Voice disorders and mental health: how they affect each other

The voice is part of how people express who they are, so a voice problem can affect much more than sound. Research has found that people with voice disorders report higher levels of anxiety, low mood and social withdrawal than people without them.

How a voice problem can affect wellbeing

• Work. Teachers, call-centre staff, performers and others who rely on their voice may worry about doing their job.

• Social life. People may avoid phone calls, noisy places or speaking up in groups.

• Identity and confidence. A voice that sounds different can feel like it no longer represents you.

• Fatigue. The effort of speaking can be tiring by the end of the day.

How stress and mood can affect the voice

Stress changes breathing and increases muscle tension, both of which affect how the voice is produced. Stress is one of the factors associated with muscle tension dysphonia, and some breathing and throat symptoms, such as inducible laryngeal obstruction, can be triggered or worsened by stress. A voice problem and stress can then feed each other.

What can help

• Getting a diagnosis. Knowing what is and is not wrong is often a relief in itself. An ear, nose and throat doctor (ENT) can examine the larynx.

• Voice therapy. A speech-language pathologist can work with you on the voice itself and on managing it in the situations that matter to you.

• Mental health support. If anxiety or low mood is affecting your life, speak with your physician or a mental health professional. Speech-language pathologists do not treat mental health conditions, but can work alongside those who do.

• Practical adjustments. Amplification, changes to your schedule and talking to your employer can reduce the load on your voice.

If you are struggling

If you are in crisis or thinking about harming yourself, call or text 9-8-8, the Suicide Crisis Helpline, which is available across Canada at any time.

This article is general information. It is not a substitute for assessment by a physician or a speech-language pathologist.

References and further reading

Psychological distress in patients with benign voice disorders.

Voice problems and depression among adults in the United States.

The frequency of perceived stress, anxiety, and depression in patients with common pathologies affecting voice.