Writing this now, with my Spotify Peaceful Piano Playlist gently playing soothing background music, I can still hear a high-pitched hissing noise in both of my ears. It's there all of the time; never goes away. Usually, it's a single, constant whirring noise. At other times it changes pitch or other sounds pop in and fade out again. And while the ringing in my ears often varies, currently my ability to cope with tinnitus largely remains unchanged. But it wasn't always like this. Rewind one year ago and things were very different.
I'd had temporary bursts over tinnitus over the past decade: I'd suddenly hear high-pitched noises but they would then fade down to zero again within a few seconds. However, one day, that familiarly shrill noise came in but didn't stop: I was now living with chronic tinnitus and would (probably) have to learn how to cope with it for the rest of my life.
I can clearly still recall the fresh hell of developing chronic tinnitus after a period of extended stress: the realization it will probably never go away; trying everything to drown out the sound; the sleepless nights, trying (yet failing) to focus on work. Unfortunately, in addition to developing tinnitus I also experienced hyperacusis, a condition in which your ears become super sensitive to sound. Listening to someone handle cutlery or plates was enough to send me over the edge.
When tinnitus first becomes chronic, your brain immediately switches into alarm mode, imaging the internal noise as harmful or dangerous. Furthermore, focusing on anything else apart from the ringing seems like an impossible task. Like me, you may experience panic, anxiety, depression and anger as you try to cope with tinnitus symptoms. You may think to yourself: ’why me?’ And you will probably ask yourself many other questions about your tinnitus too: ‘Will it ever stop?’ ‘Will it get louder?’ ‘Am I going deaf?’ ‘Am I stuck with this for the rest of my life?’
While it all feels pretty dark in the beginning, I'm here to tell you that there is hope on the horizon and that living with tinnitus is possible. Indeed, if you've recently been struck down with tinnitus and are struggling to cope, please be assured: you should see improvements with time and start to feel better mentally about it. However, if you're currently feeling like it’s an emergency or having dark/suicidal thoughts, please seek help ASAP from your healthcare provider.
The hyper-alert state you experience with tinnitus can last many weeks or months. However, day by day your brain begins to get used to the strange new sounds you're hearing and will gradually begin to get used to them. This process is called 'habituation' and just knowing that it will happen naturally can help you to learn to deal with your tinnitus.
Indeed, I – and millions others across the world – are proof of that. A year after being diagnosed with chronic tinnitus I am coping with it much better. Of course, like everyone else I have good and bad days (so-called tinnitus 'spikes' – increases or drastic changes in pitch/loudness – can be a challenge), but my condition currently doesn’t impact on my happiness to a great extent.
It's important to point out that the internal sounds those of us living with tinnitus experience are all different. Although the level of my ringing is bothersome, it is not unbearable. This may change in the future. I've read stories of people that experience ringing at extremely high sound levels: that, of course, must make the condition more challenging and impact on a person's ability to cope with tinnitus.
However, whatever type of tinnitus you are experiencing, there are many practical steps you can take to cope with tinnitus and make it less intrusive in your life. Here are 10 tips to get you started.
The first step in coping with tinnitus lies in acceptance of the condition. However, this is often easier said than done in the beginning. As much as you may want to fight against the ringing in your ears – especially during those first traumatic weeks or months – doing so will only lead to disappointment and frustration. While some people experience temporary tinnitus because of trauma to the head or an ear infection, those of us with chronic tinnitus are usually stuck with the noises for life (saying that, there have been cases where people's tinnitus appears to have vanished).
Accepting your condition is essential for you to be able to deal with tinnitus. Essentially, you first need to know if your tinnitus is temporary or chronic and if you have any hearing damage. Visit a high street ophthalmologist or ask your GP to refer you to an ear, nose and throat (ENT) specialist.
The anxiety you feel when first getting tinnitus is to be expected but it will only make you feel more stressed, and, in turn, exacerbate tinnitus. Indeed, it's believed that stress really impacts on tinnitus, so it’s important that you reduce any stressors in your life to keep tinnitus levels in check. In fact, many people living with tinnitus use their condition as a barometer of their stress levels – if their tinnitus appears to be worsening, it’s a signal something in their life is out of balance.
