TINNITUS INFORMATION Tinnitus is not a disease: it is a sensation arising from some abnormality in the ear or of the processing in the brain of normal nerve signals. It is a common condition; approximately one in ten of the adult population experiences it and approximately 85% of people with tinnitus do not find it distressing, intrusive or anxiety provoking. The reason for this is not because their tinnitus is different; in fact, the results of research suggest that the tinnitus is very similar in those who are bothered by it and those who are not. Although tinnitus can sometimes be very distressing, it is not life threatening and the quality of your life can be recovered. You may not be able to get rid of your tinnitus noise completely, you may still be able to hear it if you listen to it. But by following the ideas in these notes, you can gradually reduce or eliminate the way tinnitus affects you so that you hardly notice it. Most people who are upset by their tinnitus learn to manage it through self help doing things for themselves to improve their tinnitus. However, it may take time: this is quite normal, so don t feel disheartened. Most people find that their tinnitus worsens in quiet situations. Quiet environments are tinnitus unfriendly. Our own home is one of the worst offenders, particularly at night when the environment is naturally so much quieter. The use of sound enrichment is beneficial in reducing the contrast between tinnitus and silence and ensures that the person with tinnitus avoid experiencing an environment where the ambient sound level is so quiet that the tinnitus can be heard quite clearly. Try this yourself by always having another sound quietly on in the background, for instance a radio tuned in between stations, a domestic fan, a table top fountain, or from outside through an open window. A bedroom needs to be quiet to allow you to fall asleep, but a quiet room also means that your tinnitus may feel louder and so prevent you from falling asleep. Do not be tempted to sleep with headphones on using a personal stereo/mp3 player, it is much better to have the sound in the room around you rather than direct into your ears. Most people find that they become more aware of their tinnitus when they are worried or stressed by a particular situation. Almost everyone who experiences tinnitus reports that is it worse when they are tense, tired or anxious. In this type of situation, the presence of tinnitus will in turn make the person feel more tense and tired, particularly when tinnitus interferes with sleep. The tension is not only in the mind, it can be physical. Learning to relax properly is one of the best ways to help yourself. Many people who practice regular relaxation say it reduces the loudness of their tinnitus and helps them become indifferent to their noises the tinnitus is blaira Page 1 4/16/2012
still there but it is much easier to ignore. Relaxation helps to break down the vicious circle of distress and anxiety many people find accompanies their tinnitus. Learning to relax may also help in the dead of night as getting anxious or upset at not being able to get to sleep will only make the tinnitus worse. Activity 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. Most people find that by using their hearing aid (s) the tinnitus is reduced when the device is worn. If hearing aid(s) are suitable for you, they should be worn for around 8-10 hours daily. The reason a hearing aid is fitted, is to stop the brain straining to hear. When you strain to hear, albeit unconsciously, the vicious cycle of tinnitus is activated. Remember to use your hearing aid as much as possible, except when you are in a high level of noise, even if you only have a slight difficulty in hearing. Ear plugs If you have tinnitus, you should not wear any kind of earplugs that make it more difficult to hear, except when you are in very loud noise. They will not help your tinnitus: indeed, they will probably make it seem louder while you wear them. On the other hand, you should always use ear protection when you are exposed to very loud sounds, whether or not you have tinnitus. Unhelpful thoughts People tend to think in a negative way about tinnitus. They often have a negative view of: themselves I can t cope with the tinnitus their world life has no meaning their future things will never get any better These thoughts make the person anxious and stop them from dealing with tinnitus. Unhelpful thoughts have a lot in common: 1. They are automatic they just pop into your head, without any effort 2. They are distorted they do not match up the real facts 3. They are very unhelpful they keep you anxious and make it difficult for you to change the way you think about tinnitus 4. They are plausible they appear genuine: you just don t think of challenging them 5. They are involuntary they are difficult to switch off The more disturbing/annoying a person thinks their tinnitus is, the more unhelpful thoughts they will have about the noise. blaira Page 2 4/16/2012
