Warning: The story below contains spoilers for A Star Is Born.
In the new movie A Star Is Born, Jackson Maine (played by Bradley Cooper) is a famous musician who performs very loud, rock-n-roll concerts to sold-out arenas every night. As a result of all this noise, and the fact that he was born with hearing loss, Maine hears a constant ringing tone in his head, called tinnitus, and often has trouble hearing conversations.
Maine's manager and otolaryngologist urge him to wear in-ear monitors, which are custom-moulded ear plugs that block sound and allow musicians to hear their voices and instruments over loud audiences and speakers, but he refuses. Over the course of the film, the tinnitus gets worse, and Maine fails to manage it appropriately.
As you can imagine, ear issues and hearing loss are occupational hazards for musicians, especially those who perform live and are exposed to loud speakers. But Maine's story, although it's fictional, shows just how impactful tinnitus can be for some individuals.
Tinnitus is defined as a perception of sound in the head that's not produced by sound waves, says LaGuinn Sherlock, AuD, a research audiologist at Walter Reed Army Medical Centre. Technically, tinnitus is produced by extra electrical activity in the brain after there's been damage in the ear and auditory system. Damage could be a severe injury to the head and neck, excessive earwax, sinus pressure, or a traumatic brain injury. Often, tinnitus is associated with noise-induced hearing loss, which is why it's common among musicians, explains Christopher Chang, MD, an otolaryngologist in Warrenton, VA. In fact, some studies suggest that between 17-43% of rock musicians have chronic tinnitus.
Simply thinking about an incessant buzzing, beeping, humming, or static noise in your head is annoying enough to make most of us cringe, but tinnitus can affect people's mental health and well-being in a very serious way. "A lot of people with bothersome or intrusive tinnitus are experiencing depression and or anxiety because of the ringing," Dr. Sherlock says. On top of that, "some people who are already depressed or anxious are more likely to react to having ringing in the ears than if they were not already depressed or anxious." An estimated 48-78% of people with severe tinnitus also have depression, anxiety, or other behavioural disorders, according to the American Tinnitus Association. In some cases, these associated conditions can lead to suicidal ideation, according to the Hearing Health Foundation.
Unfortunately, there is no cure for tinnitus, so people have to simply manage symptoms. To keep tinnitus from getting worse, the best thing patients can do is protect their hearing by wearing hearing aids, or noise-maskers, Dr. Sherlock says. Sometimes, people with tinnitus are prescribed antidepressants or anti-anxiety medications — like Xanax and Valium — to alleviate some of the emotional effects of the condition, but psychiatric medications are typically not considered the best first approach for treatment, she says. "Such prescription medications are addictive and have gone out of favour; such medications are no longer considered appropriate in the treatment of tinnitus," Dr. Chang says.
In the case of A Star Is Born, Maine is prescribed pills for his tinnitus. Although it's not clear what exactly the pills are, he abuses the medication and becomes addicted to it. Without giving too much away, the end of the film is a poignant reminder that hearing loss and conditions like tinnitus should be taken seriously.