Misophonia

Misophonia is a neurophysiological disorder characterized by an excessive reaction of anger, disgust, and a “fight-or-flight” response to specific sounds. The disorder typically begins in early childhood or adolescence. Sounds that trigger this response are usually repetitive and associated with human breathing and eating sounds, or actions such as tapping on a keyboard or with a pen. The individual with misophonia has an instant and overwhelming reaction to them that is beyond their control.

The incidence of misophonia is not known, but a sample of almost 500 students on a U.S. college campus in 2014 indicated that 20 percent had symptoms of misophonia that bothered them significantly.

Misophonia is distinct from hyperacusis (an intolerance to sounds of certain loudness and/or pitch) because problem sounds are usually quiet and specific to certain people or environments.

Misophonia typically starts with a few trigger sounds related to family. A young person with misophonia who enjoys eating with their friends may be unable to tolerate a meal at home with family members who trigger them. Life at home becomes challenging as the individual with misophonia stays on constant alert trying to avoid trigger sounds, and family members walk on eggshells trying to avoid making sounds that could cause a reaction. The person with misophonia tends to acquire triggers involving people and places outside of family and home. Even the sight of repetitive body movements associated can become a trigger. Misophonia symptoms worsen when the individual is feeling stress.

We do not know the cause of misophonia, but we know that the brains of people with the disorder are activated differently by trigger sounds and have stronger neural connections between certain parts of their brains, when compared to a control group. We also know that misophonia is frequently found in more than one member of the same family, and it frequently co-exists with autism spectrum disorder and anxiety disorders.

A diagnosis of misophonia is made based on the patient’s symptoms. We do not yet have a cure for misophonia, but symptoms can be managed through the development of coping skills and strategies to reduce the intensity of reaction, ease emotional distress, reduce misophonia-related family tensions, and improve function at school and in social situations.

Your child will first see an audiologist who will take a careful inventory of your child’s triggers and their reactions to these sounds, as well as a history of related health issues. Next, they will perform a comprehensive hearing evaluation to rule out hyperacusis and other hearing disorders. The audiologist will then educate you and your child about misophonia and provide recommendations for coping and school accommodations. This will include the fitting of sound generators when appropriate. Referrals to other health care providers who can offer help for misophonia will be discussed, and resources provided.

If you are seeking assistance for your child who may have misophonia, please schedule an appointment for an audiological evaluation and state that the referral reason is misophonia.