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According to the American Psychiatric Association (APA), "Depression is a serious medical illness that negatively affects how you feel, the way you think, and how you act."1 Depression has a variety of symptoms, but the most common are a deep feeling of sadness or a marked loss of interest or pleasure in activities. Other symptoms include:
· Changes in appetite that result in weight losses or gains unrelated to dieting;
· Insomnia or oversleeping;
· Loss of energy or increased fatigue;
· Restlessness or irritability;
· Feelings of worthlessness or inappropriate guilt;
· Difficulty thinking, concentrating, or making decisions;
· Thoughts of death or suicide or attempts at suicide.
Surprisingly, depression is common-affecting nearly one in 10 adults each year—nearly twice as many women as men. Depression can strike at any age, from childhood to old age. Fortunately, according to the APA, "depression is very treatable."
Treated Versus Untreated Hearing Loss
Untreated hearing loss has serious emotional and social consequences for older persons, including depression, according to a large-scale study by the National Council on Aging (NCOA).2 Although the study was released almost a decade ago, it remains a classic in debunking "the myth that hearing loss in older persons is a harmless condition," according to Dr. James Firman, president and CEO of the council.
The survey of 2,300 hearing impaired adults age 50 and older found that those with untreated hearing loss were more likely to report depression, anxiety, and paranoia and were less likely to participate in organized social activities, compared to those who wear hearing aids.
Additionally, the survey found that significantly more seniors with untreated hearing loss (those who did not wear hearing aids) reported feelings of sadness or depression that lasted two or more weeks during the previous year. Dr. Firman said the survey was "groundbreaking" not only in the large size of the sample but also in the inclusion of 2,090 close family members or friends of the hearing-impaired respondents who were asked a parallel set of questions.
Hearing aid users reported benefits in many areas of their lives, ranging from their relationships at home and sense of independence to their social and their sex life.
The families of hearing aid users noticed the improvements, but were even more likely than the users to report the improvements in every dimension of the survey measured.
The study found that 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. And one in five offered the explanation that "it would make me feel old" or "I don't like what others will think about me."
"It is very sad that so many older people are letting denial or vanity get in the way of treatments that can significantly improve the quality of their lives," says Dr. Firman, who is hearing impaired himself. "Doctors and family members should insist that hearing-impaired seniors seek appropriate treatment."
Depression and Hearing Loss
A 2007 survey released by Australian Hearing found that six in 10 of those with hearing problems also have symptoms associated with depression.3 The Newspool telephone survey of 2,400 adults back up anecdotal evidence that untreated hearing loss impacts on quality of life, says Dr. Harvey Dillon, director of Australian Hearing's research arm, the National Acoustic Laboratories.
"Anecdotally we know from dealing with people who have hearing loss that they can experience feelings of isolation and detachment," says Dr. Dillon. "This research supports this finding and it shows many people with hearing loss are experiencing the major signs of depression."
Australian Hearing, a government agency that provides subsidized health care, has urged people with suspected hearing loss to seek treatment to "break this cycle."
Dr. Dillon said a recent randomized controlled trial has shown that wearing hearing aids reduced the amount of depression experienced by people.
Hearing Aids and Quality of Life
Dr. Sergei Kochkin of the Better Hearing Institute comments on the reluctance of many adults to obtain hearing aids as follows: "It would seem that hearing is a second-rate sense when compared to vision in our visually oriented modern society. People with hearing loss delay a decision to get hearing help because they are unaware of the fact that receiving early treatment for hearing loss has the potential to literally transform their lives."4
He provides a detailed review of research on the impact of treated hearing loss on quality of life and concludes that "hearing aids clearly are associated with impressive improvements in the social, emotional, psychological, and physical well-being of people with hearing loss in all hearing loss categories from mild to severe."
Specifically, hearing loss treatment was shown to improve:
· Earning power;
· Communication in relationships;
· Intimacy and warmth in family relationships;
· Ease in communication;
· Sense of control over life events;
· Perception of mental functioning;
· Physical health;
· Group social participation.
Just as importantly, hearing loss treatment was shown to reduce:
· Discrimination toward the person with the hearing loss;
· Hearing loss compensation behaviors (i.e. pretending you hear);
· Anger and frustration in relationships;
· Depression and depressive symptoms;
· Feelings of paranoia;
· Anxiety;
· Social phobias;
· Self-criticism.
Dr. Kochkin has the following advice for those with hearing loss: "If you are one of those people with a mild, moderate, or severe hearing loss, who is sitting on the fence, consider all the benefits of hearing aids described above. Hearing aids hold such great potential to positively change so many lives." Good advicefor audiologists to give to their patients, too.
References
1. Let's talk facts about depression. (2005). American Psychiatric Association. Accessed online at www.healthyminds.org/multimedia/depression.pdf
2. Parkin, S. (May 26, l999). Untreated hearing loss linked to depression, anxiety, social isolation in seniors. National Council on Aging. Accessed online at www.ncoa.org/PrintPage.cfm?sectionID=105&detail=46
3. Hearing impaired "at risk of depression." (2007). The Sydney Morning Herald. Accessed online at www.smh.com/au/news/National/Hearing-impaired-at-risk-of-depression/2007/08/
4. Sergei K. The impact of treating hearing loss on quality of life. Better Hearing Institute. Accessed online at www.betterhearing.org/hearing_solutions/qualityOfLife.cmf?printfriendly=1
Jess Dancer is professor emeritus of audiology at the University of Arkansas at Little Rock and can be contacted at jedancer@ualr.edu.
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