Misophonia is a little-known disorder, but it can have a significant impact on the lives of those it affects. Meaning “hatred of sound”, misophonia causes extreme sensitivity to certain noises, resulting in an intense emotional, and often physical, reaction. While a cure hasn’t yet been found, and experts are unsure what causes the condition, management is possible.

What is misophonia?

Misophonia is a neurophysiological and behavioural condition characterised by a heightened sensitivity to specific “trigger sounds”. These sounds can evoke overwhelming emotional or physical reactions, including feelings of extreme anger, anxiety, discomfort and panic, which often lead to an intense urge to escape or avoid the triggering noises.

Trigger sounds vary among individuals but usually include repetitive everyday noises such as chewing or crunching, slurping and swallowing, sniffing, loud breathing and throat clearing. Understandably, given how regularly these sounds are heard, this can interfere greatly with day-to-day life and impact relationships and social interactions.

It’s important to note that with misophonia, the emotional reaction to the trigger is disproportionate. While the sound of nails down a blackboard might make many people shudder, hearing trigger noises can have an incredibly debilitating effect on someone with misophonia.

Symptoms of misophonia

The reactions to sounds in misophonia often look like natural fight-or-flight responses, which include emotional, behavioural and somatic symptoms.

In terms of emotional responses, intense anger, irritation, disgust, anxiety, or fear are all common misophonia symptoms. Behavioural misophonia symptoms may include avoidance –  actively trying to avoid situations or environments where trigger sounds are likely to occur or leaving the area when a trigger sound begins. Sufferers may also take non-violent (or, in rare cases, violent) action to stop the offending sound, like shouting at the person making the sound to stop.

There may also be somatic misophonia symptoms (bodily symptoms) consistent with a fight-or-flight response, such as an increase in blood pressure and heart rate, sweating, chest tightness or pressure.

What causes misophonia?

We don’t yet fully understand what causes misophonia. However, researchers suspect it may be a combination of factors.

Some studies have shown that misophonia may be more common in women than in men. While it can start at any age, it’s usually first noticed during adolescence or early adulthood. It also seems to run in families, with researchers identifying at least one genetic mutation contributing to misophonia.

Certain neurodivergent and mental health conditions may have a link to misophonia. People with anxiety, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), major depressive disorder or borderline personality disorder, as well as those with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder and Tourette’s syndrome, may all be at an increased risk for the condition.

ADHD, in particular, has been investigated as a condition that may be connected to misophonia. ADHD is a neurodevelopmental condition that involves difficulties with attention regulation and often involves hypersensitivity to stimuli. But while researchers have found a possible link between the two conditions, they’re not quite sure what this connection means and whether it is a case of correlation or causation.

Tourette’s syndrome – a neurological disorder that causes people to make involuntary and uncontrollable sounds and movements called tics – is another condition that may be linked to misophonia, as both involve disproportionate responses to stimuli. But again, it’s an area that needs more research.

While these potential links exist, it's important to note that the relationships between misophonia and these disorders are still under investigation.

Interestingly, people with misophonia may also have differences in their brain structure and activity. One of these differences is having more connections and activity in and between some regions of your brain that control how we process sounds and manage our emotions. Researchers think this increased connectivity may lead the brain to interpret trigger sounds as a threat, leading to intense emotional and physiological reactions – the fight-or-flight response.

Research has also found people with misophonia have a larger right amygdala, the part of the brain that controls (among other things) the activation of the fight-or-flight response.

While misophonia is more a psychological condition than a hearing disorder, there are auditory conditions that may put people at higher risk of misophonia, too, including hearing loss, tinnitus and hyperacusis.

Misophonia triggers

The triggering sounds for misophonia can vary between individuals, but some common trigger sounds include:

  • Mouth sounds, such as chewing, slurping, lip-smacking, or swallowing noises. These are among the most commonly reported triggers.
  • Breathing – some individuals may be triggered by nasal sounds, sniffing, or heavy breathing.
  • Repetitive noises like typing, pen clicking, foot tapping, clock ticking, or dripping water can be triggers.
  • Eating-related sounds, including cutlery clinking, plate scraping, or food-related noises, can also provoke strong reactions.
  • Certain everyday environmental sounds, like sneezing, coughing, or someone else's voice, might also trigger a response.

Misophonia treatment

While misophonia can’t be cured, symptoms can be managed via a combination of strategies aimed at reducing the impact of trigger sounds and developing coping mechanisms.

If you think you or someone you love is suffering from misophonia, it’s important to seek professional help for diagnosis and treatment – particularly when symptoms significantly interfere with daily activities and quality of life.

Mental health therapies, such as counselling and cognitive behavioural therapy (CBT), can help people with misophonia identify and reduce/prevent triggers and develop coping strategies to help them manage their impulse reactions to the trigger. Using CBT to learn anger management techniques can also prove helpful, as can mindfulness-based practices. A simple at-home management option that can assist ‘masking’ the sounds is listening to a noise-generator device (such as white, pink or brown noise) to help the brain focus on something else.

While misophonia can be incredibly distressing for the sufferer and can impact daily life significantly, there are tried and tested methods to help manage symptoms. Seeking professional help is crucial, especially when symptoms start to affect relationships and emotional well-being. Be sure to visit your doctor or health professional if you’re noticing any misophonia symptoms.

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