Hi Greg,
Your explanation is excellent. In my case, my body went into full alarm state after a stressful period for years.
This stressful period ended with health issues like vertigo, migraines and other things. This caused high anxiety in me which finally triggered T. I never ever had any issues with my ears before, even no fleeting T. So T started like crazy like an alarm in me. Within a second, I was on high alert, full of anxiety and thought this is the end of my life
The MASTER question is:
How to bring the brain/body out of this hyperstimulated mode and a stop of T?
Can only a drug like AUT00063 or SF0034 do that?
Or can I reach this without drugs?
Hi Martin,
First, never give me kudos, because I will almost inevitably inundate you with massive amounts of data!
Seriously, being caught in the fight or flight negative feedback loop is, without question, one of the scariest experiences around. And it's intended to be--the ancient (not terribly nuanced) brain has nothing less than our survival as its only goal. What the ancient brain never figured on, however, was the development of the "newer" or "neo" cortext--the outer layer (and most recently evolved) parts of our brain, meant mainly to govern our ancient responses and manage our "inner animals" through smart executive decision making. Great for complicated comparisons, but... the sad reality is, however, no matter how smart we are; no matter how powerful our PFCs the ancient brain, especially the amygdala, is stronger. It's older, if not wiser, and it's buried very deep in the brain, relative to the modern brain--it's often called the "lizard brain" because it has one job and one job only: save the individual against all attacks, real or perceived. It's that last bit that gets us in trouble.
A good analogy might be this: you walk into a room, and see a dead body. What happens? Your modern brain doesn't say "Look, a dead body! Run away!" In fact, your modern brain is
completely bypassed by your ancient brain, which takes over the crime scene immediately. In fact, those signals (visual, say) of the body, bypass your higher-functioning brain and get routed at incredible speed to the amygdala which just as quickly directs your vagus nerve (your body's "second brain") to prepare you for this: you feel sick, tingly, dizzy, maybe a sudden need to vomit or defacate--a whole host of symptoms ready to "save" you by fighting or fleeing (or, in some cases, by shutting down entirely--see curling up in a ball and rocking back and forth. All the work of the ancient brain, while your more modern brain sits idly by, thumbs in pockets. Now, in animals, this scenario is handled no problem--a gazelle gets away, and it decides where it's having lunch. Cortisol? Oh, easily sorted out. Adrenalin? Pshah. But humans? When humans are faced with fight or flight, we stay
with it. (This is also PTSD for veterans, btw.) Our modern brains mull over what's happened/happening, and try to figure it out. If they can't, that's when things really get weird.
I've been there, as have, I'm guessing, most of the people on this board. The only difference is that I got there through extreme anxiety having nothing to do with Tinnitus. Once I knew what my brain was trying to do (stupid brain!) it calmed me a bit (along with some other things). It's no accident that T triggers such a freakishly fearful response by its sufferers--it's part and parcel of our survival mechanism. And it's why the
explanation of what's happening in your head is so important to Jastreboff:
Accordingly, if we can train the brain to classify tinnitus-related neuronal activity as representing a neutral, nonsignificant signal, then the process of habituation will occur automatically. To achieve this, it is necessary, however, to fulfill two basic conditions:
- removal of the negative association attached to tinnitus perception.
- preservation of tinnitus detection (but not necessary perception) during treatment.
The first condition results from the observation that signals that induce fear, indicate danger, or that are associated with any unpleasant situation cannot be habituated. To avoid unpleasant situations we must not habituate sounds that provide warning!
The decreased negative association of tinnitus is achieved through directive counseling, with emphasis on teaching the patient the basic function of the auditory system and the brain in relevance to tinnitus.
