- Causes & Risk Factors
- Symptoms & Triggers
- Support Groups
What is misophonia?
Misophonia, which literally means "hatred of sounds," while not yet officially recognized as a distinct psychiatric disorder in medical literature, is a source of great distress and sometimes debilitation in its sufferers. The definition of misophonia, which is often classified as a form of decreased sound tolerance, is severely negative reactions to sounds that have a specific pattern, meaning, and context to the sufferer based on previous experiences.
This condition usually entails a number of negative reactions, like anger, agitation, and hatred of particular sounds and is different from hyperacusis, another form of decreased sound tolerance, which is defined as a negative reaction to sound due to particular physical characteristics, like volume, type, and intensity. Misophonia should also be distinguished from phonophobia, which refers to a fear of specific sounds. Similarity in spelling is where the commonality of misophonia and misophobia ends, the latter referring to an irrational fear of being contaminated, dirty, or germy.
While there are few specific statistics regarding how often misophonia occurs in the general population, this form of extreme noise sensitivity has been found to occur in up to 60% of people who suffer from tinnitus, also called ringing in the ears. A sample of college students revealed that this condition may be quite common, as it was found in 20% of that sample.
What are causes and risk factors for misophonia?
While there is no known single cause for misophonia, it is thought to be associated with the way the central nervous system (brain and spinal cord) works rather than any change in its structure/anatomy. Specifically, this disorder is thought to be related to an increase in the hearing (auditory) pathways in the central nervous system, as well as heightened anxiety and other emotional reactions to sounds. People with one hearing disorder may be at risk for another. For example, people with hyperacusis are at a higher risk for tinnitus, hearing loss, and phonophobia.
Behavioral theories about the development of this disorder usually center around becoming conditioned to having an extreme reaction to normal noises in the environment. In other words, it is thought that this illness develops at least partly as the result of the sufferer developing an emotional association between a normal, potentially irritating noise to an aversive physical reaction. The individual may consider this disorder to be caused by what they perceive to be the trauma of hearing normal environmental sounds.
Misophonia tends to co-occur with mental disorders like obsessive compulsive disorder, obsessive compulsive personality disorder, Tourette's disorder, and eating disorders. Girls of prepubescent age have been found to be at higher risk of developing misophonia compared to males and to people of other age groups.
What are the symptoms and triggers of misophonia?
There are numerous potential triggers for misophonia, including everything from:
- nose whistling and sniffling,
- to chewing with one's mouth open,
- talking with food in one's mouth,
- teeth grinding,
- loud throat clearing, and
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.
How is misophonia diagnosed?
Many health care professionals 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.
What is the treatment for misophonia? Is there a cure?
While there is no known specific cure for misophonia and little rigorous (controlled studies) research regarding effective treatments, there are a number of approaches that tend to be used with some apparent success. Tinnitus retraining therapy (TRT) entails teaching people with misophonia how to improve their ability to tolerate certain noises. Cognitive behavioral therapy involves changing the negative thoughts that may contribute to the patient's suffering. Another treatment involves adding background noise to the person's environment in an effort to help them ignore their triggers for negative reactions. Fans and "white noise" machines along with behind the ear noise generators are some such sources of increasing background noise. Since it is thought that this illness develops at least partly as the result of the misophonia sufferer developing a conditioned response to certain noises, an approach that has had some success is the process of deconditioning people with this disorder. Specifically, this form of treatment involves pairing a positive experience with the misophonia trigger.
A variety of medications have been tried to treat misophonia, including those that treat depression and anxiety (like fluoxetine, sertraline, or escitalopram), attention deficit hyperactivity disorder (for example, amphetamine and dextroamphetamine, methylphenidate), and bipolar disorder (for example, lamotrigine and divalproex sodium), as well as dietary supplements like vitamins, minerals, and fish oil. However, medication is not usually used to treat this condition.
What are misophonia complications?
Complications of misophonia include that the sufferer may become defensive against certain situations, changing their life to avoid experiences that may trigger symptoms. That can result in avoiding socializing with friends or family members, even avoiding sleeping in the same room as a spouse. Those issues can eventually result in problems succeeding in relationships, school, or employment. Fortunately, research indicates that more than 80% of misophonia sufferers can experience significant relief from symptoms if treated.
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Is it possible to prevent misophonia?
Since most of the theories about risk factors for misophonia seem to be biologically based, prevention usually focuses on trying to prevent complications of this disorder rather than the disorder itself.
Are there support groups for people with misophonia?
Public Forum for Misophonia
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Top Misophonia Related Articles
ADHD in ChildrenAttention deficit hyperactivity disorder (ADHD) causes the following symptoms in children: excessive activity, problems concentrating, and difficulty controlling impulses. Stimulant medications are the most common medication used to treat ADHD.
Adult ADHD (Attention Deficit Hyperactivity Disorder)About 2%-6% of adults have ADHD, a common behavioral problem. Symptoms include impulsivity, hyperactivity, and inattention. Treatment may involve ADHD education, attending a support group, skills training, and medication.
