Tinnitus and Mental Health: How CBT Can Help You Cope With Ringing in the Ears

Mental health and physical health are two interconnected systems, so if our physical health is impaired, our mental health is sure to be impacted. One medical condition often not talked about in the mental health world is tinnitus, a hearing related medical issue categorized by ringing, wooshing, and buzzing noises in the ears (Michigan Primary Care, 2020). 16 million seek medical attention for tinnitus annually in the US (Hearing Health Foundation). Just like with any chronic and hard to treat physical ailment, it is often accompanied by emotional reactions such as irritability, anxiety, loss of sleep and difficulty concentrating. 

Cognitive Behavioral Therapy, based around the idea that our thoughts affect our feelings and behaviors and focusing on practices including mindfulness, is the most evidence-based and effective treatment for tinnitus. While there is no known cure for this diagnosis often caused by hearing loss, CBT can reduce distress and improve quality of life.

What is Tinnitus?

Tinnitus is characterized by:

• Ringing in ears

• Buzzing and whooshing sounds

• Constant or intermittently consistent noise

• Worsening in quiet environments or times of stress

Causes of Tinnitus?

• Hearing loss

• Exposure to loud noise (acute or chronic)

• Stress and anxiety

• Medical conditions

While tinnitus itself is not dangerous or life threatening, those who suffer from it report increased distress, frustration and anxiety.

The Connection Between Tinnitus and Mental Health

The emotional effects of a chronic symptom like ear-ringing wears on people day by day. This causes increased anxiety and stress which has detrimental behavioral effects including worse sleep quality, lack of focus and concentration, lowered frustration tolerance and heightened irritability. This amount of stress often affects other parts of someone’s life including the relationships with people closest to them, work quality and school performance and day to day functioning. 

Anxiety can turn tinnitus into a vicious cycle whereby the more you focus on the ringing in your ears, the more anxious you become to the point where tinnitus becomes all-encompassing and difficult to ignore. Fear of the sound itself leads to a cycle of

hypervigilance > anxiety > increased focus on the sound > sounds are perceived as more distressing

How CBT Helps With Tinnitus

What is CBT?

Cognitive Behavioral Therapy is an evidenced-based forms of therapy and it differs from traditional talk therapy because it focuses on skill building, stress management and uses research-backed practices to decrease stress and anxiety and increase someone’s ability to cope. The goal of CBT is not to cure tinnitus (there is no cure), the goal is to improve functioning and decrease feelings of stress related to the symptoms. 

CBT Techniques Commonly Used for Tinnitus

• Reducing Hypervigilance to Sound- Mindfulness practices help lessen the focus on the distressing sounds and focus more on the present moment by redirecting attention and building up the ability to live with the sound. 

• Replacing Negative Thought Patterns- CBT helps clients identify and shift negative thought patterns such as:

  • Catastrophizing - “This will ruin my life”

  • Fear-based thinking - “I will never get over this”

  • Hyperfocus on symptoms - “I will never relax again”

• Behavioral Strategies and Exposure

  • Switching focus to meaningful activities

  • Reducing fear and avoidance

  • Increasing coping skills and frustration tolerance

• Building nervous system regulation

  • Diaphragmatic breathing and relaxation strategies

  • Grounding strategies

A diagnosis like tinnitus can seem all encompassing and an end of relaxation and peace, however there are evidence-based and gold standard treatments like CBT that can improve quality of life while living with this new reality. 

Studies show that over 60% of people who utilize CBT for tinnitus experience support in managing tinnitus and increased life satisfaction. 

When to Seek Support

If a tinnitus diagnosis is accompanied by decreased quality of sleep, feelings of stress and anxiety related to tinnitus, feelings of panic or hopelessness, and trouble showing up for your day-to-day life, contacting a CBT trained clinician is the best next step. CBT Denver clinicians collaborate with medical providers to manage tinnitus symptoms in a safe and effective manner. 

CBT changes the relationship with tinnitus so it is not as scary and overwhelming - if you are having trouble managing your tinnitus, contact us.