Do you also feel unbearably angry or agitated when you hear certain sounds? Let's talk about Misophonia!

Have you ever noticed that the sound of someone eating, breathing loudly, or even the tapping of a pen makes you feel so angry, disgusted, or agitated that you can't bear it? Are those feelings so intense that they sometimes feel hard to control? That's the kind of condition we're going to talk about today, called misophonia. What happens is that you lose your tolerance for certain sounds and the things they're associated with (things you see, things you touch).

What exactly is Misophonia?

Simply put, misophonia is a condition in which you experience intense emotions (such as anger, anxiety, disgust) when you hear certain sounds . It doesn't affect everyone the same way. Some people may have just one "trigger" sound, that is, a sound that causes this intense response. Others may have several such sounds.

Also, the severity of these reactions varies from person to person. Some people are unable to control their emotions, but they can control their behavior. But some people are unable to control both and react in unexpected ways. In severe cases , some people may be unable to do certain things or be in certain environments. Imagine, if you can't stand the sound of someone chewing gum nearby, you might not even want to ride the bus, right?

Who is most affected by this? How common is it?

Research shows that while anyone can develop misophonia, it seems to be more common in women . According to some reports, between 55% and 83% of people with the condition are women.

Misophonia can occur at any age. However, research has found that it is most likely to begin in early adolescence , around the ages of thirteen or fourteen. Further research is being done to determine if there are other factors that contribute to this condition.

As for how common this condition is, current research suggests that misophonia may affect up to one in five people at some point in their lives. This means it may be more common than we think.

What are the symptoms of this? See if this happens to you too.

The symptoms of misophonia depend largely on how you respond to these “trigger” sounds. These responses all seem to be related to our body’s natural “fight-or-flight” instinct. That is, these responses can be as follows:

• Emotional reactions:These are the things you feel. They can be very intense, almost unbearable. Imagine, it can start as a little anger, and suddenly go to a lot of anger, maybe even a frenzy. It's like someone suddenly stepped on the `gas pedal` of your emotions.
• Body reactions: These are natural, protective processes that occur in your body. These are often similar to what happens when you encounter something dangerous or frightening.
• Behavioral reactions: These are the things you do in response to that “trigger” sound. These are often not things you think about, but things that happen automatically, instinctively. This means you may not be able to fully control them. In rare cases, you may react violently to other people or things.

Now let's see what each of these types of reactions are.

Emotional reactions

These may include:

• Anger
• Anxiety
• Disgust
• Fear
• Irritation – Feeling overwhelmed by even small things

Body reactions

These may include:

• Increased blood pressure
• Chest pressure or tightness
• Goosebumps/gooseflesh
• Increased heart rate
• Sweating

Behavioral reactions

These may include:

• Avoiding places where you might hear “trigger” sounds. For example, avoiding places where people eat together.
• Leaving as soon as you hear the "trigger" sound.
• Responding with words or vocalizations (e.g., scolding or yelling at the person making the noise).
• Stop the noise and act non-violently .
• Acting violently to silence the noise (this happens very rarely).

The severity of symptoms can vary from person to person. If the symptoms are not severe, you may only experience emotional and physical reactions. However, if the symptoms are severe, the impact is so severe that you may also have a behavioral response.

In extreme cases, a person may react so violently, either verbally or in an action, that they don't even have time to think before acting in a way that is harmful to others. In such cases, it is common for a person with misophonia to later realize and regret what they have done. However, they may have difficulty controlling such reactions in the future.

What are the most common "trigger" sounds?

Any sound can be a trigger for misophonia. However, some sounds are more likely to be triggers. For example:

• Sounds from the mouth: chewing, swallowing, drinking, smacking, swallowing.
• Breathing sounds: loud breathing sounds, nasal breathing sounds, snoring sounds.
• Hand sounds: the sound of typing, the sound of a pen tapping, the sound of fingers tapping on a table.
• Environmental sounds: the ticking of a clock, the sound of a drop of water falling.

Noise from electronic devices like TVs and radios can also be a “trigger.” However, if you are close to the source of the noise, it may not cause a severe enough reaction.

Why does misophonia occur? What are the causes?

Experts don't yet know exactly what causes misophonia. However, they suspect that it may be caused by a combination of factors. Some of these suspected causes include:

• Brain structure differences: Research suggests that people with misophonia are more likely to have certain differences in the structure and function of their brains. One of these is that some parts of the brain have more connections and activity between and within them than others. These affected parts of the brain control how you recognize sounds and how you manage your emotions . Hearing sounds and emotions are parts of your brain's defense system. That's why you can associate emotions like anger, disgust, and fear with dangerous situations.

Misophonia is like turning on a radio that was on full blast. You automatically respond to the sudden loud noise by turning it off. Similarly, in misophonia, your brain mistakenly puts you in the “ fight or flight ” mode. That’s what causes the emotional, physical, and behavioral reactions and symptoms mentioned earlier.

• Other conditions: SomePeople with neurodivergent conditions, mental health conditions, and hearing loss are more likely to develop misophonia. Some examples include:
• Neurological conditions and other brain disorders:
• Attention-deficit/hyperactivity disorder (ADHD)
• Autism spectrum disorder
• Tourette syndrome
• Mental health conditions:
• Major Depressive Disorder (MDD)
• Obsessive-Compulsive Disorder (OCD)
• Post-Traumatic Stress Disorder (PTSD)
• Borderline Personality Disorder (BPD)
• Conditions or symptoms related to hearing loss:
• Hearing loss
• Tinnitus (a constant ringing in the ears)
• Hyperacusis (hearing normal sounds too loud to bear)

Also, people who have symptoms related to ``OCD'' but not yet fully developed enough to be diagnosed with ``OCD'' are more likely to have misophonia. It has been found that about 24% of people with these symptoms have misophonia.

