It takes the average person with hearing loss 5 to 7 years before seeking a professional diagnosis, despite the reality that the signs and symptoms of hearing loss are very clear to others. But are those with hearing loss merely too stubborn to get help? No, actually, and for a couple of different reasons.

Maybe you know someone with hearing loss who either denies the problem or declines to seek professional help, and despite the fact that this is no doubt frustrating, it is very possible that the symptoms of hearing loss are much more obvious to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In most scenarios, hearing loss unfolds so gradually that the affected individual simply doesn’t realize the change. While you would perceive an instant change from normal hearing to a 25 decibel hearing loss (classified as moderate hearing loss), you wouldn’t detect the minuscule change of a 1-2 decibel loss.

So a slow loss of 1-2 decibels over the course of 10-20 years, while resulting in a 20-40 total decibel loss, is not going to be noticeable at any given moment in time for those impacted. That’s why friends and family are nearly always the first to recognize hearing loss.

2. Hearing loss is often partial (high-frequency only)

The majority of hearing loss examples are classified as high-frequency hearing loss, which means that the affected individual can still hear low-frequency background sounds normally. Although speech, which is a high-frequency sound, is difficult for those with hearing loss to follow, other sounds can usually be heard normally. This is why it’s not uncommon for those with hearing loss to assert, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not attended to by the family doctor

People struggling with hearing loss can get a false sense of well-being after their annual physical. It’s common to hear people state “if I had hearing loss, my doctor would have told me.”

This is of course not true because only 14% of physicians routinely test for hearing loss during the annual checkup. Not to mention that the foremost symptom for the majority of cases of hearing loss — difficulty following speech in the presence of background noise — will not present itself in a tranquil office environment.

4. The burden of hearing loss can be shared or passed on to others

How do you manage hearing loss when there’s no cure? The answer is straight forward: amplify sounds. The issue is, although hearing aids are the most effective at amplifying sounds, they are not the only way to accomplish it — which people with hearing loss quickly identify.

Those with hearing loss often crank up the volume on everything, to the detriment of those around them. Tv sets and radios are played exceptionally loud and people are made to either scream or repeat themselves. The individual with hearing loss can get by just fine with this technique, but only by passing on the burden to friends, family members, and co-workers.

5. Hearing loss is painless and invisible

Hearing loss is mainly subjective: it cannot be diagnosed by visible investigation and it normally is not accompanied by any pain or discomfort. If those with hearing loss do not recognize a problem, chiefly due to the reasons above, then they most likely won’t take action.

The only way to accurately diagnose hearing loss is through audiometry, which will calculate the specific decibel level hearing loss at different sound frequencies. This is the only method to objectively determine whether hearing loss is present, but the challenging part is needless to say getting to that point.

How to approach those with hearing loss

Hopefully, this article has generated some empathy. It is always frustrating when someone with hearing loss refuses to acknowledge the problem, but remember, they may legitimately not understand the severity of the problem. As an alternative to demanding that they get their hearing tested, a more reliable strategy may be to educate them on the characteristics of hearing loss that make the condition essentially invisible.