Summary: Tinnitus is commonly present in those living with post-traumatic stress disorder symptoms. But it is twice as common in veterans. Studies suggest tinnitus is present in one-third of all veterans living with PTSD. An audiologist (a hearing specialist) usually treats tinnitus. But studies show that patients may also gain from counseling, on top of drugs and hearing aids. So researchers built a form of cognitive behavior therapy to ease tinnitus-related distress in veterans. A pilot study shows that the veteran-specific CBT for tinnitus protocol (VET CBT-T) may add benefits when used with standard treatment.
Tinnitus is a ringing or noise in the ears that lasts for more than six months. Sounds that never stop can be very irritating, and they may worsen mental health. Tinnitus raises the risk of sleep disorders, anxiety, and depression. It may also significantly lower quality of life.
This condition is very high in veterans living with PTSD, and it can be counted as a ptsd military disability. Studies suggest that as many as 30% of veterans are living with the ptsd symptoms. That means tinnitus is almost twice as common in veterans with PTSD as in other groups. Studies suggest that nearly 1.6 million veterans live with the condition. That makes it a significant health issue.
But treatment falls short for many reasons. Audiologists usually manage the condition. They test for hearing loss and then prescribe hearing aids. They might also prescribe drugs to reduce tinnitus. Still, the results are far from good enough.
Veterans are also a special group, which makes things harder. Most of those with the condition are men, and most do not have much schooling.
Some studies show that counseling, along with the hearing device, leads to better results. This counseling teaches patients the basics about tinnitus. It helps, but it is not enough. Still, it shows that care without drugs matters in managing tinnitus in this group.
Keep in mind that post traumatic stress disorder causes mood disorders, anxiety, and depression. Studies show that cognitive behavioral therapy (CBT) helps with most of these mental health problems.
So doctors propose giving veterans CBT along with standard care from an audiologist. They think this is more likely to lead to better results. CBT teaches veterans coping skills and self-control. It also teaches them to cut the harm tinnitus does to quality of life (QoL).
Researchers built a CBT program just for veterans, because veterans are a unique group. They also wanted a set structure. So they made a veteran-specific CBT for tinnitus protocol (VET CBT-T). Early studies show that CBT therapy, used along with care from an audiologist, can be the potential new treatment for ptsd in veterans.
But any post traumatic stress disorder treatment protocol has to be tested in its target group before wide use. So researchers ran a study that compared standard care with VET CBT-T. They enrolled 25 patients. Of these, 14 were assigned VET CBT-T, and 11 were assigned regular counseling by an audiologist.
Both VET CBT-T and audiologist counseling ran over six sessions. CBT therapy covered several parts. It introduced CBT to patients and taught stress management. It covered planning activities to distract from the noise, mindfulness training, and cognitive restructuring (changing unhelpful thoughts). It also covered preventing flares and sleep hygiene (healthy sleep habits).
At the end, researchers compared standard audiologist counseling with VET CBT-T. Both groups benefited significantly from treatment, and both improved with each session. But the VET CBT-T group reported greater benefits.
In this pilot study, researchers found that veterans living with tinnitus and other ptsd military disability can benefit from CBT and standard counseling by an audiologist. But doctors are still refining their new treatment for PTSD in veterans, because they think there must be an even greater focus on managing mental health.
Frequently asked questions
How common is tinnitus in veterans with PTSD?
Very common. Studies suggest tinnitus affects about one-third of veterans living with PTSD. That is roughly twice the rate in other groups. Tinnitus raises the risk of sleep problems, anxiety and depression. So it piles onto what PTSD is already doing. It is often treated as part of a PTSD-related military disability.
What is tinnitus?
Tinnitus is a sound in the ears, with no outside source, that lasts for more than six months. The constant noise is irritating and wears on mental health. It raises the risk of sleep disorders, anxiety and depression. It can also lower quality of life significantly. That is why it matters so much for veterans already living with PTSD.
Does CBT help tinnitus in veterans?
A pilot study says it adds to standard care. Of 25 veterans, 14 received veteran-specific CBT for tinnitus (VET CBT-T). The other 11 received standard counseling from an audiologist. Each group had six sessions. Both groups improved with every session, but the VET CBT-T group reported greater benefit. The study was small, and researchers are still refining the protocol.
What does CBT for tinnitus involve?
VET CBT-T teaches coping skills and self-control so tinnitus has less pull on daily life. The sessions introduce CBT. Then they cover stress management, planning distracting activities, mindfulness training, cognitive restructuring, preventing flare-ups and sleep hygiene. It is built to be used alongside an audiologist’s care, not in place of it.
Who treats tinnitus?
Audiologists usually manage it. They test for hearing loss and prescribe hearing aids. Sometimes they add drugs to quiet the sound. For many veterans, those results fall short. Adding counseling improves results. In a pilot study, adding CBT did better still. That CBT aimed at the anxiety, mood problems and distress that come with PTSD.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
