Tinnitus to the inner ear can cause tinnitus, other apparent causes (e.g., temporomandibular joint dysfunction) are difficult to explain. It may be caused by increased neural activity in the auditory brainstem, where the brain processes sounds, causing some auditory nerve cells to become over-excited. The basis of this theory is that many with tinnitus also have hearing loss. Three reviews of 2016 emphasized the large range and possible combinations of pathologies involved in tinnitus, which in turn result in a great variety of symptoms demanding specifically adapted therapies. Even when tinnitus is the primary complaint, audiological evaluation is usually preceded by
Tinnitus tinnitus may cause anxiety and depression. Tinnitus annoyance is more strongly associated with psychological condition than loudness or frequency range. Psychological problems such as depression, anxiety, sleep disturbances and concentration difficulties are common in those with strongly annoying tinnitus. 45% of people with tinnitus have an anxiety disorder at some time in their life. Psychological research has looked at the tinnitus distress reaction (TDR) to account for differences in tinnitus severity. These findings suggest that at the initial perception of tinnitus, conditioning links tinnitus with negative emotions, such as fear and anxiety from unpleasant stimuli at the time. This enhances