"Suicide is the most obvious cure for it. There have been times when I've banged my head into a wall to try to knock out the noise. All I got was a sore head. I've considered sometimes taking ice picks and deafening myself," she said.

Ripley, 57, suffers from tinnitus, a condition in which a person perceives sound in one or both ears when no external sound is present. It affects up to 1 in 6 people.

She's just begun a therapy developed 15 years ago but not offered in Tucson until now at the University Physicians Healthcare audiology clinic at University Medical Center. Adobe Hearing Center also plans to offer the treatment, starting later this year.

Called Tinnitus Retraining Therapy, the treatment combines counseling and the use of sound generators worn in the ears to retrain the brain to react to tinnitus noise as something of little consequence, not as a threat or annoyance that should trigger fear and anxiety.

Tinnitus sufferers go in a vicious circle with their condition, said Christine Maré, audiology supervisor at the UPH clinic. The more fearful and annoyed they become because of tinnitus noise, the more they notice it, and the more they notice it, the more it frightens and annoys them, she said.

"The goal of TRT is to break that cycle," she said.

Tinnitus affects an estimated 50 million Americans to some degree, according to the American Tinnitus Association. About 12 million people seek treatment for it, and about 2 million of those are so severely affected they cannot function on a day-to-day basis, the association said.

Tinnitus noise can be sporadic or constant, and the volume varies. Though it's commonly called "ringing in the ears," the sounds can include ringing, buzzing, hissing, swooshing, roaring, chirping and clicking.

It's caused by damage to outer hair cells, the nerve cells in the inner ear responsible for mediating and sending sound to the brain, Maré said. The damage can be a result of exposure to loud noise, head or neck injuries, use of certain medication and various diseases.

For some, the condition is mild enough to ignore. But for others, tinnitus can lead to sleeplessness, irritability, isolation, frustration, anxiety and severe depression.

It is theorized that artist Vincent van Gogh suffered from tinnitus and cut off his left ear in a desperate attempt to quell the noise.

Ripley developed tinnitus in 1976 after a car accident that fractured her skull. She was able to ignore the slight, persistent whistle in her head as she developed a successful career as the top real estate agent in Las Cruces, N.M.

But three years ago, a malfunction with earphones sent a piercing noise directly into her ears, and her tinnitus quickly worsened into a disabling condition.

The tinnitus has her body in a constant "fight-or-flight" reaction, Ripley said. She's tense, and she often has trouble breathing because her diaphragm tightens up. She requires medication at night to sleep.

She's also become overly sensitive to external noise, a common problem for people with tinnitus. Ripley said she and her husband bicker over the volume of the car stereo.

Maré said people seeking treatment for tinnitus are usually told there's nothing that can be done, and they should learn to live with it. Because there is no cure, people seek out a variety of treatments to moderate it or treat the stress, including acupuncture, anti-anxiety drugs, herbal remedies and biofeedback. But no one treatment has emerged as largely successful.

TRT was developed by Pawel Jastreboff, a professor at Emory State University in Atlanta. According to his study, 80 percent of patients who undergo TRT show significant improvement, Maré said.

TRT begins with in-depth counseling for the patient, Maré said.

"We more or less demystify it, so they aren't so fearful of it. We make it more of a clinical, neutral thing," she said.

The second component is sound therapy. People tend to notice their tinnitus most when in a quiet environment, Maré said.

The therapy requires them to surround themselves in sound all day long to take attention away from the tinnitus. This can include music listened to on headphones and soothing noise, such as rainfall, made by a table-top sound generator at night while they sleep.

As well, they are fitted with sound generators for their ears. These hearing-aidlike devices, worn at least eight hours a day, produce a low-level, broadband noise.

This external "white noise" isn't loud enough to mask the internal noise of tinnitus. Instead, it distracts the brain from the tinnitus because the brain can't concentrate on both at once, Maré said. Eventually, the patient becomes habituated to the tinnitus and doesn't notice it unless he thinks about noticing it, she said.

The ultimate goal is to wean the patients off the sound generators, she said.

There are no known side effects, but the drawbacks to the therapy are the cost and length. It takes 18 to 24 months to complete the therapy at a cost of about $4,000 to $5,000, which is not covered by insurance, Maré said.

Ripley said her hopes for the program are modest - to be able to relax and breathe a little easier.

"It's an 18-month program, and there are no guarantees of success," she said. "What I hope to be able to do is to get my stress level down. The tinnitus will never go away. I have to be realistic about that. But I have to try to retrain my brain so the tinnitus isn't triggering the startle reflex, the fight-or-flight response.

"Hopefully," Ripley said, "I'll be able to go to sleep at night without taking drugs."

By Anne T. Denogean