Why health anxiety makes PPPD and neural circuit dizziness so much worse & how to stop it
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- čas přidán 28. 08. 2024
- Many people with neural circuit dizziness (symptoms of PPPD, MdDS, vestibular migraine, long-term uncompensated or decompensated neuritis, post-concussion syndrome) suffer from horrible health anxiety in addition to their already distressing dizziness symptoms. In this video, we explore the link between health anxiety & neural circuit dizziness and why you definitely need to work on your health anxiety to recover from dizziness. Then we talk about how trying to bypass or fix the anxiety doesn't work for many people, and I give you a new strategy for working with it that you may not have encountered before.
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• Do THIS to heal from P... DISCLAIMER: Please note that Yonit Arthur, The Steady Coach and any of our other guests are not acting as an audiologist nor offering audiology or medical services services or advice on any public videos or on any other content. This channel provides wellness education and personal opinion only, and are not meant to be a substitute for medical or mental health instruction or intervention. Use any tools discussed at your own risk.
I believe this is so true. After going through a severe anxiety, my body has not been the same.
My health anxiety started when I was younger. In school we were getting the meningitis jab and I was paranoid about getting the illness. I said to my Mum what would you do if I got it and died and she said she wouldn't want to live anymore. I remember being horrified. So ever since then I was obsessed with illnesses and not dying for my Mums sake. So now with this 24/7 dizziness my anxiety is so high and having panic attacks almost daily. But your videos have seriously become a lifeline for me.
I am glad that you have found my videos helpful. You are not alone in how you are feeling ❤
My mother also created terror in me in a very similar and very consistent way….it is hard to overcome xx
Dr Yonit, I just want to say thank you so very much for these videos they have seriously changed my life. I experienced random dizziness for over a year now. I had my first panic attack from the dizziness not knowing where it was coming from. After that attack I started disassociating badly and I thought I was seriously going crazy and developed severe health anxiety. Pure hell. Fast forward to now, a chiropractor diagnosed me with whiplash from an incident I had before my dizziness. During my treatment now I’ve had continuous dizziness and I’ve had to do alot of the techniques you teach to rewire my brain. My anxiety is very low now. I am able to turn off the alarms in my brain before they go wild. You’re videos helped me to know that I was never crazy and that all I felt was NORMAL. I still disassociate from time to time but instead of fighting it I listen to it and embrace it and it starts to disappear quicker than it did before.
Leah, WOW, thank you so so much for sharing your story with me! It is incredible that you've been able to take the tools you've learned here and take charge of what is going on. I am so happy you're feeling better! Keep at it!!
How are you doing ?
I’m glad to hear this cause I’m going through my own Hell 🥲
⁸😅😅😅
My health anxiety worsened over the last few years. And last year I went through a really stressful period. After that is when my light headedness started.
I am an anxious person and hope I can manage this because it's horrible
Same. I already have some periods of dizziness when i'm anxious (other time its nausea or random pains), when its dizziness turn sometimes I cant go outside because I'm so afraid of what my mind could do. When i dont think about it I have absolutely no health problem, and it can be so frustrating to have this anxiety when I know my body works correctly and I know its just anxiety. But I learned that the more you listen to your body the lighter the symptoms are. It's possible to win the battle, its just difficult and ask a lot of self-understanding and patience, which isnt easy. Proof is I write that during a dizziness crisis lol, but it's just a manifestation of a deeper problem that only want to be healed.
What are your symptoms?
@@kafei-cremehow do you listen to your body man, I’ve been going through exactly what you have when I say exact it’s sooooo similar, if you could reply to this I’d be happy :)
@@mrberks2172 hi ! well it usually happens when i'm overworking myself or put to much pressure upon me, so I know I need to do something about this before my body will react. Usually I do sport to exteriorize or I write on a journal how I'm feeling lately (I also have therapy so journaling helps with it to see where the issues may lies, usually the dizziness is only a symptom of something way deeper so it takes introspection to see where it comes from). Lets say I learnt the hard way what my body wants to tell me, so now I know pretty mecanically what will happen if I don't do this, or if I do that to much, so I regulate myself to avoid the symptoms appearing or becoming stronger
@@kafei-creme I see, but I just need some comforting because the thoughts are getting worser and worser and I’m currently on holiday at my home country and everything just feels like a dream, I searched it up it said something like Derealization or something idk but the thought of me being in a dream scares me a lot. Thanks for replying btw
Looking at anxiety (and other symptoms) as a third person and just observing and being curious about it. I've been practising somatic tracking for about 6 months now and it helps so much with learning acceptance and just being able to sit with your symptoms, rather than react to them. It really helps with breaking the fear/symptom cycle
It really does, and this takes it a step further- to compassionate curiosity!
