Tinnitus: Dealing with a Wicked Form of Torture

What my tinnitus taught me about our immense capacity to adapt to what’s at first unbearable

angel covering ears
Image by Goran Horvat from Pixabay

Doesn’t sound all that bad, now does it? This, however, is what tinnitus actually felt like:

An evil spirit snuck into my brain wanting to torment me and decided that zapping my hearing circuitry to unleash a relentless and excruciatingly painful high-pitched noise was the way to do it.

The most wicked aspect of it all was that only could hear it.

The onset of my perennial tinnitus was abrupt and decisive. It started on January 1, 2017, to be exact. I remember it clearly because of the date and the fact that it followed a noisy New Year’s Eve party.

It was not the first time I’d had tinnitus. I’d woken up to the same shrill noise about a dozen times over my nearly 50 years on this planet and it was always after a loud party, concert, or other such events.

I didn’t give it much mind -at least not that first day. I figured it was just taking a little longer to go away than the couple of hours my previous episodes had lasted.

By the second day, I began to consult the all-knowing Google. I was familiar with the term “tinnitus” but had never read its definition, which, as far as I’m concerned, makes the condition sound silly and made up, more psychosomatic than medical

Most sources reassured me my tinnitus would go away in a matter of days or weeks at most, and that it was most likely nothing to worry about. The message, as the Mayo Clinic website put it, was: “Although bothersome, tinnitus usually isn’t a sign of something serious.”

At least that was my takeaway on that day of superficial Googling.

By the second week, I began to scroll farther down the search results and seriously evaluate what might underlie my tinnitus. I found that, as the ATA explained, tinnitus could be “a symptom associated with an array of other health conditions.”

Here’s a list of such conditions and how each applied to me:

  1. Hearing loss ➞ Don’t believe so.
  2. Obstructions in the middle ear ➞ Don’t believe so.
  3. Head and neck trauma ➞ Negative.
  4. Temporomandibular joint disorder (TMJ)➞ Moderate, but I wear my mouthguard.
  5. Sinus pressure and barometric trauma ➞ Nope.
  6. Traumatic brain injury ➞ No, fortunately.
  7. Ototoxic drugs ➞ None.
  8. Other diseases and medical conditions ➞ Hmmm...

Item #8 had its own sublist:

  • Autoimmune disorders ➞ Not that I know of.
  • Blood vessel disorders ➞ No.
  • Psychiatric disorders ➞ Check.
  • Vestibular disorders ➞Negative.
  • Tumor-related disorders (very rarely), such as Acoustic Neuroma and Vestibular Schwannoma ➞ Fervently hope not.

TMJ and successfully treated depression were the two conditions I definitely had. I could rule out most of the others based on my medical history and yearly physical.

There had to be something for Pete’s sake! At this point, I was starting to get desperate. The noise was driving me I-N-S-A-N-E.

So I made an appointment with my primary care physician (PCP), who found nothing amiss but recommended I see the TMJ specialist and an ENT (ear, nose and throat) doctor.

After examining me, reviewing my case and history, and ruling out hearing loss, my local ENT basically said there was no discernible cause for my tinnitus, that it would probably go away -in time. In the meantime, he suggested, try to ignore it or use background sounds to counter the high-pitched ringing.

Ignore it? Give me a freakin’ break! How can anyone ignore this assault on the senses? Easy for him to say. He can’t f*cking hear it! There must be something more. A rare frightful condition must be causing my tinnitus. I gotta go to a real specialist.

And so I went to see a tinnitus specialist at Yale, in New Haven, over an hour away. He, too, found nothing wrong and confirmed what I’d read on the ATA’s website, that “There is currently no scientifically-validated cure for most types of tinnitus.”

It was the TMJ specialist who showed the most concern for my plight. By the time I went to see him, I must have looked and sounded hugely distraught.

He recommended an MRI of my brain. I was relieved since I didn’t think the possibility of a tumor was as remote as the previous doctors had said. This horrible torture couldn’t just be nothing.

You guessed: It was nothing. I was almost disappointed.

The TMJ specialist was the last doctor I consulted about my tinnitus.

Over the next few weeks, I fell into deep anguish, wondering how I’d live every second of the rest of my life hearing this monotonous, piercing beeeeeeeeeep, akin to the sound of a heart monitor when the patient flatlines, except a thousand times more shrill.

Accepting there was no ultimate solution, I turned to the how-to-manage-tinnitus advice. Here are potential areas to target to mitigate the effects of tinnitus, according to the ATA:

  1. General wellness
  2. Hearing aids
  3. Sound therapies
  4. Behavioral therapies
  5. Drug therapies
  6. TMJ treatments
  7. Experimental therapies

I focused on #3, -sound therapies- because it was the immediately applicable option for me. I viewed behavioral therapies (item #4) as a back-up since such an option would require a great deal of time and financial commitment.

As to the other areas, not to brag, but my diet and exercise habits are good; I don’t have hearing loss (yet) so hearing aids wouldn’t help me; I already take SSRIs for my depression; and my TMJ is under control.  Experimental therapies, well, I just didn’t want to go there.

Through sound therapies “patients can use real, external noise to counteract their perception and reaction to tinnitus.”

Again, doesn’t it all sound as if one’s making the affliction all up? On the one hand, the tinnitus sound doesn’t actually exist, and, on the other, real sounds can cancel out the imaginary one!

heavy rain

The heavy rain sound worked best. At first, I’d have the sound on whenever there was minimal background noise around me, which is when my tinnitus was most painful. I ordered headphones tucked in cloth headbands I could wear to bed, and actually slept with them on for many months.

