Q: What is misophonia?

A: The medical definition of misophonia (from the Greek “miso” and “phone” meaning “hate” and “voice”) is “a rare disorder in which certain sounds provoke extreme reactions that may be interpreted as unreasonable for the circumstances.” Specifically, misophonia is not that a sound is annoying to the patient (so this is not just cringing when someone scrapes their fingernails across a blackboard), but that the affected person has an intense emotional response (ranging from anxiety/dislike to anger/hatred to a flight or fight type of response) to the sound (and sometimes to the visual cues that accompany the sound).

Misophonia is slightly more common in females. Although the age of onset of symptoms is variable (I found a reference noting ages of onset anywhere from 5-50), it seems to most often begin in the “tween’ years (ages 9-13).

Although the definition I noted above notes this is a “rare” condition, one study I found noted that of 483 undergraduate students screened, almost 23% were “often or always sensitive to certain sounds.” The trigger sounds are quite variable from person to person, but most often are repetitive sounds (like chewing, breathing noises, keyboard tapping, many others). For some patients the reaction is severe enough as to disrupt their daily lives, for example disrupting their ability to participate in social activities (or other activities).

The specific cause of this disorder is not known, but it is thought to be an issue in how the patient’s brain processes sounds (patients typically have normal hearing and no ear or other abnormalities).

There is no specific treatment identified for misophonia. Understanding that this order exists (and is likely more common than might be thought), and empowering the patient to discuss the issue and seek care are crucial first steps. Avoiding triggers (including using noise canceling headphones and/or other techniques) and supportive counseling (often focused on better controlling the extreme reaction provoked) are the mainstays of treatment.

Jeff Hersh, Ph.D., M.D., can be reached at DrHersh@juno.com