Hearing loss has its own detractors and issues, including difficulty engaging with others, and being unable to engage in some previously enjoyed activities. Although these are the more widely known issues with hearing impairments, there are actually other issues, including mental health, that arise when hearing loss is present. What exactly are the psychological effects of hearing loss? First, let’s take a deeper look into hearing loss as a whole, and how it impacts an individual’s life.
Hearing Loss
While hearing loss may not be a concrete expectation as we age, there are numerous causes of hearing impairment and loss that make it possible or even likely that you may experience loss at some point in your life. Genetics, prolonged noise exposure, age related hearing loss, and medications are all among the common causes of hearing loss. Each of these can have a substantial impact on mental health, and can lead to an additional slew of concerns and conditions. Common concerns and auditory conditions include tinnitus, social isolation, fatigue, cognitive decline (including dementia), depressive symptoms, anxiety symptoms, and additional negative effects on mental health.
Self reported hearing loss and any of the above symptoms should be discussed with your physician and an audiologist for proper evaluation and diagnoses. Although hearing loss can frequently be self-diagnosed or self reported, mental health treatment and evaluation are best suited for mental health professionals, even if hearing loss is present.
Silently Suffering From Hearing Loss Can Affect Quality Of Life
Despite evidence that hearing aid use can significantly lessen depression and anxiety, and improve cognitive functioning, the stigma of hearing loss remains, and self reported hearing loss may go untreated. One study found that adults with hearing loss who didn’t wear hearing aids were 50% more likely to experience psychological distress like persistent sadness or depressive symptoms than those with hearing loss who did use them. Hearing aid users were much more likely to participate in social activities regularly, as well, suggesting that people with hearing loss may experience greater social isolation than those with typical hearing.
People with hearing impairments reportedly wait an average of seven years following initial signs of hearing loss before seeking treatment, including hearing aids. Adults with hearing loss between the ages of 20 and 69 are half as likely as adults 70 years of age or older to use hearing aids. Denial, vanity, and a lack of awareness can all be attributed as possible causes of the lack of use in these populations, despite the possibility of developing depression or anxiety symptoms when hearing loss goes untreated.
Hearing Impairment, Psychological Distress, And Subjective Well-Being In Older Adults
One study looked into the impact of hearing impairment on psychological distress and subjective well-being in older adults experiencing hearing impairment. Researchers concluded that early diagnosis and the rehabilitation of age related hearing loss did improve the overall quality of life of those older adults. Improving quality of life is one of the basic goals of any type of hearing loss treatment, including hearing aids and therapy designed to address the mental health of individuals reporting hearing loss or impairment.
The Hidden Risks Of Hearing Loss
Another study looked at over 600 adults for approximately 12 years. Researchers found that mild hearing loss doubled the risk of going on to develop dementia. Moderate loss tripled that same risk, and those with severe hearing impairment had a five fold higher dementia risk. Although the exact link was not clearly identified, plenty of hypotheses were developed, including the possibility of experiencing social isolation and fewer conversations in response to hearing loss, which can lead to dementia.
Hearing loss can also negatively impact signals that aid balance while walking by making the brain work far harder than is typical of normal hearing. The breakdown of these neurological processes can create subconscious multitasking, which can interfere with the processes required to walk and function safely. In this way, hearing loss can do harm to more than just mental health and hearing; it can actually be the source of injury.
Although nearly 27 million Americans aged 50 and older experience some degree of hearing loss, only 1 in 7 of those individuals uses a hearing aid. If hearing has diminished at all, it is worth it to make an appointment with an audiologist to get a hearing check and look into the possibility of using hearing aids to lessen your symptoms of hearing loss. At the very least, by establishing a baseline for your hearing, it is possible to track the rate of impairment over time and create a plan of action allowing time to save for treatment and come to terms with your new diagnosis.
Common Hearing Aid Myths
There is some stigma or embarrassment around using hearing aids, particularly when hearing loss is experienced under a certain age. Common hearing aid myths include the following:
- “My hearing’s not that bad.” While your hearing loss may not seem to be too problematic, it is best to be proactive and address any issues immediately, rather than waiting for further hearing loss or decline.
- “Wearing hearing aids means I’m old.” In truth, it is not as uncommon as you might think to experience hearing loss while under the age of 50. Because hearing loss can lead to cognitive decline, you can actually help keep your brain and social engagement levels more youthful by using hearing aids.
- “I don’t like the way hearing aids look.” While hearing aids in years past may have been quite large and distinct, there are many different options now – with much smaller, nearly invisible, technology available.
- “Hearing aids are difficult to use.” New hearing aid technology is capable of performing automatically to detect environmental changes and adapt appropriately, therefore requiring minimal tasks on the patient’s end. Audiologists and other health professionals can typically set up hearing aids and ease the process of using them.
Working with an audiologist who is educated and trained is typically considered the best route to begin your hearing aid journey to ease any concerns. This can be the first step before mental health care utilization, as getting to the underlying cause of psychological distress can help ease some of that distress.
New Study Links Hearing Loss With Dementia In Older Adults
While we’ve already discussed the possible implications of hearing loss as a dementia risk factor, studies have also shown that the likelihood of developing dementia is lower among those who utilize hearing aids. Over 2,000 study participants were analyzed, half of them over the age of 80, and found that hearing aid use was associated with a 32% lower likelihood of dementia onset for those with moderate to severe difficulty hearing or hearing loss.
