Is the Ringing in Your Ears Affecting Your Mental and Emotional Well-Being?
July 28, 2021

You can find help and hope!


As a doctor of audiology for more than 15 years, Dr. Whitney Smith, with Johnson Audiology, has helped thousands of people address hearing loss. “Assisting people to re-engage and re-connect with their lives through improved hearing is not just my job; it’s my life’s work and so rewarding,” she says. “Hands-down, though, giving my patients access to new rehabilitation options for tinnitus is one of the highlights of my audiology career. I now have evidenced-based tools and techniques to offer for quietening the ringing.” 



For some people, ringing in the ears, or tinnitus, is a mild bother. For others, it can be debilitating, impacting their mental and emotional health by causing profound anxiety, depression, sleeplessness, anger issues, even thoughts of suicide. “One patient described her tinnitus as being locked in a small room with a million tree frogs calling in her ears 24-hours a day. She felt like a prisoner in her own body because she could not escape the noise,” Dr. Smith says.


Subjective tinnitus, which is the most common type, is a self-perceived sound that manifests for people as ringing, roaring, buzzing, chirping—even musical notes--in the ears. The condition likely dates to the earliest human civilizations. In the last 20 to 30 years, however, tinnitus has emerged as an acknowledged serious public health issue, affecting approximately 50 million Americans. More than two million people report tinnitus so severe it disrupts daily living and function.


“While tinnitus can have a variety of causes, the number one culprit is hearing loss,” Dr. Smith says. When a person’s hearing is damaged from loud and/or repetitive noises, permanent hearing loss often results and usually occurs in specific frequencies. Dr. Smith offered these examples: “For instance, a dentist may experience the occupational hazard of losing hearing in the high frequencies because of the damage done to hearing from the repeated whine of a high-powered dental drill. A factory worker, on the other hand, may lose low frequency hearing from exposure to the constant low decibel drone of cooling fans or machinery in the workplace.” When certain frequencies within a person’s hearing spectrum are damaged, sounds in those frequencies go unheard. For example, lose your high frequency hearing, and sounds like birdsong or young children’s voices become undetectable. As the brain searches for input in those missing frequencies and comes up empty-handed, the brain will “fill in the gaps” with the ringing, roaring, or buzzing that is tinnitus. 


Dr. Smith draws this connection: “The increase in reported tinnitus is not surprising. We live in a much noisier world than at earlier times in human history. Damage to hearing is on the rise so, by default, tinnitus is also on the rise.” 


As the incidence and severity of tinnitus continue to put a heavier burden on more and more people, additional resources have been devoted to research to better understand the condition. Dr. Smith says that this should lead to increased awareness for those struggling with tinnitus as well as a deeper understanding by the healthcare providers supporting them. Dr. Smith mentions, “It’s certainly time that happens. Historically, when a person broached the subject of tinnitus with his or her doctor, they were often told, ‘Well, you just have to learn to live with it.’ When a patient gets the brush-off with a trivializing comment like that, it is so detrimental. That person may not have the courage to bring up their tinnitus struggles again for years, if ever, continuing to suffer in ‘noisy silence’ from the cumulative effects of the unresolved mental and emotional health issues the disorder can bring on. I implore healthcare providers to remove verbiage from their provider-to-patient vocabulary that dismisses a person’s tinnitus.” 


Guidelines released in March 2020 from the National Institute for Health and Care Excellence (NICE), entitled Tinnitus: Assessment and Management, may well be a factor in turning that tide. Many health care and social care professionals are beginning to use the advice NICE offers on supporting people presenting with tinnitus as well as the recommendations on when to refer a person to a qualified specialist for assessment and management.


Obvious choices for tinnitus management referral are to audiologists and otolaryngologists, the health care field’s most qualified professionals for issues dealing with disorders of the ear and hearing. “I encourage people with tinnitus to seek out these professionals and to ask if they have specialized training and experience in working with those with tinnitus. Even in these specialties, there can be varying degrees of expertise, knowledge and responsiveness.” 


