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Tinnitus Treatment: A New Understanding Brings Hope for Tinnitus Relief and your "cure."
by Kevin Hogan
(This article is excerpted from the book, Tinnitus: Turning the Volume Down (Revised & Expanded)
Tinnitus, "the noise," is running through your brain on hundreds of highways called neural pathways. These neural pathways are roads between brain cells. The "intersections" in the brainís highways are called synapses.
These intersections donít actually touch each other. The open space between the cell arms is called the synapse. The highways are made up of axons and dendrites (which you really donít need to know all that much about). One cell (neuron) sends information to another cell by sending an impulse from one cell to the next via a neuro-transmitter, much like a cellular telephone call. The phones arenít connected by wires. Weíll talk a little more about these neurons and neurotransmitters in a moment.
It is also useful for you to understand about how people get depressed, feel stressed or become panicked or experience anxiety, and, how all of this relates to tinnitus.
Research into tinnitus suffering shows that what we call SPADE (an anacronym I coined in 1995 to consist of at least one of the following:†† stress, panic disorder, anxiety, depression, and/or emotional challenges) tend to predispose people to tinnitus (and of course other somatics as well). SPADE is a significant set of variables in determining who will experience suffering from tinnitus and who will not. SPADE is most likely a significant variable in who experiences tinnitus after exposure to loud noise or other physical stimuli. The emotional part of our brain, it appears, is critical in both the experience, suffering and relief from tinnitus.
There may be a stigma that goes with this line of thinking. If we acknowledge an emotional component to the onset and later suffering of tinnitus, we acknowledge that it is at least tangentially something that could be mistaken as a "mental illness." Because such terms are useless in the healing process, we will not concern ourselves with such labels. You can call anxiety a "brain cold" and "depression" a case of the "mind flu." The name doesnít matter, getting better does. Our objective will always be the reduction and/or elimination of tinnitus. Period.
Tinnitus suffering is positively correlated to all the elements of SPADE.
For now, consider the insidious relationship between brain chemistry and stress, stress and depression, and all of these emotional states and tinnitus.
In SPADE, "the first factor" seems to be stress.
In 1993, Dr. G. W. Brown wrote that he discovered 84% of a large sample of depressed patients had experienced severe stress in the preceding year compared to 32% of control subjects. Drs. Anisman and Zacharko have suggested that the depletion of certain neurotransmitters (e.g., of dopamine, serotonin, and norepinephrine) that are associated with stress may leave an individual sensitized to subsequent stress and thus less capable of coping with it. They view the inability to cope effectively with stress as a major predisposing factor in depression. (Biopsychology, 1997, Allyn and Bacon Press)
Important studies involving patients with tinnitus reveal that depression precedes a significantly large numbers of tinnitus cases. People not suffering from depression develop tinnitus that produces suffering less regularly.
Therefore for at least a significantly large percentage of the patients suffering from tinnitus, we know that many were predisposed to tinnitus by depression and before that severe stress. Further, we know from various drug studies that anti-anxiety medications (Xanax) and anti-depressants (Pamelor) have been showing to reduce tinnitus volume in a significant number of patients. (76% and 43% respectively compared to 4% for a placebo.)
Anti- convulsants like Klonopin have also been shown to be successful in reducing tinnitus in large numbers of patients. Klonopin is regularly prescribed for individuals who suffer from anxiety, epilepsy and/or related seizures. Anti- anxiety and anti-depressant medications in general seem to help tinnitus sufferers reduce tinnitus volume and distress in significant numbers.
The beneficial effects for tinnitus reduction and distress reduction by these medications offer us our first clues as to the causes and potential elimination of tinnitus.
For many people with tinnitus, negative emotional experiences play a pivotal role in onset, suffering, and later, relief from tinnitus. Severe tinnitus challenges the emotional stability of even the most resilient individual. Tinnitus is far more than a simple hearing disorder. Tinnitus is a complex intermingling of deficient brain chemistry, phantom auditory perception, cell receptor damage, and/or negative emotional experiences (among other variables). Tinnitus sounds may be similar from person to person, but the cause, onset, volume and experience of that tinnitus can be very different. One modality of reducing tinnitus may work for some but it is becoming clear that a multi-modal approach to tinnitus reduction is going to be indicated for most individuals. (Effective therapy normally can include some or all of the follwing: auditory habituation, medication, osteopathic treatment and hypnotherapy.)
