If the sound of someone eating chips makes you want to run out of the room screaming, you could have misophonia. The disorder is characterized by extreme emotional reactions to everyday sounds, like that of other people chewing, talking or even breathing. While many of us get irritated when we hear someone slurping their soup or smacking their gum, people with misophonia experience much more intense emotions, such as panic or rage.
And while misophonia is relatively little known and little studied, it may in fact be quite common — and potentially disabling for the people who have it. A British study, published last month in the journal PLOS One, estimated that the disorder affects about 18% of the population. A 2022 study published in Frontiers in Neuroscience put the number at 20%. “Anecdotal reports from sufferers reveal serious daily impairments attributable to misophonia — job instability, deteriorating relationships, suicidal thoughts — yet the condition is severely understudied, with mechanisms vastly unknown,” the study’s authors wrote.
That may be changing, says Sharon Brown, PhD, a clinical neuropsychologist with Memorial Hermann Mischer Neurosciences. “The amount of research is increasing, and the disorder is gaining awareness and acceptance,” she says. “There are support groups online with thousands of people in them, and I think that’s helping it become more widely recognized.”
What Is Misophonia?
Controlled studies of misophonia have proliferated in the past few years, and some psychiatrists are advocating for its inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the authoritative handbook used by medical professionals in the United States and much of the world.
Research into the disorder is still in its infancy, however. The term ‘misophonia,’ which means ‘hatred of sound,’ didn’t even appear in medical literature until the early 2000s. “That doesn’t mean it didn’t exist before then, but it probably got lumped in with other disorders,” says Dr. Brown.
The latest research, however, demonstrates that misophonia is a distinct disorder and not a symptom of something else, such as obsessive-compulsive disorder or Tourette syndrome. “It’s clear that this is not just a symptom of an anxiety disorder, even though it can cause anxiety,” Dr. Brown says. “Misophonia may share some of the same components as sensory overload in autism, but with autism you’re typically more sensitive to loud sounds. With misophonia, the volume doesn’t matter. There may just be a percentage of people with autism or Tourette’s or OCD who have this disorder, and others who don’t, just like the general population.”
Origins in the Brain
Just because we find some sounds irritating or distracting doesn’t necessarily mean we have misophonia, she says. People with the disorder have such an extreme reaction to these sounds that they are often unable to control their response. Brain scans of people with misophonia show unusual levels of activity in the amygdala and the insula: regions of the brain associated with emotional reactions and our “fight or flight” response.
“The autonomic system — the nervous system — is also involved,” says Dr. Brown. “Our brains have what’s called a salience network, which attributes importance or priority to external stimuli. It helps us decide what warrants our attention, especially when it comes to evaluating threats. For people with misophonia, the salience network gets activated by these mundane, everyday sounds. There’s this irregular connection that triggers the emotional response and also a physiological response — their heart races, their breathing changes.”
Everyone responds differently to these emotional and physiological cues. “Some people will just do whatever they need to do to get away from the sound. In some people, especially in younger children, you’ll see angry outbursts,” she says.
Avoiding these everyday sounds — or becoming enraged when you hear them — can make it difficult to lead a normal life. “You don’t want to have to eat alone for the rest of your life because you can’t tolerate the sound of chewing. You can’t be a high school student with headphones on in class because you can’t stand the sound of people breathing,” Dr. Brown says. “These are sounds that, most likely, you’re not going to be able to avoid.”
It can also be tough for the families of people who develop misophonia, which tends to begin in adolescence. Sometimes, the trigger sound is specific to a single person. When a teenager suddenly starts becoming enraged by the sound of their mother’s voice, for example, it can be devastating for the mother.
That’s why it’s so important to increase awareness of this disorder, Dr. Brown says: to help people understand what’s happening — and that it’s not their fault.
“There’s more to it than just a quirk of your personality. It’s triggered by this hypersensitivity in the brain,” she says. “I think more people would seek help once they knew this was an abnormal physiological response. This is not just an overreaction that you can easily control.”
New Research Could Lead to Remedies
Because studies of the disorder are still so limited, however, there’s not a wealth of information about effective treatments. Since anxiety is often part of the response, anti-anxiety medications can help, but they’re not a cure. And earplugs aren’t always feasible. Cognitive-behavioral therapy, meanwhile, can help people change their responses to the sounds that trigger them.
“If your reaction is to throw something against the wall when you hear a certain sound, then you’ll work on desensitizing yourself to the sound so you don’t have such a strong reaction,” says Dr. Brown. “Pairing the negative sound with a pleasant sound can help. So can reframing your thoughts. Instead of thinking ‘This is intolerable! I can’t stand this sound!’ you can try to put it in perspective. It can take multiple kinds of therapy, and it needs to be tailored to the individual and the particular sound that’s a triggering event for them.”
More research may offer the best hope for people with misophonia, Dr. Brown says. “The more we study the brain, the more we learn about this phenomenal organ of the body that we kind of take for granted. There’s so much we still don’t know,” she says. “These are high-functioning people with a disorder that can have a devastating effect on their lives, and we need to be able to treat them.”
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