Tinnitus: Addressing mental health can help

Tinnitus causes stress — that’s a fact that’s probably not surprising, considering how disruptive tinnitus can be to everyday life. Up to 60% of people with tinnitus report long-term emotional distress.

But what’s not as clear is which comes first, the tinnitus or the stress. Could stress be responsible for the develop­ment of tinnitus or the worsening of it?

The answer isn’t entirely clear, although some experts have noted that it’s com­mon for people to report that they had psychological distress before or during the onset of tinnitus.

One study compared people experiencing high levels of stress to those who were exposed to loud noises at their jobs and found that the probability of developing tinnitus was about the same between the two groups. If people were stressed and exposed to loud noises, their risk of developing tinnitus doubled.

Tinnitus is thought to be strongly influenced by how a person processes emotional stimuli, and it often appears alongside other mental health issues, like depression and anxiety.

Some experts think that people who experience worsening or disabling tinnitus are those who tend to react the most strongly to unpleasant sounds. In turn, they may be unable to “shut off” or effectively cope with stressors to lessen their negative impact.

In people with distressful tinnitus, images of the brain show that these re­sponses tend to be centered in the emotional center of the brain (amygdala), while people who have lower levels of tinnitus distress tend to bypass the amygdala and use parts of the brain responsible for problem-solving and judgment instead.

Because there’s likely a psychological component to tinnitus, addressing mental health through treatment with techniques like cognitive behavioral therapy is key. Cognitive behavioral therapy often involves interventions focused on changing negative thoughts and feelings about tinnitus, cutting out negative coping mechanisms, and increasing positive ways of coping.

In research focused on cognitive behavioral therapy as a treatment for tinnitus, study participants reported significant improvements in quality of life and depression following therapy. It didn’t change the volume of tinnitus they were experiencing, but it helped them cope with it. Medication used to help treat symptoms of anxiety and stress also may be helpful.

Chat with others about hearing and tinnitus in the Hearing Loss group.

Get clear answers to your questions about the health of your hearing with a copy of Mayo Clinic on Hearing and Balance.