There are times when chewing, pen tapping, or other little noises bothers us to no end. For those with a condition known as misophonia, however, those sounds are more than just annoying — they can be unbearable.

First named as a condition in 2001, “misophonia” is the ancient Greek word for “hatred of sound.” Also known as selective sound sensitivity syndrome, it’s a genuine abnormality of the brain with both psychological and physiological symptoms. In a recent study, MRI scans showed a marked difference in the brain structure of those who have misophonia and in the way their brains react when hearing trigger sounds.

This hypersensitivity to sound causes a fight-or-flight response in people with the condition that can interfere with their daily lives. They may feel anxiety, rage, and panic upon hearing triggering sounds. This can lead to avoidance, isolation, and depression.

Research into misophonia is still relatively new. Criteria for diagnosing the disorder isn’t yet included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but some doctors have proposed including it under “Obsessive Compulsive and Related Disorders.”

Triggering sounds vary among people with misophonia and may change over time. The most common triggers are those that come from other people’s mouths. This includes:

  • chomping
  • slurping
  • swallowing
  • throat clearing
  • lip smacking

Other triggers may include:

  • sniffling
  • writing sounds
  • papers rustling
  • ticking clocks
  • car doors slamming
  • the sounds of birds, crickets, and other animals

Almost any sound can be a potential trigger. Some with misophonia also have visual triggers. This can include:

  • foot wagging
  • nose rubbing
  • hair twirling

The best way to describe what happens when someone with misophonia hears or sees a trigger may be to think about what it’s like for most people to hear nails on a chalkboard. Your skin prickles, your nerves flare, and you just want it to stop immediately. For most, that occurs just once in a while. People with misophonia, however, may experience that sensation on a daily basis because of sounds other people hardly notice.

Dr. Barron Lerner, a doctor and NYU professor who has misophonia, explains that, in a word, trigger sounds feel awful. “Like your blood is starting to boil. [There are] lots of anxious feelings, like heart racing and stomachache.”

According to Dr. Marsha Johnson, an audiologist with the Oregon Audiology Clinic who has studied misophonia for more than 20 years, people with the condition start to experience the response to the sounds before they’re even cognitively aware they’re hearing them.

“It’s like a tsunami of negative responses,” Johnson said. “It’s instant. It’s huge. It takes over most of their cognitive functioning.”

Researchers don’t know yet what causes misophonia. There appears to be a higher occurrence of the disorder among people who also have the following conditions:

It also appears to be more common in people who have tinnitus. Tinnitus is a different disorder in which you hear sounds, like a ringing in your ears, that no one else can hear.

“Misophonia seems to be its own condition, but there is definitely overlap with these other conditions,” Lerner said. “Lots of people who have these other things have misophonia, and the symptoms they generate are similar. For example, an anxious person with misophonia might get similar heart racing, sweating, etc., from a stressful situation at home or work as with hearing a particular noise.”

Johnson points out that for years, people with misophonia were misdiagnosed with anxiety, phobias, and other disorders. But misophonia is a unique disorder with its own special characteristics, including the following:

  • The onset of misophonia is generally before puberty, with the first symptoms occurring most frequently between the ages of 9 to 12.
  • More women than men have misophonia.
  • People with misophonia tend to have higher IQs.
  • The initial trigger sound typically is an oral sound from a parent or family member, and new triggers arise over time.
  • There’s likely a genetic component as it often runs in families.

While misophonia is a lifelong disorder with no cure, there are several options that have shown to be effective in managing it:

1. Tinnitus retraining therapy

In one course of treatment known as tinnitus retraining therapy (TRT), people are taught to better tolerate noise.

2. Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is another type of therapy that may help change the negative associations you have with triggering noises.

According to Johnson, ear-level devices that stream audio of rain, nature, or other sounds have proven particularly effective, with 85 percent of users experiencing a relief in symptoms.

3. Counseling

Supportive counseling for both the person with misophonia and their family is also important, as the condition can affect the entire family.

At this time, there are no medications approved by the U.S. Food and Drug Administration to treat misophonia and no conclusive scientific evidence that any medication is effective in its treatment.

Johnson asserts that most people with misophonia are able to overcome its challenges.

“From what I can tell after 20 years of following misophonia sufferers, most go on and have good lives,” Johnson said. “Many have children and incredible careers, and that’s important for young kids suffering from this disorder now to know.”