mental health

Hazardous Noise Can Affect More Than Your Hearing

By Strom & Associates

Each year, hazardous noise causes about 22 million workers in America to suffer a hearing loss on the job, and that hearing loss can affect everything from the quality of life to income potential and the ability to work. Understanding the far-reaching implications of permanent, irreversible hearing loss is critical for workers to protect their health and mental well-being.

Risk of Hearing Loss in the Workplace

Noise is one of the most misunderstood workplace hazards. The risk of hearing loss due to workplace exposure is significant. If the noise in a workplace is higher than 85 decibels average over eight hours, permanent hearing loss can occur. Even the noise from a carpenter’s shop or a farming operation can reach this threshold daily.

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Hearing Loss Affects Mental Health

People who have untreated hearing loss report a number of mental health issues. They may feel angry or irritable, and often they feel lonely because they are not able to interact with other people easily. This can cause them to avoid social situations. Untreated hearing loss can cause stress, fatigue, and undue tension. Some people with this condition also suffer from depression.

Hearing Loss Affects Income Potential

Hearing loss suffered on the job can also impact a worker’s overall income potential. When a worker cannot hear, he or she may not be able to do a job to the fullest. Reduced job performance can make it difficult to get promotions or raises. It can also lower the individual’s earning power because certain jobs require a full use of hearing to perform safely.

Additional Effects of Hearing Loss

In addition to income potential and mental health concerns, hearing loss can impact an individual’s overall quality of life. This is difficult to measure, but the National Institute of Occupational Safety and Health estimates hearing loss takes away 2.5 healthy years from workers exposed to work noises. Also, hearing loss can impair an individual’s memory and ability to learn new tasks.

The effects of hearing loss reach far beyond the ears. When workers are aware of the long-term and far-reaching impacts of hearing loss, the importance of using protective equipment may become more evident even if the sounds do not seem overly loud in the workplace.

This article was republished with permission from Strom & Associates, a Chicago-based personal injury law firm. For more, see https://stromlawyers.com.

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The Blast

By Jane Prawda

It was a crisp fall day when I was confronted by a catastrophic blast that changed my mental health, and life, forever. The violent noise caused permanent ear damage―and finding the right treatment has been a constant battle.

Auditory experts agree an untreated hearing condition can cause psychiatric disorders like depression and anxiety. At the time of the noise trauma, I had already been living with depression for decades, since age 17, making my particular circumstances quite difficult and emotionally devastating.

On that day I will never forget, I was alone on the sidewalk of Manhattan’s Upper East Side walking home. I had no warning when, suddenly, I heard a tremendous explosion at one of the notoriously noisy construction sites on Second Avenue. At the time, New York City was enlarging the “Q” subway line by more than 30 blocks, a project that left us residents subject to years of dangerous noise.

Construction site in Manhattan

Construction site in Manhattan

Without a place to turn for help following the blast, I continued walking home. By evening, in the silence of my apartment, I could hear a faint twinkling sound in my ears: tinnitus.

It wasn’t surprising that the tinnitus quickly worsened my mental wellbeing. Frightened by the ringing in my ears, I phoned my psychiatrist. He prescribed an anti-anxiety medication.

The tinnitus soon went away, but then months later it returned. Was I experiencing lingering effects of the blast, or was it the medication provoking these disturbing sounds? With their latest re-emergence, the sounds had become louder. I was scared and felt empty inside.

I went from clinician to clinician trying all sorts of new remedies, including lipoflavinoids, neurofeedback, acupuncture, and tinnitus retraining therapy, and found no relief. The constant ringing brought me to the verge of suicide―prevented by my younger brother. He understood my agony, and I am grateful for his empathy.

In 2014 I began an experimental treatment called transcranial magnetic stimulation (TMS), which uses highly-focused pulsed magnetic waves to stimulate nerve cells in the area of the brain that is thought to control mood. With the first treatment, the objective was to relieve tinnitus. Subsequent treatments were to relieve depression. Unfortunately, the one instance of the procedure was performed incorrectly, which not only worsened my hearing 30 dB, a mild hearing loss, but made the ringing present 24/7. It also caused transitory hyperacusis which, thankfully, I no longer live with today.

