Yes, that’s me on the cover! I’m sharing some of my current coping tools after being asked to write about how having tinnitus (and decreased sound tolerance) inspired my work as an audiologist: What Tinnitus Taught Me.
I come from the dark days of the 1980s when “nothing could be done” for my tinnitus distress. As an audiologist, having tinnitus myself definitely made me a more patient-centred clinician. I also learned that “something can be done” to cope and have a better quality of life.
I use a toolbox approach which includes various coping tools since there is no cure or single solution for tinnitus yet. I divide tools into general categories. I recommend people have tools from multiple categories in their coping toolbox, to use alone or in combination. Using both sound therapy and mind therapy techniques is common for many tinnitus and hyperacusis treatments.
My current toolbox has key tools that have kept me coping well from day-to-day plus tools to use during flare-ups. I’ve shared a few examples of my main tools below.
When awake, I use soft comfortable ambient environmental sound or music at home from different devices, including my Smartphone, computer, and TV, e.g. garden fountain, Spotify, YouTube, wellness app music/sounds, or online audio sources, e.g. myNoise.net, White Noise app.
When checking out new sound or audio, start with the lowest volume and gradually increase. This helps avoid unexpected loud or uncomfortable sounds. For example, my ears didn’t like sudden claps of thunder on a nature sounds app that didn’t mention thunder in the description.
For personal listening at home or when out and about, I listen to music or audio with earbuds at a low comfortable volume. I don’t like headphones, because they make my tinnitus really loud. I like most music from classical to metal except no opera or Celine Dion.
My playlist sometimes includes no percussion or acoustic music without drums or electric guitars, e.g. Radical Face album Therapy, alternative reality version.
At night, relaxation sound therapy is part of my Sleep Tools.
During the day, I use cognitive-behaviour therapy style techniques, now commonly available on wellness or mindfulness apps, e.g. Happify. I found my favourite ones by searching “best of” reviews online and trying out different apps, e.g. for sleep, relaxation, anxiety, depression, etc.
I spend time on distraction-relaxation activities-often with sound therapy at the same time-including reading, gardening, crochet, crosswords, and gaming. My current favourites include Stardew Valley, Bejeweled, Tetris, and Super Mario Kart.
I have always done needlework like cross-stitch, but recently discovered blackwork. Learning how to do it has been a good way to keep my mind occupied, without paying attention to my tinnitus. I also joined free 2022 stitch-a-longs with new sections of the pattern posted each week, e.g. The Steady Thread.
When I have severe anxiety or panic attacks, I use deep breathing techniques from the Breathe2Relax app.
At night, relaxation mind therapy is part of my sleep tools.
I have a new psychologist, and recently tried OEI (Observed Experiential Integration) which is a therapy based on EMDR (Eye Movement Desensitization and Reprocessing). My favourite part is being able to have OEI treatments over Zoom appointments. I need more treatments, but it already seems helpful for dealing with my chronic anxiety and depression. Crying and upsets make my tinnitus worse regardless of why. Working on my mental health is a constant for me.
I have tried a lot of different things for my tinnitus. Some have made me feel healthier, more relaxed or in less pain so I’m better able to cope. Most have done little to nothing as far as changing how my tinnitus sounds. The most helpful for me include healthy diet, exercise (walking, yoga, gardening), neuromuscular dentistry for my TMJ (including night guard worn while sleeping), news breaks, SAD light therapy, and prescription pain killers for headaches, migraines, and fibromyalgia.
Because my balance sucks, I use a cane sometimes when out and about, and I always use hiking sticks for walking or hiking on uneven ground.
I’ve also tried acupuncture, aromatherapy, chiropractic, removal of all my amalgam (mercury) dental fillings, dietary supplements (e.g. magnesium, B vitamins, zinc), herbal supplements including gingko biloba, non-nicotine e-cigarettes (propylene glycol ingredient made my tinnitus, hyperacusis, and hearing worse), elimination diet for food allergies, inversion table therapy, massage, naturopathy, and physiotherapy.
I have severe insomnia unrelated to my tinnitus. I try to follow sleep hygiene recommendations for better sleep. I love my weighted blanket. I follow the same routine every night to train myself into winding down and moving into sleep mode. This includes reading e-books-which isn’t always recommended-but it works to make me sleepy.
For mind therapy, I use relaxation techniques including deep breathing and progressive muscle relaxation.
For sound therapy, I always use soft relaxation sound at night. This is usually an air purifier set on low plus a ceiling fan in summer. There are lots of sleep sound sources including YouTube options with black screen and sleep apps, e.g. Calm. I’ve tried brown noise mixed with ocean wave sounds, but I’ve used “white noise” type sound for so long that it’s hard to get used to something different.
My hearing is decreasing with age so I’m going to need a pair of combination hearing aids. These devices include amplification and sound therapy options. Once I get a pair, it will be easy to use the aids with my phone, different apps, and for personal listening instead of earbuds.
I use the SoundPrint app to find quiet places when going out, e.g. restaurants.
I always have a pair of high noise reduction foam earplugs and high fidelity pre-molded musician’s type earplugs with me when I go out. If there is unexpected loud or uncomfortable noise, then I’m prepared. Note there are custom-molded earplugs from hearing healthcare providers that let you switch from high reduction to high fidelity in the same pair.
For going to concerts, I use my pre-molded musician’s earplugs when it’s not as loud, e.g. Zelda Symphony concert. When I go to a really loud rock or metal concert, it’s so loud with my decreased sound tolerance that I use my foam earplugs, e.g. Avatar metal band.
Going to concerts makes my tinnitus flare-up temporarily, even with using properly fitted hearing protection from the moment I walk in the venue until I leave. But I won’t let my ears stop me from going to live shows. I’m planning to get tickets to see Avatar for the third time at their Vancouver show in July this year.
Because it is unsafe: ear candling or coning is high risk for ear injuries and should never be part of anybody’s coping toolbox.
Because it makes my tinnitus worse: the sound of crickets chirping and trying to use a volume louder than my tinnitus to “cover it up.”
Because I personally don’t like it: mindfulness-based mind therapy approaches.
Self-help that works for me won’t necessarily work for somebody else. I don’t endorse or recommend any coping tool mentioned above. Each person needs to customize their own individual tinnitus or hyperacusis coping toolbox. Everyone should get medical clearance before trying options to make sure they are appropriate for your tinnitus or hyperacusis.
Online resources include coping basics such as Tinnitus: Healing From Home. Specific treatment programs are also available. For example, the American Tinnitus Association website shares a free workbook, sound types, and relaxation techniques used in the Progressive Tinnitus Management approach. Often people get the most benefit with guidance from a hearing healthcare professional.
Learning to manage life with tinnitus or hyperacusis takes time. Typically it takes at least 3 months of using a coping tool daily before the full benefit is noticeable.
Don’t give up. I’m living proof that it’s possible to go from the depths of despair to coping despite having tinnitus and decreased sound tolerance.