How Stress and Anxiety Can Cause or Worsen Tinnitus

Tinnitus is a condition that affects approximately 15-20% of the population [1].  If you've ever noticed your tinnitus worsening when you're stressed, you're not alone. But can stress cause tinnitus, or does tinnitus make stress worse?  Read on to explore whether stress is just a side effect or might be directly linked to how we experience tinnitus.

Dealing with tinnitus? Learn about the misconceptions around tinnitus. 

Though there’s not enough evidence to prove that stress directly causes tinnitus, can it make it worse? It’s clear that there is a correlation.

These emotional states are often linked to tinnitus:

• Anxiety and depression can make tinnitus more bothersome and harder to ignore. [5] It can often be connected to brain fog and fatigue, too.
• PTSD and tinnitus often co-exist, especially for veterans who’ve been exposed to very loud sounds in combat. [6]
• Insomnia is common in tinnitus sufferers and often worsens when stress or anxiety is high. [7] Sleep apnea is connected to tinnitus and can often result in a poor night of sleep.

Learn more about the connection between sleep apnea and tinnitus.

A study documented by the National Library of Medicine looked at participants with chronic, subjective tinnitus and examined how stress and tinnitus were related, and found the following [8]:

●      65% of participants showed signs of stress.

●      The more severe the tinnitus, the more likely someone was to have stress symptoms.

●      Every single person with the most severe form of tinnitus showed signs of stress.

The study found that stress seems to act like a volume knob for tinnitus—turning up how noticeable or frustrating it feels. And for people who already have trouble managing stress, tinnitus might become even harder to cope with.

The study highlighted a strong link between high amounts of stress and tinnitus symptoms.  While we don’t know for sure if stress causes tinnitus or the other way around, the connection is clear: emotional stress and anxiety can exacerbate tinnitus symptoms.

Take a closer look at the connection between anxiety and hearing loss.

If you or someone you know struggles with tinnitus, it's important to include emotional health and stress levels as part of the bigger picture. Managing stress might not be the cure, but it could help you feel more in control and less overwhelmed. Start by looking at some of the following tools that may help you reduce the emotional burden of tinnitus and improve your quality of life:

• Cognitive behavioral therapy (CBT)
• Yoga
• Spending time outdoors
• Mindfulness/Meditation

Managing stress, anxiety, and sleep could help reduce the severity of your tinnitus or make it easier to cope with.

Right now, there aren’t any FDA-approved medications that directly treat or cure tinnitus.[10] But that doesn’t mean you’re out of options. Some anxiety and depression medications can help manage the emotional effects, like stress, anxiety, and depression, that can come with tinnitus.[11]

Some things to keep in mind as you consider medication:

• Side Effects. All medications have potential side effects. Always talk to your doctor to weigh the pros and cons.
  
  
• Drug Interactions. Some prescriptions may not mix well with others. Be sure your doctor knows everything you’re taking.
  
  
• Medical Supervision. Never start, stop, or change your medication without your provider’s guidance.

While medications won’t cure tinnitus, they can make it easier to cope, especially if you're dealing with emotional distress. If you're feeling overwhelmed, talk to your healthcare provider about what options may be a good fit for your specific needs.

If you’re a veteran experiencing anxiety and depression related to tinnitus, you may be entitled to benefits. In 2023 alone, nearly 3 million veterans received benefits for tinnitus alone. [12] 

Many veterans also experience mental health struggles like depression or anxiety as a result of living with tinnitus. These can be rated separately and significantly increase your overall disability rating—and your monthly payments.

If your depression or anxiety is connected to your service-related tinnitus, you can file a secondary claim. You’ll need:

• Medical documentation showing you’ve been diagnosed with depression or anxiety [13]
• A letter from a doctor (called a "nexus letter") that links your mental health condition to your tinnitus.
• Strong medical evidence that confirms your symptoms and their interference with daily life.

If you’re a veteran experiencing anxiety and depression in connection with tinnitus, consider checking to see if you’ll receive benefits.