I was warned before the procedure that there was a slight chance I would lose hearing, but not that my tinnitus would become more persistent. With all symptoms worsened, I felt I’d arrived at another dead end and remained desperate for a solution.

Following the TMS treatments, I developed neuroplasticity, the brain’s formation of neural connections to adjust to injury. My audiologist believes neuroplasticity is what caused the hyperacusis to disappear and the tinnitus to subside considerably.

The tinnitus has come and gone according to my stress levels, at times even completely disappearing. With the help of my psychiatrist, I no longer struggle with depression. I’ve come to accept that a cure does not yet exist for tinnitus, so I cope in the best ways I can. Listening to the sounds of birds in the early morning, ocean waves, and babbling brooks using Resound Relief iPhone app always brought me great comfort.

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I’ve also adapted to my mild hearing loss. I inform people I meet that I have a hearing loss and to face me when they speak; that works for me.

Through all the trauma I consider myself to be a survivor, as I am the daughter of a Holocaust survivor. It is there I draw my strengths.

Jane Prawda MA, OTR, MS/Ed has been published for her expertise in occupational therapy, including Surviving 9/11: Impact and Experiences of Occupational Therapy Practitioners. She lives in New York City.

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How Ménière's Led Me to a Master’s

By Anthony M. Costello

Ménière's disease initially presented itself to me 20 years ago in a violent and unfortunate manner. I was 16 attending a New England boarding school when I experienced a vestibular (balance) episode, and it changed my health and life forever.

I remember vividly the vertigo that, without warning, controlled me. I remember the incredible pressure and fullness in my ears and the overwhelming sense of nausea. Realizing I could not stand I sought refuge in my bed, where the sensation of spinning intensified and I vomited profusely.

The school staff could only assume I was intoxicated and took disciplinary action. As I could not yet explain or understand that my behavior was caused by Ménière's disease, I had little recourse to justice. Faced by more unfair treatment, I left the school at the end of the academic year.

For the remainder of high school, I continued to struggle with bouts of vertigo, dizziness, and imbalance. These symptoms impacted my athletic performance, my ability to concentrate on my schoolwork, and my general quality of life. It was a difficult and confusing time as I appeared fine on the outside but I was internally battling a miserable existence that I could not fully understand or control. That paradox has since defined my life.

Shutterstock

Shutterstock

When I received a formal diagnosis, my thoughts, priorities, and routines obsessively revolved around managing my wellness. This new mindset made it difficult to relate to the life I once had or to the lives of those around me. I made great efforts to hide my symptoms and protect loved ones from the negative emotional and physical effects of my disease. I made excuses to avoid social events just because of my illness.

Ménière's disease has repeatedly left me in states of hopeless despair. While it can be perceived as “strong” to persevere through one’s condition independently, I have learned this only leads to more isolation. Ménière's takes so much from its sufferers; it attacks their bodies, tests their spirits, and consumes their thoughts. This is why it is so important to reach out, be honest, and bring others into your world that you trust while you are living with Ménière's. Otherwise, you deprive yourself of not only your health but the relationships you deserve.

The etiology of Ménière's disease remains scientifically disputed and I do not claim to have the answer. But I do know the condition does not respond well to stress. I’ve spent every day of my life carefully crafting my decisions and actions based on how my Ménière's may react. In the process, I’ve come to master handling and mitigating stress. In fact, at 30 I went back to school for a master’s in psychotherapy in part to study stress and the human mind. I now licensed psychotherapist, a career change inspired by my conversations with newly diagnosed Ménière's patients in the waiting room of my ear, nose, and throat doctor’s office.

I have been fortunate to have had periods of relative remission with reduced vertigo. But there is a misconception that Ménière's just comes and goes, allowing the sufferer to return to normalcy in the interim. In reality, part of it is always there, be it the tinnitus, the difficulty hearing people in a crowded room, or the feeling the floor will start moving. There is always the uncertainty of what tomorrow will bring.

