It takes the average person with hearing loss 5 to 7 years before getting a qualified professional diagnosis, notwithstanding the fact that the warning signs of hearing loss are crystal clear to other people. But are those with hearing loss just too stubborn to get help? No, actually, and for a handful of different reasons.

Perhaps you know someone with hearing loss who either denies the concern or refuses to seek professional help, and while this is undoubtedly frustrating, it is very conceivable that the indicators of hearing loss are much more apparent to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In the majority of occurrences, hearing loss develops so slowly that the impacted person simply doesn’t realize the change. While you would notice an swift change from normal hearing to a 25 decibel hearing loss (classified as moderate hearing loss), you wouldn’t notice the minor change of a 1-2 decibel loss.

So a gradual loss of 1-2 decibels over 10-20 years, while generating a 20-40 total decibel loss, is not going to be perceptible at any given moment in time for those afflicted. That’s why friends and family members are almost always the first to observe hearing loss.

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

The majority of hearing loss scenarios are classified as high-frequency hearing loss, meaning that the affected person can still hear low-frequency background sounds normally. While speech, which is a high-frequency sound, is challenging for those with hearing loss to understand, other sounds can usually be heard normally. This is why it’s not uncommon for those with hearing loss to say, “my hearing is fine, everyone else mumbles.”

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

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

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

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

How do you treat hearing loss when there’s no cure? The solution is easy: amplify sounds. The issue is, while hearing aids are the most effective at amplifying sounds, they are not the only way to achieve it — which people with hearing loss rapidly find out.

Those with hearing loss regularly crank up the volume on everything, to the detriment of those around them. Tv sets and radios are played extremely loud and people are made to either shout or repeat themselves. The individual with hearing loss can get by just fine with this approach, 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 examination and it normally is not accompanied by any pain or discomfort. If individuals with hearing loss do not recognize a problem, chiefly due to the reasons above, then they likely won’t take action.

The only way to accurately diagnose hearing loss is through audiometry, which will determine the exact decibel level hearing loss at several sound frequencies. This is the only method to objectively say whether hearing loss is present, but the hard part is of course getting to that point.

How to approach those with hearing loss

Hopefully, this article has manufactured some empathy. It is always exasperating when someone with hearing loss refuses to accept the problem, but keep in mind, they may legitimately not grasp the severity of the problem. As an alternative to commanding that they get their hearing examined, a more productive strategy may be to educate them on the properties of hearing loss that make the condition virtually invisible.