Tinnitus is the perception of a self-generated sound and an individual’s psychological reaction to it. This article discusses one element of the reaction: depression. Epidemiologic studies have noted high comorbidity of tinnitus and depression. Findings from recent brain imaging studies have noted shared neural networks in depression and severe tinnitus. As further evidence of this overlaps, antidepressants, counseling, and psychology-based approaches have been used to treat tinnitus. Multifaceted treatment strategies, using both sound-based therapies (not discussed in this paper) and psychology-based approaches, are a necessary part of the treatment options, with the aim of enhancing self-efficacy in patients with tinnitus.