Thank you for your awesome advice. I'm dealing with my first episode of vestibular migraine, and you have helped me so much already. Keeping a positive attitude, giving that scared part of me a voice, and yes, the irritated part of me too, has been helpful to keep the anxiety smaller. I'm doing what I can, believing I'll get better, and giving myself a lot of grace. Thank you!
You're very welcome, Julie! It sounds like you are on the right track!
I am feeling 95 percent better. Last week noticed differences and every day got better and better. Feeling so well flying next week with my oldest son and going on a surfing trip. Pppd and vm. After 7 months just like it’s gone. I assume this is a good thing?
Anxiety is still a big one for me. Worst in the mornings upon waking in the mornings
Thank you so much for this video I’ve been feeling anxious these past few days to the point where I kept feeling like I was going to pass out and I couldn’t calm myself down but I sat down and watched this video and it comforted me and your tips helped a lot rlly fast
I am so glad that you found this video at the right time.
God bless you and thank you so much for this video.
My disability lawyer told me the other day after speaking with me that I sounded like a hypochondriac. I never really thought about that until he said that. I felt very insulted and embarrassed. Then I got to thinking about it and then I researched it of what it meant and now there’s a new terminology “health anxiety”. And then I just was checking some of your videos as I always do and I chose this video to watch today and I am so happy that I did because this hit it right in my heart and my brain where I need it the most today. Thank you so very much for this video. You are a godsend.
You're very welcome, Stacey! I am so glad this resonated with you today ❤
Makes so much sense. Thanks. Health anxiety does trigger a lot a things.
You're very welcome, Kaustav!
Thank you sooooooo much . Going to join right now. Desperately need support in this crazy space . Xxx
Very well explained and there is no fear at all recognising the voice of irritation and speaking back to it mindfully. And in not fueling the irritated voice, the paradox is it goes away.
It is a paradox and not so easy to put into practice, so it's great to hear you're pulling it off!
My anxiety started after an accident. Education has been what has worked for me. Once I educated myself on the symptoms of anxiety and how and why they manifest I noticed that my anxiety started to reduced in intensity and frequency. You also have to allowed the feeling to come knowing deep down that you’re going to be ok. Be kind to yourself, light exercise, meditation.
Yes!!
My therapist tells me I don’t have a health issue, I have an obsessive thought issue, and I’m allowed to tell it that, but also don’t have to convince it for hours. Like you say, have an open conversation but set boundaries of not speaking to it for hours or days. Love your videos ❤
Yes, well done!! great advice!
I think this is in part what Im going through. 3 months ago I had a case of BPPV, it was quickly cured with an epley maneuver. Since then Ive had residual dizziness or light/heavy headedness. Its gotten worse over the last month or so. I just had a physical this week.....I now have high blood pressure ~155/95.......was never an issue before. I think my obsession with the dizziness has stressed my body which leads to increasing blood pressure. The increase in BP has an effect on the dizziness which stresses me more.......and the circle continues. There are times when I dont feel any dizziness........when I'm actively, physically engaged in some sort of activity.......like yard work. I can work in the yard for 2 hours and not have one episode or even a thought about dizziness. Ill then sit down for a break and boom! I can feel it again and I start thinking about it. If I can somehow keep my brain busy on other thoughts I could do better. Doesnt help much when half my youtube feed is filled with dizziness videos :)
Great insight! I agree, sounds like you know what's causing this. CZcams and other social media algorithms can absolutely contribute to the issue. I think it makes a lot of sense to limit your time on them!
I’ve had health anxiety since I was 16. PPPD began when I was 22! The fact that I was already so anxious made everything so much worse in dealing with the dizziness. It’s gotten so much better but I do still deal with health anxiety. Some really amazing tips here!! 🥰🥰
You've grown so much from this!!!
The Steady Coach 🥰 thank you
@@Megan_Jennifer Did you have dizziness 3+ months? I have it 24/7 for a week or couple of days and it just stops so i don't know if it can be PPPD.
