Ways To Manage Tinnitus

 

We're going to talk about anxiety as the driver for bothersome tinnitus.

In a previous video, I spoke about the top three complaints of people with bothersome tinnitus: anxiety, depression, and sleep difficulty.

And we talked about how anxiety and fear of tinnitus, and the stress that gets created with anxiety, is the real driver for tinnitus being in the bothersome category.

And in the process of managing tinnitus, it's really necessary to look at anxiety and its role in tinnitus.

Now, there are many ways of managing anxiety.

We've spoken about mindfulness meditation. Research has shown, through the years, over and over again, that a mindfulness meditation practice is a way of tuning the brain, and it can help you to reduce anxiety by keeping the brain in tune and making sure that our strings are not too tight.

Okay?

So that, of course, is kind of low-hanging fruit.

I think a mindfulness meditation practice is a wonderful practice, really, for anyone, but certainly for the person with bothersome tinnitus who's also obviously experiencing anxiety.

Now, there's many other ways of managing tinnitus, and, you know, anything from eating a healthy diet to getting exercise, to spending time with friends and loved ones, to being alone if you need to, being with friends if you need to.

We all have our ways, hopefully, or kind of our toolbox, for finding ways to help our bodies and our minds to reduce anxiety.

Now, sometimes anxiety can become overwhelming for the system.

Now imagine, you know, an instrument, and you've cranked up the strings so, so tight. They're so stressed that, you know, the strings pop.

Okay?

And so in our brains, we can become so overwhelmed with anxiety that there is a time to introduce some medication to help bring us to a place where we can then start to work on our anxiety using the toolkits that throughout our lives we've developed to help us manage stress.

And so today I want to talk about my experience with patients with bothersome tinnitus and what they have found helpful.

Now, again, an excess amount of anxiety, where there's just an immense amount of suffering involved, and, you know, you stay locked and loaded and tight around anxiety and tinnitus, what I have found is that there are two medications in particular that have been very helpful for the patients that I work with.

Now, I must put a disclosure here saying that I am not a medical doctor, and what I'm talking about today is simply what I've noticed in patients with bothersome tinnitus and what has been helpful for them in managing the anxiety that keeps it locked and loaded and keeps the fire of tinnitus going.

And so now, going back to a truism that stress increases tinnitus bother and relaxation decreases tinnitus bother, we want to look for medications or ways to support ourselves so that the brain can then do what it knows how to do, which is reappraise tinnitus and put it into the background.

But we want to look for medications that are able to reduce, or kind of bring down, that fire of anxiety, or lower the thermostat so that our fight-or-flight response isn't tripped so easily.

Now, we have, you know, anytime we're looking at a medication, we're hoping the medication is—you know, we kind of do a cost-benefit ratio.

We don't want to take a medication that creates other problems, right?

We want to find the medication that helps us with whatever problem we're trying to handle or deal with that doesn't create other problems that can create more suffering.

And so, oftentimes, these anti-anxiety medications, benzodiazepines, are wonderful at reducing anxiety.

But over time, you know, again, to use them in an acute situation is very important, but if we're using them over time, our bodies can get addicted to them.

So in many ways, you know, in acute situations that can be a management tool, but over a long time, I don't know that a benzodiazepine would be the first drug of choice.

Now there are two medications that people that I work with find very helpful, and they are, in particular, Zoloft and Lexapro.

Now, these are two SSRIs—serotonin selective reuptake inhibitors—that happen to be excellent for anxiety, depression, and sleep difficulty.

Now, not all SSRIs are created equally.

Now, oftentimes we take these SSRIs, you know, for their intended purpose, which is usually to help with depression, but then we also find that side effects might actually be beneficial.

And so what we found with these particular SSRIs is that they're non-activating.

Now, there are SSRIs that are activating. I think Prozac is an activating SSRI.

Now, people with anxiety do not need to be activated.

Okay?

So we can look for SSRIs that aren't activating.

And again, in particular, Zoloft and Lexapro seem to be SSRIs that are wonderful for anxiety, depression, and sleep difficulty.

And so I encourage you to go to your general practitioner, or to your psychiatrist, to your ENT, or to whatever medical professional that you're working with, and have a discussion about this.

You know, you can bring to them the idea of these two SSRIs.

Which, by the way, why I think these are wonderful SSRIs, or wonderful medications, is that they are not addictive.

And I mean, they'll even prescribe them to pregnant women.

And so anytime a drug is being prescribed to a pregnant woman, we know that there's been a lot of research and we know that there's no ill effects that could, you know, really hurt the body or certainly the fetus.

And so, you know, we can use these drugs with certain confidence, knowing that the side effects, or the effects of the drug, are not hard on the body.

So these are wonderful drugs because there's no addiction to them.

And I often say to people, you know what? It doesn't have to be forever.

Go in three-month increments. Try it for three months, and at the end of three months, if you feel that you're ready and you're no longer needing them, or they're not working for you, you can simply go off them.

But you might actually find that after three months that you're able to manage anxiety in a new way that not only helps you with tinnitus, but it helps you in every area of life.

And so that person might say, "Hey, I think I'll stay on this for another three months or another six months," and reevaluate as you go on.

And so again, you know, I'm not a medical doctor, so it would be irresponsible of me to—I can't prescribe these medications.

However, I've sat now for thousands of hours with people with bothersome tinnitus, and what I have found is that these two drugs in particular—and talk with your doctor about what might work or what might not work for you—these two drugs have been found to really help the person bring down the fire that is keeping tinnitus alive.

Bringing down the anxiety so that the person can create some space between themselves and tinnitus and start to make choices as to how they're going to manage it, whether it's through, you know, changes in lifestyle, meditation, exercise, diet—you name it.

But when a person with bothersome tinnitus gets so entrenched in anxiety, sometimes they can't even get their head above water.

And so drugs like these two SSRIs in particular, Zoloft and Lexapro, how I see it is, it's almost like you're giving this person a mattress to sleep on.

They've been sleeping on this bed of nails for so long.

And, you know, Lexapro and Zoloft don't fix tinnitus because there's actually nothing broken.

They don't fix tinnitus, but what they do is they soften it.

They help you to kind of get to the place so that you can start to implement things that you can do for yourself to shift tinnitus from bothersome to non-bothersome.