Around one in three people experience tinnitus at some point – often a ringing, buzzing or whooshing sound in the ear, when there’s no external cause. However, about 13% of the population live with persistent tinnitus – and it can have a big impact.
According to the British Tinnitus Association, 9.3% of people living with tinnitus have experienced thoughts of suicide or self-harm in the last two years, with 87% saying they think about their tinnitus every day.
The charity, who surveyed 2,600 people, also found a third admit to withdrawing from social situations and feeling like their partner and family ‘don’t understand’.
“We’ve noticed during Covid, more people telling us about their tinnitus,” says BTA’s communication manager Nic Wray. “The stress of living through the pandemic does seem to have exacerbated lots of people’s tinnitus.”
Tinnitus and stress
Most of the time, tinnitus doesn’t have a clear cause (although it’s often associated with hearing loss and sometimes occurs due to other health conditions). However, stress and anxiety can be big factors. “And it can be difficult to unpick that: is the stress and anxiety triggering the tinnitus, or is it the tinnitus triggering the anxiety and stress?” says Wray. “And sometimes it’s very difficult to stop that spiralling.”
She says tinnitus is a “very individual” thing: “Some people are not distressed by it, but for some people it can have this impact.” Audiologist Farah Kiani, of high street clinic Hidden Hearing (hiddenhearing.co.uk), agrees – and like Wray is keen to highlight that help is out there: “The main thing is for people to know they are not alone, and you can talk to somebody.”
If you have hearing loss, Kiani says “having a hearing aid can help reduce your awareness of tinnitus. That’s because hearing aids amplify sounds that you want to hear, and that distracts your brain from the tinnitus.” (Free hearing tests are available at Hidden Hearing and Specsavers).
How can you help tinnitus?
Wray says: “A lot of tinnitus management is around relaxation techniques. When we’re under lots of stress, our system is automatically more alert, it’s monitoring our senses more – and hearing is one of those. So, if we’re hyper-alert and stressed, our body is monitoring sound more closely and that includes the tinnitus.”
Kiani adds: “There are lots of techniques you can try. For example, deep breathing exercises, meditation, and even something like visualisation exercises. Imagine yourself somewhere else and really pay attention to, for example, whether there’s a river, an ocean, the colour, how you’re feeling, all these sorts of things can help.”
Yoga and tai chi can be helpful, and mindfulness meditation is also worth a try. “That has been shown – and the research is fairly new – to be very effective, and more effective than standard relaxation techniques,” says Wray.
She also suggests “just generally looking at your physical and mental wellbeing, so making sure you’re getting enough sleep, exercising regularly” etc, as all these things can influence how stress affects us. Kiani says “it’s a good idea to stick to a bedtime routine. And even things like cutting down on caffeine – some studies have shown that can help.” Quiet background noise can also be very helpful if tinnitus keeps you awake at night – whether that’s white noise, soothing sounds or music, an audio bedtime story or relaxing hypnosis track.
CBT for tinnitus
Cognitive behaviour therapy, or CBT – a form of counselling weaving in coping strategies and helping people reframe things – is a recognised treatment option. Wray says it can provide a helpful “framework for understating how you’re feeling about the tinnitus, and how tinnitus and stress are linked”, while Kiani adds “tinnitus retraining therapy can be very helpful”.
Ask your audiologist or GP about referrals, or see if you can self-refer. “Waiting lists are not as short as they could be, so some people might want to try and find a private counsellor,” says Wray – if that’s available to you. “Or try other techniques, because there are lots of things that can help.”
Apps and podcasts
For all these things, there are lots of apps and podcasts – and many of them are free (for example, search for ‘bedtime stories’ or ‘visualisation’ in whichever podcast platform you use).
Dr Ed Farrar, an ex-RAF and NHS doctor who developed tinnitus in his 20s, co-founded an app specifically for tinnitus, called Oto (joinoto.com). It combines all these techniques, guiding people to build daily self-help habits.
“Whilst I’ve been fortunate enough to adjust and manage [my tinnitus], learning to live with the ringing was tough at times. My co-founder George Leidig had a similar experience,” explains Farrar. “During our time as doctors, we saw many patients with tinnitus who weren’t as lucky. We saw how tinnitus had a huge impact on their quality of life and mental health.”
They designed Oto with this in mind. “The app provides instant access to science-based support and is backed by world-leading tinnitus experts,” adds Farrar. “Oto’s tools train your brain to respond differently to the sound and, gradually, the changes in your neural network mean you hear the ringing less and less, bringing you to a point of habituation, when someone no longer notices it at all.”