Pandemic Stress Worsens Tinnitus and Depression

During the strictest COVID-19 restrictions in 2020, people with chronic bothersome tinnitus showed significantly higher rates of depression and stress than those without tinnitus or with only mild symptoms. This is the central finding from a new analysis of Korean national health data, which also found that this psychological gap had closed by 2022 when society had adapted to “living with COVID-19.” The research, led by Sang‑Yoon Han and Young Ho Kim, pinpoints a specific period of heightened vulnerability for individuals with severe tinnitus.

How the Study Measured Tinnitus and Mental Health

The study, published in the European Archives of Oto-Rhino-Laryngology (10.1007/s00405-026-10553-w), used data from the large-scale Korea National Health and Nutrition Examination Survey. The team analyzed responses from 5,965 participants across two time points: the height of restrictions in 2020 and the more open “living-with-COVID” phase in 2022.

Participants were grouped based on their tinnitus experience. Those who rated the annoyance of their chronic tinnitus above 4 on a 10-point visual analogue scale were classified as having “bothersome tinnitus.” Those with a rating of 4 or below formed the “non-bothersome tinnitus” group, and individuals with no tinnitus made up the third group. Mental health was assessed using the standardized Patient Health Questionnaire-9 (PHQ-9) to measure depressive symptoms, with a score of 5 or higher indicating notable symptoms. Participants also self-reported their perceived stress levels.

Bothersome Tinnitus Linked to Peak Pandemic Distress

The results reveal a clear pattern tied to the timeline of the pandemic. In 2020, the group with bothersome tinnitus stood out. Their average PHQ-9 scores for depression were significantly higher than both the non-tinnitus group and the non-bothersome tinnitus group. They also reported a greater prevalence of “high stress.”

By 2022, this pattern had changed. There were no longer any statistically significant differences in depression scores or stress levels among the three groups. The psychological burden, which was disproportionately high for those with severe tinnitus during the lockdowns, had equalized as society reopened.

Further analysis confirmed the unique experience of the bothersome tinnitus group. When comparing individuals’ outcomes between 2020 and 2022, only this group showed a significant decrease in depression and stress. The mental health scores of the non-bothersome and no-tinnitus groups remained relatively stable across both periods. This suggests that the acute stressors of lockdowns—such as social isolation, disrupted routines, and limited access to healthcare—acted as a potent amplifier for the distress caused by severe tinnitus. Our existing article, “Tinnitus and Sleep Disturbance: A Bidirectional Cycle,” explores how one major stressor, poor sleep, can similarly intensify tinnitus perception.

Why Tinnitus Severity Matters for Psychological Risk

This research makes a critical distinction: it is not merely having tinnitus, but having tinnitus that is perceived as bothersome, that predicts greater psychological vulnerability during a widespread crisis. The constant, intrusive nature of severe tinnitus likely interacted with pandemic stressors in a negative feedback loop. Anxiety and low mood may lower tolerance for the tinnitus sound, making it seem louder and more distressing, which in turn worsens mental health.

This interaction between sensory processing and emotional state is not unique to tinnitus. In conditions like “Misophonia Triggers: Auditory vs. Visual Responses,” we see how specific sounds can trigger intense emotional reactions based on neural pathways linking the auditory and limbic systems. The pandemic environment may have heightened such sensitivities across auditory processing disorders.

Implications for Treatment and Future Preparedness

Han and Kim state their findings highlight the need for “integrated tinnitus and psychological management.” For clinicians, this means routinely assessing both tinnitus severity and mental health, especially during periods of collective stress. Identifying patients with bothersome tinnitus allows for targeted psychological support.

The study specifically notes the value of “non-face-to-face approaches” when in-person access is restricted. This validates the growing role of telemedicine and digitally delivered cognitive behavioral therapy for tinnitus. Effective management of co-occurring conditions is also vital. For instance, treating hyperacusis (heightened sensitivity to sound) can reduce overall auditory stress; our “Hyperacusis Treatment and Management: Evidence-Based Guide” outlines foundational strategies.

The research also points to a need for systemic preparedness. Public health planning for future crises should consider the specific risks to individuals with chronic sensory conditions like severe tinnitus. Ensuring continued access to sound therapy, psychological support, and specialist consultations—whether remote or in-person—must be a priority.

Finally, the improvement seen in 2022 offers a hopeful perspective. It suggests that as broader environmental stressors recede, the extra psychological load on those with bothersome tinnitus can lessen. Supporting general mental health resilience through proven methods, such as the strategies outlined in the cross-site guide “Evidence-Based Sleep Hygiene Guide & Tips,” may provide a buffer against future stressors. As this study confirms, the goal is a treatment approach that addresses the sound patients hear and the distress it causes, recognizing them as interconnected parts of the same health picture.