What To Know About Misophonia (2024)

Misophonia is a sensory condition that causes extreme sensitivity to specific sounds or stimuli—otherwise known as triggers. When hearing triggering sounds, a person with this condition may experience intense emotional, physiological, and behavioral responses. These feelings can range from person to person but may include anger, irritation, disgust, or anxiety. While triggers can vary, common triggering sounds are chewing food, breathing, swallowing, or tapping.

The exact cause of misophonia is unknown, but a combination of neurological (brain-related), genetic, and psychological factors likely play a role. Misophonia often develops in childhood or adolescence and tends to persist throughout the lifespan. Researchers have only recently begun to explore misophonia, so it's hard to exactly know how common the condition is. However, early research suggests that as many as 20% of adults may live with the condition, which can range from mild to severe.

There is no cure for misophonia at this time. However, certain therapies and coping strategies may help you or a loved one better manage symptoms and reduce the effect of triggers.

Misophonia symptoms involve an intense emotional and physiological response to specific triggers. These triggering sounds can vary from person to person but commonly include chewing, breathing, sniffing, swallowing, tapping, and slurping.

Symptoms can also range from mild (e.g., low tolerance for certain sounds) to severe (e.g., wanting to lash out at the person or item making the sound). For some people with misophonia, triggers can be associated with one particular person (e.g., mom's chewing or brother’s breathing).

When exposed to triggering sounds, people with misophonia may experience:

• Strong emotional reactions: Anger, irritability, rage, disgust, or anxiety. These emotional responses can be intense and may lead to a desire to escape or avoid the triggering situation or sound.
• Physiological changes: Triggering sounds can activate the body's “fight or flight” response to stress, which can cause an increased heart rate, sweating, muscle tension, or heightened alertness.
• Negative impact on daily life:Misophonia can significantly impact a person’s daily functioning and quality of life. It may lead to social withdrawal, difficulties in relationships, or avoidance of certain situations, people, or environments where triggers might be present.

Causes

The exact causes of misophonia are not fully understood, and research in this area remains ongoing. That said, some researchers have developed a couple of theories about why misophonia occurs, including:

Brain Chemistry

Research suggests that the anterior insular cortex (AIC) may play a role in misophonia. The AIC is the part of the brain that is responsible for emotional processing and interoception—a process that involves perceiving and interpreting sensations in your body. Studies using neuroimaging scans have found abnormal activity in the AIC of people with misophonia when exposed to trigger sounds. This suggests that the AIC may be involved in the intense emotional and physiological reactions experienced by people with the condition.

Genetics

Misophonia often runs in families, suggesting that the condition may be passed down genetically. Early research shows that a genetic marker near the TENM2gene, which is involved in brain development, is linked with feeling rage when hearing triggering sounds.

Risk Factors

The risk factors for developing misophonia are not well-defined. However, certain conditions are linked to an increased risk of having misophonia. These conditions include:

• Tinnitus
• Obsessive-compulsive disorder (OCD)
• Anxiety disorders
• Tourette syndrome

If you suspect that you or a loved one may have misophonia, it's best to see your healthcare provider or mental health professional for a proper diagnosis. In order to receive a diagnosis for the condition, you will likely undergo a thorough evaluation of your symptoms and medical history.

For psychological conditions, healthcare providers turn to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to understand what criteria make you eligible to receive a proper diagnosis. But for misophonia, there are no established diagnostic criteria, which can make getting a diagnosis difficult.

Some researchers propose that misophonia is a mental health condition that falls within the spectrum of obsessive-compulsive disorders. These researchers suggest using the following diagnostic criteria to reach a diagnosis for misophonia:

• Experiencing strong emotional reactions such as anger, irritation, disgust, or anxiety when hearing triggering noises
• Feeling that a physical outburst may occur as a result of the emotional reactions
• Avoiding certain environments, situations, or people that may be associated with triggering sounds
• Having significant distress when hearing triggers that can interfere with daily life and relationships

Keep in mind: researchers also suggest that in order to receive an accurate diagnosis for misophonia, your symptoms should not be due to another medical or mental health condition. This means that your provider will likely examine you for other underlying conditions that may be causing similar symptoms.

