Exploring the Connections between Hearing Loss and Mental Health

Hearing plays a critical role in our ability to understand and communicate with other people in our day-to-day life. Uninterrupted communication helps us to build and maintain fulfilling and nourishing relationships. These relationships improve our wellbeing and quality of life and are an essential part of the human experience.

As we lose our ability to hear, we may slowly withdraw from daily interactions, distancing ourselves as the clarity of speech becomes compromised. This can affect the quality of not only our conversations with people throughout the day, but our ability to understand group conversations and even our awareness of our surroundings. Untreated hearing loss can significantly change the way we interact with the world and can increase the risk of developing or exacerbating pre-existing mental health difficulties such as anxiety, low mood, loneliness and depression. Hearing loss can evoke feelings of silliness, awkwardness, shame, and inadequacy, especially when we struggle to understand others or keep pace with a discussion. Misinterpreting conversations or struggling to hear clearly can lead to confusion or disorientation. This might result in making inappropriate remarks or speaking over others, exacerbating feelings of embarrassment, loneliness, and even paranoia.

Often, people with hearing loss may choose to give up during social interactions, as the mental effort required to concentrate and decode conversation becomes overwhelming. This can result in absences from important social events such as birthdays, dinners, holiday celebrations and other events where group conversations or background noise are present. While the decision to withdraw socially may appear easier in the short term, it can compound over time and cause the person to experience social withdrawal, making them feel like an outside observer or bystander within their family or friendship group rather than a valued, involved participant.
People experiencing hearing loss can also develop anxious behaviours, as they may worry about missing phone calls or their alarm. Anxiety may arise over further changes to their hearing, when these changes might happen, and whether current treatments can salvage their hearing. They may also fear or feel guilty about misunderstanding others, even when the person has already repeated themselves. The inability to hear and understand speech clearly can also lead to feelings of frustration, resentment, and denial before eventual acceptance.

Tinnitus, a constant sound (usually ringing or buzzing) in a person’s ears, can similarly cause mental health difficulties to arise. The continuous disruption can affect sleep, concentration, and daily performance, leading to further psychological effects. Tinnitus is often associated with hearing impairment, which can elevate the cumulative difficulties associated with each condition.

‘Use It or Lose It’

When we lose our hearing, the part of our brain that is responsible for interpreting what we hear can deteriorate. This can lead to an increased rate of cognitive decline, resulting in difficulties concentrating or remembering information. This cognitive decline can increase the risk of conditions such as Alzheimer’s disease and dementia in older adults. Whilst current research is yet to determine precisely why this occurs in tandem with hearing loss, some theories as to why this may occur include:

• Losing the ability to hear in noisy situations may discourage people from being social. The effects of isolation and loneliness then contribute to cognitive decline.
• A hearing impairment causes the brain to work harder to interpret the world without certain sounds, reducing it’s ability to perform other tasks.
• Portions of the brain may become less active as they receive and decode fewer signals.

Hearing loss or tinnitus may also lead to irregular sleep patterns and poor sleep quality, increasing the risk of health complications such as depression, paranoia, and high blood pressure.

The use of hearing aids or assistive listening devices to manage hearing loss and tinnitus can transform our daily interactions and self-perception as a result of reduced social interaction. A study by Mener et al. in 2013 suggested that the regular use of hearing aids was associated with a reduction in symptoms of depression.
If you have noticed a reduction in your ability to hear and communicate with others, it is important to take action to prevent this change from affecting your wellness and quality of life. This may include visiting your primary healthcare provider to discuss your concerns, reaching out to your support system, conducting further research and exploring mental health counselling services.

References:
Bennett RJ, Saulsman L, Eikelboom RH, Olaithe M. (2021) Coping with hearing loss distress: A qualitative investigation using Leventhal’s self-regulation theory. International Journal of Audiology. Accepted May 2021.
Mener DJ, Betz J, Genther DJ, Chen D, Lin FR. (2013) Hearing loss and depression in older adults. J Amer Ger Soc 61(9):1627.