Treating Emotional Disorders with Maskers

Often when discussing hearing aids with a new patient, they’ll ask, “They just make things louder, right?” Yes, hearing aids do amplify auditory signals, but they also offer so much more. In fact, they are like mini-computers for your ears. New models can stream music and count your steps! But perhaps one of the most useful features is the masker. A masker is essentially a customizable static-like noise emitted by the hearing aids. While it can address a variety of conditions, today I want to focus on two: PTSD and misophonia.

Maskers and PTSD

According to the National Institutes of Mental Health, 6.8% of the population will develop PTSD at some point in their lives. Causes of PTSD can vary widely, but the significant impact on the sufferer’s quality of life is consistent. PTSD actually modifies brain volume in the areas regulating stress, impeding the ability to control emotional reactions. In relation to changes in the auditory system, some studies show that physiologic changes decrease a person’s ability to filter out intrusive stimuli and focus on only what they want to hear. Essentially, people with PTSD are more likely to be unable to direct their focus away from environmental sounds. They will be more easily startled by sounds and have stronger emotional reactions.

Maskers can help by drawing attention away from the chaotic environment around the patient. The user will have a steady signal to focus on and sudden sounds will not be as sharp. The masker sound will act to dull the external stimuli to a certain degree. Plus, the masker is totally customizable, meaning it can be programmed exactly as the patient wants. It can also be adjusted over time as needs change.

Studies have also shown that maskers can help manage tinnitus, which has a high comorbidity with PTSD, especially among veterans. Tinnitus in PTSD patients can trigger traumatic memories and is shown to be much more likely to be influenced by external sounds. Plus, tinnitus itself can cause increased levels of stress. Using a masker can decrease the perceived intensity of the tinnitus; thus, lowering stress levels. I want to note that counseling provided by a trained professional is essential to recovery as well, but maskers can be used as part of a multidisciplinary approach.

Maskers and Misophonia

Misophonia is a condition in which certain sounds elicit strong anger and disgust in a person. It is not related to trauma, like the emotional reactions in PTSD sufferers. And it is more severe than the annoyance you might feel when somebody clicks their pen. For those with misophonia, the sound of someone chewing, for example, leads to significant anger that can cause them to lash out at the person making the sound or go out of their way to avoid being near the sound source. Imagine the frustration you feel when planes keep flying overhead, but more intense and for everyday sounds. This is the daily reality for people with misophonia. And, not surprisingly, this can lead to the individual constantly feeling tense and anxious.

For those of you who have misophnoia, there is good news. First, you are not crazy or overreacting. A British study actually performed fMRI on those with misophonia and those without. They were specifically focusing on the anterior insular cortex (AIC), which helps control emotions and integrate bodily sensations, such as hunger or heartbeat. The scans showed that the AIC was far more active in response to certain sounds in those with misophonia than in the control group. In essence, their brains respond disproportionately to trigger sounds, similar to how the immune system overacts for those with allergies.

The second piece of good news is that misophonia can be managed with maskers. Similar to those with PTSD, the masker takes the edge off of the bothersome noises; thus, making the emotional response more manageable. I recently fit a patient with maskers for her misophonia. She reported that she was able to relax more and that the maskers were a great tool for her. Just like with PTSD, counseling services can also be a wonderful treatment. The counselor would work to slowly expose the patient to triggering sounds and reframe their emotional response in a more positive light.

Given that PTSD and misophonia possess emotional components, a team approach with multiple specialties will always provide the best outcome. Ask your audiologist which treatments will best improve your quality of life. QCBN

By Jeff Lane, Au.D.

Trinity Hearing Center is located at 1330 N. Rim Dr., Suite B in Flagstaff. For more information, visit the website at TrinityHearing.net. Jeff Lane is a doctor of audiology with a passion for improving the lives of others. Dr. Lane may be reached at 928-522-0500 or at audio@trinityhearing.net.