ACHIEVE
“ACHIEVE” describes the Aging and Cognitive Health Evaluation in Elders, or a large-scale, randomized controlled trial that looked at treating hearing loss and hearing impairment in older adults to reduce the loss of thinking and memory abilities that often precedes dementia. It also evaluates other health outcomes, including psychological distress and health statistics, well-being, physical function, and health care use. Hearing intervention slowed loss of thinking and memory decline by as much as 48% over 3 years. Researchers continue to follow participants to evaluate the effects of hearing impairment intervention on cognition and the other evaluated outcomes.
Hearing Loss And Depression
Hearing loss has been linked to limited communication, as the loss of hearing can make it more difficult to communicate with others. This can lead to withdrawal from social activities and subsequent social isolation, which can then lead to greater loneliness and depression scores on evaluations, increased frustration, and further isolation. Studies have linked hearing loss and depression in adults of all ages and populations, making it essential to consider mental health if any degree of hearing loss or hearing impairment is experienced.
According to the World Health Organization (WHO), depression affects more than 280 million people around the world. Depressive symptoms include sadness, loss of interest or pleasure (anhedonia), feelings of guilt or decreased self-worth, changes to sleep and appetite, fatigue, and decreases in cognitive ability, including difficulty concentrating.
Further Statistics: Hearing Loss And Mental Health
Nearly 22% of adults 70 years and older experience hearing loss that impacts daily communication, and less than 25% of adults with significant hearing loss actually use a hearing aid. Because hearing loss can lead to a greater likelihood of cognitive decline and psychological distress, it is important to address hearing loss when it begins, rather than waiting for it to worsen. From using an aid, to seeking treatment for your mental health, to looking into the underlying cause of your hearing loss, impaired hearing does not need to lead to mental disorders and social isolation.
Hearing Loss And Psychiatric Disorders: A Review
Evidence is strong in both cross-sectional and longitudinal studies to suggest that there is a distinct association between hearing loss and cognitive decline. One study worked to identify a reason for the association, suggesting that chronic hearing loss can result in reduced activation in the central auditory pathways that interact with the brain’s cognitive control network. This can also lead to an interruption in auditory-limbic connections, and ultimately atrophy in the frontal lobe region of the brain. These breakdowns in function can serve as a risk factor for depression, decreases to executive function, and emotional disregulation.
People with hearing loss may also exhibit more anxiety in social situations if they cannot follow conversations and fully participate, making social isolation another risk of untreated hearing loss.
The early onset of hearing loss has also been linked to an increased risk of schizophrenia diagnosis. Loneliness and disturbances to the ability to locate the source of sounds have been identified as the most likely mechanisms behind this link. Serious mental illness can clearly define severe psychological distress, making hearing loss treatment essential for mental health and well-being. In a similar vein, there is also a potential link between paranoid psychosis and hearing loss, as those with hearing loss are at greater risk of experiencing auditory hallucinations. These hallucinations may not be tied to psychiatric disorders, making it more difficult to make a clear link between hallucinations and hearing loss.
Hearing Loss, Psychological Distress, And Utilization Of Mental Health Services Amongst Adults In The United States
One cross-sectional study determined that hearing loss as a whole was associated with an increased likelihood of experiencing psychological distress and increased mental health care utilization. This further illustrated the likelihood of incurring mental health care expenditures when hearing loss goes untreated. Fortunately, hearing aid use was also associated with decreases in the likelihood of experiencing psychological distress.
Treatment And Management Options
Cognitive behavioral therapy (CBT) has been shown to successfully treat the mental distress that can accompany hearing loss. Psychological distress can also be helped with psychotherapy and compliance using hearing aids. Although there is some dispute as to the extent of psychological intervention when using a hearing aid, the psychological distress and cognitive decline associated with hearing loss makes CBT a valuable intervention.
One such intervention is auditory rehabilitation. This particular type of treatment provides evidence-based programs to help individuals reporting hearing loss adapt to their losses, become familiar with technologies to assist hearing, develop strategies to improve listening and communication, and provide psycho-social support to decrease psychological distress. Mental health services like these, delivered appropriately by a mental health professional, can help those with mental disorders and trouble hearing decrease any additional risk factor for social isolation and psychological distress as a result of hearing difficulty.
Hearing healthcare can include a hearing aid, cochlear implants, assistive listening devices, surgery, auditory training, medication, and more. Mental health services to reduce psychological distress can also be a vital part of hearing health care, and mental health professionals would do well to familiarize themselves with current treatment approaches for hearing disorders. Whether it is delivered in person or via telehealth, mental health services can deliver important care to those with impaired hearing, and remove some of the psychological difficulties experienced by those who have trouble hearing.
Early detection of hearing loss is invaluable, because the sooner you know the extent of hearing damage and its potential causes, the sooner you can stop or slow down further impairment. Impaired hearing and serious mental illness should never be ignored, and should always be reported to a healthcare professional. Chronic mental disorders and hearing disorders both frequently require mental health care services, and seeking mental health care should be a regular step in the journey toward resolution.
Conclusion
Early recognition and treatment of hearing loss can lead to interventions like mental health care services that address both hearing loss and mental distress. Chronic medical disorders like hearing loss may not initially seem to require mental healthcare utilization, but hearing loss and psychological distress are often tied together, and it is possible to experience significantly decreased depression scores linked to hearing loss when CBT and other interventions are utilized.
If you or a loved one is experiencing hearing loss, there are numerous options available with new technology and increased access to mental health services. There are also many options to improve the psychological effects of hearing loss and depression. By consulting with an audiologist or healthcare professional about your self reported health status, including any mild, severe, or moderate mental distress and changes to hearing, you can undergo a professional evaluation and discuss management options to improve your quality of life, treat tinnitus, and reduce the effects of moderate mental distress based on the presence of hearing loss.
