What is misophonia?
It is not unusual for people to occasionally be irritated by some everyday sounds. But for individuals with misophonia, the sound of someone smacking their lips or clicking a pen can make them want to scream or hit out.
These physical and emotional reactions to innocent, everyday sounds are similar to the "fight or flight" response and can lead to feelings of anxiety, panic, and rage.
- A person's reaction can be so powerful it interferes with their ability to live life normally.
- Since misophonia is a newly identified health disorder, treatment options are still limited.
- The term means "hatred of sound," but not all sounds are a problem for people with sound sensitivity.
How do you treat it?
Misophonia is characterized by a person having an adverse reaction to everyday sounds.
No specific medications or treatments for misophonia have been found yet.
Mimicking offensive sounds is an unconscious response some people have to the sounds that trigger their condition. This mimicry may enable them to handle the uncomfortable situations they find themselves in better.
Individuals with misophonia have also developed other coping mechanisms to give themselves some relief.
Tips for managing sound sensitivity include:
- using headphones and music to drown out trigger noises
- wearing earplugs to limit noise intrusion
- opting for seating on buses and in restaurants that distance trigger sounds
- practice self-care with rest, relaxation, and meditation to reduce stress
- when possible, leave situations where there are trigger sounds
- seek out a supportive doctor or therapist
- speak calmly and frankly with friends and loved ones to explain misophonia
Trying to tell a person with misophonia to "just ignore" their triggering sounds is similar to telling a person with depression to "snap out of it," and is just as unlikely to be helpful.
The key characteristic of misophonia is an extreme reaction, such as anger or aggression, to people making certain sounds.
The strength of the reaction, and how an individual with the condition responds to it, varies tremendously. Some people may experience annoyance and irritation, while others can fly into a full-blown rage.
Both men and women can develop misophonia at any age, although people typically start showing symptoms in their late childhood or early teenage years.
For many people, their first episodes of misophonia are triggered by one specific sound, but additional sounds can bring on the response over time.
People with misophonia realize that their reactions to sounds are excessive, and the intensity of their feelings can make them think they are losing control.
Studies have identified the following responses as symptomatic of misophonia:
- irritation turning to anger
- disgust turning to anger
- becoming verbally aggressive to the person making the noise
- getting physically aggressive with objects, because of the noise
- physically lashing out at the person making the noise
- taking evasive action around people making trigger sounds
Some people with this kind of sound sensitivity may start to mimic the noises that trigger their angry, aggressive reactions.
Simply thinking about encountering sounds that trigger their misophonia can make people with the condition feel stressed and ill at ease. In general, they may have more symptoms of anxiety, depression, and neuroses than others.
In addition to the emotional responses, studies have found that individuals with misophonia commonly experience a number of physical reactions, including:
- pressure throughout the body, especially the chest
- muscle tightness
- increases in blood pressure
- more rapid heartbeat
- increases in body temperature
What are the most common triggers?
The sounds of chewing and people eating food are the most common misophonic triggers.
Some sounds are more likely than others to trigger a misophonic response. Researchers in Amsterdam identified the following as the most common triggers for misophonia:
- eating sounds, affecting 81 percent of those studied
- loud breathing or nose sounds, affecting 64.3 percent
- finger or hand sounds, affecting 59.5 percent
Some 11.9 percent of participants had a similarly angry and aggressive response to the sight of someone repeating certain physical actions, such as shaking their knees.
Interestingly, humans make most of the sounds and sights that trigger misophonia. A dog slurping down a bowl of food or similar does not usually provoke a misophonic reaction.
Link to autism?
Since some children with autism can have a difficult time with sensory stimulation, and particularly loud sounds, there has been speculation that misophonia and autism may be linked.
At this point, it is too early to tell whether there is a direct connection, as scientists do not know enough about what causes people with either condition to react so strongly to sounds.
Misophonia was first considered a disorder relatively recently with the term misophonia first used in 2000.
Misophonia is considered a chronic condition and a primary disorder, meaning it does not develop in association with other conditions.
However, misophonia is not currently listed in the DSM-5, the chief resource for classifying mental health illnesses in the United States.
Some researchers suggest that the misophonic reaction is an unconscious or autonomic response of the nervous system. This conclusion is made because of the physical reactions people with sound sensitivity experience, and the fact that substances, such as caffeine or alcohol, can make the condition worse or better.
How does the brain chemistry work?
Studies have connected misophonia with tinnitus.
There are similarities between misophonia and tinnitus, the sensation of ringing in the ears.
Consequently, some researchers suggest that misophonia is linked to hyperconnectivity between the auditory and limbic systems of the brain.
This hyperconnectivity means there are too many connections between the neurons in the brain that regulate hearing and emotions.
A study using MRI imaging to analyze the brains of individuals with misophonia found that trigger sounds produced "greatly exaggerated" responses in the anterior insular cortex (AIC), a part of the brain responsible for processing emotions.
The study found greater connectivity between the AIC and the default mode network (DMN), which could prompt memories and associations.
In specific parts of the brain, the nerve cells of people with misophonia had higher myelination than the average person, which could contribute to their higher levels of connectivity.
The researchers suggested that the high levels of activity seen in the AIC, which is involved in interoception or the perception of the internal functions of the body, contributed to the skewed perceptions of people with misophonia.
The main resource for diagnosing mental health disorders in the U.S. is the DSM-5, and it does not list misophonia. Technically, this means a person cannot be diagnosed with the condition.
Nevertheless, the International Misophonia Network has developed the Misophonia Provider Network, listing specialists, including audiologists, medical doctors, and psychiatrists with knowledge of misophonia and an interest in helping people with the condition.
How is it managed?
Individuals with misophonia often try to avoid situations, such as social gatherings, where they are likely to encounter their triggers.
Some people also wear earphones or try to find other ways to drown out the offending sounds. Some mimic their triggering sounds.
It can help to find support for a challenging condition. Misophonia International, an advocacy and networking organization, seek to provide useful information and bridge the gap between research and those affected by the condition.