What Tinnitus Really Is — And Why 80% of People Learn to Ignore It

What Tinnitus Really Is — And Why 80% of People Learn to Ignore It

If you’ve ever wondered, “What exactly is tinnitus, and why does it bother some people more than others?”, you’re not alone.

To answer that, we’re drawing on the experience of Dr. Emily E. McMahan, AuD — a nationally recognized tinnitus audiologist, owner of Alaska Hearing & Tinnitus Center (All Ears Alaska), and co-author of real-world tinnitus research published in Nature Communications Medicine. She also partners with California Hearing Center to bring advanced tinnitus care and Lenire® therapy to patients in the Bay Area.

Dr. McMahan has seen thousands of people with tinnitus, both in Anchorage and through field clinics like our Tinnitus Therapy & Lenire® clinic in San Mateo. Her clinical experience lines up with what research shows:

  • Roughly 80% of people with tinnitus eventually learn to tune it out so it becomes a neutral background sound.
  • About 20% develop bothersome tinnitus that feels intrusive, stressful, and hard to live with — and they need more focused help.

If you discover you’re in that 20%, we’ll also share how you can get tinnitus support right here at California Hearing Center in San Mateo and San Carlos.

Who is Dr. Emily McMahan, and why listen to her about tinnitus?

Before we break down what tinnitus is, it helps to know who’s guiding this explanation.

When she explains what tinnitus is, it comes from a mix of science, published data, and years of seeing how tinnitus actually behaves in real people’s lives.

So… what is tinnitus, really?

Dr. McMahan describes tinnitus as “a sound your brain believes is there, even when there is no matching sound in the outside world.”

In other words, tinnitus is:

  • An internal perception created by your auditory system and brain.
  • Often linked to changes in hearing, even subtle ones that might not show up as “bad hearing” on a basic screening.
  • Usually a symptom, not a disease by itself — a sign that something in the ear–brain system or nervous system has changed.

People often describe their tinnitus as:

  • Ringing or whistling.
  • Buzzing, humming, or hissing.
  • Roaring, whooshing, or “electrical” sounds.

The key point is that tinnitus is real (your brain truly perceives a sound), but it’s not a sound others can hear or measure with a simple microphone.

For more background on tinnitus types and common concerns, explore our Tinnitus Knowledge Hub.

Why tinnitus feels so isolating

One reason tinnitus hits so hard is how invisible it is.

  • Other people don’t hear what you hear.
  • Standard hearing tests may say your hearing is “within normal limits,” even when the ringing is loud.
  • Friends and family may struggle to understand why a sound only you can hear is so exhausting and scary.

Many patients tell us they feel:

  • Alone — “No one gets what this is like.”
  • Dismissed — “I was told to just live with it.”
  • Afraid — “What if this is my life now?”

That’s exactly why Dr. McMahan invests so much time in patient education and outreach — from her blog posts on retraining the brain to fight tinnitus to her deep-dive interview on Line One and resources like her Nature Communications Medicine announcement.

Our goal at California Hearing Center is the same: to replace isolation with clear information, practical tools, and hope.

The 80% / 20% rule: why tinnitus affects people so differently

In her Anchorage clinic and in our joint clinics at California Hearing Center, Dr. McMahan sees a consistent pattern:

  • About 80% of people with tinnitus eventually experience what we call non-bothersome tinnitus. The sound may still be present, but their brain gradually learns to tune it out so it becomes a neutral background noise.
  • Roughly 20% of people develop bothersome tinnitus — tinnitus that feels loud, intrusive, and emotionally overwhelming, making it hard to sleep, work, or enjoy daily life.

The difference isn’t just the sound itself. It’s how the brain and nervous system respond:

  • If your brain decides tinnitus is “not a threat,” the sound tends to fade into the background over time.
  • If your brain treats tinnitus like something dangerous or important, it keeps you on high alert and the sound stays front and center.

That’s why stress, anxiety, and pressure (very common in Bay Area life and tech culture) can make tinnitus feel so much worse. An over-loaded nervous system has a harder time ignoring any internal noise.

What tinnitus is not

According to Dr. McMahan, it’s just as important to be clear about what tinnitus is not:

  • Not always a sign of something catastrophic. Rarely, tinnitus can signal serious medical issues — which is why a full evaluation matters — but most of the time it’s linked to hearing changes, noise exposure, or nervous-system sensitivity.
  • Not “all in your head” in a dismissive way. The brain is involved, yes, but that doesn’t mean you’re imagining it.
  • Not a perfect mirror of hearing damage. Some people with mild hearing loss have loud tinnitus; others with more significant hearing loss barely notice tinnitus at all.
  • Not untreatable. There isn’t one magic cure yet, but there are many ways to reduce loudness and emotional impact — including advanced options like Lenire® under the guidance of experienced clinicians.

