When The Ringing Doesn't Stop: If You are a First Responder and Have This- You May Have PTSD

You’re off shift. The house is quiet. But the high-pitched ringing in your ears is loud as ever. There’s no noise, just silence and a sound that won’t go away. It can be maddening some days. If this feels familiar, you’re not alone — and it might be more than just the aftermath of years of sirens and engine noise. For many firefighters, tinnitus (ringing in the ears) and PTSD are connected in ways that aren’t always obvious. Let's break it down.

What Is Tinnitus?

Tinnitus is the perception of sound (usually ringing, buzzing, or hissing) that isn’t coming from an external source. It can be constant or come and go. And for firefighters, it’s incredibly common.

Why?

Think of all the noise: chainsaws, sirens, tools, radio traffic, fans, explosions, and structural collapses. Over time, your ears take a beating. But there’s more to it than just hearing loss.

PTSD and the Nervous System

Post-Traumatic Stress Disorder (PTSD) isn’t just about bad dreams or flashbacks. It’s a neurological injury that alters how your brain processes stress, sound, and even your body’s internal sensations.

Firefighters with PTSD live in a constant state of hyperarousal — your nervous system is always on edge, the side effects of hypervigilance. That means you’re more tuned into every small noise and sensation. So if you have tinnitus, PTSD can make it feel louder, more intrusive, and harder to ignore.

The Connection: How PTSD and Tinnitus Feed Off Each Other

Firefighters with both tinnitus and PTSD often describe a vicious cycle:

• The ringing gets louder when you’re anxious or triggered.

• You become hyperfocused on the sound.

• That stress then amplifies both the tinnitus and PTSD symptoms, especially at night.

• Sleep becomes impossible, which further damages your mental health.

In fact, studies from the Department of Veterans Affairs show that veterans and first responders with PTSD are significantly more likely to experience severe, chronic tinnitus.

Fireground Trauma and Hearing Damage

Let’s be honest — firefighting is loud, violent, and unpredictable. Whether it’s a bad MVA or a traumatic pediatric incident, or the death of a fellow firefighter, your body remembers it all.

And sometimes, those memories get stored not just in your mind, but in your body — your ears, your heartbeat, your sleep patterns.

Tinnitus can become a trigger, bringing back flashbacks or emotional responses tied to trauma.

What You Can Do

If you’re a firefighter dealing with both PTSD and tinnitus, here’s the good news: there’s help — and you’re not weak for needing it. You’re human.

1. Get a Trauma-Informed Assessment

See a provider who understands both auditory health and first responder trauma. Sometimes tinnitus is physical, sometimes neurological, and often both.

2. Try Sound Therapy or White Noise

At night, try apps or devices that play soft static, rainfall, or nature sounds. It gives your brain something to focus on other than the ringing.

3. Cognitive Behavioral Therapy (CBT)

CBT — especially versions adapted for trauma or tinnitus — can help you retrain your brain’s response to both sound and stress.

4. Practice Mindfulness

Mindfulness and deep breathing lower cortisol levels, ease hypervigilance, and can actually reduce the perceived intensity of tinnitus.

Final Thought: You’re Not Broken

That constant ringing isn’t just in your ears — it’s in your story. It’s a reminder that you’ve survived noise, fire, trauma, chaos. But survival doesn’t mean you have to keep suffering.

If you’re dealing with tinnitus and PTSD, you are not alone. And more importantly, you can heal.

At RiseUpFight.org, we’re here to help you walk that path — with tools, support, and a community that gets it. Let’s talk about it. Let’s fight the silence — and the noise — together.

Stay safe out there

-Tom