Tinnitus can be frustrating for a number of reasons. First, it’s entirely subjective, so you can’t show anyone what the ringing sounds like, how loud it is, or how bothersome it is.
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.
Sound therapy works by either partially or completely covering up the internal, underlying sound of tinnitus. Doing so can divert the patient’s attention away from the tinnitus while the sound is being played. This can work to provide an immediate sense of relief for those affected with the condition.
Second, sound therapy can eventually result in what is called “habituation.” Habituation occurs when the brain is slowly trained over a period of time to reclassify tinnitus as an unimportant noise that should be ignored. Habituation is essentially the desired end goal of any tinnitus treatment method.
Third, the use of specialized sound minimizes the hyperactivity in the brain thought to be the underlying mechanism of tinnitus. This is called “neuromodulation.”
It can then be decided that sound therapy can deliver both short-term and long-term benefits by working across a multitude of levels for the individual. Sound therapy can be delivered through special sound masking devices, headphones, and even hearing aids.
While it is true that any noise can in theory provide a masking effect, specialized devices can help to deliver customized sounds that are programmed to match the individual characteristics of the 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 many ways, this could represent the most critical component, as tinnitus can trigger strong emotional reactions like anxiety, depression, and anger. Over time, this can amount to an almost unbearable burden to those who are affected with the condition of tinnitus.
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.