The Link Between Anxiety and Tinnitus: Insights from Recent Research

The relationship between anxiety and tinnitus has become an increasingly prominent focus in contemporary research, especially following the psychological challenges introduced by the COVID-19 pandemic. Evidence suggests that anxiety not only intensifies tinnitus perception but also perpetuates a cycle of emotional distress and physiological arousal that worsens the individual’s quality of life.

Studies have consistently shown that elevated anxiety levels correlate with heightened tinnitus distress. Ziai et al. (2017) identified a direct association between tinnitus severity and anxiety intensity, recommending that individuals experiencing greater anxiety perceive their tinnitus as more intrusive.

Likewise, Kirazlı et al. (2024) observed that 32% of participants reported their tinnitus worsening due to pandemic-related fears, reinforcing the impact of external stressors on tinnitus experiences. Supporting this view, Korkut and Altıntaş (2024) found that anxiety disorders are more prevalent among tinnitus patients than in the general population, particularly during stressful situations.

Chen et al. (2022) further demonstrated that anxiety disorders, especially generalized anxiety disorder, have a substantial effect on tinnitus severity. Beukes et al. (2020) corroborated this by documenting an increase in emotional distress, including anxiety, during stressful periods, which led to greater tinnitus annoyance. This evidence indicates that the auditory and emotional systems are closely interlinked through shared neural and psychological pathways.

The cyclical nature of anxiety and tinnitus has been well documented. Li et al. (2025) reported that sleep disturbances often accompany chronic tinnitus and are exacerbated by anxiety, creating a feedback loop that sustains both conditions. Similarly, studies by Lasheen et al. (2020) and Hou et al. (2020) confirmed that the aggravation of tinnitus contributes to deteriorating mental health, including heightened anxiety and depression, which in turn amplify tinnitus distress.

Recent evidence emphasizes the importance of psychological interventions. Wallhäußer-Franke et al. (2017) concluded that early recognition and management of anxiety symptoms can significantly improve the prognosis of tinnitus patients. This highlights the necessity for integrated treatment strategies that address both auditory and emotional health dimensions.

In conclusion, the literature strongly supports a bidirectional relationship between tinnitus and anxiety. Effective management requires a comprehensive clinical approach that encompasses both the perceptual and psychological aspects of the condition. Addressing anxiety not only reduces tinnitus-related distress but also enhances patients’ overall well-being and coping capacity.

References

Beukes, E., Baguley, D., Jacquemin, L., Lourenco, M., Allen, P., Onozuka, J., … & Manchaiah, V. (2020). Changes in tinnitus experiences during the COVID-19 pandemic. Frontiers in Public Health, 8. https://doi.org/10.3389/fpubh.2020.592878

Chen, S., Shen, X., Yuan, J., Wu, Y., Li, Y., Tong, B., … & Liu, Y. (2022). Characteristics of tinnitus and factors influencing its severity. Therapeutic Advances in Chronic Disease, 13. https://doi.org/10.1177/20406223221109656

Hou, S., Yang, A., Tsai, S., Shen, C., & Lan, T. (2020). Tinnitus among patients with anxiety disorder: A nationwide longitudinal study. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00606

Kirazlı, G., Uysal, G., Akmeşe, P., İnceoğlu, F., Özgürsoy, S., & Öğüt, F. (2024). An evaluation of the relationship between subjective tinnitus perception and COVID-19-related psychological factors. Ege Tıp Dergisi, 63(1), 45–55. https://doi.org/10.19161/etd.1250615

Korkut, S., & Altıntaş, M. (2024). The frequency of health anxiety, coronavirus anxiety and anxiety disorder in patients with tinnitus during the COVID-19 pandemic and the impact of pandemic on tinnitus. Clinical Otolaryngology, 49(6), 725–732. https://doi.org/10.1111/coa.14196

Lasheen, R., El-Gharib, A., & Tomoum, M. (2020). The effect of COVID-19 pandemic on the quality of life of patients with chronic tinnitus. Egyptian Journal of Ear Nose Throat and Allied Sciences. https://doi.org/10.21608/ejentas.2020.46114.1267

Li, S., Liu, Z., Xu, X., Wu, C., Li, J., Guo, T., … & Da-jing, X. (2025). Severity, age, sex, sleep, anxiety, and their correlation analysis of 1,739 tinnitus patients. Laryngoscope Investigative Otolaryngology, 10(1). https://doi.org/10.1002/lio2.70084

Wallhäußer-Franke, E., D’Amelio, R., Glauner, A., Delb, W., Servais, J., Hörmann, K., … & Repik, I. (2017). Transition from acute to chronic tinnitus: Predictors for the development of chronic distressing tinnitus. Frontiers in Neurology, 8. https://doi.org/10.3389/fneur.2017.00605

Ziai, K., Moshtaghi, O., Mahboubi, H., & Djalilian, H. (2017). Tinnitus patients suffering from anxiety and depression: A review. The International Tinnitus Journal, 21(1). https://doi.org/10.5935/0946-5448.20170013