Though there is no official way to diagnose misophonia, healthcare providers can conduct in-depth interviews to understand your symptoms, triggers, and the effect that your symptoms have on your daily life. Mental health professionals may use standardized questionnaires to assess your emotional and psychological responses to trigger sounds to evaluate the intensity and nature of misophonia symptoms.

In other cases, your provider will use certain tests to rule out other related conditions. For example, an audiological (hearing) examination can assess your hearing abilities to rule out any hearing-related issues, such as tinnitus, that may be contributing to misophonia symptoms.

Treatment

There are currently no treatments explicitly designed to cure misophonia. That said, the goal of treatment is to help people with the condition cope with triggers, reduce stress, and manage the effects of living with heightened sound sensitivity. Your individual treatment plan will be catered to your symptoms and the severity of your condition but may include:

Cognitive Behavioral Therapy (CBT)

CBT is a form of talk therapy that can help people reframe their thoughts and emotions related to triggering sounds. During sessions, therapists can also help you develop coping strategies and change the way your respond to triggers. CBT is used for a variety of mental health conditions, and one study found that nearly 50% of people with misophonia experienced fewer symptoms when using CBT as a form of treatment.

Tinnitus Retraining Therapy (TRT)

TRT aims to retrain the brain’s response to triggering sounds by combining sound therapy and counseling techniques. For misophonia, sound therapy involves using low-level background sounds or neutral sounds (e.g., white noise, gentle music) that can help reduce the prominence of triggering sounds. Counseling helps people learn to use relaxation techniques to minimize intense reactions when exposed to triggers.

Medications

Some healthcare providers may suggest psychiatrist drugs that treat common co-occurring conditions (like anxiety and depression) to reduce misophonia symptoms and emotional responses.

Because the exact causes of misophonia are not fully understood, there is no guaranteed way to prevent it. However, relaxation techniques and coping strategies may help prevent or minimize the effect triggers have on your life. These may include:

• Creating a quiet and calm living or working environment by reducing unnecessary background noise
• Using noise-canceling headphones or earplugs when exposed to triggering sounds
• Practicing stress-reduction techniques like mindfulness, deep breathing exercises, or engaging in regular physical exercise to help manage emotional responses
• Prioritizing self-care activities, such as getting adequate sleep, maintaining a healthy diet, and engaging in activities that promote relaxation
• Identifying your specific triggers and trying to minimize exposure to the sounds whenever possible
• Planning ahead to avoid or reduce exposure to triggers in social situations or public settings

Related Conditions

Misophonia often co-occurs with other mental health and medical conditions, including:

• Anxiety disorders: Misophonia is often associated with anxiety disorders, such as generalized anxiety disorder, social anxiety disorder, or panic disorder. The experience of intense emotional distress and the anticipation of encountering trigger sounds can contribute to an increase in anxiety levels.
• Obsessive-compulsive disorder (OCD):Misophonia is common in people with OCD, which is a condition that causes intrusive thoughts and repetitive behaviors. The obsessive nature of misophonic symptoms, where individuals may obsessively avoid or fixate on trigger sounds, may overlap with some OCD symptoms.
• Sensory processing disorders:People with misophonia may have heightened sensitivity to sensory stimuli (or, things that activate the five senses) beyond trigger sounds. Sensory processing disorders like hypersensitivity to light, touch, or textures may coexist with misophonia and contribute to overall sensory challenges.
• Tinnitus:Tinnitus is a condition that causes a perception of ringing or buzzing sounds in your without hearing these sounds externally. Evidence suggests that people with misophonia have higher rates of tinnitus than those without misophonia.
  

Misophonia can affect every aspect of life, including relationships, school, and work. When you’re living with misophonia, even simple tasks like grocery shopping or sharing a meal with friends can quickly become painful if you’re exposed to a triggering sound.

While misophonia is currently poorly understood, more people are learning about the condition as more research is being studied. If you have misophonia or think you may do, it may help to openly communicate your condition and triggers to your loved ones. This can help them learn to be mindful about not making certain noises around you and support you as you learn to manage triggers.

Additioanlly, finding effective coping strategies may require some trial and error. Be patient with yourself or your loved one as you or they navigate living with misophonia. It can also help to seek professional help from therapists or counselors specializing in misophonia or sensory-related conditions. With the proper support and strategies, managing misophonia challenges and living a fulfilling and productive life is possible.