Hearing loss is different from many other disabilities in that it is an invisible handicap. It is not always apparent that an individual has a hearing loss. Often times, the behaviors of the hearing impaired are attributed to something else, simply not paying attention, being distracted, and so on.
Since loss is not a disability that is limited to people over a certain age, those attributions will be somewhat dependent on the age of the hearing impaired individual. An individual who misses what’s being said at age 20 may be considered rude; an 80-year-old may be considered senile. Because hearing loss can and does occur at any age, it is well past time to consider the implications of hearing loss.
The following article appeared in an issue of Industrial Safety and Hygiene News (ISHN). ISHN covers safety news, provides vital editorial on OSHA and EPA regulations, how-to features, safety, and health management topics for professionals who direct safety & health programs in the workplace. The article addresses the impact of hearing loss on an individual’s mental health.
- A day in the life of a hearing-impaired adult may include struggles with the following:
- Hearing alarms or telephones
- Understanding someone while talking on the phone
- Understanding when several people are talking
- Understanding when a speaker’s face is unseen
- Hearing in a car, wind, or traffic
- Understanding speech on TV
- Understanding whispering
- Understanding people in a large room
- Understanding unclear or accented speech
- Being unaware someone is talking.
- Understanding in public places
- Ordering food
- Understanding cashiers or sales clerks
Individuals with normal hearing often assume that simply saying something louder or turning up the volume will enable someone with a hearing loss to hear. Volume is not necessarily the issue; difficulties with sound and word discrimination may be involved.
The need to repeat or presenting illogical responses adds to negative perceptions of older adults with hearing loss as being slow. Internalizing these stereotypes and the resultant negative self-perception certainly contributes to the emotional consequences of hearing loss.
Adults who have early-onset hearing loss report that while there are negative aspects of hearing loss, they’ve incorporated them into their personalities. They develop ways to cope with and manage hearing loss in their daily lives. It may be somewhat different for older adults who experience hearing loss at a later stage. These individuals have already developed a personality that does not incorporate hearing loss. They are accustomed to life as hearing individuals. Hearing loss may trigger an identity crisis, and reactive depression may occur.
Sometimes hearing loss exerts a direct impact on mental health. Depression and adjustment disorder can occur as a natural response to hearing loss and its subsequent impact on the quality of life. On the other hand, some people have pre-morbid mental health issues, and hearing loss compounds the problem.
Inability to hear and discern message and meaning can result in feelings of shame, humiliation, and inadequacy. It can be highly embarrassing to be unable to behave according to applicable social rules. The feeling of shame linked to hearing loss stems from inadvertently reacting in inappropriate and socially unacceptable ways, such as responding to a misunderstood question in an inaccurate fashion.
Contemporary psychiatrist William Glasser, MD, proposes that all individuals have five basic needs. How might hearing loss affect these needs?
- Survival: Is the sense of security threatened when an elder is concerned about hearing a fire alarm or a car horn?
- Love and belonging: How does hearing loss affect a relationship or the ability to have a relationship?
- Power and recognition: Does hearing loss affect job performance or others’ perceptions of the abilities of the individual who is hard of hearing?
- Freedom: How is autonomy or self-sufficiency affected?
- Fun: Does the loss impair one’s ability to hear jokes, banter, or music or to have fun in any number of ways?
The stress of living with hearing loss can put people at risk for many reactions, including distrust, chronic sadness or depression, nervousness, anger or irritability, isolation, poor self-image, feelings of incompetence or inadequacy, or feeling marginalized.
Depression is a common emotional reaction to any loss, and hearing impairment can involve a number of losses. The primary one is the reduced ability to hear and communicate successfully or on equal terms, resulting in interpersonal difficulties. Second, status and career possibilities may suffer from the perception that elders’ skills are affected by the loss.
Depressed, hard-of-hearing elders may experience fear, anger with themselves, self-reproach, self-loathing, guilt, incompetence, unworthiness, and sadness. They may see the future as negative and hopeless, with decreased initiative or energy to live an active life. At worst, thoughts of suicide can occur. The prejudices that are unfortunately often associated with hearing loss can exacerbate low self-esteem. Older adults with hearing loss carry a social stigma as troublesome, slow, and tiresome. If a person who is hard of hearing internalizes such prejudices, self-esteem suffers a severe blow.
The negative emotional strain caused by the hearing loss can provoke depressive exhaustion, especially if it is difficult to implement a solution to functioning in everyday life and validate a perception as being an equal member of the community. Personal life is affected because it becomes gradually more difficult to understand conversations, increasing isolation, and feelings of being a nuisance.
If you or someone you know has, or you suspect may have a hearing loss, please contact us today. We can help.