Then Torpey went to an audiologist. The audiologist told him that he “just had to live with it,” he says. “I felt so alone. There’s the initial shock, that the ringing in your ears isn’t going to go away. And then there’s the realization that most doctors don’t have a clue about how to treat it.”

Torpey’s experience is all too common. In a survey of 230 people with tinnitus, published in 2018, researchers at the University of Illinois Urbana-Champaign found that 80 percent had been informed by a health care provider that there’s nothing they can do about tinnitus. “Patients who come to our clinic are scared by the thought of dealing with this sound, without help, for the rest of their lives,” says Lori Zitelli, a clinical audiologist at the UPMC Eye & Ear Institute in Pittsburgh.

Tinnitus affects at least 25 million American adults—and the prevalence of the condition increases dramatically with age. A recent international JAMA Neurology study showed that tinnitus impacts 24 percent of people 65 and older and 14 percent of 45- to 64-year-olds.

“By the time they’re 50 or 60, many people have been exposed to years of loud noise, which damages the inner ear, causing hearing loss,” notes Bradley Kesser, M.D., a professor of otolaryngology at the University of Virginia School of Medicine. “While everyone with hearing loss doesn’t get tinnitus, most people with tinnitus have hearing loss.” Anyone can get tinnitus, but people with noisy jobs, from construction workers to military personnel to musicians, are especially affected.

For a condition so common, it’s remarkably misunderstood. Even “ringing in the ears,” the customary description, doesn’t capture everyone’s experience. Tinnitus can sound like buzzing, whistling, chirping, humming, hissing, squealing, wailing or clicking. For some, it ebbs and flows, or it disappears and then returns, especially during times of stress. Scientists can’t explain the individual variations, but research is starting to point to why tinnitus happens and what to do about it.

A minority of those with the condition have a treatable issue, like an ear infection or earwax buildup. Once those issues are addressed, the tinnitus often goes away.

Doctors usually can’t hear or directly measure your tinnitus. The reason: While ear damage plays a causal role, the sound comes from the brain. “People over 60 usually have high-frequency hearing loss, and tinnitus is typically a high-frequency sound. So one theory is that the brain may be trying to fill in the sound that’s missing from the ears,” Kesser observes.

Research at the University of Illinois Auditory Cognitive Neuroscience Lab indicates that nonauditory parts of the brain are involved too. “Our fMRI scans of tinnitus patients show that the networks that process attention and emotion are different in these people than in those without the condition, so these nonauditory networks are probably contributing to the tinnitus as well,” says Fatima Husain, the principal investigator at the lab. “The spectrum of what people with tinnitus complain about—difficulty concentrating and sleeping and increased sensitivity to normal environmental sounds—is mirrored in our brain imaging.”

The goal of most scientifically validated tinnitus treatments is habituation—reaching a point where the sound no longer bothers you or harms your quality of life. “We habituate to irritants all the time,” Kesser says. “For instance, a tag in your shirt might bother you when you first put it on, but an hour later you don’t notice it.”

Kesser adds that the first step in managing tinnitus may be sound therapy—bringing in external noise (such as that from a fan or TV) to mask the tinnitus. For people with hearing loss, hearing aids may be more effective. “They bring in a little external background noise and can drown out the internal tinnitus,” Kesser points out. For those who are anxious, depressed or having trouble sleeping, antidepressants can help, as can relaxation techniques such as yoga and meditation, he says.

Another method, called tinnitus retraining therapy, combines sound therapy—in which earbuds deliver a low level of sound to reduce the auditory impact of the tinnitus—with counseling to help patients view it as an unimportant sound. The American Tinnitus Association (ATA) can help you find an experienced practitioner.

Healthy habits, including a nutritious diet and regular exercise, may also help with tinnitus, according to the ATA, since they can reduce blood pressure and weight and bolster energy and well-being.

“Most people with tinnitus ultimately use a variety of techniques to create an approach that works for them,” says San Diego resident Loretta Marsh, 70, who has had the condition for 22 years and is a longtime ATA volunteer. “I always suggest that newly diagnosed patients join a support group. Being around other people who have tinnitus can give you hope and help you see you’re not alone.”

Maintaining hope is vital. Paul D’Arezzo, 70, a retired emergency room doctor in Grand Junction, Colorado, began hearing a shrill tone in his left ear five years ago. He was tormented by his tinnitus to such a degree that he had suicidal feelings. “One of the things that helped me was writing 50 questions on index cards, like ‘What am I going to do today if I start feeling overwhelmed by tinnitus?’ and going through them every morning,” he says. “To this day, every time I start paying attention to the sound, I remind myself, Just don’t go there. Then I distract myself.”

Torpey took a stress-reduction course, and the ATA helped him find an audiologist who specializes in tinnitus. “I still hear the sound,” he says. “But now that I’ve learned to manage it, it doesn’t bother me like it used to.”

Ginny Graves is an award-winning writer who contributes regularly to a variety of national publications. She specializes in psychology, health, profiles and personal essays.