If tinnitus has brought thoughts of suicide, tell someone today: call or text a crisis line, ask your doctor for an urgent appointment, or talk to someone you trust.
These thoughts are about twice as common in people with tinnitus as in people without it. In the research they track distress and depression more closely than the loudness of the sound, and both can be treated.
If you need help right now
You do not need to have reached a crisis to call. Samaritans takes calls about whatever someone is going through, and the NHS notes that helplines also give advice to people who are worried about someone else.
- United States: call or text 988 to reach the 988 Suicide & Crisis Lifeline, or chat at 988lifeline.org.
- UK and Ireland: call Samaritans on 116 123, free from any phone, day or night. In the UK the NHS also lists NHS 111, and the Shout text line for anyone who would rather not talk: text SHOUT to 85258.
- Anywhere else: Find A Helpline lets you search free, confidential helplines in more than 130 countries.
- If you are in immediate danger, or feel you may be about to harm yourself, call your local emergency number or go to an emergency department, or ask someone to do it for you. In the UK that is 999 or A&E.
The NHS also suggests telling family or friends what is going on, so they can help keep you safe. Its short list for getting through the next few hours: focus on today rather than the future, stay away from alcohol and drugs, go somewhere safe such as a friend's house, and be around other people.
You are not the only one, and this is not where tinnitus leads
A 2025 systematic review in The Laryngoscope pooled nine studies and 912,013 adults. Suicidal thoughts were reported by 19.5% of people with tinnitus and 9.9% of people without it: roughly double. Read the other way, about four in five people with tinnitus in those studies did not report them.
Both halves matter. If tinnitus has worn you down this far, you are far from alone: the review's authors concluded that ear specialists should be mindful of this risk, so a clinician should expect to hear about it. And these thoughts are not an expected stage of living with tinnitus. They are a sign that the distress has become too much to carry alone, and a reason to get help, not a forecast.
What the studies found
The evidence is observational throughout: it shows that tinnitus and suicidal thoughts occur together more often than chance, not that one causes the other.
- The first pooled estimate came with a warning. A 2021 review found six cross-sectional studies covering 7,192 people with tinnitus in four countries, and a pooled prevalence of suicidal thoughts of 20.6%. Its authors judged the studies' quality variable and said the figure should be interpreted very cautiously.
- The 2025 review was larger and had comparison groups. Suicide attempts were uncommon in both, at 1.9% with tinnitus against 0.9% without. The section on suicide risk in the depression article sets these beside a second 2025 meta-analysis that reported a larger figure, and explains why the two differ.
- National health records point the same way. In Taiwan, 386,055 people with a new tinnitus diagnosis had about twice the hazard of a suicide attempt in the following year compared with matched controls (hazard ratio 2.04), though insurance claims record nothing about thoughts or personal circumstances. In Denmark, a study of 7.4 million people followed from 1990 to 2021 found deaths by suicide rare in both groups, at 24.2 and 16.5 per 100,000 person-years, an adjusted rate ratio of 1.4 after accounting for hearing loss and for mental health conditions that came before the tinnitus. The link was concentrated in people who also had a mental health condition.
- Not every study agrees. Among 769,934 recent US veterans, 116,358 of them diagnosed with tinnitus, suicide rates were lower in those with tinnitus than in those without.
- The direction is unknown. A 2023 scoping review of 23 studies found evidence of an association and of risk factors, but no evidence of the direction of causality. A 2019 review concluded that differences in method, and confounders such as post-traumatic stress disorder, made a single conclusion impossible.
What drives the risk: distress more than the sound
The most useful studies here are the ones that measured what else was going on alongside the tinnitus.
- In a UK NHS audiology service, 150 patients answered the suicidal-thoughts item of a standard depression questionnaire, and 13% reported suicidal or self-harm thoughts in the previous two weeks. Those thoughts tracked anxiety and depression scores most closely, and tinnitus handicap, sound sensitivity and insomnia only weakly. They showed no significant link with hearing levels or with how loud or annoying people rated their tinnitus. An abnormal depression score raised the odds 6.2 times, with a wide margin of uncertainty from a small sample, and the thoughts became less common with age.
- At a UK specialist clinic, 46 of 292 patients, about 16%, reported such thoughts in the previous two weeks. After adjusting for everything else measured, two factors stood out: depression (odds ratio 7.7) and having had a parent with a mental illness during childhood (2.5). Tinnitus handicap, sound sensitivity and anxiety scores did not.
- In a Korean national survey of 28,930 adults, tinnitus and its severity were linked to both low mood and suicidal thoughts, and perceived stress carried part of that link.
Depression runs through all of it. A 2025 meta-analysis of 22 studies found tinnitus associated with depression at an odds ratio of 1.92, and tinnitus and depression covers how the two feed each other.
Anxiety came in at an odds ratio of 1.63 in the same analysis, and correlated moderately with suicidal thoughts in the NHS clinic study. Tinnitus and anxiety sets out the worry loop and what interrupts it.
