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Losing My Mind (And Dream) to Pulsatile Tinnitus: The Less Noisy Road Back

04/30/2015 10:46 am ET | Updated Jun 30, 2015

In my final year of college at Rutgers, something happened that would alter the course of my professional life as I had dreamed it. My right ear decided one night to spontaneously erupt into ceaseless, wretched cacophony.

To even begin to relate to the uniquely frustrating phenomenology of my mental existence ever since, one must consider the condition referred to broadly as tinnitus: any noise that suddenly manifests in one or both of an individual's ears. Normally, this noise is a sign of incipient hearing loss or temporary trauma to the inner ear (say, due to exposure to loud music). The most common noises are ringing, hissing, and roaring, or some combination of them. While "popular" tinnitus exhibits this classic acoustic behavior, and can only be perceived by the subject, the kind I was, and still am, afflicted by is categorically distinct.

Instead of a ringing noise, what I hear sounds much more like the beat of my own heart. A crackly, whooshing and roaring din just below the surface of my ear that I imagine simulates the mechanical fury of my cardiac system. But the similarity doesn't stop there. The relevant tonal qualities of these sounds in fact modulate to the rhythm of my very pulse: the more nervous I am, the faster and more forcefully my heart beats, and this kicks my already bothersome tinnitus into overdrive -- the whooshes are more intense and physically unnerving. I'll return later to why these characteristics are significant.

For me, this development all but guaranteed that my lifelong dream of a future in academia would come to fruition only if all of the following conditions consistently obtained:

  1. Get substantially more time to do homework and exams or write essays.
  2. Sleep as little as possible.
  3. Re-read assigned literature as much as possible.

Already beset by a debilitating amalgam of mood -- generalized anxiety and major depressive -- and neuropsychiatric -- ADD and anorexia -- disorders, my confidence going into my Ph.D. program was, you must understand, in very short supply. Yes, I did graduate from my alma mater, a top university in philosophy, summa cum laude. Yes, I did also earn highest honors from my department for my senior thesis. Yes, I did also achieve high GRE scores. But for all that, I never felt completely at home in my new department, where I was the only Asian in a department dominated by white males and females. I resolved not to pursue tack 1), as a result. Why make myself a more obvious bête noire than I already was?

In particular, an event took place my second year of graduate school that dragged me deeper into the abyss. While waiting for me to make my move in a game of Settlers of Cataan that my then-housemate, also a fellow graduate student in my department, had hastily assembled, he-who-shall-not-be-named uttered in a sort of deadpan way, "Your move, Torrey -- who will never amount to anything." Perhaps because there had been no antecedent banter to foreshadow it, no one at the table said anything. Unbeknownst to them, however, the completely random nature of that utterance and the fact that no one reproached him for it hurt me deeply.

I recount this incident only to draw attention to the parallels of obsessive compulsion seen in both tinnitus and depression sufferers. Just as those depressed tend to be consumed by negative thoughts, leading them to mentally re-play unhappy moments over and over again, tinnitus sufferers unwilling to accept a life with no possibility of true silence will fixate on their own auditory perceptions, hoping to find it somewhere in between. Of course, the more I dwelled on my inability to hear absolute silence, the more fervently my private, excruciating concert played on, worsening my latent depression.

Depression and tinnitus feed off each other frighteningly well, I came to realize. That ostensibly benign utterance conspired with my tinnitus to create a sound barrier few of my thoughts could break through. Before long, I had lost all ability to concentrate. Lectures, conversations, attempts at reading -- they all were drowned out by noise and negativity. The exact same words that were spoken that night played and replayed themselves any time I had to speak in a seminar or give a presentation. On more than one occasion, I found myself stopping mid-sentence while presenting, paralyzed for eternal seconds by my memory of that incident.

Once that happened, my heart would beat furiously, and the crescendo inexorably overtaking my hearing would overtake my cognition as well. Tinnitus made sure that no self-belief remained after depression had had its way with me. And it would be game over -- another blown presentation or point to make. I took a leave of absence the next year thinking that time would heal all. It didn't, and, anyhow, my tinnitus persisted. I never went back.

It's been a year now since I left. Finally employed full-time, I was able to hop back on a health insurance plan and go see an otolaryngologist. And this brings us back to my earlier promise to explain the significance of certain characteristics peculiar to my form of tinnitus. Apparently, what I have is something called pulsatile tinnitus. Crucially, unlike popular tinnitus, there are ways to treat and not simply alleviate it. This is because the sorts of noises that its sufferers endure aren't due to any loss of a certain faculty or sensory capacity. Their significance lies precisely in their medically, and not merely neurologically, explicable acoustics.

For instance, in my case, as is the case with many with this form of tinnitus, it is suspected that I may have a dissected carotid artery -- an abnormal narrowing of that artery which brings about blood flow disturbances near the inner ear, causing the implicated whooshing and roaring sounds. If I do in fact suffer from this condition, it would also explain why my blood pressure has been unusually high in my recent visits to the clinic.

With this particular conjecture, an MRA (magnetic resonance angiography) is the diagnostic tool of preference. Treatment of a dissected carotid artery requires intracranial surgery to enlarge the affected blood vessel. Now, I don't know for sure if this is what I will need to go through, since I just recently had my MRA. Nor are initial results from a single test ever definitive. The point is just that I know now that I am not irreversibly stuck with tinnitus.

It has taken me this long and a dream Ph.D. separation just to get to a conjecture, but at least reasonable conjectures breed solutions, whatever they turn out to be. I already feel less depressed because I am finally taking action. I can almost hear silence again. The road back is less noisy as a result. This in itself makes all the trying and failing, and trying again worthwhile.

Questions? Please email me, or find me on Facebook.