Eventually, I wasn’t thinking about my tinnitus constantly. I’d even forget to turn on the app sometimes, not noticing the sound for a good while.

One fine day, I decided I wouldn’t wear the headphones anymore. I resolved to either befriend or ignore the tinnitus sound, as it were. When I could ignore it, I would. When I could not, I’d think to myself, “There it is again. I hear it. I live with it.” Often, I’d forget it and not hear it. Until it came back.

I can summon my tinnitus at will. It also makes itself known several times a day at expected and unexpected times. Though I so wish it would go away, it’s not torture anymore.

It’s bizarre how this mind of ours works. I’ve gotten used to a stimulus I considered unbearable.

It’s hard to overestimate the human capacity to adapt when we have no other choice.

YouTube Link: Tinnitus: Dealing with a Wicked Form of Torture

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My Finger Picking Compulsion Feels Just Like an Addiction

The emotional consequences of body-focused repetitive behaviors

Image by (El Caminante) from Pixabay

I’ve been a finger picker for 37 years. I was in middle school when I began to notice and pull out flakes of skin around my fingernails.

I can’t remember how long it took for finger picking to become both habit and problem. What I do know is that I was hiding it by the time I was in high school.

Still, once in a while someone would notice a ravaged finger and ask, “What happened to your finger?” I’d come up with excuses like getting burned or having picked at it just once and then getting an infection.

I began putting on a bandaid when a finger looked noticeably damaged — a great solution since the bandaid both hid the injury and gave credibility to my explanation that I’d accidentally cut myself. I’d pick under the table or when my back was turned to others.

While still in high school, I managed to limit my picking to my index fingers and thumbs. Over the ensuing decades, I’ve been able to further narrow down my self-mutilating behavior so that my left thumb is now its only target.

My left thumb became my sacrificial finger.

I don’t want to minimize the gravity of drug, tobacco, or alcohol addiction, but finger picking strikes me as similar in some ways. In fact, I often think I know what it must be like to have a substance abuse problem.

Finger picking has caused me shame and a measure of self-hatred, just as any addiction would.

Like an addict, I strive to hide my habit from others. My husband marvels at how I was able to conceal my mutilated thumb and index finger from him for months before he noticed them. I knew how to perfectly angle my hand so my ugly fingers wouldn’t show when I rested it on a surface or used it to stir, clap, hold, scratch, or whatever.

Like other addictions, finger picking carries some risk since the possibility of infection is real. Unbelievably, it also interferes with daily activities, like when I just have to peel off a bit of skin while driving or when I must be done removing a flake before turning off the stove.

Finally, there’s the question we always ask about addiction: Why, for the love of God, can I not stop?

My failure to stop picking exasperates me. I mean, even people addicted to crack, alcohol and tobacco can manage to quit.

Still, I’ve always sensed killing this habit is harder than I usually admit to myself and that the behavior is associated with my family’s strong genetic predisposition for depression, anxiety, and obsessive-compulsive disorders.

How could there not be a genetic component when three of my five sisters have engaged in serious body-focused repetitive behaviors, as behaviors such as skin picking, nail-biting, and hair-pulling are known in the literature? There has to be a genetic component to my habit.

Every now and then, I bring up finger picking with my sister Lole — whose habit is as bad as mine — and we’ll give each other suggestions. I’ll tell her, “My finger picking’s out of control lately. I need to do something!” Recently, Lole said she’ll squeeze her finger hard ten times and tell herself, “My finger doesn’t want me to do this to it.” She’s esoteric like that.

Last year, I came across an article in The New York Times that explored body-focused repetitive behaviors such as mine. The piece, Fighting the Shame of Skin Picking (9/5/2019), could not have described my experience more aptly:

“These repetitive behaviors typically emerge around the onset of puberty, though they can begin earlier, and are more common in girls and women. They tend to occur along with mood disorders like anxiety and depression, or with obsessive-compulsive disorder. Patients report feeling an urge to pick or pull, followed by a physical sensation of relief or gratification while engaging in the behavior itself.”

The way I feel about my finger picking habit has changed. Though I don’t go around showing people my damaged finger, I’m no longer ashamed. If someone asks what happened to it, I’ll say I have a bad picking habit.

If the person’s really curious, I’ll explain that my thumb looks the way it does due to a decades-old self-injurious behavior. I might also tell them my compulsion, also known as excoriation disorder, actually appears in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), classified as an “obsessive-compulsive and related disorder”.

As all obsessive-compulsive behaviors, skin picking is extraordinarily hard to eliminate. The longest I’ve gone without doing it was around five years ago when I printed out a chart to mark the days I didn’t pick. I told myself that if I managed to go 30 days in a row without picking, I’d give myself a reward. I had to start over many times but eventually got to 30 consecutive days of no picking.

I cannot even remember what the reward was. The habit, though, was not forgotten. It resurfaced. “Just this once” became” just today” until it was back in full force.

The reason I’m writing this piece now is that I’ve been picking in earnest over the past couple of weeks, and have become impatient with myself for my inability to mitigate my compulsion.

I’ve even thought of a terrible punishment technique: For every time I pick, I must donate $1 to the National Rifle Association. This could add up to a sizable donation to an organization I’d love to see defunded. Effective as this plan sounds, I just can’t do it. The thought of it makes me want to pick!

Skin picking disorder feels like an addiction and is more common than you’d think. According to the Harvard Health Blog, it affects at least five million Americans.

If you’re one of them, knowing it’s not just you might make you feel better. It did for me at least. If you’re not, keep in mind that that close friend or family member who picks their skin to death is not weak or totally lacking in will.

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