Using mindfulness—a meditation technique that helps one maintain in the present without judgment—has been helpful in calming my anxiety. Mindfulness is especially useful when my tinnitus feels overwhelming, and I sometimes I combine the practice with music, a white noise machine, or masking using a hearing aid.

I try to live my life in a manner in which Ménière's never wins. This disease will bring me to my knees—both literally and figuratively—but I just keep getting up. You can’t think your way out of this disease and spending all your time in a web of negative thoughts can be as toxic to your mind as Ménière's is to your inner ears. In my hopelessness, I try to stop my mind from plunging into the abyss and use every tool I can—making plans see friends and family, finding glimpses of joy in the midst of darkness, or being physically active. You have to retain some control when you feel like you have none.

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The only gift that Ménière's has given me is a level of introspection and awareness that I could not have attained in 10 lifetimes. It has stripped me down to my core and forced me to explore what is truly important and made me a better person. I don’t know who I would be without this disease, but I’m positive that person could not fathom the joy or gratitude I find in a moment of health.

Anthony M. Costello, LMFT, lives in Byfield, Massachusetts with his wife, daughter, and 2 dogs. He has a private practice and specializes in helping others with chronic illness. For more, see www.costellopsychotherapy.com.

Receive updates on life-changing hearing and balance research, resources, and personal stories by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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My Cautious Gratitude

By Lauren McGrath

Clockwise from left: Heather, her daughter, her husband, and son.

Clockwise from left: Heather, her daughter, her husband, and son.

Heather Mills never imagined her early adulthood would be interrupted by Ménière's disease, a chronic hearing and balance disorder without a cure. She was diagnosed at 21—just within the typical 20-to-50-year-old range of onset—after a slew of tests and follow-up visits with a specialist at the University of Minnesota.

Heather’s symptoms initially included a unilateral (in one ear) mild low-frequency hearing loss, tinnitus, and some ear pressure and pain. Within a few years, her hearing loss became bilateral and worsened from moderate to severe. She was regularly distressed by intense ear pressure, struggled with her balance, and experienced occasional bouts of vertigo. As Heather learned, Ménière's affects each patient differently. She considered herself fortunate not to face drop attacks (instances of falling to the ground without losing consciousness), one of the most terrifying symptoms associated with Ménière's disease.

Despite its prevalence Heather family, hearing loss—once her most debilitating Ménière's symptom—came as a surprise. Her father has lived with a unilateral hearing loss since childhood, while her mother and maternal grandmother both developed high-frequency sensorineural hearing loss in their late 40s. “It never occurred to me that it may one day affect me, too,” reflects Heather, who can recall her ability to hear whispers across her high school classrooms.

Though she followed her doctor’s directions to take diuretics and maintain a low-salt diet for her vestibular symptoms, Heather chose not to purchase hearing aids. Lacking amplification, Heather faced difficulty in her job as a legal project specialist, which required frequent verbal interaction with clients, lawyers, and vendors both on the phone and in person. She found herself increasingly dependent on a close friend and colleague who truly served as her ears by repeating information for her during and after meetings.

Heather’s untreated hearing loss, combined with her constant fear of a sudden vertigo attack, fueled feelings of isolation. Unable to participate in conversations with friends, Heather stopped receiving invites to social outings. Challenges with work and friends began to affect Heather’s mental health. “I became depressed, lonely, and developed anxiety because of two unknowns: not knowing when my vertigo would strike again, and wondering how I’d continue to work to support my family.”

Heather noticed a sharp decline in her job performance when her helpful coworker—her ears—left the law firm. Part of Heather’s role required instructing staff on new software, and she was humiliated to find out that her trainees’ questions went unanswered because they’d not been heard. “This is when I began to lose confidence in myself,” Heather remembers.

Heather realized she had to address her hearing loss. In line with Hearing Health Foundation (HHF)’s findings in a 2017 survey of more than 2300 participants, cost is by far the largest barrier to a hearing aid purchase. Heather delayed taking action for so many years—11 to be exact—because her insurance provided no hearing healthcare coverage.

