Tinnitus and Obsessive Compulsive Disorder (OCD)

Anxiety disorders don’t cause tinnitus, but they can make it more noticeable – and in turn, persistent bothersome tinnitus can worsen mental health symptoms. By understanding the similarities and differences between chronic tinnitus and obsessive compulsive disorder, you can use targeted management techniques that can bring you peace of mind.  

What Is OCD?

Obsessive compulsive disorder (often shortened to OCD) is a mental health condition characterized by recurrent unwanted thoughts – obsessions – and repetitive behaviors that are intended to reduce them – compulsions. For many people, this cycle of obsessions and compulsions are related to thoughts of contamination, safety, organization, or doing things in a certain way. In some cases, the compulsion makes sense with the obsession, but the thoughts and behaviors are not always related.

It’s normal for everyone to experience these kinds of thoughts and behaviors from time to time, but a person with OCD will experience them with greater severity and more often. For about 2-3% of the adult population, obsessions and compulsions interfere with daily activities. 

What Is Tinnitus?

Tinnitus is the perception of sound when there is no external source – in the vast majority of cases, tinnitus is quite literally in your head. It can’t be observed by others, and research shows it is related to activity in the auditory part of the brain. Since tinnitus is often linked to hearing loss or damage, your brain may overcompensate for the reduced signals your auditory nerve is able to pick up.

Anybody can experience tinnitus, and in fact, almost everyone experiences mild tinnitus at least once in their life. As many as 10-15% of adults report chronic tinnitus. Of those, about 7% will experience severe tinnitus which can have a tremendous impact on the quality of life. Chronic tinnitus may worsen depression, anxiety disorders, OCD, insomnia, and other mental health symptoms.

How Are Tinnitus and OCD Related?

With OCD, you may latch onto a passing thought that may grow to uncontrollable intensity. If that thought is related to your perception of tinnitus, your attention to the condition can quickly snowball into an obsession. This focus alone can “turn up the volume” and worsen the perception of tinnitus symptoms.

Tinnitus isn’t directly harmful, but it can be very annoying and bothersome. The relentless ringing in the ears can lead to emotional distress, anxiety, insomnia, or depression. For those living with OCD, chronic tinnitus can easily trigger overwhelming intrusive thoughts. One of the best ways to find tinnitus relief is retraining your brain to ignore the sound, but if you become fixated on it, management can be more difficult. 

Similarities Between OCD and Tinnitus

Even though these conditions are not directly related, there are some notable similarities between tinnitus and obsessive compulsiveness. 

Intrusive Thoughts

OCD is characterized by recurrent intrusive obsessive thoughts – this is also a common symptom of tinnitus. With both tinnitus and obsessive compulsive disorder, this disruption can be stressful, irrational, and sometimes severe, leading to anxiety and distress. Both conditions impact your ability to relax, focus, or get a good night’s sleep. Dealing with these disruptions can consume an enormous amount of your time and energy, so you might experience difficulty keeping up with work, relationships, and other aspects of your normal life.

Hyperattention

People suffering from both tinnitus and OCD are likely to try to stop their behaviors or ignore their symptoms. However, as tinnitus sufferers well know, one can not simply decide “I will stop being bothered by this” and make it so. The human brain is capable of change, but the ability to change is not instantaneous. The tendency to develop an obsession can make progress more difficult and increase sensitivity to the background noise of tinnitus. For people who experience tinnitus but are not diagnosed with obsessive compulsive disorder, the constant sound can still draw your attention away from daily activities and impact your quality of life.

Subjective Experience

There is no straightforward diagnostic test for tinnitus or OCD. Just as one cannot directly measure another person’s subjective tinnitus, OCD diagnosis is based upon your report of your experience and medical history. The loudness of your tinnitus is not correlated to the level of distress – that is, even if your tinnitus sounds are quiet or irregular, the stress it causes can still be severe. Tinnitus severity can fluctuate, and some people may barely notice their tinnitus except when specifically asked about it. There are other variables that affect your reaction to tinnitus as well, like mental health status, coping mechanisms, hearing loss, or other external factors. Similarly, OCD symptoms can come and go, and the intensity of the obsessions or compulsions can vary depending on your circumstances.

What Causes OCD and Tinnitus?

Just like with tinnitus, researchers can’t always pinpoint the root cause of obsessive compulsive disorder. Mental health conditions like OCD may stem from a whole host of causes including genetics, structural brain changes, childhood trauma, environment, and Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) syndrome.

In some cases, tinnitus can be linked to a specific underlying condition or cause since tinnitus is often viewed as a symptom, not a condition on its own. Ear infections, hearing loss, loud noise exposure, injuries, or certain medications are known to trigger tinnitus, but this list is far from exhaustive. Sometimes, the causes of tinnitus and OCD are never identified, and managing these conditions takes priority.

How Are OCD and Tinnitus Treated?

OCD is a lifelong condition, but symptoms may come and go. Tinnitus doesn’t have to last a lifetime, either. Managing symptoms and committing to making positive changes can provide relief – and there are many overlaps in the treatment options for tinnitus and obsessive compulsive disorder.  

Treatment Through Medication

Medication is sometimes used to treat OCD. Although similar medications (such as SSRIs) may be used to help people with tinnitus, it isn’t usually a first line of defense. Tinnitus treatment is largely focused on improving your coping skills and reducing your level of tinnitus-related distress, rather than reducing the tinnitus perception itself.

Therapy and Counseling

OCD is usually treated with therapy, including cognitive behavioral therapy (CBT). Using these strategies, you can learn to realize and identify unproductive thought patterns or intrusive thoughts that are leaving them unable to cope effectively and re-form these thoughts into helpful and motivating thoughts, gradually reducing your need for compulsions. Exposure therapy is sometimes used in conjunction with CBT. This technique deliberately exposes you to the feared situation or obsession while you practice not performing the associated compulsion.

Tinnitus retraining therapy (TRT) is an excellent way to retrain your brain not to notice irritating noises. Tinnitus retraining therapy gradually reduces tinnitus to a background noise that feels much more manageable. Tinnitus patients — with or without OCD — can find long-lasting relief with these techniques.

Lifestyle Modifications

Relaxation techniques and practicing mindfulness are also effective management techniques for both tinnitus patients and those with obsessive compulsive disorder. A focus on acceptance can help you deal with chronic issues, leading to higher quality of life as you go through the process of achieving relief.

Breaking the Vicious Cycle

If you’re living with intrusive thoughts surrounding your tinnitus severity, know that there is hope for the future. With proper treatment, you can learn to ignore the irritating noises of tinnitus and feel less anxious about your health.

Research has shed light on a distinct relationship between tinnitus and obsessive compulsive behavior, even among people who do not fit the OCD diagnosis outlined in the DSM. People who are prone to anxiousness about their health or body issues (hypochondria) are especially sensitive to tinnitus as it relates to OCD. Understanding the connection between these two seemingly-unrelated conditions can help you find the path towards relief. 

The key to moving past tinnitus that triggers OCD is to focus on habituation. This process of adapting and becoming less sensitive to tinnitus sounds that trigger OCD can help you regain control of your mental health. It can be a challenging journey, but ultimately, learning about your treatment options and choosing the management strategies that fit your lifestyle will help you move forward.