Can depression cause hearing loss? What we know.

What is depression?

Depression is a common problem in the general population and hearing loss community. The World Health Organization estimates that about 5% of adults worldwide have depression. Despite the commonality, depression is sometimes misunderstood or mistaken for simply “feeling blue.”

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, was released in 2013 by the American Psychiatric Association. It defines depression, or major depressive disorder, as a mood disorder. At least five symptoms must be present for at least two weeks for a diagnosis. These symptoms must affect your day-to-day functioning.

It’s also been thought that depression results from a chemical imbalance of serotonin, a neurotransmitter that regulates mood, sleep, and other functions. However, a recent study found no clear evidence that was the case.

Generally speaking, depression is a serious mental illness that is hallmarked by a prolonged sadness and/or loss of interest in things that previously brought someone joy. It’s different from “feeling blue.” Feeling blue may happen in waves, inter-spliced by positive moments. Depression happens if symptoms persistently last for two or more weeks. Self-esteem doesn’t typically decline when a person is feeling blue, but low confidence and self-esteem issues often occur in those experiencing depression.

Symptoms of depression

Treating mental illnesses is as important as treating physical health. Recently, there’s been more of a movement to get the word out that seeking treatment options for mental health conditions, like depression or anxiety, is as vital to overall health as receiving care for other issues, such as high blood pressure. Understanding the symptoms of depression can help people reach out for help if they, or a loved one, are experiencing them. According to the DSM-5, depressive symptoms may include:

• Depressed mood — This symptom is based on a subjective report by the person or others.
• Loss of interest in activities a person once enjoyed — Subjective self-reports or observations from others that a patient no longer takes pleasure in things they once loved is another depressive symptom. For example, a person who once loved social activities may isolate themselves.
• Weight changes — The DSM-5 classifies significant weight change as a gain or loss of more than 5% in one month.
• Sleep changes — Sleeping more or less than usual is a flag.
• Psychomotor changes — Skills, such as hand-eye coordination, may decline in a way severe enough that others take note.
• Energy changes — A person experiencing depressive symptoms may feel tired, fatigued, less efficient, or like they have low energy.
• Self-esteem decline — Someone may feel worthless or guilty in a way that exceeds, for example, guilt about being sick and unable to attend an event.
• Cognitive decline — Issues thinking, focusing, and making decisions based on self-reports or observations from others is another sign. Cognitive decline is also associated with hearing loss.
• Recurrent thoughts of death — People with depression may think about death or experience suicidal ideation. They may attempt suicide. This symptom is different than having a fear of dying.

👉 A 2014 study in JAMA International Medicine indicated that people over 70 with hearing loss are more likely to experience cognitive impairment more quickly than those with normal hearing.

Hearing loss and depression: how are they related?

Depression is common, whether a person is experiencing hearing loss or not. However, why is hearing loss a risk factor for the condition?

People of any age with hearing loss can struggle with depression, according to a published 2014 study from researchers with the National Institute on Deafness and Other Communication Disorders. Still, age may also be a risk factor for depression in hearing loss patients. A 2019 systematic review and meta-analysis of more than 147,000 patients and 35 previous studies found that older adults were more likely to experience depression linked with hearing loss.

About 25% of people 65 and older are already socially isolated, according to the CDC. Hearing loss may cause someone to isolate themselves further, even if they once loved being in social situations. Why?

For starters, hearing loss can be a significant source of stress. A person may be concerned for their physical health, which can cause emotional distress, fatigue, and decreased desire to socially interact with others. A person may experience embarrassment and frustration — perhaps they can’t hear loud noises. They struggle to understand what a loved one is saying during a phone call, especially if there’s background noise. As a result, a person may decide it’s better to forego social interaction.

Recent studies show that hearing loss and depression are associated with accelerated cognitive decline, such as memory issues. A person experiencing memory issues may forget obligations and get-togethers, decreasing their social life and exacerbating depressive symptoms.

👉Depression later in life is linked with an increased risk for dementia (Alzheimer’s Disease is a common form of dementia). Early detection of depression can lead to significant improvements in a person’s physical and mental health.

How depression impacts hearing loss treatment

Getting help for hearing loss, such as the use of hearing aids, can help with depression. However, a person with depression may have more difficulties seeking assistance. These challenges happen for several reasons.

Ignoring symptoms

A person with depression may wave off symptoms of hearing loss. First, people may prefer not to face symptoms or seek help, fearing there will be a stigma associated with receiving assistance for hearing loss. They may be uncomfortable with the idea of wearing a hearing aid, but there’s no shame in it, just like there’s no shame in eyeglasses. And some modern hearing aids are nearly invisible.

Feelings of worthlessness are also common in people with depression. They may not feel they are worthy of assistance — which couldn’t be further from the truth.

Lack of follow-through with healthcare providers

A person with depression may not go for follow-up appointments. Perhaps they got put on hold, grew impatient or irritable, and decided to call back but never did. People with depression may get irritated more easily. They also may not feel worthy of a provider’s time.

Cognitive decline may also play into following up with healthcare providers. A person with depression may forget to call back or have trouble making decisions about the next steps in care, so they decide not to receive help.

Too many steps, not enough energy

Receiving a hearing loss diagnosis is a process that may include testing, doctor’s appointments, fittings for devices like hearing aids or cochlear implants, and follow-up appointments for tune-ups.

People with depression often experience fatigue and trouble sleeping. The process may feel too daunting to go through. Consider leaning on a family member or loved one to drive you to appointments or handle other tasks, such as laundry or meals, as you undergo a hearing loss diagnosis. Other groups, such as local churches, may also provide assistance. You can also speak with a primary care physician about resources in your area.

Treatment options

Hearing impairment and depression are both treatable. In fact, treating both simultaneously can significantly improve depressive symptoms. Treatment of hearing loss can be critical. Data from a cross-sectional study that included more than 25,000 participants indicated that hearing loss was linked with a higher likelihood of psychological distress. Hearing aid use was linked to a lower chance of psychological distress.

Treating depression

Just like there are treatments for heart disease, there are ways to get help for depression. Therapy and medication are the two main options. Cognitive behavioral therapy (CBT), which helps patients reframe negative thoughts and feelings into more positive ones, is a common form of talk therapy. Though often performed individually, a 2019 study found that group, phone, and self-help-based CBT were effective alternatives.

Some studies indicate that antidepressants can help with symptoms. Others suggest they do not improve quality of life long-term. Speaking with a mental healthcare provider can help you choose the best path.

Treating depression may help a person become more motivated to treat hearing loss. Treatment may increase feelings of self-worth, decrease fatigue and sleep problems, and help with focus. With a clearer mind, a person may be more able to seek help for hearing loss.

Treating hearing loss

Though the process of treating hearing loss may feel daunting to a person experiencing depression, going through it can help reduce depressive symptoms. These steps include:

• Evaluation — You and the provider will go over your symptoms of hearing loss. A provider will use this information to inform the next steps.
• Testing — A trained audiologist will conduct a hearing test to diagnose hearing loss and at what level. There are several types of tests.
• Diagnosis — An audiologist will provide a diagnosis, such as mild hearing loss or severe hearing loss. They can also tell you what type of hearing loss you have.
• Gameplan — From there, a healthcare provider will work with you to treat the hearing loss long-term. This plan may include a device like hearing aids or cochlear implants.