It takes the average person with hearing loss 5 to 7 years before seeking a professional diagnosis, in spite of the fact that the warning signs of hearing loss are obvious to other people. But are those with hearing loss just too stubborn to get help? No, actually, and for a few different reasons.

Maybe you know someone with hearing loss who either denies the difficulties or refuses to seek professional help, and while this is unquestioningly frustrating, it is very conceivable that the signs of hearing loss are much more clear to you than they are to them.

Here are the reasons why:

1. Hearing loss is gradual

In most instances, hearing loss unfolds so gradually that the affected individual simply doesn’t recognize the change. While you would perceive an quick change from normal hearing to a 25 decibel hearing loss (recognized 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 creating a 20-40 total decibel loss, is not going to be noticeable at any given moment in time for those affected. That’s why friends and family are virtually always the first to detect hearing loss.

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

The majority of hearing loss examples are classified as high-frequency hearing loss, meaning that the impacted individual can still hear low-frequency background sounds normally. Although speech, which is a high-frequency sound, is challenging for those with hearing loss to follow, other sounds can usually be heard normally. This is why it’s quite common for those with hearing loss to claim, “my hearing is fine, everyone else mumbles.”

3. Hearing loss is not addressed by the family doctor

People struggling with hearing loss can attain a false sense of well-being following 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 screen for hearing loss during the course of the yearly checkup. Not to mention that the prime symptom for the majority of cases of hearing loss — difficulty following speech in the presence of background noise — will not present itself in a silent office atmosphere.

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 easy: amplify sounds. The issue is, although hearing aids are the most effective at amplifying sounds, they are not the only way to achieve it — which people with hearing loss quickly discover.

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

5. Hearing loss is pain-free and invisible

Hearing loss is largely subjective: it cannot be diagnosed by visible evaluation and it generally is not accompanied by any pain or discomfort. If people with hearing loss do not perceive a problem, mostly because of the reasons above, then they likely won’t take action.

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

How to approach those with hearing loss

Hopefully, this article has established some empathy. It is always exasperating when someone with hearing loss refuses to admit the problem, but keep in mind, they may legitimately not recognize the magnitude of the problem. Instead of commanding that they get their hearing examined, a more productive approach may be to educate them on the features of hearing loss that make the condition virtually invisible.