Huh.

But the brain is always perched right on the razor's edge of being able to produce tinnitus.

If you look at the activity of the brain in silence of somebody without tinnitus, it's very active.

It's not like the brain is quiescent when there isn't a sound.

It's just that that activity that's ongoing isn't being read out by your consciousness as a sound.

So really, what distinguishes all this sort of blinking lights of neurons firing from being read out as a percept versus not? What is the line between a hallucination and just the ongoing sort of noise of this massive machine at work? This is the key question of, why is there tinnitus? It isn't like a switch that goes on or off.

It's probably very subtle.

Mm-hmm.

Dan told me there's a pretty fundamental difference between the mild tinnitus he has and the severe tinnitus that people like Kelly have.

People with really severe tinnitus have, like, a whole brain problem.

Their tinnitus has expanded, and it's incorporated, like, other brain networks.

And whatever hyperactivity in my auditory pathway that's causing me to perceive a sound that isn't there, it hasn't changed the ability of my executive control to concentrate, or it hasn't reprogrammed my limbic system to find all sounds horribly aversive and make me depressed.

So if we don't have a solution that works, what are people supposed to do?

I think if they can find agency, if they can understand that, like, the problem isn't beyond their control, that they can acquire some tools to cope and give them a degree of improvement, sometimes that is self-perpetuating.

Sometimes, like, by seeking community with other people with the problem, they, it can help them realize that they aren't so isolated and alone.

Their friends don't understand why they don't wanna go out to a restaurant, because it's hard to imagine what it's like to be assaulted by a world that's, like, twice as loud as it should be, and that you're hearing sounds that aren't being produced.