Misophonia (A 5 point guide)

In this guide, we are going to comprehensively overview the potential contributing factors of misophonia and its symptoms, treatment options and self-help techniques.

Misophonia is a disorder in which certain sounds or visuals trigger an emotional and physical response of a person.

Its literal meaning is “hatred of sound.” That doesn’t mean they hate all sounds; they are just sensitive to a certain type of sounds. 

People suffering from misophonia get triggered by everyday sounds or background sounds most people don’t pay attention to.

It can be the sound of someone chewing, breathing, baby crying, or a dog barking.

For a misophonic person, these sounds can be distracting, and they can respond in extreme ways.  

Types of Misophonia

  1. Selective Sound Sensitivity Syndrome: 

Each person has a set of trigger sounds. Over time, other sounds may get included in this set.

These people describe misophonia as sounds that drive them crazy as they are sensitive to certain sounds or visuals that trigger negative thoughts and emotions in them.

That’s why Misophonia is also known as selective sound sensitivity syndrome. 

Several studies have established that misophonic people are usually triggered by oral sounds or sounds made by the mouth.

It includes snoring, chewing, breathing, and eating.

Another study shows that these triggers can also be caused by repetitive motions or actions like someone fidgeting or wiggling their feet. 

  1. Misokinesia

People with misophonia sometimes even react to small visual stimuli accompanied by sound.

This type of misophonia is referred to as misokinesia

Prevalence of Misophonia

Misophonia is more common in girls than in boys. Its first signs are usually seen in younger people between the ages of 9 to 15.

However, it is not well-studied, and people are still unaware of this disorder. 

Many people suffering from misophonia feel ashamed and don’t get the help they need. It is one of the serious disorders that have affected more people than we realize.

Their social and personal lives are disturbed badly, and they are unable to perform their daily functions. 

Sounds That Trigger Misophonia

Every person reacts to trigger sounds differently. These sounds can develop a fight or flight response in a person.

They can either behave aggressively or try to distance themselves from the trigger. 

Misophonia can disturb a person’s daily life and can limit their social activities as they can’t participate in every event.

They try to isolate themselves and avoid going to public places that can have multiple sound triggers to reduce the stress and embarrassment.

Most people hide their disorder and don’t share their symptoms with friends and family.

This is because people are still unaware of misophonia. 

Several people often take it lightly, while others even turn it into a joke and tease the person with misophonia by making certain sound triggers.

There are only a few people who take it seriously and try to help the sufferer. 

The sound triggers can be categorized into two types. Learning or reading about these triggers can cause a person with misophonia to develop them. 

WARNING: If you have misophonia or are at risk then you should stop reading this right now. 

Following are some of the trigger sounds and visuals that can cause a person to react in different ways. 

Individuals’ Sounds:

  • Mouth sounds: These sounds include chewing and crunching food, slurping, sipping, and burping after drinking, chewing or popping gum, nail-biting, kissing, spitting, or licking. It also includes eating with open mouth, flossing, swallowing, brushing, grinding your teeth, and clearing your throat, or clicking your jaw.
  • Breathing or nasal sounds: These sounds consist of breathing loudly, grunting or groaning, snorting, sneezing, snoring, or sniffling. It also contains nose wheezing and whistling, yawning, hiccups, and in some cases, soft or loud talking. 
  • Vocal sounds: These sounds usually comprise of humming, whispering, or muffled talking. It also includes overused words like ‘umm’ or ‘ah’ and bad singing. 
  • Other sounds: This may include sounds of a baby crying or kids yelling. 

Environmental Sounds:

  • Sounds in Office or workplace: These sounds usually include clicking of pen, mouse or keyboard, the noise of printer printing, paper rustling, texting on a mobile, writing on a paper, or ringing of a phone. 
  • Glass or metalware: These are the sounds of utensils such as clattering of plates, spoons, forks, and other silverware, the rattling of coins, and scraping of the fork with teeth. 
  • Plastic and wrappers: The sounds made from bouncing of balls, squeezing and rustling of plastic bottles and bags, breaking of hard plastic, and opening of plastic wrappers can trigger a person with misophonia.
  • Animal noises: The sound of a dog barking, birds and crickets chirping, frogs croaking. It also includes sounds of any animal eating, drinking, slurping, licking, and scratching themselves.

