Hearing a laugh, hearing a child’s voice or a dog’s happy bark, or going to a concert by our favorite band are things that most of us find pleasurable.
These are more or less habitual sounds of our daily life that accompany us and are part of our lives. However, for people with hyperacusis what most people find normal and even pleasant is a real torture .
These people suffer a high level of discomfort when faced with auditory stimulation. What is hyperacusis? In this article we will proceed to analyze this affectation.
Hyperacusis: concept and symptoms
Hyperacusis is understood as the condition in which the sufferer manifests a decrease in the threshold of tolerance to sound . This is a type of hypersensitivity that causes the person to be unable to tolerate sounds that are normative for other people because they cause them a variable degree of pain or discomfort. Reactions often occur especially to sudden loud sounds or to repetitive and continuous sounds, which can be torture for the sufferer.
It is important to take into account an aspect that is often taken for granted: hyperacusis does not imply a greater hearing capacity on the part of the person who suffers it compared to the rest, this capacity being normal or even suffering from some kind of hearing problem. In other words, it is not that they hear more than others, but that their nerve tracts respond more easily and are less able to resist sounds.
At a cognitive level, hyperacusis tends to generate problems in sustaining attention and concentration . It can also generate an increase in irritability when faced with the persistence of sounds that they cannot avoid, as well as behavioural avoidance of those sources of sound that are annoying to them. They often suffer from symptoms such as headache, dizziness, nausea, tinnitus or physical and mental fatigue. Also sleep problems.
In addition, people with hyperacusis often have social problems because of their intolerance to sound. This problem is often not well understood socially and can be very limiting. Because of the suffering caused by everyday sounds, it is common that they avoid or become easily irritated by sound sources that are harmless or even pleasant for others. In many cases, they avoid places where there are crowds, which is difficult to achieve in urban environments today. In some cases they decide to isolate themselves by restricting social contact.
The causes of this type of condition, which can occur either on its own or as a symptom of another medical problem (such as Williams syndrome), are not fully known. There is speculation about the existence of damage or deterioration of the auditory pathways, especially in the cochlea .
These injuries can be at the level of the inner ear or at the level of the brain. The damage in question may have multiple causes, ranging from the presence of congenital alterations or malformations to acquired causes. The latter include exposure to large amounts of noise on a continuous basis, which can damage nerve connections and make them sensitive. It can also arise from the damage caused by a head trauma (which is why some subjects who have had car accidents would have such a problem) or even the consumption of some substances.
At the hormonal level, serotonin seems to be involved, being the alteration in the serotonergic ways another of the possible causes of this problem. Stimulus deprivation is also proposed as an etiology in some cases, but this is unlikely.
Traditionally, the advice given to those suffering from hyperacusis is to avoid noises that disturb them , or to use barrier methods that muffle the sounds. This avoids suffering, but in the long run it actually makes the hearing system more sensitive because it is not used to handling sound. This ultimately makes it even more difficult to lead a normal life.
It is more advisable for the patient to be exposed to environmental noise levels in a controlled manner. It is recommended that those who suffer from it have devices that help them generate a noise low enough so that it is not particularly harmful to them but that it keeps them stimulated, trying to make the nervous system adapt little by little to the most common sounds. In other words, the aim is to generate a progressive desensitisation which, over time, can reduce the sensitivity of the system.
Another fundamental aspect to be dealt with is the psychoeducation of both the subject and his environment. This last aspect is essential due to the great difficulty that can suppose to understand the suffering of the patient before stimuli considered “normal”, to demystify some aspects associated to this problem and to contribute to generate patterns of behavior and socialization that make the subject feel socially supported.
At a pharmacological level, benzodiazepines, SSRI antidepressants (remember that serotonin has been associated with some cases of hyperacusis) or even anticonvulsants are usually used. On a medical level, surgical methods have sometimes been used, although this is not usual.
It may also be necessary to work on the possible appearance of depressive episodes or to carry out training in anxiety management and coping with stress, which can be both a product and a trigger for the sensitivity of these people to noise.