Hearing Loss and Anxiety: Why It Happens and How to Cope – National Council on Aging

Whether you’ve just been newly diagnosed or have lived with it for a while, hearing loss can cause or worsen anxiety and other mental health symptoms. As you can probably imagine, feelings of worry and unease around uncertain outcomes related to hearing loss might creep into all areas of life: social, professional, physical, financial, and emotional.

With this in mind, our Reviews Team set out to understand the connection between hearing loss and anxiety by diving into research on the topic and interviewing real people who have experienced anxiety due to their hearing loss.

Why does hearing loss make you anxious?

Hearing loss can make communication and social interactions more challenging, which can potentially impact your overall well-being. Difficulty understanding conversations, feelings of isolation, concerns about missing important information, and the constant strain to compensate for hearing loss can contribute to heightened anxiety levels.

Anxiety can affect hearing

Somewhat unknown or overlooked phenomenon: anxiety can affect your ability to hear. This can occur in a number of ways:

• Stress response: The physical symptoms of anxiety, which can be referred to as a fight-or-flight response, are increased heart rate, muscle tension, and shortness of breath. These symptoms can cause tinnitus. In fact, studies have repeatedly shown a correlation between anxiety and tinnitus. Ringing, pulsing, or “fullness” in the ears is often reported at the height of a panic attack. In an online poll by AnxietyCentre.com, 76% of respondents said they had pulsatile tinnitus as an anxiety symptom. Fortunately, anxiety-related tinnitus is usually temporary and goes away once the person is no longer in a hyper-anxious state.
• Attentional bias: Anxiety can cause a person’s activated nervous system to focus on perceived threatening stimuli, including sounds. This means during high anxiety situations, you might find it harder to concentrate during a conversation, while sounds, like creaks or bumps, may be more pronounced.
• Catastrophic thinking: Anxiety may lead to a tendency for anticipating the worst possible outcome or interpreting neutral situations as threatening. This can manifest as heightened sensitivity to all sounds, or a tendency to interpret benign sounds as distressing. This can become a vicious circle where the anxiety causes hypersensitivity to sound, and then the sound causes even more anxiety, and so on.

Hearing loss creates anxiety

Just as anxiety can affect hearing, hearing loss and conditions like tinnitus can be significant sources of anxiety. A review of studies involving more than 17,000 people with hearing loss found the prevalence of anxiety was higher among people with hearing impairment than the general population, with the severity of the impairment correlating with the severity of anxiety.

Hearing loss may lead to anxiety in several ways:

• Communication difficulties: As hearing worsens or when there is significant hearing loss, people may find it increasingly difficult to communicate effectively with others. They may struggle to understand conversations, miss important information, or find it difficult to express themselves. These difficulties can lead to feelings of frustration, embarrassment, and even isolation, all of which are anxiety-provoking states.
• Cognitive strain: People with hearing loss can experience mental strain and fatigue from the extra effort constantly required to function with reduced hearing. They often must concentrate hard, fill in gaps, and work to decipher speech and unclear sounds, which can create fear regarding their ability to keep up with conversations or perform in various listening situations.
• Social impact: Communication difficulties can lead to anxiety around social interactions. People with hearing loss may feel self-conscious and withdraw from social situations and avoid group gatherings. This can lead to feelings of isolation and loneliness. In his book, “A Quiet World: Living With Hearing Loss,” David Myers, a social psychologist, discussed the struggles he and his mother had with hearing impairment, including feeling humiliated and fearful during social situations. His mother wrote in her journal, “I would chime in and say the same thing someone else had just said—and everyone would laugh. I would be so embarrassed, I wanted to fall through the floor.”
• Tinnitus ⓘA condition that is often linked to hearing loss and causes constant or periodic ringing or buzzing in the ear-related distress: About 30% of people with hearing loss also have tinnitus. When tinnitus is ongoing and persistent it can cause significant anxiety and emotional distress and can even make you feel trapped. Constant tinnitus can make it difficult to sleep and focus, worsening anxiety.
• Uncertainty about the future: We all experience some level of anxiety about the uncertainty of our futures. But if you have hearing loss, you may also worry about progressive loss, potential limitations on career opportunities, and the impact of your hearing impairment on personal relationships. Research shows that as hearing loss progresses, anxiety increases as well. Compared to individuals without hearing loss, those with mild hearing loss have a 32% greater chance of having anxiety, while those with moderate or greater hearing loss have a 59% chance of having anxiety.