Dr. Smith has embraced tinnitus as a specialty within her specialty, having a solid knowledge base in tinnitus management coupled with true compassion for people and a dogged desire to help. She recently attained a new certification through the National Council for Behavioral Health, having completed coursework in Adult Mental Health First Aid. She explains that the purpose of mental health first aid is not to diagnose mental health issues. Rather, she has learned techniques for first response. She explains, “When someone comes to me because of tinnitus, and they are experiencing a mental health crisis because of it, I can provide initial help and begin to map a plan for long term management and care.” 


Dr. Smith says many people do not even associate their struggle with tinnitus as putting them at risk for mental and emotional health issues. “I seek to learn more about how each individual experiences his or her tinnitus. It is unique for each person and can present in a myriad of ways,” she says. How does it sound to that individual? Ringing? Roaring? Buzzing? Is it constant or does it come and go? Is it in one ear or both? Does it make you feel stressed, anxious, depressed, desperate, irritable, hopeless? Does it cause sleeplessness, tiredness, poor appetite? Do you have dental and jaw issues like a temporomandibular joint (TMJ) disorder? Have you identified triggers that set off or magnify your tinnitus like caffeine, nicotine, or alcohol use? “The more honest and open patients are with me, the more I am able to help,” she says. 


Dr. Smith says that treatment and management for tinnitus can include a host of options tailored to the person. “Some are in my wheelhouse as an audiologist, such as sound therapies like masking and habituation as well as fitting a person with hearing aids to restore lost sound frequencies. Restore sound where you have hearing loss, and the brain no longer needs to fill in the silence with the ringing, roaring, and buzzing. About seven out of ten patients will notice a subjective decrease in their tinnitus just by treating their hearing loss,” she explains. 


Tinnitus therapy is not limited to these options, however. “That’s why I am committed to a team approach when I work with patients on tinnitus management. I am networking with various professionals who I can refer to. For instance, I have a behavioral therapist with training in tinnitus who I refer patients to and a dentist who specializes in TMJ. I hope to add to that list with providers like a chiropractor, neurologist and others,” Dr. Smith comments. 


She mentions that getting to the bottom of specific triggers for a person’s tinnitus and employing the appropriate lifestyle changes can make a huge difference. “I had a patient recently who was taking a prescribed medication that was exacerbating her tinnitus. She worked with her general health care provider to simply change the time of day she was taking that medication, and her tinnitus faded.” For those with triggers like caffeine, sodium, nicotine, and alcohol, reducing intake or abstaining from those substances can help.

For those with tinnitus tied to stress, techniques like relaxation and mindfulness therapy can be gamechangers. Dr. Smith says. “Interestingly, the same parts of your brain that are activated in the fight or flight response—your autonomic nervous system—also light up when a person is experiencing tinnitus. It begins to have a cascading effect because once the tinnitus is forefront in your mind that heightened state of anxiety builds on itself.” She continues, “The mind is a powerful tool, though. Using brain mechanics, many have learned to control tinnitus rather than it running roughshod through their lives. That’s why I’ve become such a proponent for cognitive behavioral therapy as a recommendation for many patients with tinnitus.” 


Dr. Smith also mentions that mobile phone apps, like the one the hearing aid manufacturer Widex offers, are especially useful tools. “The Widex Zen app is free to download and offers a combination of sound therapy options, relaxation and meditation exercises as well as practical guidance, right there on your phone,” she says. 


Another product on the market is My Butterfly Pillow. This comfortable, hypoallergenic pillow includes adaptive Bluetooth technology so you can listen to white noise, relaxation sounds, audiobooks, even television directly through the pillow via Night Owl Speakers. Plus, you will not disturb your sleeping partner. 


Dr. Smith shares: “I have had the pleasure of helping many of my patients learn to successfully manage their tinnitus. I had a patient whose tinnitus was having such a profound effect on her, she had withdrawn from life, stopped working, etc. Now that she has addressed her tinnitus with various management techniques, she has a renewed hope. She has gone back to her career, back to interacting with family and friends. She’s a ray of golden sunshine.” 


If you are experiencing tinnitus, whether mildly bothersome or life-altering, contact Johnson Audiology today for a tinnitus evaluation and get on the road to managing your tinnitus.

