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Misophonia: When You Can’t Stand Certain Sounds

When you hear someone chewing or making eating sounds, does it provoke you or cause a strong reaction? Do you feel like your reaction is over the top, and yet it feels out of your control? You might have misophonia, a disorder where your body and emotions react to certain sounds. Some people have mild symptoms that they can manage on their own, while others might have intense reactions. With misophonia, you could experience psychological and physical symptoms such as:

  • Feelings of irritation, disgust, anger, distress or loss of self-control
  • Tightness or pain in your chest, arms, head or entire body
  • Stiff muscles
  • Sweating
  • Difficulty breathing
  • A rapid heartbeat (increased heart rate)
  • High blood pressure
  • A higher-than-normal body temperature

Srinivas Dannaram, MD, a psychiatrist with Banner Health, filled us in on what’s behind this condition and coping strategies if you think you have it or you notice signs in someone close to you.

What are some common signs of misophonia?

People with misophonia are sensitive to certain sounds, and most of the time, they have been bothered by them since childhood. “These sounds tend to be trivial noises produced by other people,” Dr. Dannaram said. They can include:

  • Gum popping
  • Food chewing or crunching
  • Nose sniffing
  • Breathing
  • Pen clicking
  • Whistling
  • Lip smacking
  • Finger or foot tapping

Other people aren’t always responsible for the sounds. Sometimes people react to:

  • Clock ticking
  • Train, airplane or engine sounds
  • Sounds made by animals

And sometimes, it’s movements like these that can trigger symptoms:

  • Fingers pointing
  • Legs swinging
  • Hair twirling

What causes misophonia?

It’s not exactly clear. “Research is still in its infancy,” Dr. Dannaram said. “It’s a complex disorder that’s influenced by biological, psychological and social aspects of a person’s life.”

Misophonia varies in severity. A person’s own neurobiology, factors like how a family accommodates a person with it, and whether sounds and sights appear together, like when you see somebody eating, can make a difference in symptoms. There could also be a genetic component since the condition can show up in multiple family members. 

Is it related to other mental health conditions?

It’s hard to say, but people with misophonia are more likely than others to also have:

  • Mood disorders
  • Tourette syndrome
  • Attention-deficit hyperactivity disorder (ADD/ADHD)Hair pulling (trichotillomania)
  • Skin picking
  • Panic disorder
  • Hypochondria
  • Obsessive-compulsive disorder (OCD)

Misophonia can also be misdiagnosed, since it shares traits with other disorders, so it can be hard to come up with the correct diagnosis. These conditions have symptoms that overlap with them:

  • Specific phobia, where a trigger may cause a negative response and efforts to avoid it
  • Phonophobia, or fear of a specific sound
  • Social phobia when you avoid social situations because they lead to anxiety and stress
  • Post-traumatic stress disorder (PTSD), where you experienced a traumatic event and react to triggers afterward
  • Obsessive-compulsive disorder (OCD), where you are preoccupied with a certain stimulus and feel anxious
  • Intermittent explosive disorder, where you have episodes of violent, angry behavior or outbursts
  • Autism spectrum disorders, since people with these disorders, can be intolerant of unexpected and loud noises
  • Sensory processing disorder, where you react strongly to loud sounds and other stimuli
  • Personality disorders with impulsive aggression, where you are impulsive and have difficulty controlling anger, though these reactions aren’t necessarily related to a specific sound

How is misophonia diagnosed?

People who have misophonia symptoms, especially children, don’t always recognize what’s causing the problem. Family members and doctors will see the related behaviors but not always understand they are reactions to triggers, so misophonia can be misdiagnosed. 

“Thorough evaluation and education can help catch the condition early and prevent personal, social, and work-related problems,” Dr. Dannaram said. 

To diagnose misophonia properly, a psychiatrist or psychologist will want to know when symptoms started, how they have changed over time, what triggers reactions, and how you respond to them. They will evaluate you for other psychological conditions and find out whether you use drugs or other psychoactive substances. 

They will want to learn about your emotional state and understand how much misophonia is causing psychological distress, impaired quality of life, and symptoms of anxiety and depression.

In addition, an audiologist may test your hearing to rule out other conditions. And you might need measurements of your nervous system activity to see how your body responds to triggers.

How is misophonia treated?

You might be able to manage symptoms on your own for mild cases. It can be helpful to identify trigger sounds and find ways to minimize your exposure to them. If misophonia is disrupting your life, some treatment options and interventions can help:

  • Tinnitus retraining therapy (TRT) can help you get used to the sounds that bother you.
  • Earplugs, white-noise generators, or sound devices the size of a hearing aid can help mask bothersome sounds.
  • Antidepressants and antianxiety medications, and other drugs such as methylphenidate and propranolol, might help.
  • Cognitive-behavioral therapies (CBT) can decrease symptoms and improve quality of life by helping you develop coping skills. 

The bottom line

If you react strongly and negatively to certain sounds, you may have a condition called misophonia. If sound sensitivity is affecting your quality of life, there are strategies you can try to make it less bothersome.

Need help diagnosing or treating misophonia?

Call the Banner Behavioral Health Appointment Line at (800) 254-4357.

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