What’s the connection between depression and untreated hearing loss?

Contributed by Madeleine Burry

It makes intuitive sense that a connection exists between hearing loss and depression: When people struggle to hear, communication becomes challenging and loneliness, sorrow and social isolation can quickly follow.

Audiologist Paul Milner, PhD, CCC-A, owner of Hearing Care Center, sees it in patients all the time. At an appointment, a woman once told him that when she was unable to hear and participate in the festivities for her granddaughter’s birthday, she gave up and went to a bedroom to sit by herself for the duration of the party.

“I asked her how it felt to leave because you couldn’t hear, and she said it felt very sad,” Milner says. It’s lonely and upsetting when everyone is having a good time and you can’t participate, he points out.

What the research says about depression and hearing loss

There’s ample research to show the connection between hearing loss and depression, though the estimates vary on how many people have both.

One study found that 11.4 percent of adults with self-reported hearing impairment had moderate to severe depression, while a greater percentage—19.1 percent—had mild depressive symptoms.

Another 2009 study found that the likelihood for developing depression increased by 5 percent with every drop in incremental hearing ability (signal-to-noise ratio; SNR) for adults under age 70.

The connection between hearing loss and depression is particularly striking for hearing-impaired older adults: About one in five have symptoms of clinical depression, per a 2019 study.

Hearing impairment and mental health

The effects of this combination are far-reaching.

Following the shifts in conversations can be particularly challenging, Milner points out. That’s because of the fluid nature of talking with friends and family—one moment, the conversation is focused on basketball, and second later, it’s shifted to a story about a coworker or plans for the upcoming weekend.

“They lose connections and don’t understand what people are talking about,” Milner says. Responses that reference the discussion from a few minutes ago can make people appear disoriented. And it can also make them feel paranoid, Milner points out.

“Even without the most serious hearing loss, people might think others are talking about them because they can’t follow the conversation,” Milner says.

Psychosocial aspects of hearing loss

Hearing impairments can lead to a negative effect on both careers and personal life, says Brian Wind, PhD, CBSM, chief clinical officer at JourneyPure. People “may also become more anxious about mishearing requests or not being able to hear phone calls or alarms, which increases the risk of depression,” Wind says.

What may seem like signs of aging—a struggle to follow the conversation, a removal from social situations or a touch of paranoia—could be the result of hearing loss

And the connection between depression and hearing loss may not be solely due to the damaging social effects that accompany having difficulty hearing.

“Those who are hearing impaired may also be sending weaker auditory signals to our brains, which means our brain has to work harder to process sounds—resulting in a loss in function in other processes such as memory. Our neural pathways may reorganize, causing our brain to change the way they function, including the areas that regulate depressive symptoms,” Wind says.

In other words, there are indications that the brain is actually rewired by hearing loss.

Psychological characteristics of hearing impairment

What may seem like signs of aging—a struggle to follow the conversation, a removal from social situations or a touch of paranoia—could be the result of hearing loss. And, some depressive symptoms could be linked to hearing loss.

That makes it particularly important for older adults to get their hearing checked. Some of the classic signs of hearing loss are the volume on the TV inching up to levels that others find blaring, frequent requests to repeat something or a struggle to follow the conversation.

Sleep changes, anger, irritability

And, be on the lookout for depression symptoms, too.

“Signs of depression include sleep changes, anger or irritability and problems concentrating during work,” Dr. Wind says.

Potentially, this depression could be due to hearing impairment, or accentuated by it. That is to say, treating one condition—the hearing loss—may lead to a positive effect on mental health.

How to talk about hearing loss

Navigating this conversation with an older adult may not be easy.

“Older people don’t like to be told what to do,” Milner points outs. “It’s a role reversal for them—they used to be in charge of the family, and now the family is trying to tell them what to do.”

Framing the conversation in terms of the benefits that can come with treatment—for instance, finding it easier to participate in conversations—can help ease the way. It can also help to remind people that hearing aid technology is far more effective than it used to be, Milner notes.

Treatment options

The treatment for hearing loss will depend on the type of hearing loss. Here are some options:

Hearing aids

One of the most common treatment methods is hearing aids.

These have come a long way, Milner points out. Now, hearing aids can be linked to smartphones (so, for instance, you can hear the audio from your phone through your hearing aid).

And along with making it easier to hear, hearing aids can improve people’s social, emotional and psychological quality of life, per research. Besides hearing better, there are many health benefits to hearing aids.

For people with more severe hearing loss, or who have conductive hearing loss, bone-anchored hearing aids or cochlear implants may be recommended.

Auditory training

Auditory training can also be helpful.

“Aural rehabilitation refers to basically anything from a treatment standpoint that helps someone with hearing loss to communicate more effectively and minimize the impacts of the hearing loss,” says Jason Meyer, AuD, CCC-A and clinical training manager at Miracle-Ear.

Audiologists and hearing instrument specialists can help people set reasonable expectations for how their hearing might improve, and can also recommend effective listening techniques, he says.

“Hearing professionals also help educate on how various listening environments will be better or worse for communicating and how to minimize or overcome them.” These efforts can make a big difference: After three months of wearing hearing aids, and six months of auditory training, participants in a small study in Australia had reduced symptoms of depression.

Assistive listening devices

These devices—abbreviated as ALDs—can be helpful for watching TV or going to the theater, Meyer says.

“These devices are typically a headset style device that receive a desired signal wirelessly through various methods (FM, infrared, induction loop, Bluetooth, etc.),” Meyer says, noting that some have Bluetooth built in, so you can connect to other devices (speakers, phones and so on).

Therapy

Seeking out counseling on top of interventions to help with hearing may also be helpful.

“Seeing a mental health professional who is experienced in working with those with hearing loss to help them regain an emotional foothold and improve their wellbeing,” Wind says.

Bottom line: Best to get treatment sooner than later.

Milner finds that people don’t always recognize the psychological toll hearing loss takes—but once they spend a few weeks getting accustomed to wearing hearing aids, patients often wish they’d been fitted for them sooner, he says.

It’s not unusual for people with hearing loss to also struggle with depression. Fortunately, hearing aids and other treatments can go a long way in helping with both problems.