Untreated hearing loss and depression is linked in seniors

I have had some experience with depression, I suffered with post traumatic stress many years ago and it affected me for some time. It was a difficult time for me and my family but we pulled through it. Then a couple of years ago my son attempted to hang himself, this time we as a family went through a cycle of depression. One that perhaps we are only free of lately.

So I have some intimate understanding of depression and its effect on a person. In the hearing healthcare profession were always aware that untreated hearing loss has serious emotional and social consequences for older persons. When you work in Practice you see the link clearly on an almost daily basis. I would think that most of us would have assumed that there was a strong link between hearing loss and depression. Or at least, untreated hearing loss & depression.

A change as treatment progressed

It always appeared to me that with many Patients, as their treatment progressed their emotional outlook changed. This has been confirmed by several studies undertaken by respected groups over the years. One study conducted by The National Council on the Aging (NCOA) in the US at the turn of the century starkly illustrated that hearing loss and depression were linked.

the research

The study was conducted by the Seniors Research Group, an alliance between the NCOA and Market Strategies, Inc. The results clearly showed that untreated hearing loss in older persons is not a harmless condition. The survey was undertaken on 2,300 hearing impaired adults age 50 and older. The survey also included 2,090 close family members or friends of the hearing impaired respondents who were asked a parallel set of questions.It found that those with untreated hearing loss were more likely to report the that they suffered from the following:

• depression
• anxiety
• paranoia

They also reported that they were less likely to participate in any organized social activities, compared to those who had treated hearing loss (wearing hearing aids).

The real impact

Hearing loss is one of the most prevalent chronic conditions both in the United States and across the world.However many with hearing loss go un-treated for varying reasons.However there are consequences of Untreated Hearing Loss. This particular survey found that significantly more of the seniors with untreated hearing loss (those weren’t wearing hearing aids) reported feelings of sadness or depression that lasted two or more weeks during the previous years.

This number increased among respondents who had more severe hearing loss, 30 percent of non-users of hearing aids reported these sad feelings, compared to 22 percent of hearing aid users. Another measure of emotional distress used was the perception that “other people get angry at me for no reason,” which psychologists often identify as an indicator of paranoia.

Older non-users were more likely to agree with the statement “people get angry with me usually for no reason” (14 percent of users vs. 23 percent of non-users). Among those with more severe hearing loss, the difference was even greater—14 percent for users vs. 36 percent for non-users. Social isolation is a serious problem for some older people, because of this the study also examined social behaviour.

A lack of social contact

It found that people who don’t use hearing aids are considerably less likely to participate in social activities. Among respondents with more severe hearing loss, 42 percent of hearing aid users participate regularly in social activities compared to just 32 percent of non-users. Hearing aid users reported significant improvements in many areas of their lives. These ranged from their relationships at home and sense of independence to their social life. In almost every area measured, the families of hearing aid users also noted the improvements but were even more likely than the users to report improvements.

Improvement Area Improvement Reported by Hearing Aid User (%) Improvement Reported by User’s Family (%)
Relations at home 56 66
Feelings about self 50 60
Life overall 48 62
Relations with children, grandchildren 40 52
Mental health 36 39
Self-confidence 39 46
Sense of safety 34 37
Social life 34 41
Relations at work 26 43

Untreated, but why?

Non hearing aid users with hearing loss were asked why they did not use hearing aids? More than two-thirds of the older, non-user respondents said “my hearing is not bad enough” or “I can get along without one.” About half of the non-users cited the cost of hearing aids as an impediment to adoption. One in five offered the explanation that “it would make me feel old,” or “I’m too embarrassed to wear one.”

Hearing loss & Depression, a grieving effect?

Most hearing loss comes upon us gradually although some losses happen overnight. It is a loss we are talking about, no matter how it occurs. We need to understand the full ramifications of that word. A loss of something that is highly valued, no more so than when it’s gone. When you think of it in this manner you begin to realise that the terms of reference change. A loss of this magnitude is similar to a bereavement. When a dear friend or close relative dies, no-one thinks it strange if we grieve.

It’s not strange to grieve for lost hearing, it’s natural and healthy

Hearing loss means that you have lost the ability to communicate easily and naturally. Things that were once taken for granted such as listening to music, hearing birds in the garden. Pleasant everyday things such as the convivial chat that is so much a part of family life, the companionable feeling we get when taking part in a discussion with friends. The lazy joy of harmless gossiping on the telephone. A lot of these activities may no longer be viable or may have been detrimentally affected.

From communication being something easy and natural, it changes to a stressful activity which causes fatigue and embarrassment.

Hearing loss leads to a major change in our ability to communicate, especially in some of the complex sound environments that exist in our favourite social activities. Most people who think about hearing loss will realise these issues. Without personal experience it is hard for them to understand how pervading this problem is. How it affects every area of someone’s life and the ongoing effect on someone’s general well-being. If they consider hearing loss as a problem that has the same effect as a bereavement in some cases, it is easier to understand the difficulties.

Bereavement affects human beings in certain ways, Elizabeth Kübler Ross suggests five stages in the grieving process:

• Denial
• Anger
• Bargaining
• Depression
• Acceptance

In hearing healthcare practice we see these stages clearly every day.

Denial: Refusal to believe that they have a hearing loss. The problem is everyone else mutters. Chaps on the TV just don’t speak as clearly as they once used to!
Anger: towards anyone related to the hearing loss e.g. ENT doctor, audiologist.
Bargaining: I would give anything to have my hearing back.
Depression: I might as well give up going out with my friends if I can’t hear a word they say.
Acceptance: These aids are the best things, I can enjoy my life again.

The stages of grief are sometimes as simple as laid out, but often they may be cyclic or somebody may jump backwards or forwards from one stage to another. So if you have untreated hearing loss that you are aware of, realise that you have suffered a bereavement. Recognise the stages of that bereavement for what they are, normal human reaction. Don’t allow yourself to become stuck in one of those stages though. Work your way through those stages and most of all allow yourself to grieve your loss.

Untreated hearing loss has a dramatic effect on the psyche of sufferers, this in turn has an effect on the general health and feeling of well-being of these people. It changes their social behaviour, damages relationships and induces stress where they should be none. It’s silly to allow vanity or denial to wreak havoc on your well-being. If you think you have a hearing loss, get it checked out. If you find out you have a treatable loss, then get it treated. Life is too important not to live it.

Regards

Geoff