“All I can say now is I wish I had gotten hearing aids sooner!” exclaims Heather, who, with newfound confidence, no longer struggles in her daily professional communications and social life. Prior to pursuing treatment, her conversations had soured quickly when she constantly had to ask other parties to speak up, repeat themselves, or remind them of her hearing loss. Most painfully, communication without hearing aids often left Heather dismissed by a “nevermind” when she requested repetition. With her new devices, Heather felt her confidence restored.

Now in remission, Heather considers her life happy and her health stable. Hearing aids have somewhat alleviated her tinnitus, her ear pressure has subsided, and the vertigo spells are very rare. She’s sought treatment for her anxiety and depression. Heather credits her husband, Billy, with whom she has two young children, for his support during her more difficult years. Engaging in online Ménière's support groups has been a beneficial coping tool.

Heather is cautiously grateful for her current health, knowing the unpredictability of Ménière's could alter her circumstances at any time. She hopes for scientific advancements in Ménière's research that will one day uncover the causes, more reliable diagnostic procedures, and a cure.

Heather lives in Minnesota with her husband and children. She is a participant in HHF’s Faces of Hearing Loss campaign.

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Sudden Hearing Loss Is a Medical Emergency

By Donna Rohwer

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Mondays are always bad, right? I awoke deaf in my left ear—completely deaf. I asked my husband if he thought it was anything to worry about and he said, “Not yet.” I thought the same and appreciated the confirmation. We didn’t know then that sudden hearing loss is a medical emergency.

Sudden Sensorineural Hearing Loss (SSHL)

Damage to the inner ear, the cochlea, or related nerve pathways cause SSHL. A loss of 30 decibels or more in three consecutive frequencies in one or both ears within several days is considered SSHL. Immediate treatment can make partial or total recovery more likely. Unfortunately, many medical professionals— from emergency room to waiting room—don’t recognize SSHL or know how to treat it. As a result, many patients lose the opportunity for recovery because they don’t get the right treatment within the critical time. In my case, I received treatment within a week—it wasn’t optimal, but better than many. I had no significant recovery.  

SSHL Is LOUD, Isolating, and Devastating

The shocking thing to SSHL patients is how LOUD everything becomes. Sounds distort and blend together, sound direction is lost, and every sound seems magnified. The tinnitus is sudden and loud, with whooshing, popping, and other sounds. The tinnitus often worsens with activity or background noise, and goes long into the night. Some people don’t feel well, see well, sleep well, or balance well. SSHL strains relationships and many people simply stop participating in activities. I felt as if I had lost my life.  

SSHL Can Be Life-Threatening

I consoled myself at first that my condition wasn’t life-threatening. Within weeks, however, I no longer wanted to go on living. I later learned that many people respond this way. Physicians recognize the psychological impact when someone loses a limb. Losing the sense of hearing, suddenly, is not dissimilar. I didn’t know how to live with SSHL, or where to turn for support. I felt abandoned until I received the mental health support I urgently needed.

Alone at the Table

I have slowly reclaimed my life through the support of family, friends, and several Facebook groups. I also have used a cognitive therapy course for tinnitus, antidepressants (briefly), and months of working through the process. But there are still moments. My passion is recreational poker. I recently played with a mixed group, some with typical hearing, some with hearing loss. The hearing people were talking, but the background noise kept me from understanding them, and I don’t know ASL. I felt alone at the table—caught somewhere between the hearing world and the deaf world.

What Do We, as SSHL Patients, Want?

We want non-ENT medical professionals to learn about SSHL and treat it as a medical emergency. We want ENT doctors to recognize the psychological aspects of SSHL and refer us to appropriate resources. We want hearing loss advocates to see that SSHL has unique challenges different from other kinds of hearing loss. Lastly, we want a cure.

You can empower work toward better treatments and cures for hearing loss and tinnitus. If you are able, please make a contribution today.

 
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Ugly Emotions

By Lisa Peten

Some time ago, I was having a text conversation with a friend who also has bilateral sensorineural hearing loss. When I relayed to her that I am thankful in many ways for the changes that have occurred in having this condition, she was outraged that I would say such a thing. This prompted her to rant 1,001 ways in which her hearing loss is essentially ruining her life.