Common sources of hearing loss anxiety

Certain anxiety-provoking thoughts are common to those experiencing hearing loss. They may include:

• “I’m missing important information”: People with hearing loss may worry about not being able to hear or understand important conversations, instructions, or announcements, leading to anxiety about missing out on crucial information.
• “People are judging me”: Concerns about being judged or misunderstood due to hearing difficulties can lead to anxiety in social situations. People may worry about being thought of as inattentive, uninterested, or unintelligent because of their hearing loss.
• “I’m becoming isolated”: People with hearing loss may withdraw from conversations or avoid social events due to difficulties in communication, which can make them feel disconnected.
• “I can’t participate fully”: People may feel left out, frustrated, or anxious about their limited engagement or contribution.
• “I’m a burden to others”: Some people with hearing loss may feel guilty or anxious about inconveniencing others by needing repetition or accommodations. They may worry about being a burden to their loved ones or colleagues.
• “What if my hearing worsens?”: Concerns about the progression of hearing loss can generate anxiety about the future. People may worry about their ability to cope or adapt if their hearing deteriorates further.
• “I can’t enjoy certain activities anymore”: Hearing loss may limit participation in activities, such as watching movies, attending concerts, or enjoying music. People may feel anxious and sad as a result of missing out on enjoyable experiences.
• “I can’t rely on my senses”: Reduced reliance on a person’s hearing can create feelings of vulnerability or unease. People may worry about their safety and the ability to detect potential dangers or emergencies without the full use of their hearing.
• “My relationships are affected”: Hearing loss can strain relationships with friends, family, and romantic partners. People may be anxious about misunderstandings, strained connections, or the loss of intimacy in relationships.
• “I’m losing control”: Feelings of helplessness and loss of control over one’s hearing abilities can contribute to anxiety. People may worry about their ability to manage their daily lives, make decisions, or maintain independence.

Other anxiety considerations

In addition to hearing loss, it’s important to recognize how anxiety can be influenced by other factors. Considering the complex interplay of various factors can help individuals with hearing loss and their loved ones understand and address anxiety more comprehensively:

• Other mental health conditions: People with hearing loss have a higher likelihood of experiencing other mental health conditions, such as depression, social anxiety disorder, or generalized anxiety disorder. These conditions can interact with each other, worsening anxiety symptoms and making the overall experience more complex.
• Other medical conditions: People with hearing loss may also have other medical conditions, such as cardiovascular diseases, diabetes, or neurological disorders. Chronic health conditions can be associated with higher levels of anxiety due to their impact on daily functioning, lifestyle changes, and uncertainty about health outcomes. Additionally, Rachel Magann Faivre, AuD, owner of Oklahoma City-based ASH Audiology, said: “Acute medical conditions, like cancer treatment or injuries (especially head traumas), can also have similar effects that chronic ones do regarding anxiety.”
• Medications: Certain medications can have side effects that include anxiety or worsened anxiety symptoms. These include ADHD medications, antidepressants, migraine medications, corticosteroids, decongestants, rescue inhalers, and thyroid hormones. It’s important to be aware of the potential effects of medications and discuss any concerns with health care professionals.
• Cognitive factors: Cognitive distortions, such as negative thinking patterns, thinking the worst (catastrophizing), or excessive worrying, can contribute to anxiety. These cognitive processes can be influenced by personality traits, past experiences, and your overall coping style, all of which may be independent of hearing loss.
• Support systems and social environment: The availability of social support networks, understanding of friends and family, and a supportive social environment can play a significant role in managing anxiety.
• Access to health care and treatment: Limited access to health care services, including audiology and mental health resources, can impact someone’s ability to seek appropriate treatment for hearing loss and anxiety. Barriers to access, such as financial constraints or lack of availability, may affect the overall experience and management of anxiety.
• Coping skills and resilience: The presence of effective coping strategies, resilience, and self-care practices can influence how you navigate anxiety related to hearing loss. Developing and using healthy coping mechanisms can help you manage anxiety and overall well-being.

