Woman doctor talking to a female elderly patient about misophonia

Q: I can’t stand to hear some sounds. Am I crazy? Am I just oversensitive and need to suck it up? Or do I have Misophonia?

Most people can become aggravated at certain sounds, depending on the level. Eating dinner with a family does not usually provoke anger and disgust. However, if someone at that table is eating with their mouth wide open, slurping drinks, chomping food, and generally being disgusting, most of us are irritated. This is the reaction that a person with Misophonia has to normal eating sounds.

A 2014 study of college freshman revealed that about 20 percent of them were sensitive to eating sounds. A smaller percentage would likely be classified as having Misophonia. Misophonia is not made up, the reactions are not volitional, and they happen before the person has time to even think about the sounds. Parts of the brain that react quickly to sounds and other stimuli to keep us alive have identified Misophonia trigger sounds as invasive and damaging. The feelings of anger, rage, and disgust occur so that the individual will do something to stop the offensive sounds.

If people with Misophonia could think their way out of it, they probably would have done so already. However, their reactions are so very strong and involuntary that they are unable to successfully deal with the offenses by talking themselves out of it. Treatment for Misophonia is in its beginning stages, and new Bluetooth® technology has greatly improved the effectiveness of the treatment in the past couple of years. We have experienced significant high-level success, enabling our patients to interact with co-workers, family members, and friends without constant anxiety, anger, and fear.

Q: Do I have Misophonia?


  1. Do you find some sounds really disgusting, to the point that you must constantly ask people to stop making the sound or leave the area entirely?
  2. Do some sounds make you very angry and anxious because you find them intolerable?
  3. Are there sounds that you hate but find yourself always concentrating on, focusing on them to the exclusion of everything else? Do these sounds happen frequently?
  4. Do you rearrange your life to avoid specific sounds?
  5. Do you make others change what they are doing because you can’t stand the noise they make?
  6. Do others not understand your intolerance to sounds?
  7. Do you not understand how others can tolerate specific sounds?
  8. Would you rather not hear at all than keep hearing trigger sounds?
  9. Do trigger sounds feel like bee stings, and you just can’t get away from them?
  10. Are you afraid sounds may be driving you crazy?

If you answered yes to four or more of these questions, you may have Misophonia. It is suggested that you contact a Misophonia specialist for more details.

Q: What happens during a Misophonia attack?

Our brain makes everything in our bodies work. It also makes decisions to keep us alive, even though we may not consciously think of that decision. Imagine yourself in your home in the evening, expecting others to arrive at any time. At one point, you hear the garage door open, hear a key in the lock, and hear the door open. While you are aware of those sounds, alarms are not warranted, and you remain calm, continuing your activity.

Now, imagine hearing those same sounds — the garage door, key in the lock, and interior door open — at 3am. You become wide awake, adrenaline is released throughout your body, your heart beats faster, your palms sweat, and you listen harder to try to determine what is going on. At this point, your amygdala in the midbrain is alerting you to danger, readying your body for fight or flight, and actually increasing the intensity of those sounds within your brain. It does this to keep you alive. It’s part of our survival skills.

This same thing happens for those with Misophonia when they hear trigger sounds. Their hearts pound, adrenaline is released, and they either try to find a way to stop the sound or to get away. Their survival system is screaming “ALERT!” but they feel trapped. People with Misophonia can’t talk themselves out of it. Reasoning doesn’t work because their emotional system, in a negative and high-alert mode, overrides all attempts to make sense of the sounds and the reaction. This reaction is truly uncontrolled and happens before the person even knows what’s going on. People with Misophonia are not making up their reactions. Most can, however, learn to rethink and retrain their brain to decrease and possibly eliminate this highly negative reaction.

Q: Why do I concentrate on trigger sounds so much? I don’t want to!

The brain of someone with Misophonia has determined that specific sounds — trigger sounds — are harmful to them and that those sounds must be monitored. Our minds will focus on an important sound in order to understand speech in noise, specific sounds, or to determine the location of the sound. It is a miracle how we can concentrate at will with other noise going on. When the brain has determined that a sound is important, other parts of the brain can actually raise the volume of the sound louder within the brain.

Have you ever been at a party with lots of people talking, and someone 15 feet away says your name? Immediately we start to listen more closely to that conversation, trying to understand what is being said. This same increase within the brain happens with Misophonia, but the person with Misophonia has not consciously determined that the sound is important — something within their brain has made that determination. But having been made, the brain concentrates on it intently.

A person with Misophonia can hear people sniffle a room away and zone in on that particular sound, perhaps feeling anger and disgust at the sound. Part of our brain — probably the amygdala in the limbic system — has determined that this sound is important and needs immediate attention. The amygdala then notifies a part of the brainstem — the reticular formation — to increase the volume of the sound. These two neurological structures can increase awareness of particular sounds, decrease awareness of them, or not adjust them at all.

There are a lot of sounds we don’t concentrate on and might be unaware of. For example, there are thousands of people who live next door to the train tracks and never hear the train pass by, but they might be aware of when it doesn’t pass by! But for a person with Misophonia, the brain is always aware of trigger sounds, always trying to make them louder, and always searching for them. It is no wonder that the person with Misophonia feels anxiety and stress.

Q: The sounds are incredibly awful! What can I do to block them out?

OSHA, audiologists, and physicians all encourage people to wear hearing protection when around loud noise. Whether in a factory at work or in loud music from a radio or at a concert, loud noise can and will damage your hearing. It is always recommended that people wear hearing protection in loud noise to protect their hearing.

When someone with Misophonia hears sounds that cause irritation, anger, and extreme anxiety, the initial reaction is to cover your ears — with your hands, with earplugs, or with headphones — and maybe drown out the trigger sounds with pleasant music. Hearing protection provides a feeling of security and safety. You may even be able to relax for a little bit and quit searching for trigger sounds in the area.

While this makes sense, it actually conflicts with the way the brain processes sound, which, in turn, directly contradicts the use of hearing protection for Misophonia. It has become evident that when sound levels are decreased in the peripheral ear, the central auditory system actually increases the levels of sound within the brain. Wearing hearing protection to reduce the volume of sound causes the brain to try to increase the volume.

While trigger sounds are decreased in volume, the emotional reaction is increased. Sounds become more intense and increase in number over time when hearing protection is worn. Treatment of Misophonia, then, must somehow cushion the impact of trigger sounds without reducing the volume of the sounds.

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