Robin Williams taking his
life was a recent event that was surrounded by great sadness. This event
highlighted an issue that plagues us with perhaps no soul left untouched by the
disease that is mental illness and specifically depression. To some degree we
each have our times of feeling down and sad wishing to withdraw from others on
very healthy and normal terms and yet it feels lousy. Depression as an illness
is obviously magnified to a far greater extent even to the point where one
considers taking their life as a solution.
In my Audiology practice I
have many patients that are open about their mental illness and depression.
Over the years I have become acutely aware of the connection between depression
and hearing loss. It only makes sense that when your hearing deteriorates
without intervention one becomes less able to function in groups, having
conversations in a background of noise and even on a one on one basis. When
this degree of difficulty starts to effect the functionality of ones ability to
communicate often that individual will start to avoid those situations that
they find difficult moving in the direction of self isolation. For those whose
life has been one where human interaction is common and important this self-inflicted
isolation can lead to depression that spirals downward.
Recently I was running an
earwax (cerumen) removal clinic and encountered a male in his thirties that had
impacted wax. The patient reported that they had been plugged for a few months
now and really wanted the wax removed. Typically when this is the case and I
remove the wax occlusion my patients are amazed at the difference as being
plugged and therefore hearing impaired had become a normal part of their life.
That feeling of being able to hear again is like turning the light on for
someone who was blind only moments ago and there is a degree of overwhelming
hearing for a time. In this particular case when I removed the wax my patient
had a far more honest insightful self-revelation as he told me that he
instantly felt happier. What this patient told me in our conversation following
the wax removal was that while he does not suffer from depression not being
able to hear well was really bringing him down. Being plugged with wax had
created inefficiency in a major sense that left him very tired at the end of
the day from working so hard to simply hear. This man reported times where he
did withdraw himself from social situations because as he put it “it was too
hard”. Indeed to have one of your primary senses impaired makes one feel less
like themselves.
There are now studies that
verify and quantify this phenomenon that we as Audiologists have witnessed in
our clinical practices for some time.
“In the new study, as hearing declined, the percentage of depressed
adults increased -- from about 5 percent in those who had no hearing problems
to more than 11 percent in those who did.
"We found a significant association between hearing impairment
and moderate to severe depression," said study author Dr. Chuan-Ming Li, a
researcher at the U.S. National Institute on Deafness and Other Communication
Disorders. "The cause-and-effect relationship is unknown," Li said,
citing a need for further studies.
The study was published online March 6 in JAMA Otolaryngology--Head
& Neck Surgery.
The new findings make sense, according to two experts in the field who
reviewed the study conclusions.
"It is not surprising to me that they would be more likely to be
depressed," said James Firman, president and CEO of the National Council
on Aging. "People with hearing loss, especially those who don't use
hearing aids, find it more difficult to communicate with other people, whether
in family situations, social gatherings or at work."
Experts who care for those with hearing loss have long noticed the link,
said Robert Frisina, director of the Global Center for Hearing & Speech
Research at the University of South Florida, in Tampa. "When they come in
[to see about their hearing], they mention this," he said.”
“For the new study, the researchers looked at data from the U.S.
National Health and Nutrition Examination Survey, including more than 18,000
adults aged 18 and older. The younger people self-reported on their hearing
status, while hearing tests were given to those 70 and older. All participants
filled out a questionnaire designed to reveal depression.
As hearing loss became worse, the depression did, too, except among
those who were deaf. These adults, Frisina said, may be accustomed to coping
with the loss.
Hearing loss was linked with an increased risk of depression in adults
of all ages, but was most pronounced in the respondents aged 18 to 69, the
investigators found. Women had higher rates of depression than men did.
Among those 70 and older, no link was found between self-reported
hearing loss and depression. However, a link was found for women in this age
group if the hearing test found a hearing loss.”
SOURCES: Chuan-Ming Li, M.D., Ph.D., researcher, U.S. National
Institute on Deafness and Other Communication Disorders; Robert Frisina, Ph.D.,
director, Global Center for Hearing and Speech Research, and professor of
chemical and biomedical engineering and communication sciences and disorders,
University of South Florida, Tampa; James Firman, Ed.D., president and CEO,
National Council on Aging; March 6, 2014, JAMA Otolaryngology--Head &
Neck Surgery, online
This kind of information is extremely important as it allows us to
focus in on the preventable in health care. Seeing an Audiologist is typically
seen to be just about hearing ability as opposed to being about healthy living.
Depression is as real a health issue as is heart disease or cancer. We have
become far more knowledgeable regarding our own health and well being than we
have ever been before as a society yet here is an area that we perhaps do not
give much thought to.
On the day after Robin Williams took his life I had a very painful
conversation with a friend that was in a fight for his teenage sons life as his
young son was enrolled in a program of intervention to help him cope with his
own thoughts of ending his life. Mental illness is perhaps an even worse stigma
than hearing loss and a struggle that is even harder to talk about than hearing
loss. There is great societal reticence to accept treatment for depression as
there is some resistance to accepting the reality of the diminishing of our
sense of hearing and an even greater unwillingness to explore the solutions
that may be readily available.