Feeling anxious in the face of these conditions is entirely normal and quite common. The impact of hearing loss and related conditions on mental health, including anxiety, is well-documented.

It’s crucial to emphasize that anxiety can occur at all levels of hearing loss, from mild to severe. Even those with mild hearing loss or tinnitus may experience anxiety due to the challenges and adjustments they need to make in their daily lives.

Physical signs of anxiety

Anxiety can sh0w itself in different and multiple ways from person to person. Here are some common signs and symptoms of anxiety and the potential impact on other mental health concerns:

• Restlessness and irritability: Anxiety can contribute to a constant sense of restlessness, feeling on edge, or being easily irritated or agitated.
• Intense fear or panic: Intense feelings of fear or panic are often accompanied by physical sensations, such as rapid heartbeat, shortness of breath, and chest tightness.
• Muscle tension: Anxiety can cause muscle tension throughout the body, resulting in stiff or sore muscles and overall discomfort.
• Fatigue and sleep disturbances: Falling asleep, staying asleep, or experiencing restful sleep can be more difficult when you’re feeling anxious, which can lead to daytime fatigue and impaired functioning.
• Gastrointestinal issues: Anxiety can result in digestive problems, such as stomachaches, nausea, diarrhea, or irritable bowel syndrome symptoms.
• Sweating: Sweat glands are often activated as part of a person’s stress response.
• Trembling: Your muscles tense when the hormones adrenaline and cortisol are released during stressful situations, which is why you may shake or tremble until the stressor fades.
• Increased or decreased activity levels: You may feel more restless, leading to increased physical activity or a constant need to stay busy. On the other hand, some people may experience a decrease in motivation or engagement due to anxiety-related fatigue or withdrawal.
• Avoidance behaviors: Anxiety may prompt some people to avoid situations or places they perceive as anxiety-inducing. This avoidance can limit their engagement in activities, social interactions, or responsibilities.

Coping with anxiety

Susan Drumm, a licensed therapist and owner of Peak Counseling Solutions of Denver, Colorado, told us, “The first step in addressing anxiety is awareness, then understanding how anxiety works.” Taking control over your source of anxiety is an important step in addressing it—even if it may feel uncomfortable to ask for help or accommodations. The relationship between hearing loss and anxiety is much better understood now than in the past, and there are now many support resources available.

• Therapy and counseling: Seeking professional help from therapists, counselors, psychologists, or psychiatrists can provide valuable guidance and support in managing anxiety. Cognitive-behavioral therapy (CBT) and mindfulness-based therapies can help people develop effective coping strategies and address underlying thoughts and behaviors contributing to anxiety. Psychiatrists can prescribe medications to treat anxiety. You can search for professionals through your health insurance provider or through the Anxiety and Depression Association of America (ADAA). The American Psychological Association has a psychologist locator webpage to connect you with psychologists in your area. Online therapy platforms offer convenient access to therapy from the comfort of your own home. Websites and apps like BetterHelp, Talkspace, and Amwell provide online counseling services and connect people with licensed therapists via video, voice, or text chat.
• Licensed medical professionals: When seeking assistance for hearing loss, it’s essential to work with licensed medical professionals, such as audiologists and otolaryngologists (ear, nose, and throat specialists). They can provide comprehensive evaluations, recommend appropriate interventions, and guide you through the process of acquiring and adjusting to hearing devices if necessary. Trusted sources for finding professionals include the American Academy of Audiology and the American Speech-Language-Hearing Association websites, where you can search for providers in your area.
• Social support: Connecting with supportive friends, family members, or support groups can provide a sense of belonging and understanding. Online communities, forums, and virtual support groups for those with hearing loss can offer valuable emotional support and practical advice. Connecting with national or local hearing loss associations can offer a wealth of resources, including information on support groups, educational materials, and advocacy efforts. Organizations, like the Hearing Loss Association of America (HLAA) and the American Tinnitus Association, provide valuable resources and support networks for people with hearing loss and tinnitus. The ADAA also has a support group search page.
• Breathing and relaxation techniques: Deep breathing exercises, progressive muscle relaxation, and mindfulness meditation can help reduce anxiety symptoms. Mobile apps, like Calm, Headspace, and Insight Timer, offer guided relaxation and meditation exercises.
• Physical exercise: Engaging in regular physical exercises, such as walking, yoga, or dancing, can help reduce anxiety by releasing endorphins, improving mood, and promoting overall well-being.
• Self-care practices: Prioritizing self-care activities that promote relaxation and well-being, such as getting enough sleep, maintaining a healthy diet, engaging in hobbies, and practicing self-compassion, can help manage anxiety symptoms.
• Journaling and expressive writing: Writing down thoughts, feelings, and concerns in a journal can provide an outlet for self-reflection and help process emotions related to anxiety. It can also serve as a tool for identifying patterns and triggers. Journaling apps, like Day One and Daylio, have become popular.
• Limiting stimulants: Reducing or avoiding stimulants, such as caffeine, nicotine, and alcohol, can help manage anxiety symptoms, as these stimulants can contribute to increased restlessness, irritability, and sleep disturbances.
• Assistive listening devices: For people with hearing loss, using assistive listening devices, such as hearing aids, cochlear implants, or amplified telephones can enhance communication, ease frustration, and reduce anxiety related to hearing difficulties. A 2020 study found hearing aid use to be associated with decreased odds of psychological distress compared to those with hearing loss who did not use aids. If you need hearing aids, there are lots of affordable hearing aids and over the counter hearing aids on the market.

