Can anything cure the merciless misery of my full-blown tinnitus?
There’s a constant hissing in my right ear — like a pressure cooker letting off steam. Sometimes it changes to a high pitched whistle, like a stovetop kettle on the boil. Hissing or whistling, the sound rarely goes away.
I’ve had full-blown tinnitus for over a year now, and it’s taking over my life. Noises which used to occur only occasionally have become relentless. They accompany me on peaceful country walks, disturb dinner with friends and even interrupt when I’m watching a movie.
I can’t just pop a pill to get rid of it. It’s getting to the point where I would treasure a moment of silence.
Although researchers are starting to understand more about tinnitus its precise cause remains a mystery. The sounds that I and others hear are thought to be generated by overactive nerves in the auditory pathway which runs from ear to brain. Sufferers describe the sounds as buzzing, ringing, humming, hissing, whooshing, roaring — one unfortunate compared it to a “jet engine in the head.”
Tinnitus may be present all the time — or it may come and go. It may seem to come from one ear, or both — or from the middle of the head. Although more common after the age of 40, it affects all age groups, including children. It also affects both sexes, although women tend to hear ‘more complex sounds’ than men.
I’m not sure what caused my tinnitus, which I’ve had on and off since my mid 50s (I’m now in my early 60s). Exposure to loud noise is one established risk factor, but I was never one for ear-splitting gigs. However I do sing soprano in the local choir: could those piercing top notes be to blame? Emotional upheaval is another known trigger. Maybe my tinnitus is related to the stress of the last year, when we sold the family home?
An estimated 6 million people in the UK have the condition, 1 per cent of whom are severely affected, according to the British Tinnitus Association. Many sufferers feel quite desperate, judging by the number of online forums on the topic. A range of online pills and potions help feed that desperation, including homeopathic sprays and drops, herbal supplements such as gingko, a battery operated “tinnitus massager” and an at home tinnitus ear laser treatment, costing a hefty £300. All unproven to help, according to the BTA. “We would want more evidence that any of these work,” says chief executive David Stockdale.
So far, I have stuck to self help therapies. I meditate regularly to help me relax, especially at night when tinnitus keeps me awake. And to avoid my catastrophist tendencies, I also do DIY cognitive therapy, telling myself that tinnitus is rarely a sign of anything serious. There is good evidence that CBT can help, as anxious thoughts about the sounds can make them seem louder and more invasive.
More recently, I’ve downloaded a free app which claims to help tinnitus by generating white noise (as well as pink noise and brown noise, the “colour” of noise being related to the spectrum of sound frequencies). Dozens of similar sound apps are available and some people swear by them. As I write, I’m plugged into “pink noise”, which sounds like a waterfall and is oddly comforting. Temporarily my tinnitus disappears but once the earphones are out, my self-generated noises come back with a vengeance.
In fact, my tinnitus has worsened since I began researching this article. Which, according to Mark Williams, chief audiologist at Harley Street’s Tinnitus Clinic, only goes to show just how far the brain reacts to the importance we attach to the condition.
Mr Williams explains that in most cases, tinnitus develops after hearing loss (which is why it is associated with age, exposure to loud noise and ear infection), especially loss of the higher frequencies. “It’s a bit like a piano where keys at the higher end of the scale don’t work any more,” he says. As the brain receives fewer signals from the ear, nerve cells in the auditory system go into overdrive to compensate, creating sounds that the brain “hears”.
However, Williams says it’s also vital to look at stress and the patient’s emotional response to their tinnitus.
“Tinnitus often first appears after some ‘negative life event’ associated with ‘excitatory’ emotions such as anxiety or anger — less so with depression,” says Williams.
“The auditory system is highly reactive to our emotional state. It is like a primitive mechanism which warns us of danger.”
People coming to his clinic, he says, are often the most severely affected. “It’s a vicious cycle because as sufferers become more anxious, the brain becomes more interested and the tinnitus gets worse. There may be sleep problems, work problems, relationship problems, even mental health issues.”
Williams’ clinic is now offering a new sound-based treatment called Levo therapy, designed for use during sleep. Using an Ipod with personalised earphones, the patient hears sounds designed to match their own tinnitus in pitch, volume and band width. The theory is that once the brain becomes used to the external sound, it will filter out the tinnitus signal in the same way it filters out other noises — like a fridge humming or a clock ticking.
Could Levo help me? I am not, at this moment, destined to find out: mortifyingly, having looked inside both ears, Williams has detected a large mass of hard, impacted wax in the right one, which is probably exacerbating my tinnitus — and which I need to urgently have removed.
These individualised sound therapies aren’t available on the NHS and they don’t come cheap — Levo costs in the region of £4,000. Do they work? While the clinic says that evidence is “growing all the time”, David Stockdale stresses that further good quality, independent research is needed.
“It is quite difficult to produce sounds which accurately match someone’s tinnitus because often the tinnitus sounds fluctuate in pitch and severity,” he says. “And the effects haven’t been proven.”
Sound therapy or “enrichment” is used to distract from the tinnitus — products range from pillows with built in speakers to apps with soothing noises such as waves lapping on a beach — while pharmaceutical solutions are also being studied, in particular around drugs used in epilepsy.
What the experts all agree on is that if we can stop obsessing about our tinnitus, the brain will eventually stop noticing it too.
“There is no cure for tinnitus as yet,” says Stockdale. “But we can give people the tools to manage it effectively.”
Find out more at tinnitus.org.uk How to deal with the condition
Tinnitus is rarely an indication of a serious disorder, but it is wise to see your doctor if you think you might have it. Should something treatable be causing it, you may be referred to a specialist.
Try not to worry: The noises may seem worse if you are anxious or stressed. When tinnitus starts, particularly if it’s sudden, you may naturally be frightened and your concentration or your sleep may be disturbed. Find out more: You will probably feel better when you find out more about the condition — that it’s very common and you’re not alone. There is lots of information on the BTA website for you to explore, written by experts in the field. Stay busy: Many people say they notice tinnitus less when they are doing something. Keeping your mind occupied helps (but don’t overdo things). If the noises seem louder at quiet times, particularly during the night, it may help to have soothing music or some other environmental or natural sound quietly on in the background. Relax: Practising relaxation and taking time out for yourself can also be a great help. See your GP: Tinnitus is rarely an indication of a serious disorder, but it is wise to see your doctor if you think you might have it. Should something treatable be causing it, you may be referred to a specialist.
The precise cause of tinnitus remains a mystery.