Misophonia is a condition that involves strong emotional reactions to common sounds such as chewing or breathing. Hearing these sounds may trigger symptoms of anxiety.
It is not unusual to experience occasional irritation at everyday sounds. However, when someone has misophonia, the sound of a person smacking their lips or the clicking of a pen can significantly affect their mood.
These physical and emotional reactions to common sounds are similar to the “fight, flight, or freeze” response and can lead to feelings of anxiety, panic, or rage.
A person with misophonia has pronounced negative reactions to certain sounds. This is a fairly new concept, and scientists only began to use the term “misophonia” in the early 2000s.
Experts consider misophonia a chronic condition. However, it does not currently appear in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR), which is the chief resource for classifying mental health conditions in the United States.
The key characteristic of misophonia is distress in response to certain sounds. The emotions a person feels can vary significantly but may include:
- annoyance or irritation
- stress
- disgust
- panic
- rage
According to a 2022 review, misophonia may cause aggressive outbursts in children. In rare cases, this can also happen in adults.
People with misophonia may engage in a range of behaviors to try to reduce the effects of a certain sound, such as:
- avoiding places where they might encounter the sound
- leaving a place if they hear the sound
- trying to stop the sound
- mimicking the sound
Depending on the severity, misophonia may affect a person’s mental health, relationships, and daily functioning.
Some sounds are more likely than others to trigger a misophonic response. Common triggers include:
- mouth sounds, such as chewing, slurping, lip smacking, throat clearing, or swallowing
- nasal sounds, such as breathing or sniffing
- other sounds from humans, such as pen clicking, tapping, or typing
- sounds from objects, such as ticking clocks or alarms
- animal sounds, such as the barking or whining of a dog
Generally, the sounds a person with misophonia generates themselves will not cause as much distress as sounds that come from elsewhere.
Some people also report having visual triggers, such as the sight of someone eating, jiggling their foot, swinging their legs, or cracking their knuckles. This is also known as misokensia.
These visual triggers may be associated with auditory triggers, or they might be separate.
Scientists are still learning about what causes misophonia, but here are some of the theories:
Differences in sensory processing
One theory is that misophonia is a result of heightened sensitivity to sounds that people subconsciously associate with contamination or danger.
For example, sounds such as sniffing, breathing through a congested nose, and coughing could indicate that a person is sick, which may trigger disgust.
To some extent, this reaction could be useful, because disgust can prompt people to avoid things that may harm them. But in a person with misophonia, the sensitivity is elevated so that ordinary sounds also become distressing.
This could explain why the symptoms of misophonia resemble the “fight, flight, or freeze” response, which is the nervous system’s way of responding to perceived threats.
Brain connectivity
Some researchers suggest that misophonia is related to hyperconnectivity between the auditory and limbic systems of the brain.
A 2017 study using MRI imaging to analyze the brains of people with misophonia found that trigger sounds produced “greatly exaggerated” responses in the anterior insular cortex, a part of the brain that is responsible for processing emotions.
The study found greater connectivity between the anterior insular cortex and the default mode network, which could prompt memories and associations.
Result of other conditions
Experts do not yet know whether misophonia is a primary condition (one that occurs on its own) or a secondary condition (one that results from something else).
However, many people with misophonia also have other conditions that involve hypervigilance of the nervous system, such as anxiety, obsessive-compulsive disorder (OCD), or post-traumatic stress disorder.
A 2022 review cites some past research that suggested that half of people with misophonia also had OCD.
Some people with misophonia also have conditions that affect their hearing, such as tinnitus (ringing in the ears) or hyperacusis (a condition in which sounds seem louder).
But a 2022 study found that while some people with misophonia have more coexisting conditions, others have few or no coexisting conditions and have more severe misophonia symptoms.
These findings may suggest that there are two subtypes of misophonia, but more research is necessary.
Autistic people may find some types of sensory stimulation — particularly loud sounds — to be overwhelming. In a small 2025 study involving 60 autistic children, researchers found that 45% of the participants had misophonia and 38% had hyperacusis. however, since this study had a small sample size, more research is needed.
Some people with attention deficit hyperactivity disorder (ADHD) also report sensory sensitivities, which can include misophonia. But there is not as much research on the prevalence in this group so far.
As research into misophonia continues, scientists may uncover more about the potential connections. But at present, the exact relationship between neurodivergence and misophonia is not clear.
The main resource for diagnosing mental health conditions in the United States, the DSM-5-TR, does not list misophonia. This means that many healthcare professionals do not diagnose misophonia as a condition.
Nevertheless, the International Misophonia Network has developed the Misophonia Provider Network, which lists specialists — including audiologists, medical doctors, and psychiatrists — who have knowledge of misophonia and an interest in helping people who experience it.
There are not yet any specific treatments for misophonia, but there has been some research into psychotherapy as a possible treatment.
The idea behind this approach is that if misophonia is a result of a hypersensitive nervous system, psychotherapy may help people understand how this sensitivity affects them and find ways of reducing the impact.
A 2022 review mentions previous case studies that have investigated the following types of therapy:
- cognitive behavioral therapy
- dialectical behavior therapy for intense anger responses
- acceptance and commitment therapy
- Eye Movement Desensitization and Reprocessing
Some of these case studies had positive results, but this is not enough evidence to allow researchers to draw broad conclusions. Larger trials are necessary to determine whether any of these approaches are effective.
Many people with misophonia have developed coping mechanisms to help them manage distressing sounds, such as:
- using music to drown out triggering sounds
- wearing earplugs or noise-canceling headphones to block out sounds
- reducing stress or anger through practices such as mindfulness, meditation, and yoga
- finding quiet spaces when out in public
- choosing a quiet place to live or creating a quieter environment at home
- explaining misophonia to friends and family so they can help accommodate the condition
- leaving situations where trigger sounds occur, when possible
Mimicking trigger sounds is an unconscious response that some people with misophonia have. This mimicry may enable them to handle the uncomfortable situations they find themselves in.
It can also be helpful for people to find support from others. Misophonia International, an advocacy and networking organization, seeks to provide useful information and bridge the gap between research and the people who experience misophonia.
People with misophonia experience distress in response to certain sounds, such as chewing, coughing, or tapping. Their reaction goes beyond the typical annoyance that people might feel at everyday sounds and may involve intense irritation, stress, panic, or anger.
Scientists do not yet know why misophonia develops, and there are no specific treatments available. However, some people may find that psychotherapy or other coping skills help them manage the condition.
People with coexisting conditions such as OCD or anxiety may also find that treating these conditions helps improve their overall well-being and their ability to tolerate sounds.