Suicide and Self-Harm Considerations When Treating Hearing Health

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Depression and hearing loss

When discussing treatment options for audiological health, it’s important to understand that for 48 million Americans with hearing loss, this impairment can be a multi-faceted condition. As  Hashir Aazh, PhD, and Brian C. J. Moore, PhD, had expressed in their article “Thoughts about Suicide and Self-Harm in Patients with Tinnitus and Hyperacusis”, patients suffering from Tinnitus and general hearing loss often deal with much more than just difficulty hearing, experiencing depression, suicidal thoughts, and self-harm ideation. Aazh and Moore’s findings stress the importance of treating the mental aspect of hearing damage as much as the physical aspect with a comprehensive and collaborative treatment plan. Due to the isolation and stigma that can become an aspect of everyday life of those with hearing loss, it’s time for health care providers and patients to take mental health into consideration when seeking treatment or help.

Isolation and Frustration With Tinnitus

As hearing loss is repeatedly linked to isolation and frustration, the link to Aazh and Moore’s suicidal and self-harm ideation findings is clear, with recent surveys painting a troubling picture. Surveying over 2,300 patients with untreated hearing loss, The National Council of Aging had found that those over the age of 50 with untreated hearing loss were far more likely to experience depression, paranoia, anxiety, and avoidance of social activities, leading to feelings of isolation and suicidal thoughts. Older respondents were also more likely to state that “people get angry with me for no reason”, leading some patients to believe they are a nuisance to friends or family.

This is also true for those suffering from Tinnitus. As Aazh and Moore had found, 12.7% of respondents reported having negative thoughts over the past two weeks, showing a statistical link between perception of the severity of their Tinnitus and negative emotions. Other studies have found an unfortunately similar consensus. Citing an inability to sleep, a constant bothersome buzzing, and a lack of control or hope, an understandable frustration has caused depression, hopelessness, and anxiety, paving the way for suicidal ideation in some patients. Symptoms of “major depression” can be seen in up to 33% of patients suffering from Tinnitus, which audiologists and mental health experts are calling “mounting evidence supporting the association of Tinnitus with depression and anxiety”. As Sergei Kochkin, the executive director of the Better Hearing Insitute explained, “The constancy of tinnitus and the perceived lack of control can provoke fear, which exacerbates the problem, leading to an ever-increasing cycle of distress.”

Recommendations For Patients and Health Care Providers

For audiologists and patients, understanding the links between tinnitus, hearing loss, and mental health is critical to an effective treatment plan. As Sarah Schwartzer and Mark Parker, PhD, write in 2019, “Audiologists should be aware of the possibility that their patients with tinnitus and/or hyperacusis may have negative thoughts or other mental illnesses on top of their audiological disorders.” and implement depression or anxiety screenings along with tinnitus and hyperacusis. This can ensure that patients are receiving the resources they need to address mental health issues and build trust between patients and audiologists when discussing topics such as depression or suicidal thoughts that can often be difficult for patients to be open about.

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