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Anxiety and Tinnitus

Sally-Anne Soameson, Psychiatrist
Anxiety and Tinnitus

Tinnitus is a persistent sound or noise that appears to occur without a corresponding noise from the environment. It is most commonly referred to as a ‘ringing in the eaf’ but the sounds may be different for different people. As many as 12.2 million people in the United States alone experience tinnitus severe enough to warrant medical attention, and as many as 50 million Americans have experienced tinnitus at some point in their lives.

Many things can cause tinnitus and the condition is certainly more common as you age. But anxiety and stress have been strongly linked to the development of temporary and permanent tinnitus, and the two have a complex relationship that science is still trying to understand.

Tinnitus = Anxiety?

It is very important to see a doctor if your life is hampered by tinnitus. It is a complicated condition and while it is rarely dangerous, it still warrants medical attention.If you have anxiety and notice that you have started to experience more severe tinnitus, chances are anxiety is the culprit.

Causes of Tinnitus

Many different issues can cause tinnitus, and doctors have a variety of different theories as to why tinnitus occurs. As of yet, the exact cause of most forms of tinnitus is not entirely clear. Tinnitus is a symptom, not a disease, so many different factors may lead to tinnitus. 

The most common cause of tinnitus is hearing loss due to loud noise exposure even a loud bang can cause temporary tinnitus. According to a research paper at the Willis Medical Network, tinnitus is caused by a host of issues, including:

But the authors are very quick to point out that in MANY cases, no underlying cause is found. In fact, while some of the above list may be frightening, the reality is that the vast majority of those are not only rare, but fraught with other symptoms that make tinnitus one of the least of your concerns.

Because tinnitus is so common and the mechanism behind this condition is not entirely obvious, the link between anxiety and tinnitus is less clear as well.

How Anxiety Causes Tinnitus

The truth is that researchers aren't sure exactly how anxiety causes tinnitus, but they know that many people with anxiety do experience tinnitus. Anxiety activates the fight or flight system, and this places a great deal of pressure on the nerves, blood flow, body heat, and more. It's very likely that this pressure and stress travels up into your inner ear, and leads to the experience of tinnitus.

But most of this tinnitus is temporary. It comes at the peak of an anxiety attack, and then quickly goes away. This does not explain why so many people experience long term tinnitus as a result of anxiety. Researchers strongly believe that anxiety may not cause tinnitus at all. Rather, anxiety may cause a mindset that makes someone more prone to tinnitus distress.

Anxiety and Hypersensitivity

Many modern studies have found that tinnitus is actually more common than most people think, and likely starts at a much younger age. But the theory is that most people's ears "habituate" (ie, adjust) to the noise to such a degree that they no longer hear the noise.

In other words, you may have tinnitus right now, but your ears have essentially filtered it out because the noise isn't loud enough to be a nuisance. Those with anxiety, however, often suffer from a symptom known as ‘hypersensitivity.’ This means that a person is overly sensitive to everything their body experiences. They feel every minor pain and notice physical discomfort and unusual sensations throughout their body, but someone who has tinnitus can become more prone to hearing the noise that tinnitus actually causes.

Another common symptom of anxiety is the inability to ignore things that cause additional distress. So what happens is that you become more prone to noticing your tinnitus and the sound is perceived louder than it actually is.

Stress Induced Tinnitus Exacerbations

Studies have also shown that stress can make tinnitus worse. Once again, it's not always clear whether tinnitus simply is more noticeable, or if the noise has actually become louder, but there is a great deal of evidence that stress affects the tinnitus experience. Since anxiety is essentially persistent stress, it stands to reason that those with anxiety and tinnitus would be more likely to experience a worsening of the symptoms.

Tinnitus Induced Anxiety

Finally, it is important to mention that one of the most common problems for people who experience tinnitus is how the condition affects and stresses the individual further. Tinnitus disrupts sleep and creates a significantly lower quality of life. There are many indications that those with tinnitus end up developing greater stress and anxiety levels as a result of the condition. In this case, tinnitus is causing more anxiety, not the other way around.

How to Treat Tinnitus from Anxiety

Because tinnitus is such a complex disorder, there is no one stop treatment. The first step is to see a doctor and have them rule out any underlying medical conditions. Ask them if there are any treatments that they believe will work for your tinnitus based on the way you describe the symptoms.

Presumably, if your tinnitus is caused by anxiety, then curing your anxiety is the next step for preventing it from disrupting your life further. Even if tinnitus is not caused by anxiety, reducing your anxiety is important to make it easier to cope with the hearing condition.

Article Resources
  1. Han BI, Lee HW, Kim TY, Lim JS, Shin KS. Tinnitus: characteristics, causes, mechanisms, and treatments. J Clin Neurol. 2009 Mar;5(1):11-9.
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