Repeated noises like chewing, pen tapping, sniffling, or scratching can cause annoyance and frustration for anyone.

But for people living with a condition called misophonia, originally known as selective sound sensitivity syndrome, these noises are more than just bothersome. With misophonia, those small sounds, and plenty of others, can be downright unbearable.

To put it simply, misophonia involves an extreme sensitivity to certain sounds. As a matter of fact, the name “misophonia” comes from the Greek word for “hatred of sound.”

This hypersensitivity prompts a fight-or-flight response to triggering sounds. You might, for example, have an extreme urge to:

  • leave the room immediately
  • press your hands over your ears
  • scream, “Stop making that sound!”

Some triggers might cause so much distress that you begin to avoid certain situations and people as a result. If eating sounds usually trigger this response, you might start eating all your meals alone and avoid going to restaurants, cafes, or any other public places where people might eat.

Researchers first proposed the name misophonia in 2001, and research remains in the relatively early stages. Some experts consider misophonia itself a condition, but others believe it might develop as a symptom of other mental health conditions.

Experts have yet to agree on specific criteria for diagnosing misophonia. But they do recognize it as a real concern that can have a significant impact on mental health and well-being. Many medical and mental health professionals can help you get treatment and support.

The most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5)” doesn’t include misophonia. That said, some doctors have suggested including it in future editions, in the “Obsessive Compulsive and Related Disorders” category.

Read on to get the details about misophonia, including symptoms, triggers, possible causes, and tips for coping.

You can generally recognize misophonia by its main symptom: a strong negative reaction when hearing triggering sounds.

More specifically, that response might include a range of feelings, emotions, and physical sensations:

  • feelings of annoyance, irritation, and disgust
  • anger, rage, or feelings of aggression, including a desire to lash out physically or verbally
  • nervousness or uneasiness in situations that could involve triggering sounds
  • a sense of anxiety or panic, including feelings of being trapped or losing control
  • tightness or pressure throughout the body or in the chest
  • increased heart rate, blood pressure, and temperature

These symptoms generally appear for the first time during the preteen or teen years.

If you’re living with misophonia, you might recognize your response to certain sounds as somewhat extreme. Even so, you might find it tough to cope with the distress those sounds cause or to manage the intensity of your reaction on your own.

When you have a hard time coping with triggering sounds you hear in everyday life, you might start to avoid the places you typically hear those sounds. This might mean avoiding friends and family, or frequently missing work and school.

In short, misophonia can eventually disrupt daily life quite a bit.

Triggering sounds can vary pretty widely from person to person.

These triggers can also change or increase over time. Even when misophonia begins in response to one specific sound, as it often does, other sounds might eventually trigger a similar reaction.

Some of the most common misophonia triggers are oral sounds made by other people. Examples include:

  • chomping or crunching
  • slurping
  • swallowing
  • loud breathing
  • throat clearing
  • lip smacking

Other triggers may include:

  • sniffling
  • writing sounds
  • pen clicking
  • rustling of papers or fabric
  • clocks ticking
  • shoes scuffing
  • glasses or silverware clinking
  • nail filing or clipping
  • mechanical humming and clicking
  • birds or crickets chirping
  • animal grooming sounds

For some people, visual triggers can cause a similar reaction. This might happen if you see someone:

  • wagging or jiggling their legs or feet
  • rubbing their nose
  • twirling their hair or pen
  • chewing with an open mouth
  • moving their lips or jaw in a chewing motion

If you’re living with misophonia, you might notice that making the same sound yourself typically doesn’t provoke any reaction at all. Some people with misophonia even find that mimicking the triggering sounds can help ease the distress they cause.

If you don’t have misophonia, you might wonder exactly how it can cause so much distress.

To better understand this condition, try imagining how you feel when you hear a sound you really hate. Nails scraping a chalkboard is one classic example. Others might include a car alarm going off or a baby wailing. When you hear those sounds, your skin might prickle as your nerves flare. You just want it to stop immediately.

When you don’t have misophonia, you’ll notice this response only rarely, in response to sounds that tend to bother most people. What’s more, since others around you might have a similar response, you’ll probably find it easy to express your annoyance or disgust.

People with misophonia experience that sensation on a regular and sometimes daily basis, in response to sounds other people hardly notice. Recognizing that most people would consider their reaction extreme can make it tough to open up about how they feel. This can add to their isolation and distress.

