Quiet! Misophonia or Hypersensitivity to Sounds

What is Misophonia?

Misophonia is a disorder characterized by extreme sensitivity to specific sounds. Although they have not included misophonia in the DSM (the Diagnostic and Statistical Manual of Mental Disorders), professionals associate it with obsessive-compulsive disorder. In misophonia, the central nervous system misinterprets auditory and sometimes visual stimuli. Currently, professional knowledge suggests that the cause of misophonia does not occur in the ears but is a dysfunction of the central auditory system in the brain. They usually consider misophonia a neurological disorder related to the connection between sensory perception and the sensations they generate. However, the specifics of misophonia and its causes remain a mystery, highlighting the urgent need for further research in this area.

Pawel Jastreboff has developed the most successful treatments for tinnitus and has authored scientific papers on hyperacusis. Together with Margaret M. Jastreboff (2002), they define Decreased Sound Tolerance (DST) as adverse reactions to sound exposure «that would not evoke the same response in an average listener.» Reduced sound tolerance (DST) and its classification into hyperacusis and misophonia is a little-recognized condition that affects the lives of a sizable portion of the general population. It is complex because there is no consensus on the definitions, characteristics, prevalence, evaluation, and treatment methods.

Misophonia, which translates to ‘hatred of sound,’ is a condition characterized by selective sensitivity to certain sounds. This unique aspect of the disorder can lead to irritable attitudes in those who suffer from it, presenting them with unique challenges.

How do you know if you suffer from this disorder?

There is no specific instrument to evaluate misophonia. The most practical way to identify it is to expose the person to certain sounds and observe their reaction. If the person’s response is disproportionate, it could be misophonia. However, it is important to remember that almost everyone finds some sounds unpleasant or annoying, but that does not mean they suffer from the disorder. In cases where the reaction is explosive or aggressive, consulting a professional may be an excellent option to obtain an appropriate diagnosis.

Differentiating Misophonia

The causes that produce misophonia remain a significant mystery. Research associates it with psychological behaviors related to obsessions or phobias. Misophonia should not be confused with hyperacusis, characterized by general sensitivity to noise, even when the sound is not particularly loud. It is not an excessive sensitivity to certain noises but rather the noise level, as hyperacusis patients exhibit significant sensitivity to regular volume levels. If noises become so disturbing that they interfere with daily life, it is essential to consult a medical specialist in otorhinolaryngology.

It isn’t easy to understand people who suffer from misophonia. Like those who suffer from panic or phobia, the environment cannot understand the limitation of entering an elevator or the need to cross the street if there is a pigeon. Any person suffering from misophonia needs to explain to others that certain everyday noises are intolerable, causing them anxiety, tension, or aggression. Both hyperacusis and misophonia are disorders related to decreased tolerance for sound. However, while hyperacusis is a condition in which auditory information is perceived as excessively amplified and unbearable, in misophonia, specific, repetitive sounds or noises become intolerable. It should not be confused with phonophobia, in which an aversion to certain sounds develops, causing rejection or even a flight response.

Faced with discomfort, affected individuals become irritated, give dismissive responses, and demand that the noise stop. People around them are confused and unsure how to act. Misophonia leads to avoiding certain sounds, like someone with a phobia avoids taking the subway or encountering spiders, rats, or snakes. Likewise, people with social phobia avoid gatherings or public speaking, and in the case of agoraphobia, fear arises from places where the exit is not visible. Misophonia also differs from tinnitus, where people constantly perceive a background sound in all their activities.

What is Annoying?

Others misunderstand misophonia and label those who suffer from it as neurotic, hysterical, obsessive, or crazy, creating a hostile atmosphere around them. When misophonia reaches a psychopathological category, its effects become knowledgeable. That understanding provides the person affected and their environment a more emotionally tolerant and less conflictive climate.

There is an extensive list of sounds affecting people with misophonia. The type of sound that triggers a reaction is specific to each individual and leads to various behaviors, even aggressive ones. Examples include oral, nasal, or animal sounds, sounds produced by body movements (like joint cracking), or environmental sounds.

Beyond these categories, hypersensitivity to certain specific sounds includes coughing, chewing, breathing, laughing, slurping, eating chips, swallowing, eating popcorn, tapping a pencil on a table, sneezing, rain sounds, children’s voices, yawning, heels clicking, sighing, stirring a cup, the clinking of silverware, footsteps, turning a light on or off, a dripping faucet, the ticking of a clock, clicking a pen or a computer mouse, crumpling paper, brushing teeth, throat clearing, phone notifications, jingling keys, cracking knuckles, clinking glasses, among others.

Faced with these annoyances, affected individuals become irritable, dismissive, give rude responses, and demand that the noise stop, leaving those around them confused and unsure how to act. For example, people may chew half-heartedly and softly, try to walk as if floating, suppress yawns and sneezes, brush their teeth in the most distant bathroom, and stir a cup without making noise to avoid irritating the person with misophonia.

A conflictual atmosphere gradually develops. Everything may be going well in an affectionate and functional environment in a relationship or family. Still, out of nowhere, something as simple as chewing or coughing can lead to a rude remark, reprimand, or aggression. Suddenly, the mood experiences a significant shift.

The symptoms of misophonia typically appear in late childhood, though they can begin at any age. A specific sound usually triggers the first reaction, and the list of trigger sounds will increase over time. As the individual becomes more hypersensitive, they incorporate more sounds. The person becomes irritable, experiencing anger, discomfort, frustration, and annoyance. At this point, it is necessary to remember that when a person focuses on something, whether a sound, an image, or even pain, the extreme concentration amplifies the symptomatology’s intensity.

Clinical categorization of misophonia brings knowledge that reassures a better tolerance and reduces exposure to certain sounds for the person experiencing the disorder. At the same time, people around them may better understand the situation that misophonia creates, which improves coexistence.

Is there a Solution?

The specific sound pattern that triggers misophonia can evoke not only irritable reactions but also distress, fear, sadness, or anxiety. Currently, there is no treatment or cure for misophonia. However, medical professionals may recommend different therapies to help individuals cope. While these therapies are not 100 percent effective in curing misophonia, they are beneficial for managing daily life and fostering a more comprehensive understanding of the condition.

Some people try to mask the trigger sounds with music, using headphones when they anticipate the sounds will occur. However, this strategy is useless if there are too many bothersome sounds, forcing them to live with headphones on. Another portion of individuals with misophonia report a different approach: “I play music… I can’t tolerate hearing people chewing around me.”

People who suffer from misophonia are constantly aware of the sounds they might hear in any given location. A selective perception develops, anticipating and focusing on disturbing sounds. If they go to a restaurant, they notice the sound of silverware, the clinking of coffee cups, or the sound of people eating popcorn if they go to the movies.

Misophonia is a physio-pathological condition that can develop in a person and become systematized in perceiving certain sounds. It is idiopathic, meaning its origin is unknown, and it may be associated with psychiatric disorders. Addressing this disorder often involves auditory retraining and disrupting the systematization or naturalization of the perception of disturbing sounds. As mentioned earlier, music can help diminish the impact of intolerable sounds. Cognitive or cognitive-behavioral therapies are also recommended, using exercises and interventions to change habits and reflect on the condition.

Given the significant impact this disorder has on the social relationships of those who suffer from it, creating tense, uncomfortable atmospheres that quickly escalate into aggression, it is crucial to include the individual’s close social circle to review factors of tolerance and understanding. Psychotherapeutic hypnosis, relaxation therapies, mindfulness, breathing exercises, and yoga can also help calm the fury and anxiety triggered by specific sounds.