If your tinnitus started suddenly, became louder, or affects just one ear, you may also find these specific guides helpful:

Bothersome tinnitus vs. “there but not a problem”

Two people can have the same tinnitus sound and completely different experiences.

Non-bothersome tinnitus (the 80%)

People in this group might say things like:

  • “I notice it sometimes, but it doesn’t affect my life.”
  • “I’ve had ringing for years — I just don’t pay attention to it.”

Here, tinnitus is present but emotionally neutral. The brain has filed it under “background noise.”

Bothersome tinnitus (the 20%)

People with bothersome tinnitus often describe:

  • Trouble sleeping because the sound gets louder at night.
  • Difficulty concentrating at work or school.
  • Increased anxiety, irritability, or feelings of panic.
  • A sense that tinnitus is “taking over” their life.

If you relate more to this second group, you’re not weak or “overreacting” — your nervous system is simply stuck in a more reactive mode, and it needs structured support.

For a deeper dive into how the brain can change its response over time, check out our article on tinnitus habituation.

How the brain can learn to tune tinnitus out

Here’s the hopeful part: the same brain that can lock onto tinnitus can also learn to tune it out.

This process, called habituation, is similar to how you stop noticing:

  • The hum of your refrigerator.
  • The sound of traffic outside your window.
  • The feeling of a watch, ring, or glasses on your face.

At first your brain pays attention. Over time, it decides that sensation isn’t important, and it fades from your awareness.

For many people, this happens gradually on its own. For others — especially those in that 20% with bothersome tinnitus — it requires guided help through:

  • Education and counseling with a tinnitus-focused audiologist.
  • Sound therapy or sound enrichment.
  • Strategies to calm the nervous system and re-frame tinnitus-related thoughts.
  • Advanced treatments like Lenire® tinnitus therapy in San Mateo, which combine sound and gentle tongue stimulation to help retrain the brain.

Common triggers that make tinnitus feel louder

Even when tinnitus is usually manageable, certain triggers can make it feel much louder or more intrusive:

  • Lack of sleep.
  • High stress or burnout.
  • Caffeine, alcohol, or nicotine (varies from person to person).
  • Loud sound exposure (concerts, power tools, traffic, headphones at high volume).
  • Jaw or neck issues, such as TMJ problems.
  • Earwax buildup or middle-ear issues.

We’ve created deeper guides on several of these topics:

Want to hear Dr. McMahan explain tinnitus in her own words?

If you prefer to learn by watching or listening, here are a few places where Dr. Emily McMahan talks about tinnitus, hearing loss, and modern treatment options:

These resources are a great way to understand why she cares so deeply about tinnitus — and why she chooses to focus her clinical work on helping people who live with it.

When to seek help for tinnitus

You should absolutely consider a tinnitus evaluation if:

  • Your tinnitus is new, sudden, or rapidly getting worse.
  • It affects only one ear or is much louder on one side.
  • You notice dizziness, balance problems, or sudden hearing changes.
  • It’s impacting your sleep, concentration, mood, or day-to-day life.

A thorough tinnitus evaluation at California Hearing Center typically includes:

  • A detailed history of your tinnitus and health.
  • Comprehensive hearing testing (beyond a quick screening).
  • A clear explanation of likely causes and contributing factors.
  • A personalized plan to reduce how loud and stressful your tinnitus feels.

You can read more about our approach on our Tinnitus Therapy page.

If you’re in the 20% where tinnitus feels unmanageable…

If you’re in the group whose tinnitus feels overwhelming — the 20% with bothersome tinnitus — you deserve more than “just live with it.”

Through our partnership with Dr. Emily McMahan, California Hearing Center in San Mateo and San Carlos offers:

  • Specialized tinnitus evaluations and counseling.
  • Sound therapy, hearing solutions, and coping strategies tailored to you.
  • Access to Lenire® tinnitus therapy in San Mateo, guided by one of the world’s leading tinnitus clinicians.

If you’re in the 20% where tinnitus feels unmanageable, schedule a tinnitus evaluation in San Mateo or San Carlos.

You can start here:

You may not be able to “turn tinnitus off” overnight — but with the right guidance, your brain can learn to turn down its importance, and you can move from surviving to actually living again.