@@Maestro-le8gh I had it for 3 and a half years! And I’m still recovering lol
@@Megan_Jennifer Like every day? That's why I don't think i have it because mine comes in waves like for 4-5 days it's here and then it stops for like a month.
These videos are so helpful. Seriously, thank you.
I am so glad! You're very welcome!
This was very informative and Learned a Lot from this video. Thank you so much. This is what I Feel Everyday. 😮
What we ultimately want is to feel perfectly fantastic all the time with zero pain, zero vertigo, zero health issues. What we want is perfect physical and emotional health. Period. 😊. If only.
Very true, and often when people are dealing with chronic dizziness, they have imperfect memory of what life was like before. it is normal to have aches and pains and periodic weird sensations and colds and anxiety and sleepless nights. Of course it's NOT acceptable to have that ALL the time and be debilitated to them. But a totally sensation free and pain free life is not going to happen!
@@TheSteadyCoach❤
Thank you so much dr . You may not know or maybe you know how it feels like when someone understands your problem and tell you how to get out of it . Thank you so much
You're very welcome! You are not alone!
Anxiety has a positive intend for me. Yes, a great way of looking at it. 🥰
That's what it boils down to IMO!
Excellent video Dr. Yo. Understanding that our brains are really trying to protect us was a key concept for me. Thanks for all your hard work!
Thank you, Paula! It is certainly a big theme here among the comments that people feel betrayed by their brains and bodies, and that additional stress and anxiety certainly contributes to the cycle.
God bless you. You are my angel. Please keep producing content you’re helping me so much. You’re helping me feel safe and like I can do this.
You can do this, Kelly! Thank you so much for these kind words ❤
After I had my son , my anxiety got so severe I felt I couldn’t function, and the stress of being a new mom just threw me off , I started to get tension headaches and dizziness on a daily basis felt like I was walking on a trampoline it’s been awful
It sounds miserable. I'm glad you're here.
What advice would you give to someone, who doesn't have any thought related anxiety, where the anxiety is purely physiological?
It took me personally quite a long time to even attribute my symptoms to anxiety, because I wasn't consciously aware of anxiety, but I just noticed a more intense and fast heart beat.
I discuss more on this topic in this video czcams.com/video/pTEfRdAZLZ4/video.htmlsi=5FHK6d2L3xBoVGkA
I’ve dealt with chronic dizziness for along time, I just cannot figure it out, the only way I can deal with the dizziness is to take benzodiazepines, very low dose but it just seems to be to only thing that works along with really calming down the ear ringing.by the way your videos are great!
Do you happen to grind your teeth at night? Or clench your jaw through out the day?
@@Andreafitmommyno ma’am
Now I want a chocolate chip cookie!!! This video helped me greatly. Im under alot of financial stress, trying to find a home to move into, and just freaking with alot. I rely on Jesus my Savior, negate he knows when I'm coming home to be with him. Your video is terrific and I shared it on Facebook to help others.
Thank you, Cliff! I am glad that this video was able to help you! It truly is my privilege to be able to share this information!
I was always panicky and overthinking throughout my life, now here in my 40's anxiety has manifested into a lot of physical symptoms. Dizziness, hot flashes, rapid heartbeat, etc. Before i realized it was my anxiety i had spiral so far down i was convinced i had ALS, Parkinson's, etc
Please look into perimenopause x
That's called menopause . Everything you listed is a menopausal thing .
I have it all too . Your brain is in withdrawal from hormones .
I struggle with this for like 4 years maybe and I fell like in the last 4 months I got better,even if I had a recent accident that kept me isolated for 3 months mostly in bed. First years I searched everywhere to see what causes this symptoms and of course nothing,just money wasted. I have to stand many hours at work and sometimes I still have those symptoms. Everything here is helping a lot
I am so glad that these videos are helping you! Thank you for trusting me with your healing ❤
Thank you again for your videos. So insightful. I wish I could just turn off the over thinking, but I know that is not possible and so I will keep trying your technique you shared.
Give it a try, Jason. I have found this technique to be tremendously helpful for both me personally and my clients.
I wish I knew if my hypoglycemia was coming from being dizzy or if my dizziness is coming from poor blood sugar regulation. Ugh!
