An Introduction to Misophonia

Misophonia literally means “hatred of sound.” People with misophonia are affected negatively by common sounds, usually made by others. Hearing someone else’s chewing or yawning or even breathing can trigger a feeling of anger and aversion to the point where the person just wants to get away from that sound. Misophonia is little studied, and it is not known how common it is. Because it can seriously compromise social relationships and mental health, it is important to let your healthcare providers know if you are experiencing this condition.

What is misophonia? What triggers it?

Misophonia is one of several types of sensitivity to sound.

• Hyperacusis is sensitivity or low tolerance to a range of sounds within a certain volume or frequency.
• Phonophobia is the fear of certain sounds.
• Misophonia is an emotional reaction, like anger or avoidance, to specific sounds, regardless of volume.

The primary symptom of misophonia is an extreme emotional and physical response to common repetitive sounds. Often these are oral or vocal sounds like chewing, lip-smacking, and even breathing or other human-made sounds such as typing, knuckle cracking, and finger tapping. Sounds made by items such as windshield wipers, clocks, and plastic bags may also trigger misophonia. Even noises made by pets, including purring and licking, can be provoking. Sometimes just seeing a reminder of the sound can be just as upsetting as the sound itself. Misophonia triggers often come from close family members.

Whatever the trigger (i.e., the sound of someone chewing popcorn in a movie theater or a beeping electronic device), misophonia can affect relationships with loved ones. It is a real disorder and one that seriously compromises functioning, socializing, and ultimately mental health. Some research estimates that at least 10 to 15 percent of us have this condition. 

Those with misophonia have a fight-or-flight response to these noises; they become tense, irritated, angry, and even filled with hatred or disgust toward whatever is responsible for the triggering noise. Anxiety, panic, fear, and distress are also common.

How do you know you have it? Is there a test for misophonia?

An audiologist, one of the first to identify what later was christened “misophonia,” began recognizing that a number of her young patients had symptoms that couldn’t be explained easily as either hearing disorders or psychological problems. Happening mostly in girls, the symptoms would develop from age seven or eight through about age thirteen or fourteen. 

It is important to note that misophonia is not listed in any psychiatric classification systems. Recognized only in 2001, misophonia is not yet officially listed as a diagnosis in medical manuals. Even today, some doctors have never heard of it and symptoms may be dismissed or diagnosed as a mood disorder. Those with symptoms of misophonia often feel embarrassed and don’t mention it to their healthcare providers. As awareness of misophonia has increased, the use of clinical interviews and questionnaires has helped many to understand that they or a loved one may have the condition. Note that questionnaires on the internet indicate how much one is impacted by “sound issues,” but they are not diagnostic tools. New psychoacoustic tools to test for misophonia are being developed. 

Is misophonia a mental disorder? Is it a form of OCD or autism? Does it get worse over time?

Although it isn’t a form of autism spectrum disorder or an anxiety disorder, misophonia does share some features with both of these conditions.

Some researchers believe misophonia should be considered a new mental disorder within the spectrum of obsessive-compulsive related disorders. Others think it is a feature of a broader syndrome of sensory intolerance, rather than a separate disorder.

Researchers have discovered that in those with misophonia, neurons activate as if they were actually performing the act that causes the sound. The study’s authors speculate that the negative reaction is the result of feeling out of control, like personal space has been invaded, or that current goals are being held back.

The brains of misophonia sufferers are also connected differently (compared to normal brains) to the amygdala and the hippocampus, areas that are involved in recalling past experiences. Researchers are investigating the link between memories and misophonia. 

Can misophonia go away? How is it treated?

There are no medications to treat misophonia or make it go away. Potential misophonia therapies could build on the new findings of counseling patients about handling unconscious motor responses to triggering sounds—not just coping with the sounds themselves. Working with a mental health professional may help. 

Psychological treatments for misophonia include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), mindfulness training, hypnosis, and meditation. Physical treatments such as acoustic therapies, alpha-stim, chiropractic, and eye movement desensitization and reprocessing (EMDR) have also been effective, as have vigorous exercise, getting enough sleep, eating healthy meals, and wearing sound protection. 

It is important to know that excessive use of earplugs increases your sensitivity to many trigger sounds. In a quiet bedroom environment, misophonia rarely contributes to poor sleep, but some background noises can evoke the misophonia response and make sleep impossible. 

Noise sensitivities are like anxiety because we can’t fix them. But what we can do is behave with courage, which is a much better long-term solution for the brain. Awareness and understanding by ourselves, as well as family and friends, can bring relief.

A combination of noise-canceling headphones and learning to look at life a little differently have helped one young woman excel in school and cope at home, “Misophonia . . . I would say it used to define who I am, but now I just see it as another part of my life.”

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