Anxiety DisordersAnxiety is a feeling of apprehension and fear characterized by symptoms such as trouble concentrating, headaches, sleep problems, and irritability. Anxiety disorders are serious medical illnesses that affect approximately 19 million American adults. Treatment for anxiety may incorporate medications and psychotherapy.
Asperger's Syndrome (Asperger Syndrome, Asperger Disorder)Asperger's syndrome (AS, Asperger syndrome, Asperger disorder) is an autism spectrum disorder. Asperger's syndrome is characterized by a degree of impairment in language and communication skills, and repetitive or restrictive thoughts or behaviors. The most common symptom of Asperger's syndrome is the obsessive interest in a single object or topic.
ADHD in TeensAttention deficit hyperactivity disorder (ADHD) in teens is a disruption of neurocognitive functioning. Genetics contribute to ADHD. Symptoms of ADHD in teens include inattention, hyperactivity/impulsivity, or a combination of these. Treatment may include cognitive behavioral therapy, behavior therapy, medication, or alternative therapies.
Autism Spectrum DisorderAutism in children and adults is a developmental disorder, characterized by impaired development in communication, social interaction, and behavior. Autism is classified as a pervasive developmental disorder (PDD), which is part of a broad spectrum of developmental disorders affecting young children and adults. There are numerous theories and studies about the cause of autism. The treatment model for autism is an educational program that is suitable to an individual's developmental level of performance. There is no "cure" for autism.
Bipolar DisorderBipolar disorder (or manic depression) is a mental illness characterized by depression, mania, and severe mood swings. Treatment may incorporate mood-stabilizer medications, antidepressants, and psychotherapy.
DepressionDepression is an illness that involves the body, mood, and thoughts and affects the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about things. The principal types of depression are major depression, dysthymia, and bipolar disease (also called manic-depressive disease).
escitalopramLexapro (escitalopram) is a medication used for treating depression and general anxiety disorder. Lexapro is in the drug class called selective serotonin reuptake inhibitors (SSRIs). Some of the side effects of Lexapro include agitation or restlessness, blurred vision, diarrhea, drowsiness, difficulty sleeping, dry mouth, frequent urination, headache, indigestion, nausea, sweating, and sexual difficulties.
fluoxetineFluoxetine (Prozac, Sarafem, Prozac Weekly) is a drug prescribed for the treatemnt of depression, bulimia, obsessive-compulsive disorder (OCD), panic disorder, and premenstrual dysphoric disorder (PMDD). It is also prescribed in combination with olanzapine (Zyprexa) to treat resistant depression and depression associated with bipolar disorder. Side effects, multiple drug interactions, dosage, and pregnancy safety should be reviewed prior to taking this medication.
Obsessive Compulsive Disorder (OCD)Obsessive-compulsive disorder (OCD) is an anxiety disorder that causes a person to suffer repeated obsessions and compulsions. Symptoms include irresistible impulses despite a person's realization that the thoughts are irrational, excessive hand washing, skin picking, lock checking, or repeatedly rearranging items. People with OCD are more likely to develop trichotillomania, muscle or vocal tics, or an eating disorder. Treatment for OCD includes psychotherapy, behavioral therapy, and medication.
sertralineSertraline(Zoloft) is a medication prescribed for the treatment of depression, obsessive-compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD), social anxiety disorder, and premenstrual dysphoric disorder (PMDD). Side effects include skin rash, constipation, upset stomach, loss of appetite, headache, diarrhea, abnormal ejaculation decreased interest in sexual activity, and dry mouth. Drug interactions, dosage, and pregnancy and breastfeeding safety information should be reviewed prior to taking this medication.
How to Stop SnoringSnoring, like all other sounds, is caused by vibrations that cause particles in the air to form sound waves. While we are asleep, turbulent airflow can cause the tissues of the nose and throat to vibrate and give rise to snoring. Any person can snore. Snoring is believed to occur in anywhere from 30% of women to over 45% of men. People who snore can have any body type. In general, as people get older and as they gain weight, snoring will worsen. Snoring can be caused by a number of things, including the sleep position, alcohol, medication, anatomical structure of the mouth and throat, stage of sleep, and mouth breathing.
Teeth Grinding (Bruxism)Bruxism is the medical term for teeth grinding. Bruxism may be caused by stress or anxiety and often happens during sleep. Symptoms and signs include jaw pain, headache, and abnormalities in your teeth. Treatment may involve practicing stress-management techniques, cutting back on caffeine and alcohol, avoiding gum chewing, training oneself not to grind the teeth, and wearing a mouth guard.
Tinnitus is described as a throbbing, ringing, clicking, or buzzing in one or both ears. Tinnitus is caused by trauma to the ear, over exposure to loud noises, medication, and diseases or infections of the ear such as multiple sclerosis, TMJ, autistic neruoma, Meniere's disease, hearing loss, and aging. Treatments include medication, tinnitus masking, retraining therapy, and relief therapy.