Does anybody get shaky/dizziness in middle of the face, nose/forehead for a few seconds throughout the day? I've had sinus and brain mri all clear
Yes!
@@TheSteadyCoach it's common?
Goodmorning Yonit....I can say I'm doing better with my anxiety once I started to practice acceptance...and not resist it like I use to..with time anxiety became less and less to almost none...but now I have bad health anxiety or negative thinking I would say and makes my off balance strong along with more tense neck tension if this all makes sense? Thanks Yonit!❤️
Yes, the focus of the anxiety often shifts around! And yes, from my perspective, the anxiety you feel inside you creates tension that can lead to both off balance feelings and the neck pain. Try this technique out the next time you start to hear that voice in your head that keeps talking about the symptoms and what they mean.
@@TheSteadyCoach9
What about panic???
I feel like my symptoms started after a major panic attack that took me to the ER
I tend to get annoyed and not so lenient. Thanks for your help
it is definitely a different approach than what most people take naturally!
Thank you for making this video. How do I deal with this?
While I do struggle with health anxiety, I think the most difficult thing for me to deal with is the feeling of hopelessness and feeling like "I just can't take it anymore." My symptoms of internal dizziness, brain fog, cognitive issues, etc get so intense that it's almost impossible to bear. I can't function normally and live my life, doing the things I'd like to be doing. The thought that I've suffered for over 3 years, feeling just as bad as I did immediately after the concussion from a car accident that started all of these symptoms, and that there's seemingly no end in sight, make me feel extremely depressed and hopeless.
It goes past the point of health anxiety and feeling anxious or worried about the symptoms. It gets to a point where I feel like I simply can't stand to feel this way anymore and it's become a chore to be awake and have to feel this way. I'm afraid I'm structurally injured, that it won't heal since it hasn't seemed to in the past 3 years, and that I'm stuck feeling these absolutely terrible physical sensations and cognitive impairments for the rest of my life. How do I handle this?
You are not alone. You will see from the success stories that many others have walked a similar path and are out on the other side. I believe you can too. Here is another video too that may be of interest. czcams.com/video/P1tS9uuq7xA/video.htmlsi=-XCAL058xfR3ime1 I believe in you! ❤
Awesome. Thanks!
Fantastic video, thank you.
You're so welcome! ❤
Dr Yonit, I suffered a caffiene induced 4 hour panic attack (first time) and ever since have had this constant dizziness. Ive had tinnitus and some dizziness in the past but ever since that panic attack its constant dizziness, louder tinnitus and headaches. Its confusing cause theres many ear conditions. But i do know for sure my ear and dizziness issues got exponentially worst after the attack. Since then ive had health anxiety. Doing to much manual breathing. Would propronolol as needed be a good tool to get out of this negative feedback loop im in?
I’m so sorry, Alexander. That makes sense. I actually find propranolol has been quite helpful to some of my clients and it doesn’t usually result in many detrimental side effects. Of course good to discuss with your doctor.
How are you doing? I had a similar experience and wondering how your healing journey is going?
@@DanceHoops It improves over time. I started meds cause of it. still teying to find the mental balance I had before this happened. The advice I can give you is to stay away fron Delta8. Smoke regular thc
Makes so much sense 😢gonna try this ❤
I'm so glad it helped.
Thank you for these videos. I’ve been dealing with dizziness for nearly 4 years with Good days bad days. This video is very poignant to my experience.
I'm sorry you've been dealing with this for so long. You're not alone, as you can see here on my channel! I'm glad this resonated- I hope it helps!
Hi Dr. Yonit your videos are very insightful and I felt like I was getting better and then I worked out in a treadmill and then everything went upside down my dizziness increased by a lot and so has my anxiety I cried and I felt so bad like when will this ever stop it was just so bad like I got up in the middle of the night and my vision was so shaky and I felt like my brain wasn’t adapting to change rather it was just making me more dizzy it was very crazy
Hi Lucas, the treadmill can mess with you temporarily if you have neural circuit dizziness but don't freak out! It's just confusing to the brain because it's getting contradicting information from your eyes and ears and sense of touch. Remind yourself that you're safe and that this is just a brain prediction mistake.
@@TheSteadyCoach hi :) also I feel like there’s some pain in the back of my head do you know if neural circuit dizziness also does that? I’ve been really stressed out lately and I’ve been doing somatic tracking to heal :)
The ENT specialist told me that I have a vestibular issue on the right side of the year. However, i also suffer from chronic anxiety. Could my anxiety be increasing my dizziness?
