Hyperacusis: definition, causes, symptoms and treatments
To hear a laugh, hear the voice of a child or the cheerful barking of a dog or go to a concert of our favorite group are aspects that most of us consider pleasurable.
These are more or less common sounds of our day to day that accompany us and are part of our lives. But nevertheless, for people with hyperacusis, what seems normal and even pleasant to most people is a real torture .
And is that these people suffer from a high level of discomfort with hearing stimulation. What is hyperacusis? In this article we proceed to analyze this affectation.
- Related article: "Tinnitus or tinnitus: causes, symptoms and treatment"
Hyperacusis: concept and symptoms
Hyperacusis is understood as that condition in which who has it manifests a decrease in the threshold of tolerance to sounds . It is a type of hypersensitivity that generates that the person is not able to tolerate sounds that for other people are normative because they cause a variable degree of pain or discomfort. It is common for reactions to occur especially when there are loud and sudden sounds or repetitive and continuous sounds, which can be torture for those who suffer from it.
It is important to take into account an aspect that is often taken for granted: hyperacusis does not imply a greater auditory capacity on the part of the sufferer in comparison to the rest, said capacity being normal or even suffering from some kind of auditory problem. That is, it is not that they hear more than others, but that their nervous ways respond more easily and have less ability to resist sounds.
On a cognitive level, hyperacusis tends to generate problems when it comes to sustaining attention and concentrating . It can also generate an increase in irritability due to the persistence of sounds that can not be avoided, as well as the behavioral avoidance of those sources of sound that are discomfort. They often suffer symptoms such as headache, dizziness, nausea, tinnitus or physical and mental fatigue. Also sleep problems.
In addition to all this, people with hyperacusis often have social problems derived from their intolerance to sounds. This problem is not usually well understood socially, and can be very limiting. And is that by causing suffering the sounds of day to day, it is common to avoid or easily irritated by sources of sound that for others are innocuous and even pleasant. In many cases they avoid places where there are crowds, which today in urban environments is difficult to achieve. In some cases they decide to isolate themselves by restricting social contact.
The causes of this type of affectation, which can occur either on its own or as a symptom of another medical problem (such as Williams syndrome), are not fully known. It is speculated on the existence of damage or deterioration of the auditory pathways, especially in the cochlea .
These lesions can be found at the level of the inner ear or at a cerebral level. The damages in question can have multiple causes, which can range from the presence of alterations or congenital malformations to acquired causes. The latter include exposure to a large amount of noise continuously, which can damage nerve connections and sensitize them. It can also arise from the damages caused by a traumatic brain injury (reason why some subjects who have had car accidents would have this problem) or even the consumption of some substances.
At the hormonal level, serotonin appears to be involved, with alteration in the serotonergic pathways being another possible cause of this problem. In some cases deprivation of stimuli is also proposed as an etiology, but it is unlikely.
Traditionally, The advice given to those suffering from hyperacusis is to avoid noise that may cause discomfort , or use barrier methods that muffle sounds. This avoids suffering, but in the long run it actually causes the auditory system to become more sensitive because it is not used to handling sounds. In addition, this ultimately makes it harder to live a normal life.
It is more advisable that the patient be exposed in a controlled manner to environmental noise levels. It is recommended that those who suffer from it have devices that help them generate a noise low enough so that it is not especially harmful but that keeps them stimulated, trying to make the nervous system adapt little by little to the most common sounds. That is to say, it is about generating a progressive desensitization that with time can diminish the sensitivity of the system.
Another fundamental aspect to deal with is the psychoeducation of both the subject and his environment. This last aspect is essential because of the great difficulty that can be involved in understanding the patient's suffering before stimuli considered "normal", demystifying some aspects associated with this problem and helping to generate patterns of behavior and socialization that make the subject feel socially supported. .
At the pharmacological level, benzodiazepines, SSRI antidepressants (remember that serotonin has been associated with some cases of hyperacusis) or even anticonvulsants are usually used. At a medical level, surgical methods have been used, although this is not usual.
It may also be necessary to work on the possible appearance of depressive episodes or to train in anxiety management and coping with stress, which can be both a product and a trigger element of the sensitivity to noise of these people.