Dr. Barron Lerner, author and NYU professor living with misophonia, explains that trigger sounds feel, in a word, awful. “Like your blood is starting to boil,” he says, going on to explain that they can also cause physical symptoms of anxiety, like a racing heart and stomachache.

According to Dr. Marsha Johnson, an audiologist with the Oregon Tinnitus and Hyperacusis Treatment Clinic, people with misophonia start to experience the reaction before they’re even cognitively aware that they’re hearing the trigger sound.

“It’s like a tsunami of negative responses,” notes Johnson, who has studied misophonia for more than 20 years. “It’s instant. It’s huge. It takes over most of their cognitive functioning.”

Researchers aren’t yet certain what causes misophonia.

They do know it appears more commonly in people who also have:

Some have also suggested a potential connection between misophonia and attention deficit hyperactivity disorder (ADHD).

Lerner notes that while misophonia seems to be its own condition, it definitely has some overlap with other conditions, including similar symptoms.

An anxious person with misophonia might experience increased sweating and a racing heart when they hear a particular noise. But they might also have these symptoms when they face any other type of stress, he explains.

Johnson points out that for years, people with misophonia were misdiagnosed with anxiety, phobias, and other mental health conditions. But misophonia has unique characteristics, including the following:

  • It generally begins around puberty, with the first symptoms often appearing between the ages of 9 to 12.
  • Women tend to report more severe symptoms.
  • The initial trigger often comes from a parent or family member, but new triggers can develop over time.
  • It often runs in families.

Emerging evidence offers a brain-based explanation for misophonia.

A small study from 2019 suggests that misophonia may develop thanks to a hypersensitive connection between your auditory cortex and your salience network. The auditory cortex is the part of the brain that processes sounds, and the salience network is responsible for determining what sounds (and other stimuli) you pay attention to.

This irregular connection leads to increased activity in certain parts of your brain, which prompts the intense emotional response you experience.

A small 2021 study linked misophonia to larger amygdala volume, along with irregular brain connectivity. The amygdala, if you were wondering, helps process emotions, including your reactions to things that frighten or threaten you. Researchers suggest your response to certain sounds may relate, in part, to the amygdala’s size.

Currently, there’s no cure for misophonia, but you do have options for managing your symptoms.

Tinnitus retraining therapy

Tinnitus causes you to hear sounds, like ringing in your ears, that no one else can hear.

Tinnitus retraining therapy was originally designed to help people with tinnitus learn to accept and tolerate those sounds. It can also help people with misophonia learn to cope with trigger sounds.

Counterconditioning

This treatment pairs a weaker sound trigger with something that prompts positive or happy feelings, like a favorite song, photo of a loved one, or something soothing to the touch. In a 2015 case study, this treatment helped a woman with misophonia reduce her response to sound triggers.

Coping strategies

Your go-to coping technique might involve leaving a room when you hear a trigger, but sometimes, you might not be in a position to leave.

Other things to try might include:

  • using noise-canceling headphones
  • listening to music, calming sounds, or white noise
  • distracting yourself with a calming mantra or affirmation
  • politely asking the person making the sound to stop

According to Johnson, audio of rain, nature, or other similar sounds has proven particularly effective in her work, with up to 85 percent of users experiencing some relief in their symptoms.

Counseling

Therapy with a trained mental health professional offers a safe space to open up about the distress misophonia causes. Through therapy, you can learn effective strategies to cope with the condition.

Cognitive behavioral therapy is a type of therapy that helps you address and reframe unwanted thoughts and reactions. This type of therapy could go a long way toward helping you navigate the emotions and physical sensations caused by triggering sounds.

Interested in connecting with others living with misophonia? The nonprofit Misophonia Association offers more information about support groups throughout the United States, plus a directory of professionals who treat misophonia.

What about medication?

At this time, the Food and Drug Administration (FDA) hasn’t approved any medication to treat misophonia. No conclusive evidence suggests medication can help treat the condition.

If you have symptoms of both misophonia and another mental health condition, such as anxiety, OCD, depression, or ADHD, a doctor or psychiatrist can offer more information about medications that could help improve symptoms of these conditions.

Most people with misophonia find it possible to overcome its challenges, Johnson concludes. In other words, getting support could make a big difference.

Get tips on finding the right therapist or explore options for online therapy.