“Many people coping with tinnitus use it as a barometer of stress – if their tinnitus appears to be worsening, it’s a signal something is out of balance.”
Relaxation is obviously a key way to combat stress and therefore improve how you deal with tinnitus. Practising meditation and conscious breathing exercises are practical and simple tools you can use to immediately reduce anxiety and stress. Incorporate both into your daily routine to feel the benefits.
Also, be sure to spend as much time in nature as possible. As well as the relaxation and proven mental health benefits of forest bathing, the sounds of nature help to soothe that pesky tinnitus ringing. The crashing of waves; the rustling of branches and leaves, bird song – the many noises of nature offer your ears and brain a calming distraction.
Sea sounds help to mask tinnitus noise shutterstock/Monkey Business Images
Making mindfulness a part of your daily routine is one of the best things you can do when it comes to coping with tinnitus. Mindfulness won't make tinnitus go away, but it aims to make it less intrusive. Indeed, mindfulness teaches us how to live with difficulties such as tinnitus, without having to fight or change them. Practising mindfulness can help us help us to develop a better relationship with our tinnitus, aiding the habituation process.
In 2017 the British Tinnitus Assoctiation published two research papers that showed that mindfulness-based cognitive therapy (MBCT) is an effective treatment for those people living with distressing tinnitus. The results showed that tinnitus patients undergoing MBCT were associated with significant, reliable and ongoing improvements in their tinnitus-related and emotional distress.
Luckily, mindfulness is something we can all practise by ourselves and for free. It involves paying complete and mindful attention to whatever we're doing in the moment: breathing, eating, showering, walking or noticing the physical sensations in our body, for example. We have some great mindfulness tips you can incorporate into your daily routine to help you to become less focused on your tinnitus.
Personally, experiencing ‘flow’ is the most efficient way to cope with my own tinnitus. 'Flow' is that state in which you are so totally absorbed and engaged in an activity that you enjoy that time seems to stand still. For example, I find my flow when I'm making an artwork or editing an article.
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Sometimes my attention is so focused in the state of flow that it can seem like my tinnitus has stopped (for a while at least!). Flow is really an act of mindfulness, and as outlined above, mindfulness is one of the scientifically-proven best ways to deal with tinnitus.
Finding your flow is one of the best ways to deal with your tinnitus as it helps to shift your awareness to something other than the internal noises you are dealing with. Similarly, I find that staying busy – in a non-stressful way of course – keeps my focus off of my tinnitus so it’s easier to cope with. Sitting around in silence is when tinnitus may start to bother you the most, so staying active and on-the-go helps to keep it stop dominating your mind.
OK, we all know the drill about exercise: it boosts your physical and mental health, helping to lift depression and anxiety (which you could be more vulnerable to if you are living with tinnitus). Exercise also combats against stress which, as explained above, is a major influencing factor when it comes to tinnitus levels.
Yoga, in particular, is an exercise that has been found to help people cope better with tinnitus. A small 2018 study from Mersin University in Turkey indicated that practising yoga may reduce life stress and symptoms of tinnitus.
Researchers followed 12 participants who practised guided yoga over three months involving poses, breathing exercises and meditations. The researchers hypothesized that because tinnitus symptoms are often linked to stress, and because yoga is stress-relieving, yoga may help decrease symptoms for patients living with chronic tinnitus.
“Good sleep is essential when it comes to coping with tinnitus. Our bodies need sleep to heal and recover. When I have a bad night’s rest my tinnitus always seems louder the following day.”
Elsewhere, Polish researchers conducted a similar study in 2019. It followed 25 patients with chronic tinnitus through 12 weeks of yoga training. The researchers identified that participants benefitted most from improved sense of control over tinnitus, lessened intrusiveness, improved quality of life and better sleep.
The last point of improved sleep is important (as we shall see next). Importantly, whatever exercise you choose to do, working out will help to tire your body and lead to an increased chance of falling asleep quickly.
