Misophonia: Symptoms, Triggers And Treatments (2024)

Though misophonia is not a diagnosable medical or mental health condition, Jaelline Jaffe, Ph.D., a psychotherapist who specializes in treating people with misophonia, emphasizes that it is a very real condition. “People with misophonia have an extreme reaction to certain sounds,” she explains. “They are not just annoyed by the sound. For people with misophonia, hearing the triggering sound can cause feelings of irrational rage.”

The noises that trigger someone with misophonia don’t have to be loud, according to Lisa Fox-Thomas, Ph.D., a professor of audiology and assistant director at the University of North Carolina Greensboro Speech and Hearing Center, who treats people with misophonia. In fact, they can be as quiet as someone chewing or the hum of a fluorescent light.

People with misophonia cannot control how certain sounds make them feel, says Dr. Jaffe. It’s a misconception that people with misophonia are overreacting when they hear the noise or sound that triggers them, she adds.

“Being annoyed by a sound is a universal experience that everyone can relate to,” says Dr. Fox-Thomas. “But for someone with misophonia, it’s like their brain has been hijacked [when they hear the noise that triggers them] and they can’t focus on anything else.”

Since misophonia is not technically a medical or mental health condition, there is no formal set of symptoms that are used to diagnose someone with it, says both Dr. Fox-Thomas and Dr. Jaffe.

But the symptoms of misophonia that are generally accepted by auditory specialists and psychologists who treat people with misophonia are as follows:

• Feelings of strong anger, irritation or disgust when hearing the triggering sound
• A strong physiological response when hearing the triggering sound (such as pressure in the chest, arms, head or entire body, as well as feeling tense)
• Showing a behavioral response when hearing the triggering sound (such as glaring at the person making the sound or being verbally aggressive)

It’s especially important for parents, daycare workers and teachers to know the symptoms of misophonia because they may incorrectly assume a child is acting out when hearing a noise when, in actuality, they have misophonia, says Dr. Jaffe.

The causes of misophonia are not completely understood, but what is known is that hearing the triggering noise causes a fight-or-flight reaction in the person with misophonia, says Dr. Jaffe. “It’s as if their body is being attacked,” she says. This can cause the person with misophonia to feel extreme anxiety or the need to escape. It also explains why someone with misophonia is unable to function when they hear the noise; their brain is preoccupied with ensuring their safety.

Additionally, individuals with bipolar disorder, attention deficit disorder, autism or obsessive compulsive disorder are more likely to have misophonia, notes Dr. Fox-Thomas. These conditions do not cause misophonia, but there may be a connection, she adds.

Anecdotally, in Dr. Fox-Thomas’ clinical experience of working with more than 200 people with misophonia, people with misophonia tend to have better-than-average hearing, especially in higher pitches. This, she says, may contribute to the awareness of sound triggers, but does not explain why the sounds are bothersome. To this point, scientific research does show that high pitch voices can be a trigger for people with misophonia. “I also have observed that people with misophonia are generally highly intelligent with exceptional attention to detail, which may make it difficult to ignore sound patterns or nuances in sounds,” says Dr. Fox-Thomas.

As the misophonia symptoms listed previously show, when someone with misophonia hears the triggering noise, it can affect them both mentally and physically. Not everyone with misophonia is impacted to the same degree or in the same way; it is a spectrum, says Dr. Jaffe.

“For people on the severe end of the spectrum, they describe feeling physical pain when they hear the noise, like someone is attacking their body or they’re being punched or stabbed,” she says. Dr. Fox-Thomas adds to this, saying that some people with misophonia may feel tingly and hot, have a racing heart, be sick to their stomach or have tension throughout their body.

Both experts say that it’s common for someone with misophonia to become extremely angry when they hear a triggering noise. “Their fight-or-flight response is kicking in and they need to either obliterate the sound or run away from it,” says Dr. Fox-Thomas. Recovery time can vary from minutes to hours, depending on the sound and how long it lasts, she explains.

