Coping techniques to prevent tinnitus and anticipatory anxiety

When you live with bothersome tinnitus, you are forced to confront a seemingly endless barrage of difficult moments on a regular basis.

Emotions and anxiety tend to run high for most sufferers because there is always so much uncertainty. In the blink of an eye, the sound of your tinnitus can change in some problematic way that ruins the rest of your day.

Unpredictable volume increases and sound changes are always possible, but often the sound can just become more intrusive for no apparent reason at all.

I’ve previously discussed the strategy of looking for tinnitus triggers (specific external factors that can cause tinnitus spikes), but for many people, this is very difficult to accomplish. And if no triggers are found, it can end up being just one more let down on the search for relief.

Fortunately, there is another strategy that can help you to prevent difficult tinnitus related moments and spikes entirely – one that has nothing to do with finding triggers.

I call it "preventative coping," and it’s a simple, effective way to raise your quality of life with tinnitus.

Identifying patterns of vulnerability

Most tinnitus coping strategies are meant to be used reactively, after a difficult moment has occurred. There are many coping tools that can help you find relief when you are suffering, like sound masking, breathing exercises, and relaxation techniques.

But what if you could prevent the difficult moments that produce the suffering altogether? It’s a much better strategy.

The first step is to look for what I call patterns of vulnerability, which are specific times of day, environments, or situations where you are more likely to be bothered by your tinnitus in some way.

That doesn’t mean you are certain to suffer more or have a spike every time you encounter one of these vulnerable moments – just that there is a greater likelihood that you will have a difficult time.

A few common examples include:

• Transitionary periods where you leave a distraction-rich environment for one with less stimulation, such as:
  • Getting home from work
  • Getting home after being out with friends
  • Going to sleep and/or waking up in the morning
  • Attending meetings or events in quiet locations
  • Winding down in the evening after a busy day
• Stressful situations
• Spending time with problematic or difficult friends or family members

Once you have identified your patterns of vulnerability, the preventative strategy is simple: You create a coping routine comprised of the tools and techniques you normally use reactively, but practice it ahead of time, in an effort to avoid the difficult moment entirely.

The idea here is to use the preventative coping routine before the difficult moment occurs, regardless of whether your tinnitus is bothering you beforehand or not.

Anticipatory anxiety is the problem

When these types of patterns emerge in your daily life with tinnitus, anticipatory anxiety is usually the result.

For example, if your tinnitus tends to bother you right when you get home from work in the afternoon, you’ll probably start to worry about it on your commute home, even if it’s been a great day so far.

It’s not irrational anxiety either. If you struggle with your tinnitus after you get home from work several times per week, of course you start to worry about it on your drive home.

With a condition like tinnitus, where the intensity of your suffering is often correlated with the amount of attention you give to the sound, this anticipatory anxiety can quickly become a self-fulfilling prophecy. The simple fact that you are now focused on (and worried about) the sound of your tinnitus can cause the difficult moment to manifest, even on days when it may not have happened otherwise.

If you can use a preventative coping routine to avoid having the difficult moment on any given day, that’s a clear win.

But there is another more important reason that this strategy deserves your effort and consideration: If you can prevent the difficult moment from occurring for multiple days in a row, the anticipatory anxiety will start to fade, and you can ultimately eliminate the pattern of vulnerability and suffering altogether.

Crafting a preventative coping routine

The specific coping tools and techniques that you choose to use for each preventative coping routine matter less than being consistent, once you figure out what works best.

It’s important to understand that each specific pattern of vulnerability that you identify may require a different preventative coping routine comprised of a different combination of coping tools. Luckily, you have a lot of options at your disposal.

Any coping tools or techniques that normally help you find relief from your tinnitus in the middle of a moment of suffering can work as part of your preventative coping routine.

In some situations, a single coping tool used preventatively might be all you need. But more often than not, a combination of tools and techniques will work best.

Just to give you an idea, here are a few ideas for coping tools to consider, though anything that helps to relax you, distract you, or masks the tinnitus in some way can be effective:

• Background noise/sound masking: Music, podcasts/radio shows, nature sounds, and broadband noise (white/pink/brown noise) can all work well
• Breathing exercises
• Meditation
• Trigger point massage (myofascial release) with a lacrosse ball or foam roller
• Progressive muscle relaxation
• Taking a hot bath
• Sauna/steam room
• Going for a walk or getting some exercise
• Brainwave entrainment relaxation audio

You will likely have to experiment a bit to figure out what combination of tools works best for you in any given preventative coping situation.

But once you find the tools that work best for a specific pattern of vulnerability, just be consistent and use your coping routine preventatively every day, even when you think you don’t need it. Remember, the anticipatory anxiety can creep up on you even when you’re coping well beforehand.

Now let’s take a look at some specific examples of how preventative coping in action.

Preventative coping example: Difficult mornings

Pattern of vulnerability: You often have a difficult time in the morning, right when you wake up.

Many tinnitus suffers have a tough time in the morning, right when they wake up, especially if they don’t get out of bed right away. It’s a time where many of us are vulnerable to negative thoughts and rumination.

One example of a preventative coping routine that can help would be to first go to sleep with sound masking. This way, you avoid waking to the sound of your tinnitus blaring in silence.

Remember, the strategy is to use your coping routine whether your tinnitus was bothering you when you woke up or not. The goal is to prevent it from even being a possibility. And you won’t need to do this forever – just long enough to break the pattern.

Next, get out of bed immediately and turn on some enjoyable audio, like a podcast or music you love. This is a difficult step for many people but more often than not, lying in bed when you are suffering only intensifies the negative thoughts and emotions. Keep the audio on as you go about your morning routine.

Lastly, you can finish out the coping routine with a meditation or some other relaxation technique, before you continue on with your day.

Many other combinations of coping tools can also work well for preventative coping when you first wake up. This is just one simple example.

Remember, the strategy is to use your coping routine whether your tinnitus was bothering you when you woke up or not. The goal is to prevent it from even being a possibility. And you won’t need to do this forever – just long enough to break the pattern.

Preventative coping example: Difficult evenings

Pattern of vulnerability: Your tinnitus often bothers you when you when you try to relax at the end of the day, when you sit down to watch television or another relaxing activity.

In addition to being a sound, tinnitus is a psychological, emotional, and physiological problem, and when it’s bad, it takes a lot of energy to cope throughout the day. Many sufferers tend to be most bothered at the end of the day, when they are tired and aren’t able to cope as well.

At this point in the evening, many people just want to relax on the couch and watch TV but find it difficult as their tinnitus may suddenly become more intrusive.

The best preventative coping routine here would involve using various coping tools to help you relax as much as possible before you sit down to watch TV. You can eat a snack, take a bath, meditate, give yourself a massage, use brainwave entrainment audio for relaxation, or practice breathing techniques. Really anything that helps to calm your nervous system can put you in a more comfortable state to enjoy watching TV.

But again, you need to practice this ahead of time, even on good days, until you stop experiencing the anticipatory anxiety. Otherwise, you may start thinking about the tinnitus as soon as you sit down in the front of the TV.

Final thoughts

If you have struggled to find your tinnitus triggers, or if you are just looking for a new tinnitus coping strategy to further improve your quality of life, I hope you will give preventative coping a try!

This type of thinking can be applied to a wide variety of problematic situations and environments, and it can be extremely effective when you practice it consistently.