Turn the sound on.
Watch this video. Don't shut it off after ten seconds, watch it for the whole thirty.
Did you shut it off after 10 seconds? I don't blame you. I mean, it's really annoying. Hell, it hardly even qualifies as a video. But I insist: watch it. Because as much as tinnitus - a constant phantom ringing sound produced by the mind - is an auditory phenomenon, it demands attention; it demands mental resources.
Now try clicking the replay button and watching it for a minute. Or thirty. If you're feeling particularly masochistic, set it on replay for an entire hour. For this challenge, I'll let you open other tabs, just leave it playing in the background.
Now, understand that I've been watching this video for the past four years. On repeat. Every. Single. Second. Of Every. Single. Day. Not by choice, and I can't press pause.
Reader, welcome to my private mental torture. Make no mistake, it is torture in the fullest sense of the word. People have killed themselves over tinnitus and will continue doing so. Take a moment, calm yourselves, rest assured that I will not. This post is not a cry for help; please do not rationalize it as one. There are many things I need to do before I go, and I have hope yet.
What makes it torturous?
Let's really examine this question. One of the most amazing aspects of the human mind is its ability to adapt to adverse circumstances. I wouldn't mind having tinnitus so much if it remained at the same volume constantly; my brain would just tune it out. But because my tinnitus gets worse from time to time, my brain resets itself into a panicked fight-or-flight state every time. Turns out the mind is only good at acclimating to constants, not to changes. The worst part? When it gets worse, it can get worse permanently. And on an absolute scale, it has never gotten better.
This is no fun. When it gets worse during the day, I completely zone out and focus on the noise, hoping it's just temporary. This is especially bad in meetings for very obvious reasons. Far more agonizing is when it gets worse during the night, or after I wake up. These incidents are likelier to be permanent worsenings. Unable to go back to sleep, I frantically pace about the room, sweating, heart pounding, log in to my computer to distract myself, but the sheer enormity of its new loudness feels like a hand constricting my chest - a hand very familiar to those with anxiety and depression. I feel a brute emotional anguish as my mind forces me to listen to the ringing, ringing, ringing; a vicious cycle in which the latter exacerbates the former.
Just the thought that it can get worse instills in me an imprisoning paranoia. I carry earplugs in my pocket everywhere I go. I shouldn't have to. I'm so afraid of being in situations that are even remotely loud or noisy. I shouldn't be. I shouldn't know what the word otolaryngoloist means. But I do. I've seen five of them.
By the way, its getting louder isn't even the worst. Sometimes I develop an entirely new tinnitus. Remember that video? It only has one sound. Today, I have three:
- A very high-pitched CRT monitor / TV-like screech (similar to the one in the video).
- A deep, low, powerful rumbling.
- A mid-tone that adjusts its volume based on external sounds. If my environment is loud, it will be loud; if my environment is quiet, it will ring more softly.
And sometimes, it feels like I'm losing my grip on reality. Like the real world exists less, the empty space taken up by the dreadful world of tinnitus.
I can hear tinnitus:
- Over whispers
- Over music
- Over conversation
- Over traffic
- Over a jet engine in an airplane cabin
Well, the first three for sure - the last two will inevitably come someday in the future. My worst fear is that the tinnitus will become louder than any physical sound, and I end up like Beethoven, completely deaf for all practical reasons. The difference being, of course, that I am no musical savant.
On that topic, listening to music can never be the same; never again will I hear any work performed exactly as its musician intended. Imagine an orchestral masterpiece, but the government decrees it cannot be played unless one violinist plays a constant, sharp, cacophonous note throughout its duration. How ruined that piece would be. Want to try this out? Put on your favorite song, then play the video over it.
As a neurotic, not knowing what causes it to worsen can, at times, be as unbearable as the tinnitus itself. I document in a spreadsheet all the daily noise incidents (potential why for the worsening), tinnitus worsening incidents (when the tinnitus worsens), and exactly how the tinnitus changed for the worse whenever it does. How OCD. Is there even any point to this? No doctor can possibly make use of this information, no other human can understand the particular characteristics of the imaginary phantom sounds echoing through my head. Maybe it gives me some sense of relief, to rationalize its worsening, to have an array of things at which to point my finger and proclaim "it got worse today because of this." But it's all bogus; I can never truly know.
