Tinnitus can be an extremely perplexing condition for a large number of reasons. First and foremost, it’s an entirely subjective condition. What we mean by this, is you can’t exactly show anybody what the constant ringing of tinnitus sounds like, how loud the unending ringing is, or how much of a burden the constant barrage of noises can be over time.
Second, there’s no objective way to measure tinnitus, so you can’t, for example, go into the doctor’s office, get some blood drawn, and get diagnosed.
And third, we still don’t understand exactly how tinnitus works, so our understanding of the causes and treatment options remain less than perfect.
This is all frustrating, of course, but not hopeless. In fact, despite the frustrations, many people do show significant improvements in their symptoms with the right treatment plan.
In this article, we’ll be discussing one treatment option in particular, known as Tinnitus Retraining Therapy (TRT), that has proven to be particularly effective. To understand how it works, you first have to understand the two parts of tinnitus.
The Two Parts of Tinnitus
Tinnitus is the perception of sound when no external sound source is present. We can break tinnitus down into two parts:
- The actual sound – usually perceived as a ringing sound, but can also be perceived as a buzzing, hissing, whistling, swooshing, or clicking sound.
- The emotional reaction – the perception of the loudness and character of the sound and its disruption to everyday life.
The effective treatment of tinnitus therefore requires addressing both parts, which is the underlying rationale of Tinnitus Retraining Therapy.
Sound therapy is the use of external sound to “mask” the internal sound of tinnitus. This mitigates tinnitus on a number of levels.
First and foremost, the newly introduced external sound can either partially or completely cover the underlying sounds that tinnitus produces. When doing so, sound therapy can also divert the patient’s attention away from the tinnitus while the sound is being played. This can all work together to provide an immediate sense of relief for those affected with tinnitus.
Second, sound therapy can eventually work to result in what is called “habituation.” Habituation occurs when the brain is slowly trained over a period of time to reclassify the underlying sounds of tinnitus as an unimportant noise that should be ignored.
Third, the use of specialized sound minimizes the hyperactivity in the brain thought to be the underlying mechanism of tinnitus. This is called “neuromodulation.”
The medical community has therefore decided that sound therapy can offer both short-term and long-term benefits for the patient, and works across multiple levels to help lessen the intensity of your tinnitus symptoms. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.
While it is true that in theory, any sound can provide a desired masking effect, it is also true that specialized medical-grade devices can help to deliver customized sounds that are programmed to match the individual characteristics of each patient’s unique form of tinnitus. Your hearing care professional can help you select the right device and sound.
Cognitive Behavioral Therapy
In addition to sound therapy, TRT also employs behavioral therapies that address the second, emotional component of tinnitus. In ways, this is the more critical component, as tinnitus can trigger strong emotional reactions like anxiety, depression, and anger.
Research in this area has led to some surprising conclusions. For example, studies have found no correlation between the loudness/pitch of tinnitus and patient-reported distress. Whether or not tinnitus is viewed as no-big-deal, slightly bothersome, or devastating is largely dependent on the cognitive/behavioral response of the patient.
That’s good news because it means that you can learn various techniques to reduce the anxiety caused by tinnitus (which itself can make the tinnitus worse). And that’s why behavioral therapy has been so effective—in fact, a 2010 meta-analysis of eight research studies showed significant improvement in depression and quality of life for patients that participated in the programs.
Behavioral therapy can be delivered one-on-one or in groups, from a clinic or over the phone or internet from the patient’s home. Therapy includes education, identifying tinnitus triggers, instituting healthy lifestyle choices to mitigate symptoms, and mindfulness-based stress reduction.
Take Action and Silence Your Tinnitus
Tinnitus Retraining Therapy is effective because it leads to habituation on both fronts, both in terms of the actual sound and in terms of the emotional and behavioral responses.
While there is no known cure for tinnitus, you can mitigate the symptoms with the right plan and some perseverance. As your tinnitus is masked and the brain is trained to ignore it, you’ll be able to better cope with the sounds and improve your quality of life.