Does the sound of your friend breathing drive you batty? Do you avoid restaurants because the sound of chewing gnaws right through you? Does your co-worker’s clicky keyboard make you want to climb out the window? If certain sounds drive you up the wall but don’t seem to bother anyone else around you, you might have misophonia. The condition, which translates to “hatred of sound,” is the extreme emotional and physical reaction to specific noises.

What Is Misophonia?

People with misophonia or “selective sound sensitivity syndrome” experience involuntary emotional or physiological responses triggered by specific sounds. People without the condition generally considered these responses extreme.Misophonia causes individuals to be affected by common sounds, usually made by others, to which most people do not pay attention. Their reactions can range from irritation and anger to panic and considerable emotional distress.The severity of a person’s reactions does not determine whether or not they have misophonia. The determining factor is whether or not the person has an immediate response of disgust or irritation to a single instance of the trigger sound.

Sounds that Trigger Misophonia

Sounds that trigger an adverse reaction in people with misophonia include

• Lip smacking
• Chewing
• Crunching
• Throat clearing
• Licking fingers
• Shuffling papers or turning pages
• Typing on a keyboard
• Heels clicking across a floor
• Irregular breathing
• Sniffing
• Coughing
• Water dripping from a tap
• Fidgeting, such as foot wiggling or finger tapping

People with severe misophonia might even experience adverse reactions to seeing something that they anticipate will create the offending sound, whether or not they can hear it.

Common Sound-Based Irritations

It is normal to be irritated by certain sounds, like babies crying, nails on the chalkboard, or utensils scraping a plate. As a species, we are evolutionarily programmed to respond negatively to certain high-pitched sounds because of their similarity to a shriek or scream.This is not the same thing as misophonia, which is characterized by intense emotion in response to highly specific but otherwise ordinary sounds that other people make.

Other Forms of Sound Sensitivity

To better understand misophonia, it helps to know what misophonia is not.

• Phonophobia is the fear of a sound. It is common for young children to be scared of the sound of a vacuum cleaner or a toilet flushing, for example.
• Hyperacusis is the sensitivity to the volume of a sound. This is also common in young children.
• Sensory Processing Disorder (SPD)can cause a person to be unable to tolerate loud sounds. A person with SPD has heightened sensitivity to multiple forms of sensory input, including sounds, touch, smell, sight, and taste.

Causes of Misophonia

The exact cause of misophonia is unknown, but it has nothing to do with hearing. Researchers believe it might be an issue with how the brain filters sound. A 2017 study in Current Biology found that people with misophonia have unusual brain activity when exposed to certain sounds, triggering a fight-or-flight response. This response did not occur in people without misophonia when they were exposed to the same sounds.When exposed to other neutral sounds, the brain activity in people with misophonia did not differ much from that of people without the condition.

How Common is Misophonia?

According to the Misophonia Institute, misophonia affects just one in 1,500 people in the United States. That’s only 0.07% of the population. Many people with the disorder have at least one close family member with the condition, which suggests there might be a genetic component. Misophonia might also be comorbid with other conditions, such as generalized anxiety disorder and obsessive-compulsive disorder.

Diagnosing Misophonia

People with misophonia often feel embarrassed by their condition and hesitate to mention it to healthcare professionals. However, a checkup with the doctor will rule out any underlying medical condition or a reaction to a medication or other substance.Because misophonia occurs in people with normal hearing, doctors often have trouble making a diagnosis. Misophonia is not yet in the DSM-5 (the standard classification of mental disorders in the US), so standards for its diagnosis are lacking. The condition is sometimes mistaken for anxiety, bipolar, or obsessive-compulsive disorder.

Mild to Severe Reactions

People with misophonia report a range of emotional and physiological reactions to the sounds by which they are triggered. A mild reaction might make a person feel uncomfortable, anxious, disgusted, or offended, or prompt an urge to flee. More severe reactions include intense anger, rage, panic, fear, hatred, or emotional distress.Misophonia can cause an overwhelming urge to make the sound stop, even to the point where some people want to verbally or physically assault the person causing the trigger sound, though most people with the disorder can control this urge.

Effect on Social Life

People with misophonia can develop anticipatory anxiety about situations where they know a trigger sound will be present. They might avoid eating in restaurants or choose to eat separately from their family, spouse, or roommates.Because so little is understood about misophonia, people close to the individual with the disorder often have trouble understanding or believing how distressing symptoms can be. This can negatively impact relationships and make people feel isolated by their condition.

Treatments for Misophonia

Although misophonia interferes with daily life, there are ways to manage it. Common coping strategies include

• Talk therapy
• Hypnotherapy
• A healthy lifestyle, with regular exercise and plenty of sleep
• Earplugs or noise-canceling headphones to tune out sounds
• Establishing quiet areas and safe spaces at home
• Online support groups
• Medication for anxiety