Misophonia: When everyday sounds become emotionally distressing

Imagine the clinking of silverware, the sound of someone breathing, or chewing food sending shivers down your spine. That’s what it means to live with misophonia. Sounds which aren’t even a cause of mild irritation for most of us, are vividly uncomfortable for people living with misophonia. This condition is characterised by an extreme and often irrational reaction to everyday sounds. Seemingly harmless noises can trigger intense emotions like anger, anxiety, and even panic attacks. Read on to understand the symptoms of this sensory condition, why this happens, and how to manage misophonia.

What is misophonia?

Misophonia is a condition that can cause an extreme and exaggerated reaction to certain sound stimuli such as eating sounds, nose sounds, loud breathing, throat-clearing, finger or hand sounds and others. “This condition involves extreme sensitivity to certain sounds, invoking strong emotional reactions towards the stimuli. In some cases, there can also be a physical response to the triggering sounds,” explains ENT specialist Dr Amit Kumar Sharma.

A study published in Frontiers in Neuroscience, defines misophonia as a neurobehavioral syndrome where one experiences a decreased tolerance for specific sounds. This can cause irritation, anger, and anxiety.

What causes misophonia?

While the exact cause of misophonia is not known, it is believed that it can be caused by a combination of factors including neurological changes, genetic and psychological. “It has been suggested that hyperconnectivity between the brain areas that process sounds, memories and emotions could be the precursor to the condition,” explains Dr Sharma.

According to a study published in Scientific Reports, there is a hypersensitive connection between the auditory cortex, the part of the brain that processes sounds, and the salience network, that helps you understand what the sound indicates. Besides this, over-myelination of neurons in these specific areas of the brain can increase the sensitivity. However, the condition is still being understood.

Symptoms of misophonia

The key characteristic of misophonia is an extreme and exaggerated reaction to certain sound stimuli such as eating sounds, nose sounds, loud breathing, throat-clearing, finger or hand sounds and others. This reaction could be physical, behavioural or emotional. You might experience the following symptoms:

• Irritation and disgust towards certain sounds
• Extreme anger
• Sweating, nervousness, panic or anticipation in an atmosphere where the sound can be heard
• Anxiety and panic
• The person might also experience physical symptoms including chest pressure, muscle tightness, increased heart rate, increased blood pressure and changes in body temperature.

The perceiver’s body experiences these sounds as a “threat” and initiates the fight-flight response. While the sounds are difficult for a misophonia patient to hear, their extreme reaction is one of the biggest symptoms. The reactions are so severe that it might even disrupt your everyday life. The symptoms of misophonia might start as an extreme negative reaction to one specific sound but additional sounds can bring upon the response over time.

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Symptoms usually appear after the age of nine years and before 12 years. More triggers keep getting added as you grow older.

Sounds that act as triggers

Everyday sounds can often make patients of misophonia very uncomfortable. Sounds made by other people while eating, breathing, and smacking of lips can be very distressing. Other small sounds such as the clicking of a pen, writing, ticking of a clock, clipping of nails humming of birds can also cause an extreme reaction.

Life with misophonia

Living with misophonia is not easy as patients experience adverse reactions to everyday sounds. These trigger sounds can cause significant discomfort in the lives of the perceiver. It can interfere with their day-to-day life. “This can also cause them to socially withdraw in fear or anticipation of the triggering sounds. Even the thought of accidentally encountering the sound can make them uncomfortable,” says Dr Sharma.

Some of these harmless sounds could be somehow associated with a physical or emotional traumatic event in the life of the perceiver. The response to these sounds is mostly instinctive and unconscious.

A study published in the Journal of Psychopathology and Behavioral Assessment, states that people may even react to trigger sounds with verbal and physical aggression, urging them to stop making the noise. They might cover their eyes and ears, cry, or actively avoid hearing triggers. People with misophonia might develop coping mechanisms to deal with the physiological and psychological discomfort caused by specific sounds. Unconsciously mimicking the triggering sound is often a mechanism adopted by some patients.

Risk factors of misophonia

While misophonia can happen to anyone, a few factors can increase the risk for the person. These include people having a history of tinnitus or hearing ringing sounds, obsessive-compulsive disorder (OCD), anxiety disorders, migraines with aura and Tourette syndrome, wherein patients make uncontrollable movements or sounds called tics.

Treatment of misophonia

Currently, there is no cure for misophonia. However, a combination of behavioural therapies, relaxation techniques and anxiety-reducing medications can make the condition manageable. Tinnitus retraining therapy that has been designed to help patients with tinnitus can also help manage misophonia and help them cope with their triggers. A study published in Sage Journals also suggests  counterconditioning treatments. Here, a positive stimulus was paired with a trigger sound. This helped a woman cope with misophonia.

People having misophonia could also engage in meditation and breathing exercises to calm down the hypersensitivity. They could also use aiding tools such as headphones or earplugs to cut down the unpleasant sounds.

Patients manage misophonia by avoiding situations such as social gatherings where there are increased chances of them being triggered. Headphones or other noise-cancelling equipment can also help them manage their symptoms.

Summary

Living with misophonia is not easy as patients experience an uncontrollable reaction to certain everyday sounds. Some of the sounds that can act as major triggers include the smacking of lips, the sound of chewing, the ticking of a clock etc. When the patients make these sounds themselves, they are not triggered, but hearing it in their background can cause an extreme reaction such as irritation, crying, racing heart, panic and anticipation. While there is no cure for the condition, many behavioural therapies, counselling as well as using devices such as noise-cancelling headphones can help patients manage life with misophonia.

FAQs

Is misophonia genetic?

Yes, scientific evidence strongly suggests that this condition can be passed on in a family.

How do you detect misophonia?

While there is no medical test to determine this condition, an evaluation of your triggers as well as the extreme reaction, and other physical conditions such as a racing of heart, and panic can help doctors determine this condition.

Can misophonia go away?

Unfortunately, there is no cure for misophonia and it cannot go away on its own. However, there are many therapies to help patients deal with their triggers.