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Five Strategies for Managing Tinnitus During The Pandemic

COVID-19 has not been kind to tinnitus patients. As the global pandemic stretches on, patients everywhere are really struggling with the ringing in their ears.

Between the overwhelming anxiety many of us feel at the state of the world, financial insecurity, forced social isolation, and the massive disruption of normal routines, the coronavirus has created a perfect storm of suffering for people living with tinnitus.

It’s difficult to cope with these kinds of conditions even when you’re otherwise healthy. For tinnitus sufferers, it can feel hopeless.

Since the pandemic began, I've received an endless flood of email from tinnitus patients all over the world in despair. The coronavirus didn't just make bad cases of tinnitus worse–I've heard from countless people who had previously habituated and found relief from their tinnitus, only to experience a "relapse" in these trying times.

The good news is that you are never actually powerless to cope. In my previous column published at the start of the pandemic, I discussed five strategies to help tinnitus sufferers weather the storm and better cope with the increased stress and anxiety.

But the coronavirus is showing no signs of slowing down, especially here in the US, and so more and better tools are still needed.

Here are five more things you can do to cope with tinnitus, stress and anxiety during the pandemic.

Focus on coping with moment in front of you right now

Sometimes, the best thing you can do to cope with tinnitus is to just focus on winning the moment in front of you.

Even in your most difficult moments, you can always take some action to make yourself a little bit more comfortable, relaxed, or distracted. You may not be able to change the volume or make it go away, but you can reduce your suffering in that moment.

The challenge is that rumination, and obsessive negative thinking, make it exceedingly difficult to focus on dealing with present moment. And a large part of the suffering experienced is directly tied to the story you are telling yourself about what it all means. It’s not just the anxiety or emotional discomfort you are feeling in that moment, it’s also the thoughts like, “What if it stays like this? What if this spike is permanent? I’ll never be OK!”

When tinnitus becomes severe, the nervous system is essentially stuck in a vicious cycle of fight or flight and emotional and psychological suffering.

Rumination is insidious because in some ways, it’s like your mind is authoring an additional layer of suffering on top of any actual physiological or emotional pain you are experiencing in that moment.

Even if you aren’t actually bothered by your tinnitus immediately when you notice it, ruminating thoughts like “why do I still have to hear this?!” can cause the suffering to start up again.

But here’s the thing: If you can separate yourself from the fear of what you think this difficult moment means for your life and just focus on dealing with it, right here and now, you can dramatically improve your ability to cope.

The 'tinnitus reaction technique' for moments of acute suffering

When your tinnitus is spiking or bothering you very intensely, you are experiencing a strong negative emotional reaction.

But the truth is that even in your worst moments, there are always things you can do to cope. The challenge is that these moments can be so paralyzing that doing anything more strenuous than taking a pill can feel impossible.

The good news is that there is a better way to cope with these moments of acute suffering, one that enables you to act more quickly and find relief more effectively. I call it the "tinnitus reaction technique" and it requires a little bit of context.

The first thing you need to understand is that the intensity of your suffering doesn’t go from 0 to 100 instantaneously. Like anger, anxiety, or any other negative emotion, it escalates quickly, but there is always a ramp-up period. And the closer you can act to the first moment the emotional reaction starts, the more effective you can be at stopping it altogether.

The next thing you need to understand is that when you’re suffering, your nervous system is trying to say to you, “Hey, can you hear that sound? You’re in danger, you need to get up and do something about this!” But most people just try to push it away or ignore it, which almost never works because their nervous system is trying to force them to give it attention.

Instead, the next time your tinnitus is spiking/fluctuating or suddenly bothering you more intensely, try this technique:

  1. Stop what you're doing, sit or lie down, and get comfortable.
  2. Close your eyes and start taking deep breaths. Relax your muscles as much as possible with each exhale.
  3. Focus on your tinnitus and think about the time leading up to this moment. Recognize that at some recent point, your suffering was not this intense. Become aware of how much time has passed since the last time it was this difficult. This helps to break the feeling that your suffering is endless.
  4. Remind yourself that every other time your suffering was this intense, you calmed down eventually. This is no exception, even if you are afraid it’s different this time. The intensity of your suffering will calm back down again, just like it has every other time.
  5. Choose a coping strategy or tool and use it right away. The goal here is to break the rumination and negative thought patterns by actually taking an action. The coping techniques that work best include anything that masks the sound, relaxes you mentally or physically, or distracts you from the sound.

Experiment with different types of tinnitus masking

For many tinnitus sufferers, masking the sound is a simple and effective way to cope. It has limitations, but if you have enough hearing left to actually hear the masking sounds, it can provide temporary relief by lowering the perceived volume of your tinnitus.

It also gives you another noise to hear in quiet environments, so even if it doesn’t actively cover the sound of your tinnitus, you aren’t alone with the sound either.

The problem is that many people give up on masking before they figure out how to make it work for them. Or worse, they feel that using masking is giving in to the tinnitus, like it’s a sign that the tinnitus is winning the battle, and so they resist using it.