Sleep had a stronger association than either in that analysis: insomnia at an odds ratio of 3.07. Separately, a 2020 review of 41 longitudinal studies found that sleep disturbance, including insomnia, predicted later suicidal thoughts and behaviours, with small-to-medium to medium effects. Sleeping with tinnitus covers what helps at night.
Sound sensitivity was weakly linked in the first clinic study and not independently in the second. People with hyperacusis do carry a heavy load of mood and anxiety problems: across five studies, between 8% and 80% had depression and between 39% and 61% an anxiety disorder. Hyperacusis and tinnitus covers the condition itself.
Trauma complicates the picture: the 2019 review named post-traumatic stress disorder among the confounders that make the contribution of tinnitus itself hard to separate. PTSD and tinnitus covers that overlap.
Every one of these is something a clinician can assess and treat.
What helps
- Telling someone. Everything else starts there.
- CBT for tinnitus. The 2020 Cochrane review of 28 trials and 2,733 participants found it may reduce the impact of tinnitus on quality of life and may slightly reduce depression, both at low certainty, with evidence only up to the end of treatment. It did not measure suicidal thoughts as an outcome. CBT for tinnitus covers what a course involves and how to find one.
- Treating depression, anxiety or insomnia in their own right, through a GP, psychologist or psychiatrist, rather than waiting for the tinnitus to settle first. Be realistic about sleep: a 2024 review of eight studies found sleep treatments had a small, non-significant effect on suicidal thoughts themselves, so better sleep is one part of care, not the whole of it.
- Therapy aimed at suicidal thoughts and behaviour directly. A 2026 meta-analysis of 56 randomised trials broke these therapies into their components; treatments containing 11 of the 18 it could test were associated with fewer suicide attempts. The largest effects were for training in managing emotions and in handling relationships with other people.
- A safety plan. A written plan for the worst moments: the early warning signs, things to try alone, people and places that help, professional contacts, and making it harder to harm yourself by moving things that could be used out of reach. Samaritans estimates it takes 20 to 40 minutes, and the NHS points to the Staying Safe website for templates. A 2021 meta-analysis of six studies with 3,536 participants found that safety planning lowered suicidal behaviour (relative risk 0.57, about 43% lower). It did not significantly reduce the thoughts themselves, so a plan sits alongside treatment, not in place of it.
How to raise it with a doctor or audiologist
- It can be said in one sentence: my tinnitus has got so bad that I have had thoughts of ending my life. If saying it aloud is hard, write it down and hand it over.
- It is something clinicians are advised to ask about. The authors of the NHS clinic study recommended that audiologists screen for these thoughts, especially in people with depression, and refer on to mental health services.
- Being asked does not make things worse. A 2018 meta-analysis of 13 studies found no significant harm from assessing suicidal thoughts.
- Say how long the thoughts have been there and whether they are new or getting stronger; NIMH advises getting help as soon as possible when warning signs are new or have increased recently. Mention sleep, mood, alcohol or drug use, and who you have around you.
- Ask for a mental health assessment, treatment for any depression, anxiety or insomnia, and a referral to a tinnitus CBT service.
- In the UK, the NHS says you can call a GP and ask for an emergency appointment.
If a clinician brushes it off, ask again or see someone else: talking to a doctor who dismisses tinnitus covers how. Crisis lines need no referral. For the ear side of the appointment, the When to See a Doctor checklist and the guide to how tinnitus is diagnosed help you prepare.
How family and friends can help
NIMH lists these as possible warning signs that someone is thinking about suicide:
- talking about wanting to die, great guilt or shame, or being a burden to others
- feeling empty, hopeless, trapped, or in unbearable emotional or physical pain
- withdrawing from friends, saying goodbye or giving away important things, extreme mood swings, eating or sleeping more or less, using drugs or alcohol more often, or taking dangerous risks
- making a plan
Its advice is to get help as soon as possible, particularly if the behaviour is new or has increased recently. In someone with tinnitus, poor sleep or pulling away from noisy places can easily be put down to the sound. When they come with hopelessness, ask.
- Ask directly. Samaritans says evidence shows that asking someone if they are suicidal can protect them, because it gives them permission to talk and tells them they are not a burden. A plain question works: are you thinking about suicide?
- Listen, and take the answer seriously. You do not need solutions. The NHS suggests open questions, and says that listening and taking someone seriously can be more helpful than having answers.
- Help them reach support. Offer to sit with them while they call a helpline or book an appointment.
- Help with a safety plan, including making home safer by removing things that could be used for self-harm. Samaritans stresses that the person should own each step of the plan.
- If they are in immediate danger, call your local emergency number.
- Look after yourself too. Helplines take calls from worried family and friends. For the longer run, see talking to family about tinnitus and tinnitus support groups.
The distress behind these thoughts is the part of tinnitus that treatment has the best evidence for easing. That is the strongest reason to tell someone now.