Misophonia

There are numerous potential triggers for misophonia, including everything from:

• snoring,
• wheezing,
• nose whistling and sniffling,
• to chewing with one's mouth open,
• talking with food in one's mouth,
• teeth grinding,
• loud throat clearing, and
• slurping.

For example, the person with misophonia may react with fear, irritation, or rage at what they may consider to be annoying popping of gum or loud chewing. He or she may try to distance himself or herself from the trigger or engage in acting out at the source of the sound, as by yelling at or hitting that person. A key aspect of this disorder is that once the sufferer is exposed to what they deem to be an offensive stimulus, the reaction usually begins with irritability or disgust then quickly escalates to an extreme level that is clearly out of proportion to the trigger in terms of anger, hate, and/or disgust. The misophonia sufferer usually believes their response is uncontrollable.

Many health-care professionals, including psychiatrists, primary-care providers, audiologists, speech and language therapists, psychologists, psychiatric nurses, physicians' assistants, and social workers may help make the diagnosis of misophonia. One of these professionals will likely conduct or refer the patient for an extensive medical interview and physical examination as part of the assessment. One of the key aspects of establishing the diagnosis of misophonia includes ruling out other hearing disorders, including age-related hearing loss, tinnitus (perception of sound due to abnormal hearing perception), hyperacusis (decreased tolerance to ordinary sounds in the environment), and auditory hallucinations (hearing things, often voices, that have no basis for perception).

This illness is sometimes associated with a number of other mental-health problems, like depression, bipolar disorder, obsessive compulsive disorder and other anxiety disorders, obsessive compulsive personality disorder, the condition that used to be called Asperger's syndrome, as well as other autism-spectrum disorders. The distractibility that may be exhibited by misophonia sufferers may be misdiagnosed as, or co-occur with, attention deficit hyperactivity disorder (ADHD). Therefore, the evaluator will likely screen for signs of depression, manic depression, anxiety, behavioral disturbances, and other mental-health symptoms. The symptoms of misophonia may also be the result of a number of medical conditions or can be a side effect of various medications. For this reason, health-care professionals often perform routine laboratory tests during the initial evaluation to rule out other causes of symptoms. Occasionally, an X-ray, scan, or other imaging study may be needed. As part of this examination, the sufferer may be asked a series of questions from a standardized questionnaire or self-test to help disqualify other diagnoses.