• Family history or genetics: There is also evidence that misophonia may run in families. Experts have also identified a genetic mutation that is thought to be involved. However, more research is needed to confirm whether this is indeed the case.

How do you diagnose this?

The American Psychiatric Association has not yet officially recognized misophonia as a disorder in the fifth (latest) edition of its Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). However, in 2022, a committee of experts reached a consensus on a definition that can be used to research, diagnose, and treat the condition.

A doctor can ask you questions and listen to you about your experiences to identify common symptoms of misophonia. Based on your answers, they can tell you if you have the condition. However, it's important to remember that it's not an official diagnosis .

Is there a treatment for misophonia? Can it be cured?

Although misophonia is not an officially recognized disorder, its effects are not untreatable. The similarities and connections between misophonia and other conditions, such as OCD and PTSD, suggest that people with the condition may benefit from various forms of psychotherapy.

While psychotherapy cannot completely cure a condition like misophonia, it can help with the following:

• Identify your "trigger" sounds .
• Find ways to reduce or avoid "trigger" sounds.
• Develop strategies and methods to prevent sudden, involuntary responses to “trigger” sounds.
• Reduce your sensitivity to existing triggers.

Treatment for other conditions associated with misophonia (e.g., anxiety, OCD) may also help with misophonia symptoms. Your doctor is the best person to know if treating these related conditions will help you and what treatments they may recommend.

What are the things we can do alone?

Many people with conditions such as misophonia, which are sensitive to sounds, can adapt to or manage their condition using commonly used items, technology, or coping strategies. Here are a few examples:

• Using earplugs or noise-canceling headphones/earbuds .
• Instead of waiting for a “trigger” sound to occur in your brain, you can listen to something else (e.g., songs, podcasts).
• Listening to noise generator sounds (especially white noise, pink noise, or brown noise) can help drown out other sounds in the environment.
• Workplace accommodations: Your employer may provide you with things like headphones or make changes to policies to help you avoid or reduce the impact of “trigger” sounds.

Your doctor can refer you to resources that can help you find these kinds of workplace accommodations. There are also many groups online and on social media where people with misophonia can come together to share their thoughts, advice, and resources that can help you.

What will this situation be like? What to expect?

When misophonia is mild , it may be a minor annoyance. Symptoms can be managed, and although you may still experience intense emotional and physical reactions, you can control your responses and quickly regain control of your emotions.

But, in severe cases, the emotional and physical reactions can be overwhelming. The resulting “fight or flight” responses can be difficult, if not impossible, to control. Your brain automatically goes into a defensive mode, so you may act out of control. This can lead to you hitting the person you “trigger” with something, verbally, or physically.

Your brain is designed to make and strengthen connections that help protect you. As a result, your reactions to “trigger” sounds may become worse over time , and you may start to respond to new “trigger” sounds.

Current research suggests that misophonia is a lifelong condition , but experts need more research to confirm this.

Is this dangerous? How does it affect our lives?

Misophonia is not directly life-threatening or life-threatening . However, it can negatively impact your mental health, relationships, and overall well-being. People with misophonia often have other mental health conditions as well.

People with severe misophonia may experience fear or anxiety about hearing “trigger” sounds. These feelings can sometimes be so strong that they interfere with your daily activities or tasks. Treatment can help you cope with and adapt to the condition. However, more research is needed before experts can agree on the best ways to treat the condition and what you can do to improve your quality of life if you have it.

When should I see a doctor?

Misophonia can be unpleasant or annoying, but in most cases it is not severe enough to interfere with your life. However, if your symptoms are severe enough to interfere with your life (social or professional) , you should see a doctor. They can help you learn more about your condition, or refer you to a specialist who can help.

What to do in an emergency?

People with severe misophonia, especially those with other mental health conditions, may be at increased risk of developing thoughts and behaviors that could harm or kill themselves . If you are having these thoughts, you should seek help immediately . Also, if you suspect that someone you know is in imminent danger of harming themselves, you should seek help immediately.

To get help in situations like this, you can:

• Contact mental health support services in your area . In Sri Lanka, you can call the national mental health helpline number 1926 .
• Go to the emergency room of the nearest hospital.
• If you or someone you know feels like there is immediate danger,Call local emergency services (e.g. 119 police emergency number).

Is misophonia a type of anxiety?

No, anxiety and misophonia are two different conditions . However, there may be a connection between misophonia and anxiety, and a person can have both conditions.

Finally, things to remember

Misophonia can be a really annoying condition. It can be so common that you feel like you can't escape it because certain sounds are "triggering" it. While it's not an officially recognized disorder (though there's evidence that it should be, and many experts support it), doctors are beginning to understand what it is, how it happens, and how it can affect you.

Although more research is needed to develop ways to diagnose and treat it, some treatments for related conditions may help. You can also learn ways to manage it and limit the impact it has on your life. Then, you can focus less on the things you don't like and more on the things you do like. Don't worry, you're not alone. It's important to talk to a doctor about this.