Misophonia: Common sounds are all the rage

Click click click.

“Dear GOD, why does she keep doing that? Doesn’t she know how irritating that is? Has she no respect for the rest of us trying to work? Is she intentionally trying to piss me off?!”

Your blood pressure rises as you bite your lip, suppressing the urge to verbalize this inner dialogue. You take several deep breaths to assuage the flood of anxiety. The anger and stress slowly dissolve, replaced by shame as you realize just how irrational this emotional response was. After all, your coworker was simply … clicking her pen.

Loud-noises

For most of us, sounds such as pen-clicking, chewing or whistling are everyday elements of a neutral auditory landscape that go largely unnoticed. But for a small portion of the population, such common sounds evoke extreme rage, disgust or anxiety. The first such cases were documented just over a decade ago, when the condition was coined misophonia, literally “hatred of sound”. Since then, thousands of self-diagnosed misophonics have sought comfort and advice from online support groups. Misophonia is gaining increasing attention by psychiatrists who believe it should be recognized as an official psychiatric disorder 1 and neuroscientists curious about how nervous system dysfunction may contribute to the condition. As a first step, a team of psychologists sought to better characterize misophonia in their study recently published in Frontiers in Human Neuroscience 2.

Misophoni-who?

The researchers conducted a series of extensive interviews with eleven self-reported misophonics to characterize their trigger sounds, environmental features that exacerbate their reactions, and personal thoughts and coping strategies. Despite the small sample size and the somewhat anecdotal nature of the data, the study reports some interesting common threads. Most participants reported that symptoms first appeared in childhood and either continued or worsened over the years. Chances are, just today you’ve probably made some of the very sounds misophonics report as most maddening, including eating or chewing, pen clicking, footsteps, finger tapping or whistling. And depending on who you are, your innocent walk down the hall or your chipper whistle may have sent a nearby misophonic into a horrified rage; 82% claimed that their discomfort is only set off by certain people, while none were bothered by making the sounds themselves. Although the victims of such noxious sounds may not outwardly display their horror, internally they’re feeling intense anxiety, anger, irritation or physical pressure, thinking that your sounds are rude or disgusting, and experiencing high blood pressure or a racing heart rate. In fact, underneath their blank expression, they just might be thinking … (yup. These were actual thoughts reported by study participants):

“I want to punch this person”
“I hate this person”
“Would you shut up?”

But don’t dismiss misophonia as an extreme case of hateful intolerance. Misophonics are acutely aware that they focus abnormally on sounds. Their agony can be so extreme that it forces them to avoid certain social situations and can even elicit suicidal thoughts. Their self-directed thoughts clearly reflect this inner struggle:

“Why am I like this?”
“I envy people who aren’t bothered by sounds”

Hot and bothered

Might misophonics simply be a crew of melodramatic hypochondriacs? To determine whether participants actually demonstrate physical signs of “sound hate”, the researchers measured the skin conductance reponse (fancy term for sweat production) to a variety of sounds and images. To no surprise, the misophonics reported greater discomfort than controls to sounds but not to images. Justifying their claims, they also produced a greater skin conductance response than controls to sounds than images, and this reponse was positively correlated with subjective aversion to sounds.

The misophonic brain

But sweat can tell only so much about a disorder that is likely neurological in origin. To understand why misophonia occurs, in addition to what it is, scientists will need to look beyond skin-deep, into the brain. To date, no research has directly studied the neurobiological basis of misophonia, although testable hypotheses are in the works. One prevailing theory has emerged from the similarities between misophonia and another intriguing condition that has long fascinated scientists – synesthesia. synesthesiaMuch as misophonics abnormally associate sounds with intense emotions, synesthetes experience aberrant associations between sensations; for example, associating letters with colors, or months with spatial positions. It’s believed that this atypical sensory integration arises from enhanced interactions between the brain’s sensory networks. In support of this idea, neuroimaging studies have shown activation of the color-selective visual area V4 when synesthetes hear words 3, and increased structural connectivity between implicated sensory regions 4. If misophonia arises from similar processes, it might be generated from excessive cross-talk between the brain’s auditory and limbic systems. This is an enticing theory indeed, but it is just a theory. The obvious next step is to test whether, in fact, misophonics abnormally activate limbic regions in response to trigger sounds, or show increased connectivity between limbic structures and auditory cortex.

