. Yesterday while watching TV my T did react and get pretty annoying but after a little while I was able to tune out my t so I took that as a good sign but didn't push it too much.

Again I appreciate your advise.

 

[Zimichael]

@Natalie Roberts ...

Again I appreciate your advise.

You are welcome...

Plus remember one other very important thing. According to your Profile you got T in October 2015...That is basically "zero time ago", versus say 59 years and counting. If you play it smart there is complete justification in believing that you will adapt to this in the not too distant future. And in the scale of things, a year or 18 months is not that long, if that's how long it takes.
My caution again though, is that I suspect people who get SRT (versus non reactive 'normal' T) or added H, may be a bit more susceptible to repeat damage in the future. Just a theory. Maybe our genetics, or ??????

So take care, and best to you... Zimichael.

 

[Natalie Roberts]

@Natalie Roberts ...


You are welcome...

Plus remember one other very important thing. According to your Profile you got T in October 2015...That is basically "zero time ago", versus say 59 years and counting. If you play it smart there is complete justification in believing that you will adapt to this in the not too distant future. And in the scale of things, a year or 18 months is not that long, if that's how long it takes.
My caution again though, is that I suspect people who get SRT (versus non reactive 'normal' T) or added H, may be a bit more susceptible to repeat damage in the future. Just a theory. Maybe our genetics, or ??????

So take care, and best to you... Zimichael.

Yes, it started up just before Halloween so I think I am going on roughly 5 weeks. I don't know if I mentioned it to you specifically or not but they think mine is caused by either pregnancy or mild hearing loss (by my audiogram results) but of course they aren't sure. I have had zero exposure to excessively loud noises, concerts etc. I HAVE been under a great deal of stress this last year which I'm sure played a part in it all. The ENT suggested that if it is pregnancy related it should resolve sometime after giving birth/ceasing to breastfeed, otherwise I will adapt as everyone here has done. It is very new onset T in the scheme of things, I realize. I have had about 5-6 good days in the past 2 weeks where my T was super quiet and I almost could not hear it at all. A few days where I actually didn't hear it at all and where the reactivity was really low. Yesterday is a perfect example. I could hardly hear the T all day and it reacted at a MUCH lower level to the tv then normal. Today so far the volume has also been very quiet and tolerable. I am also able to control my panic/anxiety towards it most days. I am taking these good days positively that my T very well may continue to disappate or improve. Trying to stay positive, better then being negative and freaking out all the time, right?