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This study examined the relationship between hearing impairment and mental distress. We hypothesized that fear of negative evaluation by others and avoidant communication strategies are associated with increased symptoms of depression.Hearing-impaired adults (N = 105) who signed up for a stress management course completed the Hospital Anxiety and Depression Scale (HAD; Zigmond & Snaith, 1983), the Fear of Negative Evaluation Scale (FNE; Watson & Friend, 1969), and the Conversation Tactics Checklist (CONV; Hallam et al., 2007). The participants' ratings of subjective hearing disability were assessed on a 5-point Likert scale and pure-tone audiometry obtained. Hierarchical multiple regression analysis was used to assess associations between fear of negative evaluation, avoidance, and symptoms of depression.Objective hearing impairment was moderate or less for 81% (n = 87) of participants, and the correlation between subjective hearing disability and objective hearing impairment was not significant. Multiple regression analysis showed that fear of negative evaluation and avoidant communication strategies contributed significantly to the variance in depression symptoms, and the total explained variance was 41.7%, F(5, 93) = 13.32, p = .000. Subjective and objective hearing disability did not make significant contributions.Symptoms of depression appear to be closely related to fear of negative evaluation by others and use of avoidant communication strategies. Future clinical studies should address whether targeting these problems in rehabilitation interventions decreases depressive symptoms among hearing-impaired individuals.