To the latter point, I have a different perspective: If all it takes to feel better in a moment of difficulty is to put on some music or background noise, don’t ever hesitate. It won’t always be that easy, so take full advantage when you can.

The trick with masking is that you may have to experiment extensively to figure out what works best with the unique sounds of your tinnitus. Sound sensitivity and hearing loss can complicate this process, as well.

Tips for tinnitus masking

So if masking hasn’t worked for you so far, don’t give up! Try the following suggestions:

Don’t use your phone’s speaker to play masking sounds: It can work in a pinch, but the sound quality is severely lacking in these tiny speakers, and sound quality makes a big difference when masking, even with broadband sounds like white noise.

Test as many different types of masking sounds as possible: A common misconception about sound masking is that there is something special about white noise (and other broadband sounds). For some people, it works well, but not for everyone. Instead, experiment with different types of music, nature sounds, and broadband sounds (ex: white/pink/brown noise). Even spoken word audio, like podcasts and audiobooks, can be helpful here. All that matters is that it helps you cope with your tinnitus. Try as many different sounds as you can until you have a list of at least 5-10 to choose from, so if one isn’t working, you have other options.

Experiment with different listening devices: All headphones and speakers are not created equal, so don’t just stick to one type of listening device. Experiment with different types of headphones and speakers to find what works best for you. Portable Bluetooth speakers are a great option here.

Try bone conduction audio: Bone conduction headphones work by transmitting sound as vibration directly through the bones of your skull to the cochlea (bypassing the eardrum and middle of ear). The benefit to bone conduction audio is that you don’t have to put anything in or over your ears, like you would with regular headphones. And no one else can hear what you’re listening to, like they would with a speaker. This makes it a perfect option for using masking in environments where you still need to hear what’s going on around you, like while you’re at work or walking around a city.

Don’t break the chain: A simple life hack to maintain healthy habits

When the pandemic first began, my normal routines went out the window, and I had to make a concerted effort to prioritize the healthy habits that have helped me build a strong foundation of mental and physical health.

I exercised consistently and spent a lot of time outside with my 2-year old son. I meditated and journaled daily, went to bed and woke up on a consistent schedule, and avoided sugar whenever possible.

But as the days turned into months, I found it more and more difficult to maintain these daily habits, and it was starting to negatively affect my quality of life.

There are many healthy habits that can help you better cope with tinnitus, but consistency is everything. It’s hard enough to build new healthy habits from scratch, but it’s just as hard to get the ball rolling again when you lose momentum.

Fortunately, you can make the process easier and trick yourself into adopting new healthy habits with a simple technique. It’s called “Don’t Break the Chain” and it can boost your motivation and consistency in a big way.

All you have to do is hang a calendar somewhere readily visible, write down the changes you want to make and the healthy habits you want to adopt at the top, and then cross out each day that you successfully complete each task.

The idea here is to give you a clear visual representation of your progress to help keep you motivated and moving forward. As the crossed-out days accumulate, you will feel an internal pressure to not break the chain by missing a day.

Click here to download my free, printable “Don’t Break the Chain Calendar” PDF Tool!

Ujjayi breathing for falling asleep faster with tinnitus

There are many breathing techniques that can be helpful for tinnitus patients to cope in a variety of different circumstances. In previous columns, I’ve discussed breathing exercises for anxiety and emotional overwhelm, but until recently, I had not discovered any breathing techniques to fall asleep faster.

Like many of you, my stress levels have risen dramatically during the pandemic. It hasn’t affected my tinnitus, but for months now I’ve been struggling with insomnia. And the chronic sleep deprivation has only taken a further toll on my health.

Insomnia is a big challenge for many tinnitus sufferers, making it both hard to fall asleep and stay asleep, which only makes it more difficult to cope during the day.

Fortunately, I recently discovered a yoga breathing technique that has been helping me fall asleep faster than anything else I’ve tried. It’s called ujjayi breathing and it’s remarkably simple to put into practice. After 8-10 ujjayi breaths, I typically find myself starting to fall asleep.

Here is the ujjayi technique, according to

“In ujjayi breathing, both inhalation and exhalation are done through the nose.

As you inhale and exhale:

  • Keep your mouth closed.
  • Constrict your throat to the point that your breathing makes a rushing noise, almost like snoring. (Similar to the throat constriction when whispering.)
  • Control your breath with your diaphragm.
  • Keep your inhalations and exhalations equal in duration. (4-6 seconds)

This can be calming and balancing.

At first, it may feel like you’re not getting enough air, but the technique should become easier with practice.”

Adapting to the new normal

It’s been a challenging couple of months for just about everybody. No one expected the pandemic to last this long and we are all now learning how to live in this ‘New Normal’.

Coping with tinnitus under these conditions is difficult, but it’s always possible, and that’s what matters most. I hope some of these techniques and strategies will help you find relief, or at the very least, more peaceful moments as you go about your day.

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