For just a moment, let’s talk about advertising. On average, how many ads would you estimate you see in a day? Twenty? Fifty? How about 10,000? That’s right. In 2018, it’s estimated that Americans see an average of 10, 000 ads and branding messages a day.
Television ads, newspaper ads, billboards, junk mail, banner and pop-up ads on the internet, product packaging, store fronts, signage, corporate logos and more all combine to do daily battle for our attention and our wallets. “But how can that be?” you may ask. “I don’t remember seeing that many. And if I did see 10,000 ads a day, how could I ever have time to concentrate on anything else?”
The answer lies in the brain’s ability to discriminate or to quickly decide what’s important to us and what isn’t like a gatekeeper.
Silently and subconsciously, our brains are constantly recognizing and categorizing information into two piles: what deserves our attention and what doesn’t. It’s why when reading a movie poster, you may look at the title and the show times, but you wouldn’t read or even notice the fine print.
Somewhere deep inside your head, your brain recognizes the fine print isn’t relevant to your needs, and it compels you to move on with your day.
But what if your gatekeeper function isn’t working properly? What if you noticed and reacted to all of the stimuli around you? You would be overwhelmed with the constant barrage of input, information and noise. You wouldn’t be able to concentrate on anything that mattered. You would be emotionally distraught. You wouldn’t be able to function.
Sound distressing? It is. And some scientists believe that this same broken gatekeeper theory may perfectly describe what’s happening to patients living with severe tinnitus and help.
What Is Tinnitus?
Tinnitus is sound in your head or middle ear that doesn’t have an external source. While many people describe it as a ringing sound, others experience it as whistling, buzzing, chirping, hissing, humming or roaring.
It can be loud noise or soft, occasional or constant, a mild annoyance or a severe and debilitating chronic condition. In general, there are two types of tinnitus: subjective and objective tinnitus.
What Is Considered A Severe Tinnitus Diagnosis?
You may think that severe tinnitus would be characterized by the sound the patient hears: how loud it is, how high-pitched, how frequent. But study after study has shown that the severity of tinnitus is not determined by the quality of the sound, but by how the patient reacts to it.
Some people have the good fortune of being completely unperturbed by their tinnitus. They experience it as non-threatening background noise that is easily ignored or forgotten.
But for others, chronic tinnitus triggers a vicious stress loop. Consciously or unconsciously, these patients’ brains perceive tinnitus ringing in their head or ears as a threat. The sounds distract, annoy or anger the patient, and can lead them to think something is very wrong. This can cause body tension and other biological stress responses.
These are more signals to your brain that danger is present. And, because stress exacerbates tinnitus, the responses can lead to the patient experiencing tinnitus even more intensely, triggering the stress loop all over again.
The patient can go round and round in circles of frustration, anger and desperation that can eventually lead to depression, anxiety, insomnia and even suicidal thoughts or actions.
Why Do Some Patients React Strongly to Tinnitus and Other Don’t?
Some scientists believe the answer may lie in the limbic system. The limbic system is an area of the brain where functions like emotion, behavior, motivation, mood and memory are controlled.
However, recent research also shows that the limbic system is involved in deciding the value of thoughts, perceptions, behaviors and sounds. In other words, it’s one of the areas of the brain that acts as the gatekeeper for what gets our attention and what doesn’t.
When noise-induced hearing loss is present, our auditory nerves can sometimes misfire and generate sound that isn’t there. Those sounds are tinnitus.
In one study, medical imaging has shown that patients with a properly functioning gatekeeping system process the sounds of tinnitus partially in the prefrontal cortex. These patients who researchers called the “low distress” group, were significantly less bothered by their tinnitus symptoms. The symptoms had little to no effect on the patients’ quality of life.
But what about the “high distress” group or the patients who experience tinnitus as debilitating?
In the same study, medical imaging showed that high-distress patients had gate-keeping systems that weren’t working properly, and their brains were processing tinnitus sound partially in the amygdala, an area of the limbic system responsible for emotional response.
This suggests it’s possible that people with severe tinnitus partially process the signals in an emotional center of the brain, triggering the stress loop and fight or flight response described above.
And people who aren’t bothered by their symptoms of tinnitus may partially process the sound in an area of the brain unrelated to emotions, leading to no disruption in their quality of life.
How Can Patients with Severe Tinnitus Improve their Quality of Life?
The medical imaging study described above found one more interesting piece of information: patients who exercised regularly were much more likely to process their tinnitus in the prefrontal cortex.
This is consistent with what we know about tinnitus: exercise and other improvements to a patient’s health and lifestyle can significantly improve symptoms. Here are some other ways patients with severe tinnitus can lessen their emotional response to tinnitus and improve their symptoms:
- Start with your family doctor. Tell them you are struggling to manage your tinnitus. They’ll get you started with finding tinnitus treatment options manage your symptoms.
- Find a psychologist or therapist you trust. Talk therapy has been shown to improve symptoms in most people with tinnitus.
- See a psychiatrist. Studies show that the best treatment of tinnitus related stress, depression and anxiety often involves a combination of talk therapy and medication. Your psychologist dispenses the advice and your psychiatrist dispenses the meds.
- Add meditation to your routine. For the best results, meditate twice a day for 20 minutes. You can also incorporate exercises into your daily routine that have a meditation component like yoga and tai chi. This practice will help to train the brain to quiet the constant ringing in ears.
- Improve your diet. Eat a diet rich in vitamins and nutrients. Also, limit your caffeine intake.
- Buy a light therapy lamp. Light therapy is a proven technique for tackling symptoms of depression and anxiety, especially during the winter months when we get less sun exposure and our vitamin D levels are low.