At a glance, anxiety and tinnitus appear to be unrelated, but with a closer look you’ll find that both can be intricately connected. As we’ve established, tinnitus, also known as ringing in your ears, affects around 15% of people in the United States, while anxiety disorders affect about 18% of adults. And some people struggle with both tinnitus and anxiety.
Their relationship is complex because it’s difficult to know which came first: the tinnitus or the anxiety. Anxiety has been found to cause tinnitus, and tinnitus has been shown to worsen episodes of anxiety. Read on to learn more about tinnitus and anxiety, sleep issues, depression, and how to relieve tinnitus.
Can anxiety cause ringing in the ears?
A nationwide study conducted in 2020 found that tinnitus and anxiety are closely related, but the cause of one or the other is still unknown. Researchers have proposed that anxiety could be a possible cause for tinnitus, but they’re not able to explain how or why.
One theory is that the body’s fight or flight system is activated by anxiety, putting a lot of pressure on the nerves, increasing blood flow, body heat, and more. It’s likely that the pressure and stress travels up into the inner ear, leading to tinnitus.
How can tinnitus trigger anxiety?
A study from 2018 found that symptoms like dizziness and tinnitus are associated with emotional distress, and that this kind of stress can worsen tinnitus symptoms. Some scientists say this could be because tinnitus acts as an alarm signal for when you’re reacting to stress. From a high-level, it seems to be a vicious cycle of one leading to the other and vice-versa.
Why might people with anxiety disorders experience ringing in their ears?
More research is needed to determine why anxiety may lead to tinnitus, but a recent study found that ringing in the ears may not be caused by the ear itself, but rather by a neural network in the brain that is involved with auditory processing. This same study also discovered that this neural network can be stimulated by feelings like stress and anxiety, which further shows that tinnitus could be caused by emotional distress, and not just by problems in the ear or inner ear.
Other MRI studies have also demonstrated that the abnormal brain activity associated with tinnitus and hyperacusis isn’t confined to a specific area in the brain, but that it involves a neural network instead. The most promising piece of data shows that the brain’s emotional center, the amygdala, is also present in this activity. Since many patients present with tinnitus after experiencing significant anxiety, researchers believe emotional factors in the brain are impacting the brain’s auditory functions too.
What else might cause tinnitus?
The cause for tinnitus can be due to a variety of different factors. Usually, tinnitus is caused by noise-induced hearing loss and can start in the middle or inner ear. Other causes include:
- Age-related hearing loss
- Temporomandibular joint disorder (TMJ)
- Sudden exposure to a loud sound resulting in acoustic trauma
- Ototoxic drugs that have been known to damage the eardrum
- Earwax blocking the canal
- Stress
- Head injury
It’s important to note that tinnitus is usually a symptom, not a disease, so the first step in reducing tinnitus is finding out what the underlying cause is and going from there. That’s why the link between anxiety and tinnitus is important to understand. It may be that once your anxiety is reduced, through therapy, medication, or different lifestyle changes, your tinnitus may dissipate too! However, some people develop tinnitus for no apparent reason, so there is a chance that none of the items listed above is affecting you. No matter what, always consult with an audiologist to determine the best course of action for your needs!
Tinnitus and Sleep Problems
How can tinnitus provoke sleep problems?
Tinnitus can happen periodically, last one minute to five hours, or be present at all times. In severe cases, the sounds can be so loud and obtrusive that they interfere with your ability to concentrate or hear other sounds. For some people, tinnitus can be painfully severe and present at all times, making it difficult to fall asleep or stay asleep. In fact, trouble sleeping is a common and frequent complaint reported by those suffering from tinnitus. And recent studies have shown that when insomnia and depression are associated with tinnitus there is increased discomfort with the tinnitus.
The more severe the tinnitus, the stronger its impact on your ability to sleep. The insomnia associated with tinnitus causes stress, and a lack of sleep leads to lower energy levels and alertness, which makes getting through the day that much harder. An endless cycle of sleepless nights can make you feel emotionally drained and anxious, and can even lead to weight gain, chronic health conditions, and accidents. The good news is that only 50% of people with tinnitus develop sleep problems.
Tinnitus and Depression
Researchers have found that around 10–60% of individuals with chronic tinnitus also live with depression. Unfortunately, there isn’t enough data to help determine whether tinnitus comes before depression, or if depression leads to tinnitus. However, their link is very clear, like the link between tinnitus and anxiety. And as many reports have shown, anxiety and depression have a fairly strong bond too.
One study used self-reported stress questionnaires to record and analyze stress levels in people struggling with tinnitus across all demographics, and it was found that many of the patients who reported tinnitus, also reported depression. This leads researchers to believe that there might be a cause-and-effect relationship between tinnitus and psychological distress, like depression and anxiety.
One thing is clear, tinnitus isn’t a condition that works on its own, rather, it is always accompanied by another condition, which makes sense since tinnitus is a symptom, not a disease. Because of this link with depression, it’s recommended that medical professionals screen their tinnitus patients for depression to ensure they’re getting the best possible care.
What to do to relieve tinnitus?
When it comes to tinnitus relief, there are a variety of options out there, and they all have varying levels of success depending on the person. If you try an option below and it doesn’t work, do not despair! There are plenty of strategies to experiment with, so make your way down the list to find the option that works best for you!
- Get your hearing checked: Since tinnitus is a symptom, discovering what it is a symptom of is a great way to start finding out what treatment option will work best for you. Did you know? Tinnitus is often the first symptom of hearing loss, so before anything go see an audiologist, to see if you’re experiencing any hearing loss. It may be that if you have a hearing impairment, that it can be treated with hearing aids – some even have built-in tinnitus relief! Start with a hearing test, and hopefully you’ll be able to kill two birds with one stone: improve your hearing AND alleviate the discomfort associated with tinnitus!
- Sound therapy: Another successful way of addressing tinnitus is to mask the sounds that are bothering you through sound therapy. Different tinnitus sufferers have found success with white noise machines that can help while they’re at home, or trying to sleep. There are also a variety of smartphone apps that allow you to create different customized sound palettes to work against specific sounds.
Mindfulness: Some people have found relief by engaging in different mindful practices, like meditation. There are different kinds of meditation, and some can be used to help retrain your brain and its perception of tinnitus. It helps the mind accept tinnitus and provides you with more peace of mind. This method does not address the tinnitus problem directly, but rather your ability to process and deal with it.