The more anxious the tinnitus makes the person feel, the more likely they will believe these thoughts In turn these thoughts will make the person feel more anxious, this is a vicious circle. The first step in dealing with unhelpful thinking is to: know how you think and its effect on how you feel Unhelpful thoughts make a person feel more annoyed with tinnitus. They can make him/her feel sad, anxious, hopeless, angry or depressed. Instead of being overwhelmed by these feelings, you can learn to use them as a signal for taking some action. 1. You can start to notice when your mood changes 2. You can note what was happening and what was going through your mind at the time. If you do this, you will become more aware of changes in your feelings 3. You can also become more aware of thoughts which spark off these changes in mood 4. You may find that the same thoughts occur over and over again It is important to look at ways of: recognizing when you are thinking negatively and identifying ways of catching the unhelpful thoughts Once you can learn to do this, you will learn how to look for more positive or helpful ways of looking at the things which happen to you. At first, people find it difficult to catch and answer all the unhelpful thoughts, don t be discouraged, this is normal. This exercise does gets easier with practice, soon it will become more natural. Catching and answering unhelpful thoughts is a skill. In common with learning any new skill, you need to practice the skill to become competent. Personal contact It can often be very helpful to talk to someone who understands how you are feeling, who can reassure you about any anxieties you may have and answer your questions. The British Tinnitus Association (BTA) office in Sheffield can provide details of self-help groups and contacts in the UK. Even if you don t want to take part in group activities, it can be a comfort to know there is someone you can contact. Some useful addresses and contact numbers: British Tinnitus Association (BTA) Ground Floor, Unit 5 Acorn Business Park Woodseats Close blaira Page 3 4/16/2012
Sheffield S8 0TB Freephone helpline : 0800 018 0527 Office line : 0114 258 5694 Fax: 0114 258 2279 Email : info@tinnitus.org.uk Website : www.tinnitus.org.uk Royal National Society for the Deaf (RNID)Tinnitus Helpline Monday to Friday 10am to 3pm Tel 0808 808 6666 (voice) or 0808 808 0007 (text) All calls are charged at local rates You can also contact their website www.rnid.org.uk Websites www.tinnitus.org - Jonathan Hazell's Tinnitus and Hyperacusis Centre in London www.tinnitus-pjj.com/ - Pawel Jastreboff s Tinnitus and Hyperacusis centre in Atlanta www.tinn.com - a website created by tinnitus specialist Dr Nagler featuring a range of information from Tinnitus Retraining Therapy (TRT) to complementary therapies www.sciencedaily.com - a free website with latest research news. tinnitus can simply be typed into the search box for news on the topic Some do's and dont's 1. Do try to get up at the same time each day-even at the weekends. This will help you to establish a regular sleep cycle. 2. Do try to take some time each day to practice switching your attention between the tinnitus noises and other bodily sensations. For example, close your eyes and take a couple of minutes to focus on the rhythm of your breathing, then switch your attention to your hands-mentally count your fingers, refocus on your breathing, switch to monitoring your tinnitus noises, then focus back on your breathing again. 3. Do try to learn to relax-either with the guidance of a professional, or by using relaxation CD s. 4. Do go to bed when you feel sleepy, and not just because it's a certain time. If you are not asleep in 20 or 30 minutes get up and go into another room and do something quiet and relaxing such as reading and return to bed when you are sleepy. Repeat this as often as is necessary. Resetting your sleep patterns like this may take several months so persevere. 5. Do try to live your life in spite of the tinnitus, not because of it. Do things because you want to rather than because they will help ward off the tinnitus. By planning your life around the tinnitus, you are feeding it with attention, and it will only demand more and more. blaira Page 4 4/16/2012
6. Do try to increase the activities that help to shift your attention from the tinnitus (these will probably be activities that you enjoy or are interested in). Expect the noises to be more noticeable in some environments (e.g. where there is less background noise). If possible, try to think of making these environments less tinnitus friendly (e.g. introducing some low-level background sound). 7. Do try to think of anything else that is on your mind that you need to sort out. Having tinnitus does not make you immune to other worries and stresses - are you giving the tinnitus more credit for your stresses than it deserves? 8. Do try to reduce your daily caffeine intake and to cut caffeine out completely two hours before you go to bed 9. Do not smoke for two hours before going to bed, nicotine is a stimulant. 10. Do aim to get some exercise each day but not too close to bedtime 11. Do not cat nap in the daytime 12. Do not do anything mentally stimulating in your winding down period before bed or when you go to bed, e.g. Watching TV, doing crosswords or listening to talk programmes on the radio 13. Do not exercise near bedtime. It will stimulate you and stop you sleeping. 14. Do not rush about frantically. Allow yourself plenty of time for doing things like keeping an appointment, shopping, visiting friends and family, going out for meals or doing the housework. Otherwise, it will only increase your stress levels. 15. Do not test your tinnitus, each time you are listening out for the tinnitus, you are guiding your attention towards it. 16. Do not feed the tinnitus by putting your life on hold by chasing a cure. There is no proven cure for tinnitus at this time. blaira Page 5 4/16/2012
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