Misophonia

Misophonia is a condition in which everyday sounds—including chewing, breathing, coughing, or foot tapping—elicit a severe negative reaction in the patient. Depending on their trigger noises, people who have misophonia may experience high levels of anxiety in social situations, as they never know when they might hear the noise. This can lead to avoiding situations in which they will be around other people who might make the noises they fear. Although misophonia is not classified as a psychological or psychiatric disorder, some research suggests that those with misophonia exhibited traits consistent with other psychiatric disorders, such as post-traumatic stress disorder (PTSD) and social phobia. There is currently no cure or medications available to treat the disorder, but some patients benefit from cognitive behavioral therapy or from using headphones or earplugs to block out unwanted sounds.

Background

The word misophonia comes from the Greek words misos, meaning “hate,” and phónè, meaning “voice.” Therefore, misophonia means “hate of sound.” Although misophonia has been described by other names in the past, American scientists Margaret M. Jastreboff and Pawel J. Jastreboff coined the term misophonia in an article they wrote on another auditory condition in 2001. Jastreboff and Jastreboff noticed that misophonia differed from other auditory conditions in significant ways. Misophonia does not involve hearing loss or other hearing problems. In misophonia, specific “trigger sounds,” such as chewing or breathing, elicit the intense reaction in patients. The condition is not widely understood, though research suggests that it has both an emotional and physiological component.

Studies have indicated that misophonia often begins in late childhood or early adolescence. Women seem to be more susceptible to the condition than men are. Typical trigger sounds often include chewing, breathing, throat sounds, or repetitive noises, such as the clicking of a pen or the tapping of a foot.

In mild cases, the trigger sound can create a feeling of anxiety, disgust, or discomfort in the patient. Those with severe cases may experience anger or rage. In some cases, the patient may exhibit physiological symptoms, including tightened muscles, a constricted feeling in the chest, or an elevation in blood pressure. Certain patients even report experiencing panic attacks when exposed to their trigger sound. Some patients also report visual triggers associated with the trigger sounds. For example, if a person cannot stand the sound of someone munching on potato chips, the image of someone opening a bag of potato chips might trigger the negative response before the sound even begins.

Because patients with misophonia do not usually have other hearing problems, obtaining a diagnosis can be difficult, as physicians do not always understand the disorder. It often requires taking a detailed patient history to confirm the symptoms, track the trigger sounds, and assess whether the patient has any co-occurring conditions, such as anxiety or depression. In addition, some physicians may use questionnaires to attempt to determine the severity of a patient’s misophonia. However, experts do not agree on the validity of certain questionnaires.

Some experts believe that misophonia is related to other psychological disorders, such as obsessive-compulsive spectrum disorder, commonly known as OCD. Others believe that misophonia is a unique disorder that deserves separate classification. As of 2019, misophonia was not listed in the Diagnostic and Statistical Manual of Mental Disorders, which is widely used by physicians to diagnose psychological and psychiatric conditions.

True misophonia is also rare. According to the nonprofit Misophonia Institute, only about two hundred thousand people in the United States are known to have the disorder, though some experts suspect that many more people suffer from misophonia than researchers know.

Overview

Because little is understood about misophonia and why it occurs, researchers from around the world have begun looking into the condition. In 2013, Arjan Schröder, Nienke Vulink, and Damiaan Denys from the University of Amsterdam published a report in which they examined forty-two patients who reported having misophonia. One of the interesting aspects that the researchers noted was that all these people’s trigger sounds were related to humans. Some examples included other people chewing, breathing, or clicking pens. Another interesting aspect of the study found that patients did not experience any discomfort, disgust, or anxiety when they themselves produced the sounds. The Norwegian study also noted that the most common reaction to trigger sounds was irritation, followed by disgust and anger. The researchers concluded that misophonia might be a variant of OCD that requires its own separate classification.

A 2017 study conducted by neuroscientists at Newcastle University in the United Kingdom published in the journal Current Biology shed some light on the disorder. The scientists studied twenty-two people with misophonia and twenty people who did not have the disorder. These test subjects listened to three types of sounds while inside functional magnetic resonance imaging (fMRI) machines. The sounds included commonly distressing noises, such as a baby crying and someone screaming; neutral sounds, such as the sound of rain; and trigger sounds, including eating and breathing sounds. Researchers found that in the people with misophonia the trigger sounds overstimulated a part of the brain called the anterior insular cortex (AIC), which is connected to the processing of emotions. The researchers also noted that the structure of the brain was different in patients with misophonia. The AIC was connected to amygdala and the hippocampus, areas of the brain that have to do with memory. This led the researchers to believe that past memories or experiences may have something to do with patients developing misophonia.

Researchers have also noted that misophonia can be debilitating for some patients. Depending on their trigger sounds, patients might avoid social environments, such as restaurants or movie theaters, to try to escape the sound of other people eating or breathing. It can also interfere with personal relationships with friends and family members, as those with misophonia may not be able to stand being around people who chew loudly or breathe heavily.

Scientists who study the disorder hope that additional research can lead to effective treatments that can help to improve quality of life for patients with misophonia.

Bibliography

Cartreine, James. “Misophonia: When Sounds Really Do Make You ‘Crazy.’” Harvard Health Publishing, 21 Apr. 2017, www.health.harvard.edu/blog/misophonia-sounds-really-make-crazy-2017042111534. Accessed 19 Feb. 2019.

de Freytas-Tamura, Kimiko. “Misophonia Sufferers: Scientists May Have Found the Root of Your Pain.” New York Times, 3 Feb. 2017, www.nytimes.com/2017/02/03/health/sounds-people-hate.html. Accessed 19 Feb. 2019.

Gallagher, James. “Misophonia: Scientists Crack Why Eating Sounds Can Make People Angry.” BBC News, 3 Feb. 2017, www.bbc.com/news/health-38842561. Accessed 19 Feb. 2019.

Kumar, Sukhbinder, et al. “The Brain Basis for Misophonia.” Current Biology, vol. 27, no. 4, 20 Feb. 2017, pp. 527–33.

Palumbo, Devon B. et al. “Misophonia and Potential Underlying Mechanisms: A Perspective.” Frontiers in Psychology, vol. 9, no. 953, 29 June 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6034066/. Accessed 19 Feb. 2019.

“Prevalence of Misophonia.” Misophonia Institute, 2016, misophoniainstitute.org/prevalence-of-misophonia/. Accessed 19 Feb. 2019.

Spankovich, Christopher, and James W. Hall III. “The Misunderstood Misophonia.” Audiology Today, July/Aug. 2014, www.audiology.org/sites/default/files/resources/misophonia.pdf. Accessed 19 Feb. 2019.

“What Is Misophonia?” WebMD, 10 Dec. 2018, www.webmd.com/mental-health/what-is-misophonia#1. Accessed 19 Feb. 2019.