Untreated hearing loss is changing your brain

By Jan Hollingsworth • May 16, 2024
Research reveals that hearing loss actually rewires your neural pathways Your Amazing Brain Your brain is an amazing organ! This wrinkly, reddish-pink mass weighs about the same as your two-slice toaster, tipping the scales at about three pounds. Acting as a master control center, your brain enables every thought, breath, eye blink, heartbeat, movement—everything—that happens in your body. Rivaling the world’s most powerful supercomputer, your brain can download, process, and react in milliseconds to the tidal wave of information coming from your eyes, skin, nose, tongue, and ears. Neuroplasticity and Your Sense of Hearing Researchers have discovered that the human nervous system—made up of the brain, spinal cord, and a complex network of nerves—has incredible capacity to modify itself, both in function and physical structure. This is called neural plasticity . Dr. Megan Johnson, audiologist and owner of Johnson Audiology explains, “Neural plasticity is going gangbusters in a child’s brain as the child develops and matures into adulthood. Based on years of brain research, we also know that the adult brain is far from being fixed. It, too, changes and adapts when you learn new information or skills or as a response to stress, hormonal fluctuations, drug interactions, injury, and much more.” Dr. Johnson also relates that “your brain displays neuroplasticity when you experience hearing loss.” By measuring brain waves using an electroencephalograph, or EEG, scientists have studied how the brain of a person with hearing loss functions compared to a person with normal hearing. The results are both fascinating and sobering as studies reveal that, in those with hearing loss, the portion of the brain devoted to hearing becomes reorganized. This can be true even with early-stage, mild hearing loss, and the process happens quickly, often in months rather than years. The Hearing Center of Your Brain and Beyond What is actually happening when this takes place? Your brain has a right and a left hemisphere and six major lobes. Think of your frontal lobe as your brain’s boss, where executive functions like decision making, emotion and impulse control, and planning occur. Your temporal lobe, which contains the auditory cortex, is doing the heavy lifting when it comes to interpreting sounds and assigning those sounds meaning. The temporal lobe processes speech and language, and it is where initial learning of new information takes place, which is the first step for logging that information into memory. Dr. Johnson goes on to relate, “When the delicate infrastructure of your ear has become damaged through noise exposure, infection, etc. leading to hearing loss, your auditory cortex cries out to your frontal lobe, saying ‘Help! Help! I’m not receiving any sound to process, so I feel lost.’ The frontal lobe ‘boss’ jumps to attention, and your occipital lobe, responsible for processing vision and touch, takes over the areas in which hearing is normally processed. In other words, your other senses seek to compensate for the deficit due to the loss of your sense of hearing.” Amazing, right? So, where’s the rub? Picture a car assembly line; each worker has an assigned task. One day, the worker who installs the windshields is absent, and the worker who attaches the rearview mirrors is assigned double duty, and a duty that was not part of job training. It is easy to see how the worker left juggling both jobs is compromised, and a car might slip through minus a rear view mirror. Similarly, the areas of your brain that are being taxed to make up for a lack of hearing are overloaded and less able to do their assigned responsibilities. “This explains why so many of my patients with hearing loss relate feeling exhausted and frustrated after a big family gathering—where multiple talkers and sounds must be interpreted—rather than happy and invigorated by the experience. We call this listening fatigue ,” states Dr. Johnson. Additionally, when left untreated long enough, researchers point to the brain’s reorganization due to hearing loss as a significant correlation with dementia. Hearing Technology and Your Brain “But here's the great news!” Dr. Johnson says. When a person is fit with hearing aids or a cochlear implant and sound is restored, the brain has the ability to adjust back—partially or completely—to proper function. How swiftly that happens often depends on how long the hearing loss went untreated and is why she encourages patients to treat hearing loss sooner rather than later. “Here is what I tell patients who are downplaying the importance of hearing: If you won’t treat your hearing loss for the sake of your ears, do it for your brain!”

