Heyo Eskimo I'm tempted to say it was initially "physical," but I'm not 100% sure anymore. The onset of my tinnitus coincided with a severe reaction to a drug that landed me in the hospital for over a week. But it was the culmination of months of EXTREME neurological side effects that brought me to death's doorstep. Once I got stabilized, most of the symptoms slowly faded and the tinnitus also got better. But it never totally resolved, and I have to think that it's more connected to being an anxiety-prone person. It does sound like it's extremely common, and I would bet good money that it's more your OCD doing a number on you (and me!) than anything else. If it wasn't tinnitus, then it would be something else. See the pattern?