Yes, i am recovering from anxiety and have episodes of dizziness...every day it decreases bit by bit and i don't pay much attention to it!
Thank you very much for sharing your expertise as regards vestibular dizziness. I have a chronic type as I have been suffering for like 2 years now. My TMJ disease is being addressed through teeth splints while my BPPV is being managed, too. I hope that you will also discuss the relationship of middle ear imbalance which is also associated with TMJ disease. My left ear is usually painful with popping sound at times when I deep breath, as well as tinnitus-like. My EENT suspected that I had an ear infection when I was a child as he has inspected it. I hope that my dizziness will be addressed through your expertise as an audiologist. Thank you in advance for your possible help.
You may be interested in this video czcams.com/video/y6UQmNSnVFo/video.htmlsi=J1TkZmpajuAsyVdm
Brilliant!!
You may sound it so easy but when you are in the situation its like the part of me wants to go home cause I feel safe there .Today im going to school and try your advice im taking gingko so I will see if its working
It is SO not easy! It takes a ridiculous amount of courage. I am amazed every day by the incredible people I hear from on this channel. I know you're one of them.
Thanks Dr Yo. You mentioned turning of the threat response in our brains to allow the brain to heal. I have vestibular migraine and would like to know if my symptoms are really bad currently, can medication possibly be necessary to allow the symptoms to subside in order for my brain to heal or should I try to achieve this without medication
Hi Chatiqua, I wouldn't say they are necessary but only you can decide if you need to use them. I have seen people recover without them, and I've seen people recover with them. If you are suffering horribly, it is perfectly ok to get the help you need. If that doesn't feel right to you, you can do it without them.
This happens to me, i always think about getting dizzy and it just starts hitting me out of blue. Sometimes I can manage it to not take over me but majority of time it takes over and it lasts for days 24/7.
Last year it didn't come back for 8 months and then i hit my head, got scared because of my severe health anxiety and it just appeared out of nowhere again.
It started yesterday again because i was just thinking "what if it comes back again today", I can't sleep because of it so it makes me not enjoying my life.
So sorry to hear that has been going on for you. Sometimes this part of us is particularly entrenched due to past experiences and it can be really hard to help it relax. In those cases it can be helpful to work with someone who has experience with health anxiety.
Is it possible to have neural circuit dizziness and cervogentic dizziness together? As i go dizzy to the point the room spins when i tilt my head forward and look down, i also go dizzy when i'm stressed, causes alot of anxiety which doesn't help
Hi Gary, check out this video in which I go into more detail on this topic czcams.com/video/Mjt67Ab6XQ8/video.htmlsi=OWH2ny3Py5x2bgyh
This is my Exact experience!
Dr Yonit, do you have any opinion on using anxiety med's, my gp is suggesting to take Sertraline (a generic for Zoloft) but I have other dr's saying don't take those. I'm favoring not taking them. Thank you for your vids!
Ask Dr. Yo: Do I need to take medication to get better from chronic dizziness or PPPD? czcams.com/video/NLnSNCpewh4/video.html
I had a anxiety since 2022 had many symptoms but now for about one year Im facing severe eye symptoms such eye floaters, light sensitivity, visual snow, light flashes and negative after images like when I see any obj its img is saved in my eyes for few sec and then slowy vanishes furthermore I feel like everything is moving and when I walk I feel like everything is shrinking in ward motion im facing thses problems continuous for about one year.plse a guide thesevthing are mormal or not Im very afraid of my eyes?
I feel weird every time I walk into a room I'm scared and the dizziness is ruining my life
I am sorry you are going through this. You are not alone! Please check out my free course on healing chronic dizziness. thesteadycoach.com/free-course There is hope!
Hi, tanks for are you're awesome video's! I have changed my mind about pppd completely and now I finally can relax my body for the first time in 4 years. I am very tired now and want to sleep all day. Is it oké to sleep as much as my body ask for it, or is it better to push through?
Hi Jacolien, totally normal for your fatigue to increase during recovery and it's ok to listen to your body and rest!
@@TheSteadyCoach thank you so much for al your answers, you are literally changing my life
Please. Can you help with tinnitus?
