Misophonia: Triggers & Management

Misophonia is a condition in which a person is overly sensitive to sounds. Usually the trigger sounds are noises made by other people, such as chewing or tapping a pen. People who suffer from misophonia become disturbed or aggravated when they hear the sounds. Some misophonics avoid the irritating sounds by physically leaving the room, while others may display angry outbursts.

Sounds that trigger misophonia 

A number of sounds can elicit the agitation characteristic of misophonia. Chewing noises are probably the most common trigger, but other sounds such as slurping, crunching, mouth noises, tongue clicking, sniffling, tapping, joint cracking, nail clipping, and the infamous nails on the chalkboard are all auditory stimuli that incite misophonia.

Most of the sounds that trigger misophonia are produced by the human body, but some misophonics become annoyed by the sounds of inanimate objects, such as clicking of a remote control or the whirring of a motor, although the degree of irritation is not usually as severe. Interestingly, people who suffer from misophonia do not experience irritation when they produce the same exact noises themselves.

Physical response to trigger sounds 

It turns out that people who suffer from misophonia do, in fact, have real physiological effects when they are exposed to the provoking sounds. The few studies of the physiology of this condition demonstrate that physical responses include measurable autonomic responses that are not seen in a control group. 

Comorbid conditions 

There are degrees of severity misophonia, and it can be heightened in times of stress. Comorbid conditions include obsessive-compulsive disorder and generalized anxiety disorder, but interestingly, there is not an association with attention deficit hyperactivity disorder.

Managing misophonia

Most people who experience misophonia have enough insight to understand that their level of agitation is not reasonable or fair and would like to reduce the symptoms. A few common methods of self-treatment include simply leaving the room, wearing headphones, or finding a way to drown out the noise. Self-distraction is a more advanced and difficult technique of managing symptoms and it is easier to practice distraction in times when personal stress level is low and when the noises themselves are less agitating. Some misophonia sufferers cope with the feelings of turmoil by mimicking the annoying sounds, which seems to disempower the sounds while also possibly allowing an acceptable ‘venting’ of some of the illogical rage.

There have not been studies looking at therapeutic treatment for misophonia and at this time there is no standard pharmacological approach. It appears to be a disorder that is likely to be self-diagnosed. In some instances, friends or family members who are repeatedly the targets of anger may identify the problem. But, it is possible that some sufferers could lack the conscientiousness to insightfully self diagnose themselves or that some misophonia sufferers could become violent, believing that the perpetrator of the noise is to blame.

Have you ever had to deal with misophonia in the clinical setting? How would you advise patients and their loved ones to cope with this disorder?

Reference: Edelstein M, et al. Misphonia: physiological investigations and case descriptions. Front Hum Neurosci. 2013 Jun 25;7:296.