By Brian Taylor, Doctor of Audiology & Senior Director of Audiology, Signia
When people think of hearing loss, many think of being unable to hear. Period. That’s understandable. A literal loss of hearing — the onset of silence — can have dramatic ramifications for a person’s life.
But other forms of hearing loss, characterized by difficulty hearing, can have equal impact. And we’re learning, especially in the case of military veterans, that it can have a related effect on their mental health.
Two of the most prominent conditions affecting veterans are noise-induced hearing loss (NIHL) and post-traumatic stress disorder (PTSD). While prevalent in the general public, each is a uniquely common health problem for veterans based on the important jobs they’re asked to perform. Also common is tinnitus, that ringing in the ears that afflicts about 10 percent of Americans but disproportionally affects veterans. The combination of the three presents a possible long-term health concern that requires coordination among disparate specialties to handle effectively.
According to a recent study of injured military personnel, hearing loss and PTSD may be linked. The study’s authors found that “the odds of PTSD are approximately three times higher in individuals with postinjury bilateral hearing loss [hearing loss in both ears] when compared to personnel without hearing loss.” The reason, at least in part, is that hearing loss — even partial — can affect a veteran’s ability to listen and communicate, which decreases their quality of life and exacerbates mental health conditions, such as PTSD.
The Case for Coordination
As an audiologist, I’ve seen the mental health effects of hearing loss firsthand. Again, a person doesn’t have to experience total hearing loss to suffer. NIHL, in particular, affects communication because it impacts sound frequencies that are common in speech. NIHL makes hearing voices more challenging, especially in spaces where ambient sound competes to be heard. As a result, those affected strain to hear, which often leads to fatigue and difficulty concentrating, or they may withdraw from social situations, adversely affecting their mental health.
In the case of tinnitus, the study’s authors found that because it often co-occurs with NIHL, it may also be associated with higher rates of PTSD. In some cases, tinnitus may impact traumatic flashbacks. “Sounds triggering exacerbation of tinnitus similarly affected PTSD symptom severity,” they wrote.
Tinnitus is not hearing loss, but research has indicated it can be a sign of hearing loss to come. Therefore, like hearing loss, tinnitus requires early identification and treatment.
In fact, veterans and their healthcare providers need to be on the lookout early for all interrelated signs of NIHL, tinnitus and PTSD. Delay could have a serious impact on quality of life. There also should be fresh coordination between audiologists and mental health professionals. In short: veterans with bilateral hearing loss need to be monitored for PTSD.
Better Hearing in Noise
On the audiology side, technology now exists that can dramatically improve a veterans’ ability to hear and communicate in various settings, addressing one of the subtler effects of NIHL on mental health. Signia recently created a platform called Augmented Xperience that features hearing aids with two different microprocessors built in to handle speech and background noise separately. This kind of split processing in hearing aids makes it so NIHL sufferers can listen and communicate more effectively in all environments — quiet, noisy or normal.
Most of Signia’s hearing products also include innovative notch therapy technology for helping suppress tinnitus. Notch therapy identifies the wearer’s unique tinnitus frequency and creates a frequency notch in their hearing aids that ultimately offsets and silences the tinnitus.
Unfortunately, most primary healthcare professionals don’t automatically screen for hearing loss or tinnitus, and patients usually don’t recognize the problems until they’ve been examined. Fortunately for veterans, the Department of Veterans Affairs recognizes the heightened risk of NIHL and tinnitus from military service and covers diagnostic audiology from the moment a veteran exits the service. Healthcare professionals and veterans themselves should expand from there and begin exploring the possible connections between a vet’s hearing loss and PTSD.
We know hearing loss and PTSD are significant public health problems among military veterans. Although further research still needs to be done, there are indications that identifying and treating the former through hearing technology that enhances human performance can begin to address the latter. In all likelihood, a coordinated approach to hearing and mental health can boost veterans’ quality of life.
Brian Taylor is a Doctor of Audiology and Senior Director of Audiology for Signia. He is also the editor of Audiology Practices, a quarterly journal of the Academy of Doctors of Audiology, editor-at-large for Hearing Health and Technology Matters and adjunct instructor at the University of Wisconsin. Dr. Taylor has authored several peer reviewed articles and textbooks and is a highly sought out lecturer. Brian has nearly 30 years of experience as both a clinician, business manager and university instructor. His most recent textbook, Relationship-Centered Consultation Skills for Audiologists, was published in July 2021.