Until we better understand the disorder, why not keep those closet misophonics in mind at your next lunch? Chomp your sandwhich a tad quieter and you just might save someone’s sanity.

References

1. Schroder A et al. 2013. Misophonia: Diagnostic criteria for a new psychiatric disorder. PLoS One. 8.
2. Edelstein M et al. 2013. Misophonia: physiological investigations and case descriptions. Front Hum Neurosci. 7:296.
3. Nunn JA et al. 2002. Functional magnetic resonance imaging of synesthesia: activation of V4/V8 by spoken words. Nat Neuro. 5:371-5.
4. Zamm A et al. 2013. Pathways to seeing music: enhanced structural connectivity in colored-music synesthesia. Neuroimage. 74:359-66.

ResearchBlogging.org
Edelstein M, Brang D, Rouw R, & Ramachandran VS (2013). Misophonia: physiological investigations and case descriptions. Frontiers in human neuroscience, 7 PMID: 23805089

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15 thoughts on “Misophonia: Common sounds are all the rage

  1. Anonymous says:

    My particular sound-sensitivities don’t appear to be entirely like those suffered by the majority of Misophonics, in that mine are mostly impact-type sounds caused by people’s movements and gestures. However I certainly share the same anger-reactions. The only anxiety I get is the anticipation of these impact sounds happening.

    If this might be of interest to you I provide two Links, below, to my ‘symptoms’. Do feel free to use these in any publications, printed or online.

    http://www.misophonia.info/Forum/viewtopic.php?f=14&t=36&p=50#p50

    http://www.misophonia.com/Forum/viewtopic.php?f=14&t=36&p=50&sid=56bca1e679ac1bb5e4f0aa8e673f5d89#p50

    (I hope either of these Links will take you straight to my posting. If, instead, it takes you to the beginning of the Forum in which it is posted just scroll down until you find my posting).

    • Emilie Reas says:

      Thanks for sharing your experience. It will be interesting to see how symptoms vary across individuals as we learn more about the condition. The Edelstein study also suggests that movements contribute to sound triggers for some subjects (they mention leg movements). If the neural “cross-talk” theory is correct, I wonder if those experiencing gesture-related triggers might have increased visual-auditory-limbic interactions?

  2. Thank you for your timely column. I am a person with misophonia and mild synethesia. I knew my noise sensitivities were not normal, but I did not realize that my assigning colors to numbers or seeing days of the week or months all lined up in orderly fashion out in front of me in my mind, was not normal. I thought everyone saw things that way and it was pretty cool. When I started taking antidepressants for my miso, my color assigning condition diminished somewhat, but my miso remained. Guess which one I would have preferred to diminish? I have started NFB and my practitioner has mentioned the “excessive cross-talk between the brain’s auditory and limbic systems”. Thanks again for spreading the awareness of misophonia. It’s a nasty disorder that needs more attention and research.

    • Emilie Reas says:

      Fascinating. Your experience certainly supports the neural cross-talk theory and makes me wonder how prevalent misophonia-synesthesia comorbidity is. Looking forward to the day we better understand the disorder and can selectively treat misophonia without disrupting your awesome sensory experiences!

  3. Anonymous says:

    I always thought I was Crazy. Then I one day I typed “Noises Enrage Me” into Google and discovered Misophonia and realized I was not alone. I really want to get into one of these studies SO badly. It is the Strangest, Very Misunderstood, Maddening Thing to deal with on a daily basis. Thank You for this article.

  4. Jessica says:

    I have become very interested in misophonia ever since I found out that there was a name for the “condition” I have experienced for the past 13-14 years. I saw the 20/20 special a couple years ago.
    I started noticing my aversions to certain sounds probably around age 10-11. From what I have read, this is a common age. With such limited information, I have hypothesized that something happens in the brain in pre-puberty. I have tried to research that theory more, but do not see any studies or other thoughts on that subject.

