When tinnitus gets in the way of making plans, it's time for a reset

When you live with a challenging health condition like tinnitus that can suddenly ramp up and ruin your day, it can fundamentally change the way you interact with the world.

Many people with tinnitus start to avoid making plans. Vacations get canceled and noisy environments are avoided at all costs. Many tinnitus patients end up isolating at home where they feel safe and in control of their environment. For better or worse, most sufferers put life on hold out of fear of experiencing a tinnitus spike.

It’s not irrational to experience this kind of fear either. It is incredibly scary to live with a health problem that can randomly cause intense suffering with little to no warning. And it doesn’t help that many things we may encounter in daily life actually can exacerbate our tinnitus.

To try to cope with this kind of fear, many sufferers impose potentially unnecessary limitations on themselves. Most people find that they can avoid suffering by making their world smaller, and so they say no to activities they would have otherwise enjoyed.

But it doesn’t have to be this way.

With the right strategy and a little bit of planning, you can accurately predict how your choices will affect you and you can start to make plans and decisions without fear.

The decision-making process

The next time you are invited to participate in an activity that you might enjoy, but are inclined to avoid out of fear, don’t just say no because there is a chance something could go wrong.

Instead try the following exercise and answer these six questions as best as you can:

Question 1: Will I enjoy myself if I do this activity?

Before you do any actual planning, you need to decide if this is something you actually want to do. There will always be the risk of things not working out like you hoped, so it’s important to be honest with yourself here. Sometimes pushing yourself could mean taking a risk entirely for someone else’s benefit. And that may not always be a good enough reason to participate.

(If the activity involves something you are obligated to do and you don’t have the option of saying no, continue directly to question 2.)

Question 2: What could go wrong? (Write it all down)

This is the first real step in the planning process. Grab a pen and paper and write down a list of everything that could go wrong if you go and fully participate in this activity. Be as specific as possible with your answers and make sure to include a “worst-case scenario.”

Often, the fear we experience around making plans is felt as a vague feeling of emotional uncertainty. There is generally not a lot of clarity and specificity in our thinking when we feel this kind of fear. Sometimes, the act of simply writing down everything that can go wrong—as clearly as possible—can eliminate the fear. I can’t tell you how many times I’ve looked at my list of things that could go wrong only to realize that I wasn’t actually worried at all. Often, it was a feeling of anxiety, felt in and around my stomach, that had been causing me to say no reflexively. The fear I felt was like an invisible force field that kept me from the things I wanted to do, and probably could have done much sooner.

Question 3: How can I prepare for everything that could go wrong?

Now that you have a specific list of potential problems, the next step is figuring out what you can do to prepare. What specific actions can you take ahead of time to minimize the risk of any negative outcome? Write it all down.

Question 4: What can I bring with me to address potential problems?

You will not be able to control all the variables when you are out participating in the world, but you can bring the tools and supplies that you might need to deal with problems as they arise. Keeping a medical go-bag with you can help to address problems on the fly.

In the case of tinnitus, this could mean bringing things like medications or supplements, and other tinnitus tools, such as a way to play background noise for masking, audio options, headphones, earplug options, or other emergency equipment. If you haven't already, add tinnitus apps to your phone that you find helpful.

Make sure you have everything you might need to solve potential problems either on your person or closely accessible. Even if you don’t end up using them, it’s always better to bring these items and not need them than to not have them when you wish you did.

Question 5: What will I do if things go wrong?

Now it’s time to make a plan, and not just one plan, but a contingency plan for every possible thing that could go wrong (that you identified in question 2).

For each potential problem that could arise, decide exactly what you will do. How will you get out of the situation if necessary? How will you get to safety (or in the case of tinnitus specifically, feeling safe)?

And most importantly, for each potential problem, plan how will you recover afterward. Is there a chance you will need a few days to rest? Make this part of the plan.

As a person living with Meniere’s disease (it’s the underlying cause of my tinnitus), I still live with unwanted limitations. But I will often do the things that matter most to me, even if I know there is a price to be paid.

I view this as a kind of empowerment. I choose to live my life on my own terms, even if that means I may not feel well after doing some of the things I want to do. So recovery is always part of my plan, and when I take those days to rest, everything ultimately works out exactly as I expected.

Question 6: Taking all this information into account, is it worth it?

Now that you have thought it through as completely as you possibly can, ask yourself, “Is this activity worth the risk?” After considering all the variables, you might decide that it is not worth the risk. Maybe there is too much downside and not enough upside. Maybe you have an important responsibility to meet soon after this activity, and you can’t take the chance of causing a problem that will prevent you from meeting your obligation.

If you think it through and ultimately decide not to participate, you are making a highly informed decision where fear is not the motivating factor.

But if it is worth the risk, accept all of the possible consequences in advance.

Acceptance, participation and enjoyment

If you decide to participate, fully and completely accept all the potential problems in advance, then put it out of your mind and go enjoy yourself as much as possible!

If anything happens, you will be fully prepared. You will have a contingency plan to deal with any problem that might arise. You will have the tools and equipment you need to minimize discomfort. You will have a way to get home safely, and a plan to recover if necessary.

Most importantly, if things go wrong, you will not be nearly as disappointed as you might have been otherwise, because you will have fully accepted this outcome in advance.

There is always the chance that it may not end up working out in your favor. But by choosing to participate, it’s still a massive win, because fear didn’t hold you back from living your life on your own terms.

It will not end up being just one more example of tinnitus ruining something you care about. And it might just work out in your favor the next time!

Want a worksheet for this exercise? Get my free Activity Planning Tool.