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Despite being 20 years my senior, we share similar emotions in dealing with our late-deafened and hard-of-hearing experiences. Since we are usually so very aligned in our thoughts and emotions, I imagine my appreciation for this condition caused her outrage and to be even more perplexed about my gratitude for this condition. In any event, we hashed through this discussion and came to an “agree to disagree” conclusion which posed a crossroads in our friendship. We closed this discussion with authentic, raw emotion, conjuring up dispassionate experiences which urged persuasion to change the other’s mind. In the end, we were both thankful for the honest sharing and I learned a thing or two more about compassion and empathy.

I learned that “ugly” emotions (i.e. rage, envy, and hate) about being deaf/hard-of-hearing have not been given the time, space, or energy to address them. They are sometimes buried falsely with the perception that these types of emotions are unacceptable. Emotions like helplessness, frustration, and sadness seem to easily find ready support, but the ugly emotions present an elephant in the room never to be acknowledged.

After years of being unsuccessful in burying “ugly” emotions, I found three techniques to love yourself through these moments:

Share Immediately

For a long time I told no one except my family about my hearing challenges. It was too vulnerable an act for me to bare. Nowadays, sharing this detail immediately has had a positive effect on my experiences at restaurants, retail establishments, and even medical visits beyond the ENT and audiologists. Lessons learned along the way has taught me to release the emotions quickly, to avoid an emotional explosion later.

Dispense Energy

When emotions of any kind, especially the ugly, surface, dispensing activity provides another early release. In the past, I would practically run from humiliating situations when hearing incorrectly. Now, I can easily own up to the error and explain my hearing loss. While the embarrassment is still present, it does release my ugly emotions and allow the moment to pass without festering.

Forgive with Compassion

I continue to struggle with others’ reactions to my hearing loss. Eleven years after my diagnosis, I still feel sullen when I communicate with people who I have known before my hearing loss. Often times, after they learn of my hearing loss, they speak louder and unconsciously use body language to essentially ignore me, especially during group conversations. I know this is ignorance or discomfort on their part, but it still hurts. I have learned to fire away compassion for all of us in order to ease these emotionally ugly moments.

I hope the point of contention of my hearing loss someday subsides. However, in the meantime, I will own all emotions associated with my hearing loss, and will remember to extend greater compassion and empathy to those of us who need it when ugly-filled emotions become present.

Lisa Peten is a self-help hearing coach, mind-body empowerment speaker, and health advocate blogger, on a mission to empower health-hungry communities to become more proactive in obtaining nourishing foods and seeking holistic health alternatives. She is the founder of Sound Health and Hearing, a health coaching boutique consultancy. She is also a participant in HHF's Faces of Hearing Loss campaign.

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 



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Untreated Hearing Loss Puts Overall Health at Risk

Hearing Health Foundation (HHF) CEO Nadine Dehgan’s “Treating Hearing Health for Better Overall Health” was published online to My Prime Time News following its original print appearance in The American Legion’s December 2017 issue.

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The article details how the state of the inner ear impacts other critical functions, like the heart and the brain. Cited are the various conditions that can arise as a result of untreated hearing loss, including cardiovascular disease, dementia, diabetes,  depression, and falls. When the auditory system is functioning well, however, the risk for these ailments declines.

Additionally, hearing loss is also linked to other medical conditions and drugs. People with anemia are twice as likely to have hearing loss. According to Peter Steyger, Ph.D., a scientific adviser to HHF. Further, certain cancer-fighting chemotherapy drugs, such as cisplatin, may permanently harm hearing.

While the relationship between hearing health and overall health is always significant, the publicity of “Treating Hearing Health for Better Overall Health” is an especially timely and helpful follow-up to ERG recipient Harrison Lin, M.D.’s new findings concerning the gaps between self-reported hearing loss and patients evaluation and treatments for hearing loss, which appeared in this month’s issue of JAMA Otolaryngology—Head & Neck Surgery.

Individuals who believe they may have a hearing loss are encouraged to consult an audiologist or ENT, and can learn more about the relationship between hearing health and overall health in the full article on My Prime Time News.

