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Tinnitus, powerlessness and PTSD: Framing tinnitus as an acute stress disorder

If you ask a hundred tinnitus sufferers to explain how the ringing in their ears affects their quality of life, you will get a hundred different answers, but you could easily conclude that the root of the problem–emotionally speaking–is anxiety.

The sound of loud tinnitus can cause a very intense fight-or-flight stress response that never fully goes away, because the sound never stops. And being stuck in a vicious cycle of fight-or-flight certainly feels like anxiety.
But when you look deeper, you start to see that the core emotion at the center of every problematic case of tinnitus is not anxiety–it’s powerlessness.

It’s feeling utterly powerless to find any kind of relief in the face of a confusing health problem that is actively destroying your quality of life.

All of the anxiety, fear, sadness, and every other negative emotion that tinnitus sufferers experience–it all flows outward from this central feeling of powerlessness.

But you are not actually powerless like you think you are. You just need to understand where your power lies, and how to exert that power to achieve results. Some things are within your control, and some are not.

Differentiating between the two starts with a better understanding of the problem.

How tinnitus can make you feel so powerless
Imagine you’re watching a movie, feeling relaxed and fully distracted from your tinnitus, when suddenly there is an explosion on screen and the movie plays the high-pitched tinnitus sound that the hero is supposedly experiencing.

Hearing this sound will most likely cause you to immediately notice your own tinnitus in a negative way, possibly even louder than before.

Most tinnitus sufferers have had this experience, or something similar.

In that moment of anxiety, most people try to push the sound away. You will probably be thinking, “Please go away! Just let me enjoy my movie. I need 5 more minutes of peace!”

But now think about what is happening from the perspective of your nervous system.

Your nervous system is saying, “Hey can you hear that sound? Something terrible is happening! You need to get up right now and go deal with it!”

A man at a desk grabs his forehead from tinnitus and stress. People with chronic ringing in the ears have higher rates of depression and anxiety.
In response, you’ll think, “I don’t want to deal with this even for a second! Please just go away! Leave me alone and let me enjoy my movie!”

And so your nervous system responds, “What do you mean go away? Something terrible is happening! You can’t hear that sound? Okay–volume up, anxiety up, adrenaline up. All systems go! We have to deal with this right now!”

By trying to push it away, you are fighting against the way your nervous system evolved to protect you from danger, the way you would want it to protect you if the danger was real.

If the sound wasn’t your tinnitus but the fire alarm going off in the middle of the night because your home was on fire, you would want it to wake you up with so much adrenaline that you could pick up your family in one arm and your pets in the other while sprinting out of the house to safety.

But in some ways, this level of activation is happening on the couch, while trying to watch TV. We try to push away the sound of our tinnitus but fail, and only succeed in feeling more powerless (and more anxious and afraid).

Where powerlessness leads
On an individual level, tinnitus experiences can vary wildly case by case. Two separate tinnitus patients may give you two completely differing accounts of suffering.

One person experienced an acoustic trauma, the other a medication side effect. One hates noise, the other hates silence. One person hears a high-pitched tone, the other a loud low-pitched roaring sound, like a jet engine. One person isn’t bothered by the sound at all, the other is completely miserable.

Every patient has a different story to tell.

But despite all the differences, patterns emerge.

Most sufferers have had a medical professional incorrectly tell them there is nothing they can do about their tinnitus, that they just have to learn to live with it. (And what can make you feel more powerless than a medical professional wrongly telling you that your situation is hopeless?)

Many patients are deeply afraid that they won’t be able to find relief, which can mutate into feelings of sadness and a state of depression.

Nearly all sufferers experience high levels of stress and anxiety.

There is always hope, even in the most severe cases. Despite what your doctor may have told you, there is absolutely something you can do about your tinnitus. With habituation alone, you can get your quality of life back to what it was before the tinnitus started.

It starts with powerlessness, but the downstream psychological and emotional impacts of tinnitus can quickly become significant and overwhelming. Patients can begin to feel like they are trapped in a 24/7 state of suffering and anguish.

It can become hard to eat, hard to sleep, hard to focus–hard to feel normal at all, let alone happy.