On the occasion of National Hearing Day, Why Doctor publishes the good sheets of the book “Acouphenes: recognizing them and forgetting them”, by Sylvie Hébert, published by Editions du Rocher (Extract 1/2).
“Two factors often spontaneously reported by people with tinnitus as triggers or aggravators of tinnitus are noise and stress.
Cumulative or acute exposure to noise that produces hearing loss is a known risk factor in triggering tinnitus. Exposure to moderately or downright loud noise can also increase its intensity. This modulation is usually temporary, in the sense that the increase in intensity returns to normal after a more or less long period.
Stress is also often described as a trigger and aggravator of tinnitus. Many people, in fact, report that their tinnitus appeared during a period of great emotion, shock or stress. In some people, tinnitus is perceived as more severe during times of stress. For others, it is the tinnitus that creates stress. Stress is therefore described as both a consequence, a trigger and an aggravating factor of tinnitus.
The physiological and psychological response to stress is a powerful tool to facilitate adaptation and the ability to cope with it, or to oppose it (fight or flight). The mobilization of resources – including the hormones associated with stress, the autonomic nervous system and selective attention – makes it possible to function appropriately in all sorts of life situations, whether delivering an oral presentation in front of colleagues, to move house, to ask the boss for a raise or to accompany a loved one to the doctor. Sources of stress can also be internal, such as uncertainty about one’s future or negative self-talk. When the stressful situation exceeds the capacities to face it, the stress becomes harmful and if the exposure persists, the stress becomes chronic.
How tinnitus develops under stress
What makes a situation stressful? According to all of the scientific studies on stress, the four elements that make a situation stressful are the following: you have little or no control over it, it is unpredictable (you cannot know what is is going to happen), it is new and it threatens the ego (skills are tested). The more elements there are, the more the same situation is stressful. The recent appearance of tinnitus as a signal interpreted at first sight by the auditory system as dangerous and the uncertainty as to its development meet all or some of these criteria. People with tinnitus, especially in the early stages, experience a completely new situation (element of novelty) over which they feel they have no control (element of loss of control). They do not know how the tinnitus will evolve (element of unpredictability) and do not know if they will have the resources to manage this problem (element of threat to the ego).
In this sense, the onset of tinnitus can trigger an acute and adaptive stress response. However, the persistence of tinnitus can lead to a repeated and chronic stress response. However, the neuro-hormonal stress response system can become exhausted, become hypersensitive and no longer be able to deal with stress appropriately. Data from our lab are consistent with depletion of the axis responsible for stress hormone secretion in people with tinnitus.”
To learn more, read: “Tinnitus: recognize it and forget it”by Sylvie Hébert, published by Éditions du Rocher.
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