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Protecting Your Hearing Means Protecting Your Mental Health

By Carol Stoll and Lauren McGrath

October is Protect Your Hearing Month—and, today, October 10, is World Mental Health Day, a time for mental health education, awareness, and advocacy. Hearing loss and tinnitus (ringing in the ears) can increase one’s risk of developing mental illnesses including depression, anxiety, schizophrenia, and dementia, and can trigger episodes of extreme anger and suicidal ideation. Protecting one’s hearing not only prevents or delays hearing loss, but also benefits mental wellness. Understanding the signs of mental illness and having access to mental health resources is critical—and can even be life-saving—to all individuals with hearing loss or tinnitus.

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According to an April 2014 study published in JAMA Otolaryngology Head & Neck Surgery, 11.4% of adults with self-reported hearing impairment have moderate to severe depression, significantly higher than the 5.9% prevalence for those with typical hearing. Individuals with hearing loss have reported feeling socially inept in group settings, entering conversations at inappropriate times, talking off-topic, or dominating conversations and coming across as rude simply because talking is easier than listening. When a person cannot hear properly, engaging in conversations is a daily struggle, and can lead to social isolation and depression. Other factors that increase the risk of depression include being female, low-income, a current smoker, binge drinking, having fair or poor health status, trouble seeing, and sleep disorder. However, even controlling for these factors, those with hearing impairment still had significantly higher rates of depression than those without hearing impairment. In people 65 and older, hearing impairment is among the most common chronic conditions associated with depression.

In addition to depression, hearing loss has been linked to schizophrenia. Several studies support the social defeat hypothesis, which proposes that social exclusion and loneliness can predispose people to schizophrenia by increasing sensitization of the dopamine system. In a December 2014 study published in JAMA Psychology, participants with hearing loss reported significantly more feelings of social defeat than healthy controls. Though their psychotic symptoms were similar to the control group, exposing them to a stimulant drug showed that those with hearing loss had significantly higher than normal dopamine sensitivity. Further studies are needed to draw definite conclusions of the causation, but this research is a first step in understanding the relationship between hearing impairment, social defeat, and psychosis.

In older adults, hearing loss is associated with cognitive decline and dementia, according to a February 2013 study published in JAMA Internal Medicine and several other studies conducted at Johns Hopkins University. The scientists concluded that reduced social engagement and a cognitive load focused on coping with hearing loss rather than higher level thinking can lead to poorer cognitive functioning and faster mental decline. Hearing aids could possibly be a simple fix to increase healthy brain function in the older adult population and reduce the risk of dementia.

Exposure to noise often results in tinnitus instead of or in addition to hearing loss, which can also contribute to a range of psychological disorders. Tinnitus affects about 1 in 5 people in the U.S., and causes permanent ringing in the ears. Though research for therapies is ongoing, there is currently no cure. Without therapy, constant ringing in the ears can be debilitating; it can affect job performance, cause insomnia, and provoke fear, anxiety, and anger. This can lead to depression, anxiety, suicidal ideation, and can exasperate post-traumatic stress disorder (PTSD).

Compromised hearing is an invisible disability, often unnoticed or ignored even by those affected. However, hearing loss and tinnitus are widespread and can have serious psychological repercussions. Hearing loss caused by noise exposure is completely preventable by taking simple measures like turning down the volume on your earbuds and using hearing protective devices in loud situations. Regular hearing screenings can also help detect hearing issues early on. Talk to your audiologist about best ways to treat or manage your hearing impairment. Find help for mental illnesses here.

Per the National Institute of Mental Health: "If you are in crisis, and need immediate support or intervention, call, or go the website of the National Suicide Prevention Lifeline (Voice: 1-800-273-8255 or TTY: 1-800-799-4889). Trained crisis workers are available to talk 24 hours a day, 7 days a week. Your confidential and toll-free call goes to the nearest crisis center in the Lifeline national network. These centers provide crisis counseling and mental health referrals. If the situation is potentially life-threatening, call 911 or go to a hospital emergency room.”

Receive updates on life-changing hearing research and resources by subscribing to HHF's free quarterly magazine and e-newsletter.

 
 
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