I have been hearing something a lot recently in our office, and it’s something I want to gently, but clearly, encourage to stop. Sometimes when a patient sits down in front of me and I ask what concerns brought them in, they explain their symptoms and then add a quiet qualifier at the end: “…but I’m probably crazy.”
That sentence almost always catches my attention. This qualifier is never the whole story. And I hear it most often with two specific issues: auditory processing difficulties and tinnitus.
Auditory Processing: When Hearing Tests Say “Normal,” but Life Doesn’t
Auditory Processing Disorder (APD) refers to how the brain interprets and makes sense of the sounds we hear. It is not a problem with the ears themselves, but with what happens after sound reaches the brain. APD can be present in both children and adults. Some individuals are born with auditory processing differences, while others develop them later in life due to factors such as head injury, illness, toxic exposure, or neurological changes (i.e. stroke).
Individuals with APD often look like they have hearing loss. They may frequently ask others to repeat themselves, seem lost during conversations, or struggle significantly in environments with background noise. They may feel exhausted after social interactions or meetings because of the constant effort it takes to listen. Children and adults with APD may also have difficulty with reading, spelling, or following multi-step verbal instructions.
These challenges are so disruptive that individuals with auditory processing difficulties often seek a hearing test. When that test comes back “normal,” confusion sets in. A standard hearing test measures the softest sounds a person can hear—it does not measure how efficiently the brain processes, organizes, or interprets those sounds.
In our experience, many individuals undergo two or three “normal” hearing tests over several years before finding a provider who discusses auditory processing more deeply. This is often the moment I hear it again:
“I have all these concerns… but I’m probably just crazy.”
After we talk through their lived experiences, complete comprehensive auditory processing testing, and review the results together, something powerful happens. There’s often a pause, followed by relief:
“Wait… I’m not crazy.”
That realization matters. Validation is the moment we can stop questioning reality and start finding solutions. From there, we can focus on strategies, accommodations, therapy options, and tools that improve communication and quality of life.
Tinnitus: Yes, it can be bothersome
Tinnitus is defined as the perception of sound when no external sound is present. It may be described as ringing, buzzing, humming, hissing, or roaring—and importantly, no one else can hear it. Tinnitus is invisible; individuals who experience it are often dismissed. When tinnitus is mentioned to some physicians—and even some audiologists—patients may walk away with messages like: “There’s nothing that can be done.” “You’ll just have to live with it.” “Try not to focus on it.”
Over time, those messages can turn inward, leaving a patient thinking, “Maybe I’m just crazy for being so bothered by this.”
While tinnitus is common and affects approximately 17% of the general population, it is important to note that it does not affect everyone the same way. Only about 23% of individuals with tinnitus experience significant distress. That distinction is crucial. If tinnitus is bothersome, disruptive, or emotionally distressing, the individual does not need dismissal—they need support and management tools.
Tinnitus is influenced by many factors, which is why it can look so different from person to person. It may be impacted by hearing loss, stress levels, sleep quality, diet, head trauma, medications, overall health status, and neurological factors, among others. Because of this complexity, tinnitus management is rarely one-size-fits-all.
Effective care often focuses on education, counseling, sound-based strategies, and addressing contributing factors. While there may not be a single cure, there are evidence-based ways to reduce distress, regain a sense of control, and improve day-to-day functioning.
Say it with me: I am not crazy.
When patients minimize their symptoms or question their sanity it is often a reflection of how often they have felt unheard. Auditory processing difficulties and tinnitus affect far more than hearing—they affect communication, confidence, relationships, work performance, and mental health.
If you see yourself in these experiences, please know this: Your symptoms are real. Your frustration is valid. Normal test results do not invalidate lived experience. You are not imagining things. You are not weak. And you are not crazy. You deserve care that listens, investigates, and supports—not care that dismisses.
Validation is not the end of the journey, but it is the beginning of meaningful help.