    • Emilie Reas says:

      Interesting – It seems reasonable that it could be a developmental disorder. During early childhood, the brain undergoes “pruning”, during which unnecessary connections are lost. If misophonia results from excessive connectivity, one possibility is that those aberrant auditory-limbic connections weren’t appropriately pruned. Just a thought … can’t wait for research to provide more answers.

  5. Anonymous says:

    I have had dislike of certain sounds since I was a child. My long suffering husband said I was spoiled by my parents being quiet around me so as not to bother me with noise and that I should get used to the noises. However his theory was blown out of the water when I met up with my sister (as I was adopted) and she also suffers from misophonia.

    • Emilie Reas says:

      Wow – your situation strongly suggests a genetic influence. I’d love to see a study looking at the prevalence of misophonia in separated twins, or other close family members. Thanks for sharing!

  6. Alchemist says:

    The story of the twins with misophonia is fascinating. I guess it would be illogical to knock away any ‘nurture’ influences, but it suggests that there is a subset of sufferers who will be unable to pinpoint any environmental cause.

  7. Anonymous says:

    This first manifested as a complete intolerance to the sound of my younger brother smacking his mouth across the dinner table from me. I begged my mother to make him stop, but she simply accused me of being intolerant. I was 11. In the last 40 years, it has not improved much, and I eventually picked up a few new triggers – most eating or drinking sounds (only the sounds made by a body – silverware scraping a plate doesn’t bother me), any other smacking sound coming from the mouth (esp. if someone is talking while nervous or emotional, or if they are chewing gum while speaking, and it includes kissing sounds), labored breathing through the nose, the snorting of sinus drainage (also makes me want to vomit). Lately, I find that the light quick scratches to my back that my beloved spouse uses to greet me make me want to hurt him. It is the first time that I have had a problem with a kinetic trigger.

    My father recently revealed that the sound of his wife eating chips sends him into a rage. “She crunches on purpose!” he said with exasperation. I did not grow up with him, nor was I aware he had such a strong sound reaction. Of my children, #1, #4 and #7 have misophonia, which began in early adolescence. They are also bothered by eating and breathing sounds, but have various triggers that I do not. They don’t tolerate the sound of silverware scraping and clinking on dishes. One is driven insane by the sound of her cat licking, which she can hear all the way across the house, and even while sleeping. One cannot bear the sound of the mourning doves cooing in our back yard. One can’t stand the way certain peoples’ lips move while they chew.

    For all of us, the general reaction is instant rage, and a desire to punch the offender in the face. I learned to control my outbursts long ago, and my children are usually good about doing the same. We are great fans of headphones and cheap ear plugs which muffle the higher pitched sounds which tend to trigger us.

    We have gluten intolerance, but some of my GF kids are sound oblivious. I’ve been a hormonal mess most of my life, and believe there is a hormonal connection due to the usual time of symptom onset. I predict a connection to estrogen will eventually be found. Over the years, I have become very aware that my sound tolerance rises and falls with my estrogen levels. When my estrogen levels are very low, my sound tolerance sharply declines. At times, I have had to temporarily stop eating as I could not bear the sound of my own chewing.

    It’s hard to imagine that much effort will be devoted to solving this puzzle. However, it is a relief to discover that we are not suffering alone, and that we are not simply mean and intolerant people. Thank you for posting the article, and helping to educate people.

  8. ezzsakr says:

    I’m 49, I don’t remember when it started, the sound of eating generally, probably before the first 11 years of my life. My father, a Navy officer, started, on his own, a behavioral cognitive therapy but he failed to treat me.
    I’m a physician, surprisingly I never heard of this term, until my wife a pharmacist discovered it. Thank God I don’t feel any pain from her side, she eats quietly.
    There is genetic predisposition, my father and my sister but no one as severe as me going to scale 7-9. I made the fatal mistake of telling a Saudi young doctor that I hate the sound of chewing gums, now all of them chew gums during the round every day. I will not jeopardize my job for a punch of stupid kids. But it’s getting hard sometimes. I cannot try white noise because of the stethoscope.
    I have false innervation so that while I’m eating my left eyelid retracts synchronously with masseter contraction. I don’t know if this is related. May be this auditory input found its way to some displeasure centers. I cannot imagine what Synesthesia is.
    If there is any research going on I would be happy to participate.
    Thank you

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