Is Tinnitus Psychogenic?
Tinnitus, as it is normally defined as perception of sound in the absence of a corresponding external acoustic stimulus. From the 18th century Beethoven to Eric Clapton, tinnitus has been an ubiquitous medical condition that affects 276 million people across the world according to the World Health Organisation. While the origins of tinnitus have long been debated, hence we will be approaching the question with both physiological and psychological acknowledgement of tinnitus.
From the world of medicine, tinnitus often correlates with hearing loss and damage to the auditory system. Hence, it can trace back to the patient’s past, such as frequent exposure to loud noises, ageing, or even ototoxic medications can damage the inner ear's hair cells, disrupting signals transmitted to the brain. If the hairs inside your inner ear are bent or broken — this happens as you age or when you are regularly exposed to loud sounds — they can "leak" random electrical impulses to your brain, causing tinnitus. Also the brain, in an attempt to compensate for lost auditory input, may amplify background neural noise, resulting in the perception of sound where none actually exists.
However, this physiological perspective is not directly narrating the causes of tinnitus across populations, as each varies in severity and perception. Some people with similar auditory damage do not experience tinnitus, while others perceive it intensely. This leads to psychological factors, such as somatization, depression, obsessions, and irritability often accompany tinnitus which in turn makes the sound seem more intense due to increase in the levels of glutamate in the body. Some cognitive-behavioural models of tinnitus emphasize this cycle, suggesting that tinnitus is a self-reinforcing condition where psychological factors play a central role. Specifically, the two cognitive-behavioural models includes the Neurophysiological Model (Jastreboff’s Model) which how the way the brain reacts to tinnitus and suggests that tinnitus becomes problematic when it’s linked to negative emotional responses, often mediated by the limbic (emotional) and autonomic (stress-response) systems. Moreover, tinnitus is often associated with somatoform (psychogenic) disorders; even patients with somatoform disorders sometimes complain of tinnitus; a vicious cycle may be created between the two conditions. Overall, tinnitus could be considered partially psychogenic since its persistence and severity are closely tied to psychological distress.
Conclusively, according to guidance from the Mayo Clinic, it is advised to use hearing protection. Over time, exposure to loud sounds can damage the nerves in the ears, causing hearing loss and tinnitus. Try to limit your exposure to loud sounds,and if you cannot avoid loud sounds, use ear protection to help protect your hearing. Also, limit alcohol, caffeine and nicotine as these substances, especially when used in excess, can also affect blood flow and contribute to tinnitus. As tinnitus can be caused physiologically, with our unhealthy mental well-being, it can certainly augment the austerity of tinnitus. Hence, this is a testament for the maintenance of good mental health and the importance of stress-life in order to minimise the annoying ringing tinnitus.
Written by Bernard
Moderated by Adelene
References
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Eye, M. (2016). Brain’s ‘amplifier’ compensates for lost inner ear function. [online] Medicalxpress.com. Available at: https://medicalxpress.com/news/2016-01-brain-amplifier-compensates-lost-ear.html
Ellis, K. (2023). The link between tinnitus and stress. [online] The Hearing Care Partnership. Available at: https://www.thcp.co.uk/articles/the-link-between-tinnitus-and-stress Mayo Clinic (2022). Tinnitus - Symptoms and causes. [online]
Mayo Clinic. Available at: https://www.mayoclinic.org/diseases-conditions/tinnitus/symptoms-causes/syc-20350156. Amplifon. (2024). Can stress and anxiety cause ringing in ears? | Amplifon. [online] Available at: https://www.amplifon.com/uk/ear-diseases-and-disorders/tinnitus/tinnitus-and-stress [Accessed 7 Nov. 2024].
