COVID-19 Pandemic Worsened Tinnitus and Depression

Bothersome tinnitus was associated with significantly higher rates of depressive symptoms and high stress during the peak COVID-19 restriction period, a large national study has found. The research, published in the *European Archives of Otorhinolaryngology*, analyzed data from nearly 6,000 adults in South Korea. It reveals that the psychological burden of tinnitus was uniquely heightened during a time of widespread social isolation and health anxiety.

How the Study Measured Tinnitus and Mental Health

Researchers Sang-Yoon Han and Young Ho Kim from Hanyang University and Seoul National University used data from the 8th (2020) and 9th (2022) Korea National Health and Nutrition Examination Survey (KNHANES). This is a nationally representative survey that provides a robust snapshot of public health. They analyzed information from 5,965 participants, classifying them into three groups based on their tinnitus experience over the past year: a non-tinnitus group, a non-bothersome tinnitus group (tinnitus loudness ≤ 4 on a 0-10 visual analogue scale), and a bothersome tinnitus group (loudness > 4).

The team then assessed psychological health using the validated Patient Health Questionnaire-9 (PHQ-9) to screen for depressive symptoms and a single-item question to identify high stress. Using complex statistical models that accounted for the survey’s design, they compared these mental health outcomes across the three groups within each time period, and then examined how outcomes changed for each group between 2020 and 2022.

Bothersome Tinnitus Linked to Worse Mental Health in Lockdown

The results show a clear pattern tied to both tinnitus severity and the pandemic’s timeline. In 2020, at the height of restrictions, the bothersome tinnitus group stood out. They had significantly higher PHQ-9 scores and a greater prevalence of depressive symptoms and high stress than both the non-tinnitus group and the non-bothersome tinnitus group. The statistical significance was strong (p < 0.001 and p < 0.05, respectively).

This changed dramatically by 2022. During the “living-with-COVID” period, no significant psychological differences were found among the three groups. The mental health gap had closed. When the researchers looked at changes over time, they found significant differences only within the bothersome tinnitus group. Scores for PHQ-9 (p = 0.048), depressive symptoms (p = 0.009), and high stress (p = 0.039) all improved from 2020 to 2022 for these individuals. The other groups showed no such change.

This indicates that the extra psychological burden was specific to people whose tinnitus was already severe and was likely triggered or worsened by the unique pressures of lockdowns and isolation. The findings align with an earlier article on the site, “Tinnitus Distress Increased in Pandemic”, which documented similar reports of worsening symptoms.

Why Tinnitus Severity Matters for Mental Health

The study makes a critical distinction: it is not the simple presence of tinnitus, but its perceived severity and intrusiveness that correlates with psychological vulnerability. Bothersome tinnitus often disrupts concentration, relaxation, and sleep, creating a constant background of stress. The COVID-19 restrictions acted as a potent amplifier. Reduced access to routine healthcare, loss of social support networks, increased anxiety, and quieter home environments that made tinnitus more noticeable likely combined to create a perfect storm.

The fact that the association faded by 2022 is encouraging. It suggests that the mental health impact is not a fixed, unchangeable trait of tinnitus but is responsive to improvements in the broader environment and possibly a return to more normal social and healthcare access. This dynamic relationship between a sensory condition and mental state is a core feature of many hearing-related disorders, including hyperacusis and misophonia, where emotional and cognitive responses to sound are central to the experience.

Implications for Treatment and Patient Care

Han and Kim conclude that their findings “highlight the importance of tinnitus severity assessment for identifying psychological vulnerability.” For clinicians, this means actively screening patients with chronic tinnitus for depression and stress, particularly during times of widespread societal stress. A simple loudness rating can be a useful indicator of who might need more comprehensive psychological support.

The authors specifically note the need for “integrated tinnitus and psychological management, including non-face-to-face approaches, when in-person access is restricted.” This points to the value of telehealth, structured online cognitive behavioral therapy (CBT) for tinnitus, and app-based sound therapy. The mental health component is essential; improving a patient’s coping strategies and emotional regulation can directly reduce tinnitus-related distress. This integrated approach is supported by broader mental health strategies, such as those discussed in the article “CBT-I Outcomes: Baseline Depression Predicts Long-Term Results” on SleepScience.space, which emphasizes addressing underlying depression for better treatment outcomes.

For patients, the study offers validation that their increased distress during the pandemic was real and measurable. It also provides hope, showing that as external pressures ease, so too can the psychological weight of tinnitus. Managing overall stress through proven techniques, maintaining social connections, and seeking help for both the tinnitus and any co-occurring low mood remain the pillars of effective management.

The full research paper, “Increased prevalence of depressive symptoms and stress in patients with chronic bothersome tinnitus during the COVID-19 pandemic,” is available for review (DOI: 10.1007/s00405-026-10553-w, PMID: 42684457).