I didn't always have tinnitus.
Are you curious about how it started?
During my sophomore year of college, I was flying back to New York from Chicago, and as soon as we landed, I found that I was unable to hear out of my right ear. I attributed this to the difference in air pressure caused by the rapid descent and decided to give it a few hours before full panic mode set in. It didn't get any better throughout that afternoon, nor the following morning, and the following night, I had some intense ringing in that ear, pitched around 1280Hz.
This entire period was wracked with anxiety and depression. The idea that one of my senses had been permanently taken away from me, perhaps due to sensorineural hearing loss - a term I'd learned from Google during my panic - was unbelievably agonizing. I could not sleep at all. I'd play League of Legends all day to try and distract myself from the terrible noise. If I remember correctly, the next day was a Monday, which meant doctors' offices were open, which meant Mom was able to take off from work and drive her son, on the verge of a nervous breakdown, to the otolaryngologist (an ear, nose, and throat doctor, also called an ENT).
The one I saw that fateful day was, according to those medical magazines you see lying around doctors' offices, one of the best in the country. I was so incredibly on edge, waiting for him to come get me, just so incredibly tense (although still not quite as much as the thought of asking a girl out); the words I'd hear would decide my fate. He examined my ear canals with a periscope and concluded that it was impacted earwax, which was met by extremely welcome relief on my end. This meant it was a purely physical affliction that could be treated with relative ease.
He suggested that because I was young, it would be better to flood my ears with water to drive out the earwax, whereas with older patients he'd take a pick, break it up, and extract it. He took a syringe, filled it up with water, and jetted my canals to push out the earwax. It was kind of gross seeing all of it clumped together. Afterwards, he vacuumed my ears with some other tool - this did result in a sharp pain at one point - but I didn't care at the time... I could hear normally again!
The tinnitus went away too. Most of it. The 5% that remained was still bothersome enough for me to call their office again the next day - he said it should go away within a few days. It didn't. My anxiety started coming back; I'd plug my ears with my fingers to test if it was still there or not many times every day, in hopes that my brain would tune it out; I'd fill my ears with water while taking showers just in case they missed some earwax, although I knew they didn't. I would try the Valsalva maneuver multiple times in hopes it'd make the noise go away; it didn't.
Sadly, some of this probably ended up exacerbating the condition.
Once my school break was over, I started listening to music while taking naps or going to sleep to drown it out. This definitely helped, and I used to do it from time to time for enjoyment, but it became a mandatory thing. I knew that the second silence hit, I'd hear nothing but. I'd give a lot to hear true silence again for just a minute or two, you know.
The rest is history.
Part of me is angry at that ENT, the part which thinks all this could've been avoided had he used the gentler, scraping method, or if he didn't vacuum my ears - which could've damaged my eardrums - after the flooding, but in retrospect I don't think it could've unfolded any other way, given the situation. We can't change the past.
I should be grateful for the fact that my hearing is fine. While tinnitus is usually associated with hearing loss, I can still hear everything normally - all the frequencies that the audiologists test, anyway. Take a look at my hearing chart:
You can also see a prescription for the antidepressant Elavil, which my most recent ENT says has been shown in double-blind studies to demonstrably reduce tinnitus volume. I'm not going to use it for a while because it has a bunch of unsavory side effects; what I need is a cure, and not, regardless whether it works, temporary drug-induced relief.
Perhaps you think something can be done.
You want to believe something can be done. To hope for your fellow man is to be human.
Realize - I've spent hours upon hours upon days upon weeks doing research, poring over the literature, reading support group fora, testing different "remedies," attempting TRT (tinnitus retraining therapy), eating sham pills... all that for a chance of alleviation, much less a cure.
So let me tell you, nothing can be done.
Just as cancer is unique to the type of cell, so tinnitus is unique to each sufferer's neural map. We know far too little about how the brain works today to solve this problem. Frankly, the best shot at a cure in 2015 is lobotomy - a shotgun blast which, perforce, obliterates many of the brain's executive and automatic functions - and even then, only a chance that the bird is hit. I need a scalpel to exist, an electron scalpel, or... in the best case, a supercomputer which can map out my brain, calculate exactly where my tinnitus lives, and shut off exactly those neurons.
But they don't exist.
And I am so tortured.