What Is Misophonia?

Being extremely sensitive to sound

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For many people, the sound of someone eating or clicking a pen can be annoying, but sufferers of misophonia feel disgust and even rage when exposed to certain noises.

Also known as selective sound sensitivity syndrome, misophonia, literally the Greek for “hatred of sound,” is a chronic condition in which specific sounds provoke an extreme and often emotional reaction.

Trigger sounds include ones typically produced by another person, such as chewing, breathing, pen clicking, tapping, and lip-smacking.

Misophonia is poorly understood, under-researched, and not yet officially recognized as a distinct psychiatric disorder. Still, it can cause great distress in those who deal with it. Read on to learn more.

Woman with fingers in ears


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Symptoms

The primary symptom of misophonia is an extreme reaction, such as anger or aggression, in response to other people making certain sounds.

Common misophonia triggers include:

  • Chewing (gum, chips, popcorn)
  • Pen tapping
  • Chomping
  • Slurping
  • Swallowing
  • Throat clearing
  • Lip smacking
  • Sniffling
  • Breathing
  • Nose whistling
  • Snoring

The strength of the reaction, and how an individual responds to it, will vary greatly. Some people may experience mild annoyance and irritation, while others can quickly experience full-blown rage.

Sometimes even the anticipation of a specific noise is enough to trigger someone with misophonia.

People with misophonia realize their reactions to sounds are excessive, and the intensity of their responses can make them feel like they are losing control. It can also affect their ability to complete everyday tasks and engage in social interactions.

Reactions to trigger sounds may include:

  • Anxiety
  • Disgust
  • Anger
  • Panic
  • Fear
  • Emotional distress
  • Verbal or physical outbursts

The response a person with misophonia has to triggers is involuntary and sometimes compared to the body's fight-or-flight response.

The fight-or-flight response is also called the acute stress response. It is the body's natural way of responding to a situation it deems threatening. It is unclear why a person with misophonia might respond to a triggering sound like it's a threatening event.

Diagnosis

There are currently no established diagnostic criteria for misophonia, and the main resource for diagnosing mental health disorders in the United States, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), does not list misophonia.

Proposed diagnostic criteria were published in 2013, and researchers suggested that the disorder be classified as a separate and discrete psychiatric disorder. The researchers note that while misophonia resembles some other conditions, such as specific phobias and obsessive-compulsive disorder (OCD), none of these conditions fully fit the symptoms patterns that are characteristics of misophonia.

The proposed criteria suggest that misophonia is characterized by:

  • Anticipating that a certain sound will result in irritation, anger, or disgust
  • Feelings of anger initiating a loss of control
  • Avoidance of known triggering sounds or tolerating these sounds with extreme anger, discomfort, or disgust
  • Significant distress that interferes with normal daily activities
  • These feelings are not better explained by another mental disorder or medical condition

One of the key aspects of establishing the diagnosis of misophonia includes ruling out other hearing disorders, such as:

  • Age-related hearing loss
  • Tinnitus
  • Hyperacusis (a type of reduced tolerance to sound)
  • Auditory hallucinations (hearing things, often voices, that have no basis for perception)

Diagnosis

While there is no official diagnosis, your doctor may be able to recommend treatment options that can help you manage the symptoms of the condition.

Causes

Researchers don’t know yet what causes misophonia, but there are a number of factors that may play a role.

  • Brain chemistry: In one study, researchers found misophonia to be a brain-based disorder. They point to a disruption in the connectivity in parts of the brain that process both sound stimulation and the fight-or-flight response.
  • Mental conditions: Research suggests that those who have obsessive-compulsive disorder (OCD), Tourette's syndrome, or anxiety disorders are more likely to also have misophonia.
  • Tinnitus: It is estimated that 4% to 5% of people with tinnitus, a condition in which people hear noises, often a ringing sound, that no one else can hear, experience some form of misophonia.

Despite increased awareness of the disorder, research on misophonia is very limited, with most information coming from extremely small studies and case reports. More research is needed in this area.

Treatment

There are currently no established treatments for misophonia. However, some treatment options that may be beneficial include:

  • Cognitive behavioral therapy (CBT): Through CBT, individuals can learn to better understand their reactions to triggering sounds as well as develop coping strategies to manage these negative reactions. One study published in the Journal of Affective Disorders found that almost 50% of people with misophonia who were treated with CBT experienced a significant reduction in symptoms.
  • Medications: While there is no medication approved to treat misophonia, medications may be prescribed to treat co-occurring conditions such as anxiety or depression.
  • Tinnitus retraining therapy (TRT): This involves learning to tolerate noise so that it no longer causes the person as much discomfort. While traditionally used in the treatment of tinnitus, TRT may help people with misophonia learn to better tolerate certain triggering noises.

Coping

There are also lifestyle changes, coping strategies, and relaxation techniques that can help you manage the symptoms of misophonia:

  • Carrying earplugs in case you are exposed to a trigger
  • Wearing earphones if you start to feel overwhelmed
  • Investing in a white noise machine or app to drown out specific sounds
  • Having a plan in place for when you feel an outburst is imminent, such as practicing a relaxation technique like deep breathing or visualization
  • Joining an online support group or forum for those with misophonia

You may also find it helpful to talk to loved ones about the condition. People will be better able to avoid making certain noises around you if they know it might trigger a negative reaction.

Frequently Asked Questions 

What are common misophonia triggers?

Some sounds are more likely than others to trigger a misophonic response. Researchers identified the following common triggers for misophonia:

  • Eating sounds, like lip-smacking, affected 81% of those studied.
  • Loud breathing or nose sounds affected 64.3%.
  • Finger or hand sounds, like typing or clicking a pen, affected 59.5%.

Is misophonia diagnosable? 

There are currently no established diagnostic criteria for misophonia. The main resource for diagnosing mental health disorders in the United States, the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), does not list misophonia. Therefore, it is not a diagnosable mental disorder.

Can anxiety cause misophonia?

Preliminary research demonstrates that misophonia and anxiety are two separate disorders. However, the two conditions can interact. When you feel anxious, the part of the brain that readies a person for fight-or-flight is activated. That is also the same response in people with misophonia.

People with misophonia often experience anxiety either when they are triggered or when they are anticipating a trigger.

What is the link between misophonia and autism? 

In general, people with autism have unusually delicate sensory systems, meaning that their senses, like hearing, can all be easily overloaded.

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.

How do I manage misophonia?

To manage misophonia, you could try a white noise device, noise-canceling headphones, therapy, or other treatments directed at reducing your discomfort. Know your triggers, and come up with a plan to remove yourself from a triggering situation if you become overwhelmed.

A Word From Verywell

If you're experiencing symptoms of misophonia, know that you are not alone. Research is being carried out all the time to learn more about the condition and how to treat it. It's important to reach out to your physician, mental health professional, or audiologist to learn about options that could help you.

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6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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