Misophonia is a type of noise sensitivity also known as Selective Sound Sensitivity Syndrome (4S). Misophonia literally means a dislike or hatred of sound. People suffering from misophonia don’t have an aversion to all sounds, as in phonophobia, but to specific sounds.
Causes of misophonia may be physical or emotional, but usually involve a combination of both factors. In misophonia, a person doesn’t hear certain sounds in the same way other people do. Some sounds seem louder or more abrasive. A seemingly inconsequential sound can trigger extreme reactions such as sudden rage.
Misophonia often develops in childhood or the early teen years. Initially, the condition may have a single trigger such as noises made by a parent or sibling. Over time, the condition expands to more than one sound trigger.
People suffering from misophonia may react strongly to sounds made by other people. Common sounds affecting misophonic patients include:
• radio or television in another room
• clock ticking
• water dripping
• crinkling sounds of chip bags, candy wrappers etc
• outside noises (people talking, traffic, distant music)
People with misophonia may also be overly annoyed by another person’s body movements and the accompanying sounds, such as in leg-tapping or nail-biting. Animal sounds can also trigger a reaction. While sounds affecting noise-sensitive people usually emanate from others, in some cases the patient may have a strong reaction to sounds he or she personally makes, such as the sound of chewing.
Misophonia is involuntary. The noise-sensitive person usually has no control over her reaction to certain sounds. Intolerance to some sounds may be particular to the individual.
Symptoms of misophonia include:
• intolerance to certain sounds (triggers)
• acute awareness of sound
• muscle tension
• clenching or grinding the teeth
• feeling of going crazy
• outbursts of rage
• feelings of helplessness
• physical feelings of pain – ie knives in the head
• feelings of intrusion – the sound overwhelms one’s personal space
A person with misophonia is acutely aware of the specific sound(s). As the condition progresses, the person may begin to hear the sound even if it’s not actually there. The mere suggestion or thought of the sound can cause extreme anxiety.
Some scientists suggest that misophonia is genetically-acquired, but thus far have no concrete evidence. Misophonia is usually a combination of physical and emotional factors. Physical factors may include:
• narrowing of the ear canals
• ear infection
• sinus infection
• dermatitis or skin condition in the ear canals
• dysfunction of the tensor tympani (the middle ear muscle that dampens sounds in the head)
• dysfunction of the stapedius (the middle muscle ear muscle responsible for dampening sound in general)
• infection of the Eustachian tubes
• wax or debris accumulation in the ears
• underlying medical condition, such as TMJ disorder
Misophonia gets worse in situations of stress or fatigue. The emotional factors associated with misophonia range from mild annoyance to uncontrollable rage or violence. The brain is in a state of anxiety and hypervigilance, and the body is extremely tense.
While the mind is on high alert, the patient perceives the sound as louder and more abrasive than it actually is. At the same time, the ears may physically attempt to block out the sound. Over time, this involuntary body reaction can lead to structural changes in the ear, or damage to the hearing mechanisms.
A person suffering from misophonia may attempt to block out the sound with earplugs, music or noise from a fan. In some cases, the noise-sensitive person will self-medicate with alcohol or drugs in an effort to stop hearing the noise. Attempts to block out the sound are usually not successful, and may result in increased sensitivity to the offending noise. A person with misophonia may become severely depressed or reclusive.
Misophonia can be a lifetime condition. The patient may move residence often and take extreme measures to avoid or block the sound(s). Anxiety disorders are common, and quality of life is severely compromised.
Treatment of Misophonia
Like other conditions of noise sensitivity, misophonia is often misunderstood. Many misophonic people don’t seek treatment, and may feel they are going crazy. Doctors may suggest that the person’s sensitivity to noise is imaginary.
Some therapists may use sound sensitivity training to treat misophonia, but this method is usually not effective by itself. Other methods of treating misophonia include bilateral white noise generators. These small appliances fit into the ear to help defray the disturbing effects of sound.
A doctor may prescribe anxiolytic drugs to calm the emotional effects of misophonia, such as anxiety and rage. Often, medication may help relieve symptoms, but doesn’t address the cause of the condition. In the long run, medication is not always effective. Medical science continues to study the causes, effects and treatments of misophonia and other conditions relating to noise and sound.
For a personal account of dealing with misophonia, please see: Misophonia and Little Brown Birds: How I Conquered Noise Sensitivity.
Noise Sensitivity: Health Effects of Noise and Sound