“A whining mosquito”; “a screaming kettle”; “like a steam train, puffing by”, “a muffled heartbeat”. Imagine what it’s like to hear noises in your head. They are strident and unceasing, yet everyone around says that they can’t hear them. You are having trouble sleeping at night, and in the day time, you can’t concentrate on your work because of the noises. You feel anxious and on edge all the time, and you’ve stopped socialising and have become withdrawn, because it’s a struggle to hear other people.
This is daily life for some people living with tinnitus. Tinnitus is the sensation of hearing noises in the head or the ears for which there is no external source. It is often described as “ringing in the ears” but as we have seen, it can appear as almost any type of noise, or mixture of noises. Some people even hear snatches of music. The noises can be constant, or they can come and go.
About 10% of adults in the UK have tinnitus, and of those, about 1 in 10 find it has a significant effect on their quality of life [1]. It is possible to experience tinnitus at any age, including in childhood, but it is more common in older people, and in people who have hearing loss.
Tinnitus is not a disease or an illness, it is a symptom generated within a person's own auditory pathways. Although it is often assumed that tinnitus occurs as a result of disease of the ears, this is often not the case. The precise cause of tinnitus is still not fully understood although experiences of tinnitus are very common following exposure to loud noise.
THE IMPACT OF TINNITUS ON MENTAL HEALTH
Tinnitus can affect a person’s mental and physical wellbeing, their relationships with others, and their daily activities.
A recent survey of British Tinnitus Association members [2] found that in the last 12 months:
• 23% agreed or strongly agreed that they had suicidal thoughts because of their tinnitus
• 55% agreed or strongly agreed that tinnitus had affected their mental health
• 53% said that their tinnitus made them feel anxious, and the same percentage said they often felt down because of their tinnitus
• 42% said that they felt isolated from others because of the condition
• 59% reported trouble sleeping
TINNITUS DISTRESS
We don’t know what causes tinnitus, but we do know what causes some people to be distressed by their tinnitus. It appears that is not the physical qualities of the tinnitus itself – including its volume – but rather how the person responds to their tinnitus. How someone thinks, behaves and pays attention to their tinnitus determines how bothersome it is to them [3].
Making changes in ones or more of these areas can help a person with tinnitus reduce the distressing feelings they are experiencing that are associated with their tinnitus.
COGNITIVE BEHAVIOURAL THERAPIES AND TINNITUS
Given the above, it is no surprise that cognitive behavioural therapy (CBT) is often recommended for tinnitus. A recent literature review reported that CBT is the most evidence-based treatment (so far) for tinnitus management [4]. It has been used to effectively treat tinnitus for decades [5]. CBT has been shown to decrease tinnitus distress, anxiety and annoyance and to improve functioning in a person’s day-to-day activities.
Whilst some CBT (or a form of the treatment) may be offered to patients within an audiology setting, or via onward referral, NHS provision can be patchy. Counsellors and therapists in private practice therefore are in a good position to provide help to improve the quality of life for people with tinnitus.
Although less thoroughly researched, Acceptance and Commitment Therapy has also been shown to reduce tinnitus distress and impact [6].
A major new study, funded by the BTA has shown that Mindfulness Based Cognitive Therapy (MCBT) helps to significantly reduce the severity and intrusiveness of tinnitus [7], making it less bothersome. MBCT teaches to pay purposeful attention to their tinnitus in the moment, rather than trying to suppress it or avoid it.
Nic Wray, Communications Manager
British Tinnitus Association
TINNITUS WEEK
Tinnitus Week 2019 will run 4-10 February, and the main focus will be the isolation that people with tinnitus can experience. With our national and international partners, we will be exploring the isolation theme, looking at a range of issues. We will explore how tinnitus can make someone feel isolated in their daily lives, personal relationships, social activities and what can be done to help with those feelings
You can follow us on Twitter at @BritishTinnitus and on Facebook at www.facebook.com/BritishTinnitusAssociation. The hashtag for the campaign will again be #TinnitusWeek.
RESOURCES
_British Tinnitus Association_
For more information and for free patient leaflets, contact us:
Helpline: 0800 018 0527
Website: www.tinnitus.org.uk
Take on Tinnitus
Website: www.takeontinnitus.co.uk
_National Counselling Society_
Find a counsellor near you: https://www.nationalcounsellingsociety.org/find-counsellor/
Phone: 01903 200666
Website: www.nationalcounsellingsociety.org
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