Associated Situations with Tinnitus

Tinnitus not only affects the person himself, but the effects go far beyond. Co-workers, family members and friends of a person can be affected, too. Being excessively sensitive and fragile due to tinnitus may also affect social life. Tinnitus influence the dialogues with spouses, children and close friends negatively. Sometimes, these situations can disrupt their communication in their social lives. They might isolate themselves from society. They often have some certain feelings of irritability, disappointment, stress and anxiety. Thus, normal people should try to understand and help the tinnitus sufferers, with whom they have intimate contact. At the same time, doctors who examine these people need to be very careful not to use any words that can deteriorate the psychological situation.

In our scientific studies conducted on our own patient groups, we observed that isolation from society is mostly due to the general reluctance and inability to get pleasure out of life of people because of the situation in which they are in. We also determined that these people have usually hearing loss and they isolate themselves due to the severity of both hearing loss and tinnitus. This situation surely creates differences among countries. Also, they show differences according to the regions even within the country. Sociocultural differences, living standards and many of such factors are among the prominent reasons of that. The incidence of tinnitus in the American or European communities is different from our country. Even in our country, hearing loss may be a matter of ridicule in some regions, but this is very different in developed countries. Moreover, if a person has tinnitus, the people around don't pay attention about it. So, the isolation from society is higher at this point. In addition, hyperacusia is seen less in our patient population. This can be attributed to our more noisy society. Outdoor sound decibels are well above European and American standards. Indoor sound decibel is more tolerable due to the serious difference from the outdoor sound decibel. Besides, people who already have tinnitus in our society are not taken into consideration and even this situation is perceived as insignificant to other normal people. If the person has even hyperacusia, society doesn't let him to feel this as a complaint matter. Most of our patients are generally those who have tinnitus for many years. Since no solution has been offered to patients by physicians during these long times, patients get accustomed to live with tinnitus. Depression, anxiety, and stress are less common in the patients with stable tinnitus, as the familiarity for disease is increased. However, we observe that depression and anxiety become more severe when tinnitus is stable and the sound is growing in later periods. Depression and anxiety can usually be in the foreground in patient groups, who are new to tinnitus. Though not as much as a percentage, the finding in some of our patients is panic attack. This is more common in our patients than in Europe or America. Sleep disorder is one of the other conditions that we see in our patients, whose tinnitus has emerged recently and acquired activity. One of the very rare cases we have observed is the reluctance and adaptation problem about their works. This situation is less in our patients with tinnitus in our country. This is because of the high level of work anxiety and the absence of an alternative in our society. Reluctance against work is more common in our society. Further accompanying situations to tinnitus in American and European societies can be attributed to high living standards.

In a study of 1100 people conducted by the American tinnitus group in 2014, a questionnaire was made to assess the condition of tinnitus sufferers and concluded that tinnitus was a debilitating condition that adversely affects the general health and social well-being of the patient. It was reported that some influence might be seen even for mild cases.

The feelings that people with tinnitus usually experience;

Stress, distress, depression, anxiety, bad moods, sleep disorders, irritability or disappointment, poor concentration, pain (especially when accompanied by hyperacusia)

Associated situations with tinnitus:

Tinnitus and Hearing Loss: Approximately 55% of all tinnitus patients are accompanied by hearing loss. Hearing loss can occur at a later time besides tinnitus in 30 to 40% of the patients. For this reason, tinnitus may not be a problem only indexed by hearing.

Tinnitus in Meniere's disease: Ménière's disease, sometimes called as endolymphatic hydrops, is a vestibular disease that affects hearing and balance in the inner ear. While Ménière patients often have mild-to-severe dizziness, tinnitus can also be seen. Incidence of tinnitus in Menier patients is very different according to the literature information. These ratios vary between 7% and 45% according to scientific studies.

Hyperacusia; Hyperacusia is abnormal hypersensitivity to noise, including ordinary surrounding sounds that are considered normal. Patients with hyperacusia experience physical pain when exposed to noise (as opposed to emotional distress). Hyperacusia can be seen itself without tinnitus. The rate varies between 7.7-15%. This rate is around 12% in tinnitus patients.

Misophonia;also known as differential sound sensitivity, misophonia is an abnormal negative emotional reaction against certain sounds. Misophonic patients are overly angered, feel disgust or frightened of certain sounds. They can often react similarly to certain visual stimuli. The rate of misophonia in the population level is not known, but it is estimated that 4-5% of people with tinnitus encounter with misophonia-like conditions. Less than 1% of the tinnitus patients describes themselves as misophonic.

Phonophobia; Phonophobia is a fearful emotional response to loud noises. Prevalence of phonophobia is unknown both in general population and tinnitus population.

Depression and Anxiety; tinnitus symptoms have often created feelings of despair and anxiety in the individual. This can be seen in most patients, 48-78% of patients with severe tinnitus experience depression, anxiety or other behavioural disorders. For this reason, mental health problems are reported to be accompanied by tinnitus in the future by 13% rate. In a broad-based scientific study, it was reported that people with generalized anxiety disorder were approximately seven times more likely to have chronic tinnitus. In addition, panic attack may occur due to the situation they are in. Patients with panic attack might face with tinnitus, in some cases.