Move from the Gunbarrel Road office to a new and larger office will allow Johnson Audiology to help even more people in the Chattanooga region

By Jan Hollingsworth • January 9, 2024
Johnson Audiology is pleased to announce that the practice will be moving one of its Chattanooga area offices from its current location on Gunbarrel Road to a new location at 6830 Lee Highway. The move will take place January 15. “We are extremely excited to be re-locating to a much larger space later this month,” Dr. Megan Johnson, founder and owner of the award-winning practice, says. “About a year ago, we realized that we needed more room to meet the needs of our growing patient base so we could help even more people with hearing loss. We sought a place that would allow us to stay in the East Brainerd/Hamilton Place area so that the office would still be conveniently located for patients. Our Hixson office will remain at 5617 Highway 153, Suite 203 and is also being upgraded with a second sound booth and beautiful new decor. These two strategically located offices mean that we can continue to serve patients who live east and west of the Tennessee River.” Dr. Johnson says that when she identified the building on Lee Highway, she knew it was an ideal site for this next growth leap. “Our company culture is anchored on the premise of always offering an exceptional patient experience,” she says. “Thanks to our wonderful family of Johnson Audiology patients, we have outgrown our current office and have found the perfect location for offering the best care to even more of our Chattanooga neighbors.” The new location offers many positive features that will benefit patients: The office is conveniently located off Lee Highway in the area between Shallowford Road and Hickory Valley Road, directly behind Dr. Keith B. Dressler’s orthodontic practice. It is a stand-alone office that is not shared with any other businesses. The building is more than 4,000 square feet, which is double the space of the current office on Gunbarrel Road. The added square footage will accommodate a spacious patient welcome and reception area, three sound booths for hearing testing, and a private area for patient check-out. The building has exam rooms for four full time audiologists and an audiology assistant, a large front desk area, and a sizeable lab for hearing aid maintenance and repair. The office has ample space for the practice’s growing Cochlear Implant (CI) Program with a dedicated sound booth and exam area just for CI patients. The building design allows for easy circular patient flow throughout the office. The building has a dedicated, 20-space parking lot just for Johnson Audiology patients and additional parking for Johnson Audiology staff. Dr. Johnson mentions that the building was a non-medical office previously, so updates were needed to bring it up to par for a bustling hearing health care clinic. It currently is being remodeled, and the parking lot resurfaced. “We have plans to transition to the new building by January 15 with some final touches to the office’s aesthetics continuing through the spring,” she says.  Dr. Johnson wishes to assure folks that measures are in place to alleviate disruption to the service patients receive during this time and thanks patients in advance for their continued support and understanding during the transition. “The new office is going to be incredible!” she says. Initial correspondence has been delivered to patients about the move. Dr. Johnson says, “Patients who have appointments scheduled in early January or those who need walk-in service for hearing aid maintenance and supplies from now until January 15 should continue visiting the Gunbarrel Road location.” Dr. Johnson says, “In February, we will invite our friends and neighbors in the Chattanooga community to an open house celebration, where we will do an official reveal of the new space!” Johnson Audiology has been faithfully serving the citizens of Chattanooga since the practice opened its doors on October 1, 2009. “As we prepare to celebrate our 15th anniversary this year, the new office location on Lee Highway and the upgrades to the Hixson office are evidence of our commitment to patients.” Dr. Johnson goes on to say, “Chattanoogans have named Johnson Audiology Best of the Best in the category of Favorite Audiologist and Hearing Aid Clinic for 11 years straight. And they consistently name Johnson Audiology in the top three in the category of Best Customer Service among all Chattanooga businesses. We seek to live up to those accolades daily!” Dr. Johnson concludes, “One of our patients, Mr. Van Tenpenny, recently had this to say about us: ‘My visit to Johnson Audiology has been life changing! After decades of hearing loss, I am able to hear normal conversations in any environment.’ It is our highest ideal to be here for Mr. Tenpenny and the thousands of other patients like him who prioritize their hearing for the best quality of life.” Do you want to get on the road to healthy hearing? Johnson Audiology is currently accepting new patients at all locations. Call today to schedule an appointment or book online at www.johnsonaudiology.com/schedule.
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