Tinnitus: Ten Stages of Debilitation

Imagine walking around with a bull-horn next to your ear for 24 hours a day. How would it impact your quality of life, your sleep patterns, your work, your health, and your relationships? What if it was so loud that you could no longer ignore it? This is what chronic severe tinnitus is like.

Tinnitus is currently the number one condition facing the Veteran's Administration. Since tinnitus can present secondary conditions such as chronic insomnia and depression, it can be debilitating and lead to suicide.

Although the topic of debilitation is difficult to discuss it is important to recognize that knowing about debilitation stages can help treatment providers know how to treat a patient before debilitation progresses.

Here is how debilitation can happen:
1. The tinnitus gets worse for more than a year.
2. Insomnia sets in.
3. Friends, family, co-workers, supervisors begin to notice a difference in behavior, judgement, work performance as a result of the insomnia and constant annoying tinnitus.
4. Work performance declines. (This can reduce the tinnitus sufferer's likelihood of being promoted or sustaining gainful employment.)
5. The tinnitus sufferer begins to avoid annoying environmental noise and stressful situations that might impact the tinnitus.
6. The tinnitus sufferer has to endure unending probing questions, ridicule, disbelief, and insensitivity by people around him or her. Depression worsens.
7. The tinnitus sufferer begins to avoid people due to a lack of trust.
8. The tinnitus sufferer losses a job. At this stage, Abraham Maslow's Hierarchy of Needs begins to set in but in reverse. Instead of self actualizing the tinnitus sufferer becomes dependent on the very support system that is failing him or her.
9. The tinnitus sufferer losses something cherished (e.g. a marriage, a home, family and friend abandonment).
10. The tinnitus sufferer becomes more depressed and begins to isolate at home. In the worst-case-scenario he or she becomes suicidal.

Stage #2 above is the point at which a treatment team should be sought by the tinnitus sufferer. A good psychologist can help the tinnitus sufferer navigate the social affects and wrong thought patterns associated with chronic insomnia.

No medical professional should ever say, "You have tinnitus, just deal with it." For the tinnitus sufferer whose support system is failing him or her, the only support may come from a good treatment team. Chronic and severe tinnitus is a very serious condition that is equal to an amputation of a limb. Tinnitus is just less visible than an amputated limb so tinnitus tends to be taken less seriously.

In the case of my tinnitus, my cilia cells inside of my cochlea have been amputated. There is no prosthetic for cochlear cells. The hairs are non-regenerative. People who have chronic severe tinnitus have not had a quiet moment since the tinnitus started. It is no wonder that people with chronic severe tinnitus sometimes feel hopeless, worthless, and exhausted.

Some people wrongly believe that tinnitus is not that bad because no one has ever died from tinnitus. They fail to see that the secondary conditions caused by tinnitus can lead to suicide. Long-term sleep deprivation in addition to a consistently loud sound over time is torturous.

If you have severe chronic tinnitus and you feel that your support system is failing you then you should join a group like the American Tinnitus Association for social support. It may take your friends and family years to truly understand what you are facing on a daily basis. The ATA members understand immediately. Also, chronic pain management techniques may be helpful.

Here is a link to an image of tinnitus: http://www.mayoclinic.com/health/medical/IM00193
Here is a link to a video that illustrates tinnitus due to cochlear damage: http://www.youtube.com/watch?v=tGMOrp1i_aQ