When Treatment for Depression Triggers Tinnitus

By J. Nagel*

After suffering from both depression and anxiety for most of my life, and after trying numerous medications and seeing many different therapists in search of help with these conditions, I got up the courage to try transcranial magnetic stimulation (TMS). I had learned of it from a close family member who, like me, found little relief from medications but enjoyed excellent results from TMS.

TMS is a machine treatment that utilizes a large magnetic device to target specific areas of a patient’s brain in treatment sessions that are done five times a week for four to six weeks. In theory, TMS treats depression and anxiety by “rewiring” the parts of the brain associated with these conditions. For some people with depression and tinnitus, TMS also seems to provide some relief from tinnitus. Unfortunately, that was not the case for me. To the contrary, the tinnitus that I have been coping with for more than a year actually was the product of my TMS sessions because I wasn’t given hearing protection to wear during the sessions!

Committed as I was (and still am) to exploring different treatment modalities for improving my mental health, I first considered electroconvulsive therapy (ECT), a more invasive, albeit more readily available, treatment for anxiety and depression. But when I found out that a clinic was opening that would offer TMS in the West Coast city where I lived, I concentrated my efforts there, arranging an interview and assessment to discuss treatment and payment options.

Because TMS is a relatively new and experimental treatment, it is not always covered by insurance. After several phone conversations, my insurance company agreed to cover the treatments, although my contribution was still substantial, including a $1,000 deposit to cover the copayments of $30 per treatment. Thinking the financial details had been settled, I began the treatments—only to find out that, once the clinic began billing my insurance, the claims were denied. It took nearly a year for the account to be paid.

Beyond the anxiety aggravated by the payment issue itself, I struggled with the treatments. Hearing the thumping noise on a daily basis caused me pain and occasional nausea. Apparently, this was not a normal reaction. However, I always have been particularly sensitive to loud noises, so I continued. The technician eventually had to reduce the voltage of the treatment because of my discomfort, before gradually increasing it again to the suggested daily dosage. Later on, I was offered headphones and the option to listen to music, but by then I had established a routine of taking my mind off the noise and pain by talking with the technician during the sessions.

I was never given any written information about wearing hearing protection, nor did anyone suggest that not wearing protection could be harmful.

About halfway through the course of 35 sessions, I remarked that I had a strange new ringing sound in my ears. The technician told me the noise would probably go away when the sessions ended, but it didn’t. And it still hasn’t. Indeed, it’s gotten worse. At first, the depression lifted a bit, but never the anxiety. And the tinnitus has continued to worsen, especially when I’m in a quiet room or trying to sleep. This, itself, has worsened my depression.

I never had experienced “ringing in my ears,” as they say. As days, weeks, and months passed, I wondered whether I was going crazy. I was plagued with dark thoughts of giving up and surrendering to the situation. My depression and anxiety worsened. I desperately researched the matter and talked to others who suffered from tinnitus and found many had resigned themselves to the conclusion that there is no cure for the condition.

Having already endured a 30-plus-year struggle with fibromyalgia after a bad car accident and numerous back surgeries that followed, I seemed to be facing yet another incurable medical problem. My outlook seemed bleak.

After a brief respite in the Florida sun for the winter, I resumed my quest for answers—for some kind of solution. I visited the audiologist I had seen before I left for the winter and was fitted with hearing aids (costing $5,000). They were highly recommended and were supposed to relieve tinnitus by masking it with white noise. That didn’t work for me, so I returned the set after a 30-day trial, only to be shamed by the audiologist for not trying hard enough to make them work.

Next, I heard about a technician who offered in-home audiology service. This individual provided me with a different brand of masking hearing aid, which I thought might be right for me. But, after numerous readjustment sessions, I had to return this pair as well. I felt increasingly hopeless. Even worse, in the course of these audiology tests, I learned that I had high-frequency hearing loss. This surprised me, because I still could hear what every couple seated around me was discussing in a noisy restaurant.

Since returning the hearing aids, I have tried meditation, headphones with calming tapes, white noise machines, and everything else I have read about in tinnitus-related literature. At this point, I have accepted that my best hope is to habituate. To this end, Tinnitus Today has been very helpful. I’ve learned of the struggles of others as well as their coping mechanisms. Knowing there are people out there bearing the same weight offers me guidance and hope.

So, too, has it been helpful for me to participate in a new pilot program for tinnitus sufferers, offered at a local hospital and following a model developed by the Department of Veterans Affairs. After an extensive interview process and many delays, I was accepted into the program. With two other individuals, I recently completed a five-week course, acquiring both practical knowledge and coping skills from the stories of other affected individuals. Classes have focused on cognitive behavioral skills, while also encouraging use of a variety of headphone devices, meditation, calming sounds, and more. These techniques have been helpful, and I am committed to continuing with them and avoiding setbacks.

Because I struggle daily with tinnitus, I look at every social situation differently. I evaluate every coffee shop, grocery store, restaurant, airplane ride, car ride, and social gathering with a new set of eyes (or ears), and I never go anywhere without my earplugs. Sometimes I have to step outside and away from loud social gatherings because of my tinnitus and my hyperacusis.

With the constant support of my husband and family, who do their best to understand my challenges, I now see how my depression, anxiety, hopelessness, and tinnitus are intertwined. I didn’t arrive at this condition by conventional means, in the way readers of this article might have found themselves dealing with tinnitus, but I’ve suffered just the same. I hope my story can help us continue to learn more about this condition, including its causes, its correlations, and its complicated relationship with other conditions.

*Having struggled with anxiety and depression for most of my life, telling my TMS story was a big leap for me and one that I hope is helpful for others. I wrote my story anonymously because progress in the public’s understanding of and empathy toward people with mental-health challenges remains limited and inconsistent, in my view. Right now, my progress requires that I keep my story a private one, to a certain extent, so I don’t feel the burden of explaining my struggles to others. Managing depression is challenging, as is living with tinnitus!