Remember, everyone’s journey with anxiety and hearing loss is unique, and it’s important to find the strategies and resources that work best for you. Generally, a combination of these tools can help in managing anxiety and promoting overall well-being.

Research from 2017 shows that people who use hearing aids had a 15% lower odds of anxiety than those with hearing impairment not using hearing aids. Although the study authors were careful to point out that this is not statistically significant due to limitations in their study.

Supporting a loved one with hearing loss-related anxiety

Supporting a loved one who is experiencing anxiety due to hearing loss requires empathy, understanding, and effective communication. Here are four helpful strategies for supporting someone with hearing loss-related anxiety:

1. Educate yourself about hearing loss and anxiety:

• Learn about hearing loss: Take the time to understand the nature of hearing loss, its impact on communication, and the common challenges associated with it. This knowledge will help you to empathize with someone’s experiences and provide better support.
• Understand anxiety: Educate yourself about anxiety, its signs, symptoms, and how it can be related to hearing loss. This understanding will allow you to recognize anxiety-related behaviors and respond with compassion.

2. Effective communication strategies:

• Practice active listening: Be patient and attentive when talking. Give your full attention, face people directly, and maintain eye contact to improve communication.
• Speak clearly: Use clear and concise speech, avoiding mumbling or speaking too quickly. If necessary, ask about their preferred communication strategies and adjust accordingly.
• Give them time: Allow extra time to process and respond to conversations. Avoid interrupting or finishing their sentences, as this may increase feelings of frustration or dependency.

3. Emotional support and encouragement:

• Validate their feelings: Acknowledge and validate emotions related to hearing loss and anxiety. Let them know their feelings are valid and you’re there to support them.
• Offer reassurance: Be encouraging by emphasizing their strengths and abilities rather than focusing solely on their limitations. Remind them they’re not alone in their journey and you will be there to support them every step of the way.
• Be patient and understanding: Recognize that anxiety and the challenges of hearing loss may sometimes lead to frustration or withdrawal. Offer patience and understanding, creating a safe space for them to express their feelings and concerns without judgment.

4. Encourage professional help and resources:

• Suggest seeking professional support: Gently recommend seeking help from licensed professionals, like audiologists or therapists, who specialize in hearing loss and anxiety. Explain how professional guidance can provide valuable coping strategies and support tailored to their needs.
• Share relevant resources: Provide information about support groups, online forums, or organizations that offer resources specific to hearing loss and anxiety. Direct them to websites mentioned above, like the HLAA and the ADAA.

Remember, supporting someone with hearing loss-related anxiety requires patience and understanding. Encourage open and honest communication, validate their experiences, and be a trusted ally as they navigate their journey.

Have questions about this review? Email us at [email protected].

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