Hearing Loss Affects More Than Your Ears

In the United States, hearing loss is the third most common chronic health condition, twice as prevalent as diabetes or cancer. Like many other conditions, hearing loss is on a spectrum that can range from mild to profoundly deaf—and affects every person differently. Even a mild hearing loss can have an impact and often progressively worsens over time. Whether from birth or acquired later, having a hearing loss requires learning new ways to adapt personally and navigate the hearing landscape.

Many doctors and audiologists may only address the physical aspect of hearing loss without recognizing its psychological impact. However, hearing loss is primarily a communication disability that affects every aspect of personality, mental health and interactions with family, friends, relationships, co-workers and society at large. The daily effort to understand conversations, music or professional meetings can lead to a constant state of stress—from the frustration of asking people to repeat themselves, to the embarrassment of misunderstanding conversations, to the fear of missing out (FOMO) on the punchline or important information.

Due to such communication challenges, hearing loss is often associated with a higher risk of anxiety, depression, withdrawal and isolation, particularly in older adults. Many people with this invisible disability also find themselves “in between” the hearing and non-hearing worlds, which leads to a sense of not belonging. For example, my client Marco—a 28-year-old photographer who was born deaf—is in therapy for loneliness and isolation. Raised with an oral approach that involved speaking, he never learned sign language. Thus, Marco feels unsupported socially, as he doesn’t seem to fit into either the hearing or deaf community.

People who lose their hearing as adults typically experience an identity crisis as their sense of competence and self-esteem plummet. About 10 years ago, I worked with Jeffrey, a cancer survivor who had lost his hearing after a second round of chemotherapy. An addiction counselor, Jeffrey wondered if he would ever be able to interview clients again, which was a critical part of his work, and realized that his identity as a professional was radically impacted. To regain his confidence, he first needed to grieve and then become more accepting of his loss. Jeffrey had to learn that his hearing loss was only a part of who he was and that it didn’t define him or his work as he learned strategies to help him communicate effectively.

Understanding the Impact of Hearing Loss
Several assumptions inform my communication with others in the hearing world: First, I assume that they know little, if anything, about hearing loss. Second, I realize most people are embarrassed about asking how to best communicate with me, because they think they should know. Telling them what I need up front lowers their stress and mine, too! Lastly, I must be patient with them and myself, which often means repeating my accommodation requests, such as: “Please face me” or “I can’t see your mouth when you cover it.”

A useful analogy I often use to help people understand the complexity of hearing loss is to compare it with low vision. A person who wears glasses doesn’t need to explain their condition, and they may use their glasses for specific situations, like for reading or distance. They can easily explain what their vision is in finite numbers, e.g., 20/80. In contrast, hearing loss is an invisible disability that encompasses a multitude of factors and variations such as frequency, pitch, word discrimination and volume. Even for seasoned hearing aid or cochlear implant (CI) wearers, trying to explain the intricate interplay of all these factors can be confusing and difficult.

Unlike corrective lenses that may, in many cases, restore one’s vision, hearing loss can never be fully restored, even with hearing aids or an implant, and is more subjective. One’s identity might even change between different environments; for instance, am I “hard of hearing” when speaking to someone or “deaf” when I’m at a restaurant or movie theater?

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