“Often, people with misophonia tell me they think the sounds are unnecessary, rude, gross and sometimes intentional,” says Dr. Fox-Thomas. “Importantly, these emotional and physiological responses can occur in the presence of triggers, in anticipation of sounds or even when thinking or talking about sounds.”

The noises that can trigger someone with misophonia vary greatly; people with misophonia are not disturbed by the same sounds. “Trigger sounds are often, but not always, associated with the mouth, nose and throat—like eating, sniffing or coughing—and can include other human made sounds such as pen clicking, nail picking and foot tapping,” explains Dr. Fox-Thomas. “Other mechanical sounds are described as bothersome such as clocks ticking, air conditioners, traffic and lawn equipment.”

The most common misophonia triggers, according to research, are listed below:

• Chewing, crunching food or slurping
• Breathing, sniffing or sneezing
• Clearing throat
• Machine-related sounds (like computer typing, the clock ticking, coffee maker, stapler or hair dryer)

It can be helpful for someone with misophonia to work with both a therapist as well as an audiologist, experts say.

Since many of the noises that are triggering to people with misophonia are unavoidable, Dr. Jaffe says that a major part of treatment centers around how to cope when one does encounter a triggering noise. “Since the noise elicits a fight-or-flight response, it’s first important for someone to know how to calm their body down,” says Dr. Jaffe, adding that this can be done using diaphragmatic breathing (also known as belly breathing).

Cognitive behavioral therapy (CBT) is also a common treatment for misophonia, she adds. This may involve helping someone reshape negative thoughts connected to triggering sounds or teaching them how to shift their focus to something else. When CBT for misophonia is successful, an individual is able to build up their tolerance to the triggering noises and have an easier time ignoring them.

Audiologists can help someone with misophonia with treatment options like tinnitus retraining therapy. In this type of therapy, the goal is to change the nervous system’s reaction to triggering sounds to eventually be able to tolerate the sounds. This is a form of exposure therapy, where someone is exposed to the sound in increments.

Misophonia can impact one’s entire family, note both Dr. Fox-Thomas and Dr. Jaffe. For example, if someone is triggered by the sound of someone chewing, they may not be able to enjoy eating meals with their family.

Most people with misophonia tend to take their frustration out on their family members because it’s who they are emotionally closest to, explains Dr. Fox-Thomas. “They may have spent the day trying to hold it together when they encounter triggering noises and when they get home, they feel they can finally unleash the anger they’ve been hiding all day,” she says. For these reasons, both experts say that it can be beneficial for the entire family to attend therapy together.

In addition to impacting family dynamics, misophonia can impact the ability for someone to be with their family or friends or the ability for them to function at work, says Dr. Fox-Thomas. It isn’t uncommon for people with misophonia to self-isolate as a way to avoid triggering sounds, she adds.

When someone with misophonia receives treatment and learns how to calm their body down (along with other coping mechanisms) when they hear triggering noises living with misophonia can become much easier. For example, children with misophonia who are allowed to wear earplugs or headphones while taking tests (a simple coping mechanism) perform better than children with misophonia who are not given any accommodations, explains Dr. Jaffe.

If you think you have misophonia or if certain noises are so disruptive to you that you can’t function in your daily life, you should seek help, according to both experts. Audiologists and therapists who specialize in misophonia can be found through the Misophonia Association’s provider directory, which is organized by state.

If you can’t find a misophonia expert near you, consider seeing a cognitive behavioral therapist who is understanding of your condition and can teach you ways to calm your body when it’s in fight-or-flight and other coping mechanisms, suggests Dr. Jaffe. If having misophonia is impacting your relationship with your partner or family, she says that couples or family therapy can be beneficial.

“Misophonia is an invisible condition that is under-diagnosed and misunderstood,” says Dr. Fox-Thomas. “People with misophonia need support, guidance, tools and hope to better manage their condition. Establishing a multidisciplinary network of caring professionals who can each contribute to the management plan is essential for mitigating the impact of misophonia on individuals and their loved ones.”