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Misophonia: Sound sensitivity

Misophonia: Selective Sound Sensitivity Syndrome

Misophonia or Selective sound sensitivity syndrome refers to a neurological condition in which certain sounds evoke negative emotional or physiological responses, such as anger, annoyance, panic, and flight response. Symptoms of this condition can severely impair a person’s day-to-day functioning. Often, Misophonia is diagnosed by its sufferers themselves. Hence, awareness is the first step to getting help.

Meaning and Definition of Misophonia

First used in 2003, Misophonia is derived from two Greek words: ‘miso’ meaning hate or strong dislike, and ‘phonia’ meaning sound. Hence, The term misophonia refers to a strong dislike and hatred for sound. In other words, It is a negative physiological and emotional reaction to a specific sound.

Edelstein and his colleagues define this condition as persistent negative emotional experiences and autonomic arousal to a particular sound. Usually, these emotional experiences are negative and include emotions such as disgust, irritation, and distress at first that escalate into anger or hatred. There are a variety of decreased sound tolerance (DST) disorders, such as hyperacusis, exploding head syndrome, phonophobia, and tinnitus. While misophonia is different from these disorders, it can co-occur or share symptoms with them.

Signs and Symptoms of Misophonia:

  • The most basic symptom is an extreme reaction to certain sounds.  
  • As opposed to continuous, loud, disturbing, or infuriating sounds, misophonia is triggered primarily by soft noises or common sights.
  • The trigger stimulus produces an immediate and involuntary reaction.
  • A single trigger causes the symptoms. In other words, If misophonia sufferes encounter a single trigger stimulus, they immediately feel annoyed or disgusted.
  • People with this condition experience strong emotions such as hatred, anger, rage, disgust, resentment, and offence.
  • It is common for emotional reactions to be accompanied by anxiety, panic attacks, tension or pressure in the chest or all over the body, as well as an increase in heart rate, blood pressure, and body temperature.

Misophonia Triggers:

Triggers are sounds that cause an intense emotional response. Misophonia is triggered by sounds specific in nature and thus In 1999, Marsha Johnson described it as a syndrome of selective sound sensitivity, or 4S. Every individual with this condition has their own triggers that they react to. However, In most cases, people with misophonia are mostly bothered by the mouth and throat sounds of the people around them. Triggers differ from person to person; some have a few, and others have many. While it is impossible to list every sound trigger, here are a few of the most common.

  • Breathing
  • Sniffling
  • Yawning
  • Nose whistling
  • Whistling
  • Snorting
  • Chewing 
  • Slurping
  • Smacking
  • Crunching
  • Teeth sucking
  • Nail tapping
  • Nail clipping
  • Spoon scraping
  • Clinking of glasses
  • Plates clattering 
  • Clicking 
  • Typing
  • Page flipping
  • Pen tapping 
  • Dogs barking
  • Cat/dog grooming sound

Diagnosis of Misophonia:

A diagnosis of misophonia (selective sound sensitivity syndrome) isn’t recognized by the DSM or ICD as a mental disorder. However, increasing evidence suggests it can be classified as a distinct psychiatric disorder. Since the condition has not yet been classified into a taxonomic system, researchers are still trying to clarify its features and diagnostic symptoms. It is possible, however, to diagnose misophonia based on six criteria.

  • An aversive physiological reaction in response to the presence or anticipation of a specific sound. These aversions can be irritation, disgust, agitation, and anger. 
  • These impulsive aversions and anger lead to a profound sense of loss of control and aggression.
  •  The individual is aware that his physical and emotional reaction to the particular sound is excessive and unreasonable. 
  • The individual tends to avoid sounds and associated situations. If he fails to avoid it, he endures it with great distress, disgust, and discomfort. 
  • There is a significant impairment of a person’s well-being and his social or occupational life, and it severely interferes with his daily activities. 
  • There must be no other psychological disorders or mental health conditions, substance abuse, or other medical conditions causing these symptoms.

Causes of Misophonia:

Unfortunately, very little is known about the etiology of misophonia. 

Anatomical abnormalities may contribute to misophonia. The condition may have a connection with abnormal anterior insular cortex (AIC) function. The anterior insular cortex (AIC) is responsible for detecting and responding to environmental stimuli. A high level of AIC activation leads to an increase in autonomic responses (Kumar et al., 2017).

The etiology of anxiety spectrum disorders can also provide insight into how misophonia develops. The application of learning theories suggests that misophonia may have roots in the initial association between innocuous sounds and negative physiological or emotional experiences. Another study suggests that several factors influence an individual’s misophonic response, including their previous experience with the sound, its context, and their psychological characteristics. In other words, traumatic experiences or repeated negative experiences occurring with a particular sound may cause lifelong aversion to that sound resulting in Misophonia

Misophonia is also more common among people who suffer from obsessive-compulsive disorder (OCD), Tourette syndrome, Tinnitus, and anxiety disorders. The problem is also thought to run in families, so it is likely that there is a genetic component involved that increases the possibility that it will develop in the future.

Treatment of Misophonia:

According to research, around 80% of individuals suffering from Selective sound Sensitivity syndrome can experience substantial relief from symptoms when they receive treatment. Listed below are some treatment options that have shown some success in treating misophonia.

  • Cognitive Behavioural Therapy (CBT) can help people change some of the negative thoughts associated with certain sound clues that trigger negative emotional responses in people
  • The use of dialectical behavior therapy (DBT), Acceptance and commitment therapy, and stress management techniques are also helpful in facilitating the management of the emotional component of misophonia.
  • The use of relaxation techniques can be beneficial for minimizing automatic stress response to the sertInsound triggers and dealing with them more effectively.
  • A tinnitus retraining therapy (TRT) can help to teach people to ignore certain sounds by using devices designed to divert their attention from the triggering sounds. 
  • In addition, Medication may also be useful in the treatment of anxiety and depression associated with misophonia.

You can also manage the symptoms of misophonia by changing your lifestyle, coping strategies, and relaxing techniques. Some people have had success in reducing exposure to trigger sounds by wearing earplugs, using a white noise machine, and removing certain noises from their environment. Discussing about the condition with others may also be helpful, knowing that certain noises might trigger a negative reaction will help people avoid making them around you.