Hyperacusis and PTSD
Those with Post Traumatic Stress Disorder (PTSD) can often develop difficulties with sounds such as an exaggerated startle response, fear of sound (phonophobia), aversion to specific sounds (misophonia), and a difficulty in tolerance and volume of sounds that would not be considered loud by normal hearing individuals (hyperacusis).
Hyperacusis is a condition that arises from a problem in the way the brain’s central auditory processing center perceives noise and is estimated to affect between 7% and 23% of the UK adult population. It can develop as a result of physical damage sustained to the hearing apparatus (through a head injury, Lyme disease, air bag deployment, Bell’s Palsy etc), or from conditions such as PTSD.
There is a confirmed link between PTSD and hyperacusis due to a cerebral processing problem specific to how the brain perceives sound and as you can imagine, when they are present concurrently have the potential to exacerbate one another. Hyperacusis is very different from the reduced tolerance for noise that most of us have when we’re tired or stressed, or reacting to an obviously unpleasant noise, such as someone scratching their fingernails down a blackboard.
People with with hyperacusis have difficulty tolerating sounds which do not seem loud to others, such as the noise from running water, sirens, a phone ringing, dogs barking, walking on leaves, a washing machine, laughter and shouting, and the vacuum cleaner – any sound can potentially trigger a reaction in someone with hyperacusis – even the sound of their own voice.
Our Founder of PTSD UK remembers ‘When my PTSD was at it’s worst, I had a real issue with an advert on TV which featured a well-known comedian. In the advert, he pretends to be asleep and is snoring, and it used to drive through my head like nails. I had to mute the TV every time it came on.’
Although all sounds may be perceived as too loud, high frequency sounds may be particularly troublesome and can often lead to pain and discomfort. Often too, for those with PTSD and hyperacusis, a sound may be linked to the previous trauma which means that every time they hear the noise, it automatically triggers the “fight or flight” response and fear, anger and anxiety or can trigger a flashback.
Treatment specifically for Hyperacusis
Hyperacusis is thought to result from the brain amplifying sound signals too much. Retraining counselling and sound therapy aim to modify this brain response by removing negative emotional associations to sound.
Retraining counselling teaches patients how emotions and the nervous system may play a role in hyperacusis, and encourages them to reclassify troublesome noises as neutral signals.
Sound therapy helps this process by temporarily desensitising the hearing system so that the individual can go to noisy places without being constantly affected by them. “Desensitising” means listening to and gradually getting used to the sound, which is achieved through the use of noise generators worn on the affected ear or ears. The device produces a gentle static-like sound (white noise) that is barely audible. Completion of sound therapy may take up to 12 months, and usually improves sound tolerance.
It’s important to note, that while choosing your PTSD recovery path you need to address both the symptoms and the underlying condition. NICE guidance updated in 2018 recommends the use of trauma focused psychological treatments for Post Traumatic Stress Disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).
SOURCES: Healing From Complex Trauma and PTSD, Entnet, Recovery on Purpose, The Association Between Tinnitus and Posttraumatic Stress Disorder, Marc A. Fagelson, American Journal of Audiology • Vol. 16 • 107–117 • December 2007, Wikipedia,
IMAGE: Silence, please by Shawn Rossi
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