Most of the causes of tinnitus alter neurological activity within the auditory cortex, the portion of the brain responsible for hearing. The transmission of sound is interrupted, so some of the neural circuits fail to receive signals. Instead of causing hearing loss, as you might expect due to the lack of stimulation, the neural circuits begin chattering. First, they chatter alone. Then, they become hyperactive and synchronous. When we experience this deviation, our brains attempt to compensate for the change by interpreting the neurological activity as sound. This can resemble ringing, buzzing, hissing, whistling, or roaring, amongst a variety of other noises.
If your mind is occupied with something absorbing, it is easier to forget about the tinnitus. Work, leisure pursuits and other interests can all help to provide a worthwhile focus. If you don't have a hobby, now might be the time to start something, many people say that painting or writing helps. Bear in mind however, that excessive activity may produce stress, so take time for relaxing activities and social interaction where possible.
Assessment of psychological processes related to tinnitus involves measurement of tinnitus severity and distress (i.e., nature and extent of tinnitus-related problems), measured subjectively by validated self-report tinnitus questionnaires.[18] These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning.[62][63][64] A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual.[65] Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness.[66] Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures.[67]
The best supported treatment for tinnitus is a type of counseling called cognitive behavioral therapy (CBT) which can be delivered via the internet or in person.[5][77] It decreases the amount of stress those with tinnitus feel.[78] These benefits appear to be independent of any effect on depression or anxiety in an individual.[77] Acceptance and commitment therapy (ACT) also shows promise in the treatment of tinnitus.[79] Relaxation techniques may also be useful.[3] A clinical protocol called Progressive Tinnitus Management for treatment of tinnitus has been developed by the United States Department of Veterans Affairs.[80]
Dr. Julie Prutsman’s team of audiologists offer a higher standard of expertise. She has been deeply involved with tinnitus for more than 15 years, long before effective treatments had been developed beyond hearing aids and maskers. Dr. Julie also studied under one of the industry’s most respected and leading medical experts, Dr. Pawel Jastreboff, and she has personally trained each and every one of her doctors.

In this exercise you are going to imagine yourself in another place – as if you’re actually there. What it looks like, the smells, the sounds… You can make this exercise as long as you want to and you can take your time to visualise a number of different places, such as a forest, a garden or a beach. Here is a short example of how you can do this (remember not to rush through it).
When a medication is ototoxic, it has a toxic effect on the ear or its nerve supply. In damaging the ear, these drugs can cause side effects like tinnitus, hearing loss, or a balance disorder. Depending on the medication and dosage, the effects of ototoxic medications can be temporary or permanent. More than 200 prescription and over-the-counter medicines are known to be ototoxic, including the following:
Most people who suffer from tinnitus also experience hearing loss to some degree. As they often accompany one another, the two conditions may be correlated. In fact, some researchers believe that subjective tinnitus can only occur if the auditory system has been previously damaged (source). The loss of certain sound frequencies due to hearing loss may change how the brain processes sound, causing it to adapt and fill in the gaps with tinnitus. The underlying hearing loss typically results from exposure to loud noises or advanced age:
Earwax (ear wax) is a natural substance secreted by special glands in the skin on the outer part of the ear canal. It repels water, and traps dust and sand particles. Usually a small amount of wax accumulates, dries up, and then falls out of the ear canal carrying with it unwanted particles. Under ideal circumstances, you should never have to clean your ear canals. The absence of ear wax may result in dry, itchy ears, and even infection. Ear wax may accumulate in the ear for a variety of reasons including; narrowing of the ear canal, production of less ear wax due to aging, or an overproduction of ear wax in response to trauma or blockage within the ear canal.
Seek out cognitive-behavioral therapy. Cognitive behavioral therapy, or CBT, involves working with a clinician (or independently, with a clinically-developed self-treatment program) to re-frame negative thoughts, emotions, and behaviors. CBT is effective with a wide range of physical and mental health conditions, including stress, anxiety, and depression. CBT is also highly effective in treating insomnia and other sleep problems. And research shows CBT can help improve the management of tinnitus.
As an initial test of our treatment, we first conducted a small pilot study to see if there were measurable benefits within 3 to 6 months of using this therapy. While we did not inform participants of whether they would receive a treatment or unaltered music, every participant in fact received a treatment. Participants reported a drop in scores on the Tinnitus Handicap Inventory (THI) within 3 months of using their personalized sound therapy for about 2 hours a day. THI is a psychometrically robust and validated questionnaire that assesses the impact of tinnitus on daily living and the degree of distress suffered by the tinnitus patient. Furthermore, we saw increased benefits after 6 months of treatment use (Figure 1). This data suggested that our treatment may be engaging brain plasticity in a positive manner, thereby gradually reducing tinnitus over time. Armed with this information, we designed a more rigorous trial that is very uncommon among research in tinnitus therapies.
Assessment of psychological processes related to tinnitus involves measurement of tinnitus severity and distress (i.e., nature and extent of tinnitus-related problems), measured subjectively by validated self-report tinnitus questionnaires.[18] These questionnaires measure the degree of psychological distress and handicap associated with tinnitus, including effects on hearing, lifestyle, health and emotional functioning.[62][63][64] A broader assessment of general functioning, such as levels of anxiety, depression, stress, life stressors and sleep difficulties, is also important in the assessment of tinnitus due to higher risk of negative well-being across these areas, which may be affected by or exacerbate the tinnitus symptoms for the individual.[65] Overall, current assessment measures are aimed to identify individual levels of distress and interference, coping responses and perceptions of tinnitus in order to inform treatment and monitor progress. However, wide variability, inconsistencies and lack of consensus regarding assessment methodology are evidenced in the literature, limiting comparison of treatment effectiveness.[66] Developed to guide diagnosis or classify severity, most tinnitus questionnaires have been shown to be treatment-sensitive outcome measures.[67]
It’s the same mechanism that’s happening in people who feel a phantom limb sensation after losing a limb, explains Susan Shore, PhD, a professor of otolaryngology, molecular physiology, and biomedical engineering at the University of Michigan in Ann Arbor. With tinnitus the loss of hearing causes specific brain neurons to increase their activity as a way of compensating, she explains. “These neurons also synchronize their activity as they would if there were a sound there, but there is no external sound,” she adds.
Tinnitus masking or noise suppression devices are common treatment options for tinnitus sufferers. This type of device is worn in the ear like a hearing aid and produces either a constant signal or tonal beats to compete with the sounds you're hearing. The hearing care professional will use the pitch matching and loudness matching tests to set the signal at a level and pitch similar to the tinnitus you are perceiving.

In this exercise you are going to imagine yourself in another place – as if you’re actually there. What it looks like, the smells, the sounds… You can make this exercise as long as you want to and you can take your time to visualise a number of different places, such as a forest, a garden or a beach. Here is a short example of how you can do this (remember not to rush through it).
If you experience tinnitus, don’t suffer in silence. The ringing, roaring, buzzing, or hissing in your ears may be interfering with your sleep, your relaxation, and your enjoyment of life. Why let tinnitus control your life? Many effective treatments for tinnitus exist these days – treatments based on solid research that have proven effective and benefited many people. With help from a tinnitus treatment expert, you could finally silence the tinnitus that has perturbed you for years.
Although there’s no proven cure for tinnitus, there are treatments that help make it easier to ignore. For example, you can wear devices in your ear(s) that produce soothing therapeutic noises to shift your focus away from the tinnitus. Other devices produce constant, soft noise to mask the tinnitus. Tinnitus sufferers who also have hearing loss sometimes find relief simply by wearing properly fitted hearing aids.
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