Visual Actions: 

These triggers include repetitive motions such as hand movement, leg swinging, or someone fidgeting.

These visuals can also generate a fight or flight response in a person. 

Signs Of Misophonia & How People React To It:

When people suffering from misophonia come in contact with their sound triggers, their body releases physiological and neurological stimuli.

This is the body’s way of protecting the individual from danger and stress.

During these triggering events, the body usually initiates a fight or flight response. This response is also known as an acute stress response. 

The body releases adrenaline or norepinephrine, which increases the heart and breathing rate and blood circulation.

The body becomes more aware of its surroundings and considers the situation as threatening.

This is an automatic response of the body which a person has no control over. 

Most people, when exposed to certain sounds, create negative emotions or thoughts as a response.

They can become offensive, defensive, or agitated and can react in a very extreme way.

Each person shows a different reaction. It ranges from mild to severe.

They can either become annoyed and irritated or be full-blown angry and aggressive. 

The misophonia can be heightened in times of stress. It is also seen in people suffering from obsessive-compulsive disorder and generalized anxiety disorder.

However, it is not associated with it. Below is the list of mild to severe reactions of people when exposed to trigger sounds. 

Reaction to Mild Stimuli:

  • Irritation
  • Disgust
  • Discomfort
  • Tightening of muscles
  • Increase of heartbeat
  • Anxiety 
  • Desire to flee

Reaction to Severe Stimuli:

  • Irritation and disgust convert to anger
  • Hatred and Rage
  • Panic and fear
  • Emotional distress
  • Feeling low or depressed
  • Being verbally abusive to the source of sound
  • Physically aggressive towards things or people

Many people become anxious, just thinking about the triggers.

They try to distance themselves from the source as much as possible.

They go to lengths to dodge encounter by eating alone and avoid going to restaurants and public places. 

Potential Causes of Misophonia

A study was conducted that involved two groups, one consisting of normal people while the other had misophonic people, were shown a video comprising of different triggering sounds and visuals.

The group of misophonic individuals all reacts with disgust, irritation, or anger.

It was also seen that the salience network of their brain activity was hyperactive.

This region is responsible for directing our attention to light things in our surroundings. 

Another study showed that misophonic people, when exposed to the sound of eating or breathing, have increased stress levels.

This may be because the trigger sounds send the salience region into overdrive that is responsible for long-term memory and regulation of fear and other emotions.

That’s why it is this disorder is seen in an individual with a bad experience. 

Although the main cause of misophonia is still unknown, it usually results from the abnormal functioning of the autonomic nervous system, auditory cortex, and limbic system.

A study of MRI scans show that people with misophonia had heightened responses in the anterior insular cortex (AIC).

Moreover, in specific parts of the brain, the nerve cells had higher myelination.

This contributed to the higher connectivity between AIC and the default mode network (DMN).

Classification: 

Misophonia is a poorly understood disorder as the research is still going, and there are not enough studies done yet.

People are starting to acknowledge misophonia as a disorder, but there is still very little information regarding its classification and causing.

The evidence found from studies is inadequate, and the research is limited.

One major reason for this is that people with mild conditions don’t seek help or treatment. 

Misophonia is neither classified as a psychiatric disorder or a hearing one.

It doesn’t resemble hyperacusis, which is caused by a dysfunction of the central auditory system of the brain.

However, misophonia is caused by the abnormal functioning of the auditory insular-cortex and is not specific to one sound.

It also differs from phonophobia, which is the fear of a certain sound, unlike misophonia. 

There is no approved diagnosis criterion for misophonia. One criterion was proposed, but it was considered restricted for youths and is not applicable in every scenario.

This criterion classified misophonia as obsessive-compulsive disorder. 

Misophonia shows many similarities to different disorders. One such is autism.

Misophonic and autistic people have similar sensory processing behavior and get easily overwhelmed by stimuli.

While, misophonia or selective sensitivity to sounds are also common in many other disorders such as OCD, Tourette syndrome, and anxiety disorders.

However, no proper classification is done.

