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What is Misophonia?

Hate is a strong word, but some people respond so emotionally to certain sounds that the word “hate” is appropriate. These individuals may suffer from misophonia.

Misophonia is best defined as a neurophysiological and behavioral condition where an immediate physical and emotional response occurs to very specific sounds (i.e., triggers), regardless of the loudness level.

Examples of common trigger sounds for patients with misophonia are human-generated sounds like chewing, keyboard typing, and breathing. The reaction to the sound will be very fast and the patient will react without even thinking of the meaning of the sound.

One of the mysteries of misophonia is that patients are often more triggered by individuals they are close to, such as family members and close friends. For instance, the chewing sounds of a total stranger do not trigger the reflex response, but their spouse’s or sibling’s chewing does cause extreme distress. Below are some other common auditory triggers of misophonia.

Common Auditory (Sound) Triggers:

  • People eating (chewing, swallowing, talking with food in their mouth)
  • People drinking (sipping, swallowing, slurping, saying “ah” after a drink, breathing after a drink)
  • Other mouth sounds (Kissing, flossing, brushing teeth, lip popping)
  • At the dinner table (Fork on a plate, fork scraping teeth, the clinking of glasses and plates)
  • Vocal triggers (dry mouth, whispering, several people taking simultaneously, whistling, singing, humming)
  • Work/school (Typing, mouse clicks, pencil on paper, pen clicking or tapping, page flipping, tapping on a desk)
  • Breathing sounds (snoring, hiccups, sniffling, coughing, normal breathing, heaving breathing, nose whistle, hiccups, throat clearing)

Misophonia can create dysfunctional behaviors, such as anger, rage, and/or self-isolation, due to over-activation of the nervous system and the fight or flight response. When trigger sounds occur, a patient with misophonia is unable to consciously stop their response to the sound. This causes the response to intensify or become worse with time, and the vicious cycle can cause multiple psychosocial effects such as anxiety, depression, social isolation, and reduced quality of life overall.

Emotional responses can vary from mild to severe and include:

Mild

  • Anxiety
  • Disgust
  • Feeling uncomfortable
  • Having the urge to flee

Severe

  • Panic
  • Disgust or irritation turning to anger
  • Becoming verbally and/or physically aggressive with the person making the noise
  • Purposefully avoiding people or objects causing trigger sounds
  • Lashing out physically at people or objects making the noise
  • Emotional distress

Those with misophonia also can experience physical reactions, including:

  • Muscle tightness
  • Increased blood pressure and/or body temperature
  • Rapid heartbeat
  • Pressure throughout the body – particularly in the chest

When does misophonia occur?

Most commonly, the onset of misophonia occurs around age 12 years old, although cases have been reported as early as age 5 and into late adulthood. Misophonia prevalence is more common in females than males and may start around pre-puberty or puberty (8-12 years old).

What causes misophonia?

Misophonia has been described as an organic brain-based disorder (Kumar, 2017). It is often caused by over-activation of the nervous system, specifically the limbic and autonomic nervous systems in the brain. Misophonia can cause people to avoid many daily activities, such as going to school or work. In severe cases, a person will avoid offensive sounds to the extent that they cannot leave their home or be with their family.

The scientific understanding of misophonia is still in its early stages. Recent misophonia research has aimed at understanding the neural mechanisms behind the condition. Some studies have found that people with misophonia have different patterns of brain activity when exposed to their trigger sounds compared to those without the condition. There’s also growing interest in exploring the genetic basis of misophonia, its overlap with other neurological and psychiatric conditions, and the efficacy of various treatment approaches.

In some cases, misophonia may be a component of Generalized Anxiety Disorder, Autism Spectrum Disorder, Obsessive-Compulsive Disorder, Oppositional Defiant Disorder, Neurodevelopmental Disorders, Attention Deficit Hyperactivity Disorder, or Post Traumatic Stress Disorder.

Since there are many sensory processing disorders where symptoms of misophonia might overlap with other nervous system-related symptoms, it is imperative to have a team-based approach to the assessment and treatment of these patients. In other words, there may be multiple elements and aspects from more than one medical professional to find an optimally effective treatment plan for misophonia management.

How to treat misophonia?

For those looking to learn more about the various misophonia treatment options, they can learn more here.

Living with misophonia can be challenging, but individuals don’t have to face it alone. At Sound Relief Tinnitus and Hearing Center, we work with patients to find misophonia coping strategies through misophonia therapy.