Been having PPPD Since January 2021 and some symptoms have changed over time and have gone through periods where I was almost completely fine, but also notice alot of fatigue main when am not active if I lay down and could just fall asleep on point. Is this due to PPPD symptoms or could it be something else??
Fatigue is a big "co symptom" of dizziness. I talked about this in a Q&A somewhere but it's probably time for a dedicated video on the topic :). Short answer: very common, and a normal part of neural circuit dizziness.
Thank you
You're very welcome, Pat!
My respons to the health anxiety thought are that I believe the them and then I get scared. Should I also try to meet my thoughs the way you described in the video?
I think it would be enormously helpful to do that.
Dr Claire weekes found this in 1960 s to
Claire Weekes’ work is amazing!
I'm wondering how to deal with health anxiety & dizziness which is triggered by a diagnosed issue in my spinal cord which is potentially serious, but which my doctors say doesn't cause any problems. So basically my spinal issue is usually serious (according to doctor Google) but in my particular case it probably isn't (99% according to my own doctors).
Many people have serious health issues that caused their dizziness to begin with but that don't explain why they have ongoing dizziness. If your doctors say your dizziness is not the result of the spinal issue, then your dizziness is a neural circuit problem. czcams.com/video/4QDFGvHGURc/video.html
In other words don't feed the anxiety distracted your mind.
It’s good not to feed the anxiety for sure, but I don’t think distracting is always a good strategy because that can increase fear.
Of course 🤦♂️
ive got my CT scan done & doc said you are fine & your brain is fine but why am always dizzy?
Why you have PPPD, MdDS, and other unexplained chronic dizziness & how to recover
czcams.com/video/4QDFGvHGURc/video.html
Hii doctor yonit how are u ?? Doctor just want to know my symptoms intensity got less as before but want to tell u sometimes I feel boat feel, some days I feel lightheaded, some day depersonalisation so is this occurs in pppd and if so these symptoms eliminates slowly over time passes??
That is wonderful to hear! It's very common for symptoms to change and even go up and down over time! I have a name for it- symptom drift. czcams.com/video/APOw4MWc-Gc/video.html
How do you feel about SSRIs for PPPD. This seems to be commonly recommended
Ask Dr. Yo: Do I need to take medication to get better from chronic dizziness or PPPD?
czcams.com/video/NLnSNCpewh4/video.html
Dr. Yonit, I want to ask , why is PPPD worse when upright or standing up? Coz mine gets better as soon as I lie down
Your balance system has to work harder when you are standing! Brain works harder = more room for brain errors.
@@TheSteadyCoach please help me. Im in the Philippines and I do not know what specialist i need to look out for relief , I have had this for 3 years now , and its getting worse
The more you resist the more it persists
Amen, Jackie!
@@TheSteadyCoach easier said!! Im
Still working at this!
@@jackiegroden416 I’m working on this, but I like the technique of “focus on how you want to feel.” Like, I feel calm. I feel steadiness from my arms or legs, when I walk. Etc.
I just have swaying and lack of balance when walking.
Is it also neural circuit?
Hi Sherri, I talk about this more in this video: How to tell if your chronic dizziness is PPPD or MDDS (neural circuit dizziness) czcams.com/video/rtwNNaw7dqA/video.html
@@TheSteadyCoach what is the mechanism that causes the swaying?
Or ground is bouncing.
I am a healthcare professional and would like to know.
Thank you 🙏🏻
Is Pppd dangerous? Can I fall due to it? I have generalised anxiety disorder and I am facing off balance problems since 2 years. I'm worried i might fall because of it. I can workout and go to the gym, but oddly walking and standing seems very difficult. Will I fall due to it? How do I overcome this fear? :(
Hi Sanya, I talk about this fear more in this video czcams.com/video/B1iQELBDYII/video.html
This is happening to me, I don’t know how to fix it, I’m desperate.
You're in the right place. Start here: czcams.com/video/4QDFGvHGURc/video.html
Ever since a bad attack of b
I'm sorry Christine, your comment is cut off.
Is tinnitus usually a part of pppd symptoms ?
It's very common with PPPD, but not everyone has it.
Hi dr i want to ask about ear ringing is a common symptom of anxiety?
Very common- almost everyone has ear ringing actually, but people who are anxious tend to hear the ringing more loudly and in a more bothersome way.