This is performed because a known danger evokes a weaker reaction of the autonomic system than an unknown danger. As it is argued in the listed papers, the reactions of the autonomic nervous system are responsible for tinnitus annoyance and decreasing these reactions is a primary goal of the therapy.
emphasis added
This and more are available at Dr. Jastreboff's excellent (but very dated) web site:
http://www.tinnitus-pjj.com. He explains the connection between Tinnitus and our ancient fight or flight response quite well (if somewhat turgidly). I've been studying the ancient brain for years, but have only been researching the fight or flight response and T connection for a few weeks. What's clear to me is that the two are quite closely intertwined: the ear was one of the earlier survival mechanisms, and since the Limbic system (home of the ancient part of the brain) harbors our emotional response to the signals being sent from our auditory cortex, it's a bit of cruel feedback loop. That's why, I think, Jastreboff's RTR methodology works so hard to re-program our response to the sound. The trick--and really, we are trying to trick the brain here--is to convert these signals into sounds that are as harmless as a refrigerator motor kicking on, or a car door closing. But to your questions, which, in all honesty, I have few answers, but:
>>How to bring the brain/body out of this hyperstimulated mode and a stop of T?
The first goal is to stabilize youself so that you can stop the fight or flight negative feedback loop (see:
http://www.ancientbrain.net/home/science-behind-stress-anxiety-ancient-brain)
For me, it took ER visits, seeing two neurologists, and several other "doctors." Not a one of them ever explained what I had, not really, just the generic "high anxiety." Ultimately, I determined that had somatic disorder resulting from this extreme anxiety (the symptoms you described, plus, you know, the feeling of being on fire, stuff like that). When I found out that it was all just my ancient brain trying to protect me, that little, but critical bit of info was a life saver. So was Klonopin. That stopped it; it literally slows down the brain. That and Escitalopram--together, they stabilized patient me and helped disrupt the negative feedback loop. Well, those and an incredibly understanding wife. I hate these drugs, but they work, and if you're in a fight/flight negative feedback loop, I wouldn't hestiate to recommend them. I did wean myself off of both, btw, over a period of a year (but that's when my T really kicked in, so who knows? I cannot draw a correlation there, because there are so many other potential factors, and the Clonazepam had been out of my system for at least two full months.)
Anyway, the second half of your question is more complicated--because Fight or Flight may not be the only things causing T. And therein lies the rub: it's a varied, many-headed beast from what I've learned, and while yours might be the result of fight or flight, it's probably more complicated than that.
>>Can only a drug like AUT00063 or SF0034 do that?
I can't answer this. I doubt anyone can at this point. I've read the data and from what I can tell, they're on the right track, but we can--and should, in my opinion--do everything we can to manipulate our plastic brains to the extent possible.
>>Or can I reach this without drugs?
That's certainly what TRT is supposed to do--and CBT, as well. What's known is this: the brain is "plastic." That is, it rebuilds neural networks constantly, throughout your life. It can even rebuild split sections of your brain after stroke (check out this amazing TED talk about a neurologist on what happened after she had a stroke:
).
One thing is certain: meditation and mindfulness practice are proven--scientifically--to build up resilience in your brain. That's the neuroplasticity that can help keep your ancient brain impulses in check. But it ain't easy, and it takes time. One Harvard neurologist has found that parts of your brain are built up (the good parts!) with meditation:
Check out Sara Lazar's work here (another TED talk).
and here:
http://news.harvard.edu/gazette/story/2011/01/eight-weeks-to-a-better-brain/
Participant-reported reductions in stress also were correlated with decreased gray-matter density in the amygdala, which is known to play an important role in anxiety and stress. Although no change was seen in a self-awareness-associated structure called the insula, which had been identified in earlier studies, the authors suggest that longer-term meditation practice might be needed to produce changes in that area. None of these changes were seen in the control group, indicating that they had not resulted merely from the passage of time.
Other people to check out: Richie Richardson at the University of Wisconsin; Dr. Bruce Hubbard, CBT expert and Tinnitus sufferer (he understands fight/flight very very well); and Dr. Gans, on this site, who has modified MBSR to meet Tinnitus sufferers' needs. Emotions play a HUGE role in suffering from Tinnitus. Understanding that is a good first step. I hope this helps!! (Sorry for the lengthy verbiage.)