The voice is a fundamental tool of human communication. Through it, we express our needs, thoughts, and feelings — and it reveals things about us too, like our age, education, gender, and where we come from.
Voice disorders (dysphonia, or disorders of vocalization) can stem from a range of causes, including conditions affecting the larynx or psychogenic factors. They typically show up as changes in pitch, volume, or vocal quality, often alongside pain, difficulty, or fatigue when speaking — and in some cases, complete loss of voice.
The link between voice disorders and mental health is a close one. Research shows that voice disorders affect mental health — and, in turn, that mental health difficulties can make voice disorders worse.
Stress has a measurable effect on how we speak. Studies show that in fearful situations, pitch rises and speech speeds up. In people with depression, the voice is often quieter and more monotone.
People dealing with a voice disorder — whatever its cause — frequently experience emotional distress, along with higher levels of anxiety and depression. They may become highly anxious about their health, or show symptoms of disordered eating or adjustment difficulties. Research also points to links with traits like perfectionism, difficulty asserting oneself, and trouble managing negative emotions.
People with voice disorders often report a lower quality of life. In one study, patients with dysphonia rated their quality of life at levels comparable to those living with chronic conditions such as Chronic obstructive pulmonary disease.
Voice disorders can make communication difficult or even impossible, effectively becoming a communication disability. Professionals who rely heavily on their voice — singers, teachers, cantors, kindergarten teachers, lawyers, and others — are especially vulnerable. For them, a voice disorder can affect performance, sense of competence, and self-esteem. The impact often extends into personal relationships too, as people with dysphonia may withdraw and become socially isolated. Losing one’s voice can feel like losing a part of one’s identity — even like a form of grief.
It’s clear that a voice disorder touches many parts of life: work, relationships, and self-image. Understanding vocal hygiene is an important step toward prevention.
Treatment for voice disorders depends on their severity and underlying cause. It should always be handled by qualified healthcare professionals and tailored to the individual, to ensure effective treatment and recovery.
Psychotherapy can play a meaningful role in treating voice disorders. Factors like anxiety, stress, and mood difficulties negatively affect vocal health, and psychotherapy helps manage these psychological burdens through appropriate techniques and strategies. Research has specifically shown that patients who combined voice therapy with Cognitive Behavioural Therapy (CBT) reported greater overall wellbeing, fewer symptoms of anxiety and depression, and fewer relapses.
References
Baker, J. (2008). The role of psychogenic and psychosocial factors in the development of functional voice disorders. International Journal of Speech-Language Pathology, 10(4), 210–230.
Gray, H., Coman, L., Walton, C., Thorning, S., Cardell, E., & Weir, K. A. (2021). A comparison of voice and psychotherapeutic treatments for adults with functional voice disorders: a systematic review. Journal of Voice.
Jordan, V. A., Lunos, S., Sieger, G., Horvath, K. J., Cohen, S., & Misono, S. (2020). Association of voice and mental health diagnoses with differences in voice-related care utilization. The Laryngoscope, 130(6), 1496–1502.
Jordan, V. A., Cohen, S., Lunos, S., Horvath, K. J., Sieger, G., & Misono, S. (2020). Mental health and dysphonia: which comes first, and does that change care utilization? The Laryngoscope, 130(5), 1243–1248.
Miller, T., Deary, V., & Patterson, J. (2014). Improving access to psychological therapies in voice disorders: a cognitive behavioural therapy model. Current Opinion in Otolaryngology & Head and Neck Surgery, 22(3), 201–205.
O’Hara, J., Miller, T., Carding, P., Wilson, J., & Deary, V. (2011). Relationship between fatigue, perfectionism, and functional dysphonia. Otolaryngology–Head and Neck Surgery, 144(6), 921–926.
Exarchakos, G. (2001). Physiopathology of the Voice. Athens: Ellinika Grammata.