Yoga is a perfect way to shift awareness shutterstock/Ulza
Good sleep is essential when it comes to coping with tinnitus. Our bodies need sleep to heal and recover. When I have a bad night’s rest, my tinnitus always seems louder the following day.
However – as you will no doubt know – sometimes falling asleep can be difficult for those of us with chronic tinnitus. That’s because tinnitus appears to sound worse at night – there are fewer external noises to mask the internal sounds, so we may have 'external' silence but have to put up with our 'internal' noises.
One thing I love to do to help shift awareness from my tinnitus when going to bed is follow a body scan meditation script. Gradually tensing and releasing different body parts and feeling the sensations it brings directs your thoughts away from your tinnitus and to those other places in your body.
You can also find ways to externally ‘mask’ your tinnitus sounds at night to help you drift off more easily. In my first few months of living with chronic tinnitus, I used mobile apps such as the excellent T-Minus to play 'white noise' such as rain sound, which works wonders balancing out my high-pitched tinnitus. There are also plenty of great YouTube videos of rain sounds that you can play in the background while you're in bed.
Sound-masking devices such as the apps mentioned above provide an external noise that partially drowns out the internal ringing of tinnitus. As well as using apps you can also try:
Furthermore, if you have hearing loss in addition to tinnitus, there are now hearing aids with inbuilt white noise generators which help many with the condition cope with tinnitus symptoms.
Whatever masking method you choose, always set the volume of the device a notch lower than the perceived sound of your tinnitus – you don’t want to drown out the sound completely or you may find it harder to habituate.
It’s important to remember that you don’t have to cope with tinnitus alone. As the number of people who live with persistent tinnitus is thought to be around 13 per cent, there’s a chance someone in your close circle is going through the same thing. Open up to family members and friends, or put your thoughts out on social media if you feel comfortable sharing your tinnitus story – you may be surprised by the responses.
However, friends and family may not be able to support you unless they have experienced tinnitus themselves, so they may not realise how distressing tinnitus can be (or even know what it is). If this is the case, do connect with someone who has dealt with tinnitus themselves in order to get the help you need. In the UK there are tinnitus support groups up and down the country where you can meet in person to discuss living well with tinnitus.
“Tinnitus can dramatically impact on your quality of life and can be hard to adapt to. However, as with everything in life, we can choose how we react to it.”
The internet is also full of tinnitus support groups and forums such as the excellent TinnitusTalk forum which is full of useful and insightful threads. However, do so with caution! Be careful when browsing for tinnitus help online as you will come across many dubious ads for methods or items claiming to stop or cure tinnitus. Unfortunately there is no cure for tinnitus, so please don't waste your money.
Finally, if you prefer a friendly voice in real time, the British Tinnitus Association offers a confidential tinnitus helpline. You can call its team for support.
This final suggestion may seem like the last thing you want to do, but it actually brings us right back to the first tinnitus coping tip of 'acceptance'. Depending on your personal tinnitus noise level, you may find it beneficial to employ some mindfulness techniques and simply sit with your tinnitus for a while. Try to listen to it with curiosity and without judgement.
Take some time to observe your tinnitus and ask yourself some questions about it. Does your tinnitus noise level stay the same or does it get louder or quieter? Does it stay at the same pitch or do you hear new sounds come in and out? Does it sound the same in your left and right side?
If you feel comfortable and ready for this type of exercise, you can even sit and meditate on your tinnitus, bringing all your attention to the sounds and your breathing. Exploring your tinnitus in this way may seem difficult if you've bee recently diagnosed with the condition, but realizing that tinnitus is just 'there' and cannot harm you can help you to cope with its day-to-day symptoms.
Tinnitus can dramatically impact on your quality of life and can be hard to adapt to. However, as with everything in life, we can choose how we react to it. If we fight against our tinnitus, we are more likely to struggle.
But, if we learn to accept it and live with it, habituation to tinnitus can become easier. Whatever type of sounds you experience – hissing, whistling, humming or buzzing – by following the ten tips above, coping with tinnitus should become easier. Hopefully, as is the case with myself, tinnitus will just become another part of your life, and not a dominating factor. •
Main image: shutterstock/aleks333
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