Q: What happens during a misophonia attack?

A: 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 is 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.