Stress, depression, panic disorder, and anxiety are like fertilized soil for a farmer. The farmer planting the crops can be likened to the physical stimulus that causes the tinnitus and makes it persist (grow) when in most people, without the fertile soil, it only lasts a period of time. Once the tinnitus is "planted" in the brain of stressed or depressed individuals, it grows and soon plateaus in volume.
The brain initially becomes aware of this noise and initially does not like the noise. The part of the brain that probably detects the potential negative impact of this noise is the amygdala. It does this by comparing the sound of the noise to other noises the brain has experienced in the past then determines whether action should be taken or not against the sound. (Unfortunately the amygdala cannot help us take action at reducing the noise.)
As the brain becomes accustomed to having the noise around, the noise is accepted as part of the daily experience of life. Tinnitus is often perceived as a threat to survival and the amygdala demands that it be found when the conscious mind notices it is "not there." (Have you noticed that when you awaken from a nap your tinnitus volume increases? For many, this is your brainís way of trying to keep you alive. The tinnitus is as persistent as breathing and like breathing it will make sure the noise is detected if the brain has the tinnitus correlated to a survival issue in one manner or another.)
The brain does not think that tinnitus is "good." It simply is a survival issue. An intruding sound has been detected and a "sound loop" is created in the neural pathways that keeps the tinnitus perception intact. Long after the physical stimulation for the tinnitus is gone (a loud concert for example), the tinnitus persists. The brain continues to find the noise. This is what is meant when it is said that tinnitus is psychosomatic in nature even though the tinnitus onset was physical. Psychosomatic means that their is a significant emotional cause or relationship with a physical medical problem. In tinnitus, this is often but not always the case. You will soon discover that this relationship works to your advantage when you begin your daily regimen to reduce tinnitus volume and distress. Tinnitus in many people is like a paradoxical memory. With skillful therapeutic intervention, the brain can sometimes "forget" the tinnitus. Sometimes the forgetting is for minutes or hours. Sometimes the forgetting is for days or years. This is good news for the sufferer.
The continuation of noise (persistent tinnitus) is often not "necessary." If there is no evidence of significant sensorineural hearing loss, then the probability of tinnitus remission is significantly increased. The brain can be re-wired and re-programmed to stop playing the endless looping of tinnitus tapes. (Those with sensorineural hearing loss can also experience remission of tinnitus, but in our clinical experience, it is less often.)
If you need help please read all the articles about tinnitus on this site, then E-mail me at firstname.lastname@example.org for further direction. Please do not call. Please E-mail!
Now available! The 6-CD Tinnitus Reduction Program utilizes the newest information about tinnitus volume reduction in a helpful, instructive manner. The easy-to-listen-to CDs are full of information you can start using now! See a full description in our store. Link appears below.
by Kevin Hogan, Psy.D.
WHO SHOULD OWN THIS PROGRAM?
The Tinnitus Reduction CD Program has helped thousands of individuals reduce the distress associated with tinnitus. In most cases, when individuals utilize the Tinnitus Reduction Program as part of a multi-modality approach to tinnitus reduction they experience long term improvement.
"I had meant to write before as I have had your tapes from July now. They have been wonderful and saved my sanity. My tinnitus is greatly reduced and my Meniere's under control. I return to your tapes as I find them excellent and I use them every night to go to sleep with. Thank you." Anne Clarke
Your CD program includes three hours of up to date information about how to reduce the volume and distress of your tinnitus. This portion of the program is updated regularly.
In addition to the reporting you will receive of what is working in the area of medicine, tinnitus retraining therapy, and other modalities, you will receive self hypnosis CD's specifically designed by Kevin Hogan which assisted him in the elimination of his tinnitus. The first two CD's in the program are the most up to date information about tinnitus relief you can get. Now, you can utilize the same program as part of a multi-modal effort in reducing your tinnitus volume.
Kevin Hogan is a psychotherapist specializing in hypnosis, who didn't stop with just one possible way to experience silence. A multimodal approach is the only way to assure your success in reducing your tinnitus volume and the intense emotional distress that comes from the tinnitus. If you are sick of hearing that "nothing can be done" and "you'll have to learn to live with it," this is the starting point.
The program includes the brand new revised edition of, Tinnitus: Turning the Volume Down which includes the latest developments in reducing tinnitus and hundreds of citations for further research.
Tinnitus Reduction CD Program and the 260 page book, Tinnitus: Turning Down the Volume
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