Treatment and Coping Skills:

As there is little research done on misophonia, there is no evidence-based treatment present.

However, therapists use multiple techniques to help people with misophonia to manage their disorder.

Although people suffering from misophonia have many similarities in their experience, there is also a lot of diversity. 

This has complicated the understanding of misophonia and its treatment.

Usually, people who experience anxiety and fear are given exposure therapy where therapists help them learn and manage their reactions by exposing them to a similar stimulus.

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Whereas, people who react with anger are shown relaxation techniques to manage their distress

Here are a few of the following treatments that have proven to be effective and have improved the quality of many misophonic people. 

  • Tinnitus therapy: This therapy is used to treat patients with tinnitus and hyperacusis; it is also very effective for treating misophonia. People with misophonia are taught to associate trigger sounds with positive emotions by combining sound therapy with counseling. They are allowed to listen to pleasant sounds, which increases their ability to tolerate trigger sounds.
  • Cognitive Behavioral Therapy: This therapy is usually combined with TRT and also involves pairing of triggering sounds with positive emotions. This therapy is mostly used to alter the negative thoughts of a person triggered by certain sounds and decrease their misery.
  • Medication: Although medication is not usually preferred to treat misophonia, Lyrica, and Klonopin are found to be useful for misophonic people. 
  • Changes in Lifestyle: It is seen in many cases that positive changes in lifestyle have to reduce misophonia in many people. These changes include exercising, taking a healthy diet, using sound protection, and having a proper sleep schedule.

Other tips for managing misophonia in daily life include:

Some Helpful Resources

  1. Understanding and Overcoming Misophonia” is a very nice book that covers the disorder quite comprehensively.
  2. Crack Smack Punch: Living with Misophonia (Selective Sound Sensitivity Syndrome or 4S)” is a nice autobiographical account on this ailment. 
  3. Another good book about misophonia is titled as, “Understanding and Overcoming Misophonia: A Conditioned Aversive Reflex Disorder”.
  4. Exploring Misophonia” is a book offering in-depth insight about misophonia
  5. Too Loud, Too Bright, Too Fast, Too Tight: What to Do If You Are Sensory Defensive in an Overstimulating World” is a great book that shares some useful strategies to help cope with misophonia.

By following the above mentioned tips and techniques, you may devise some strategies that are focused around your unique needs and requirements and would help you in dealing with misophonia. 

Frequently Asked Questions

Q1. Is Misophonia a mental illness?

Misophonia is usually not recognized as a mental illness because it is not enlisted in the list of disorders in either ICD-10 or DSM.

It may be categorized as a synthesis of sound-and-emotions and overlap some anxiety related disorders. 

Q2. Does Misophonia get worse?

As a matter of fact, yes. Misophonia keep getting worse if treatment is delayed and the symptoms and behavioral consequences deteriorate.

The disorder takes a hold on everyday functioning of the sufferer and substantially undermines the overall well-being. 

Q3. Is Misophonia dangerous?

Misophonia is not necessarily dangerous, however, it is a debilitating ailment and excessively impacts the well-being and quality of life of the sufferer.

The people who are struggling with misophonia, often experience profound irritability upon hearing everyday sounds around them (e.g. chewing, breathing). 

Q4. Is Misophonia curable?

Unfortunately, there is no known cure or established treatment for misophonia.

However, health practitioners and professionals may administer focused therapy or intervention that is uniquely designed to address specific needs of the patient. 

Q5. Can Misophonia cause panic attacks?

Yes, people who are suffering from misophonia may experience anxiety, anger outbursts and panic attacks upon hearing triggering sounds (that include regular everyday sounds). 

Q6. Is Misophonia a sign of autism?

Symptoms of misophonia resemble some symptoms of autism, however, it is not an autism spectrum disorder.

Although uncomfortable or irritable response to regular noises or loud noises is an overlapping characteristic in misophonia and autism. 

References:

  1. Sounds that People with Misophonia may hate
  2. Management of Misophonia triggers
  3. Guide to cope with misophonia
  4. What is misophonia
  5. Treatments for Misophonia
  6. Symptoms of Misophonia
  7. Understanding Misophonia
  8. Misophonia and Autism

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