How does one avoid triggers? Identify people and places that you’ve had problems with in the past. Weigh the pros and cons of interacting with these people and going to places that are likely to trigger you. Are there people who don’t trigger you are or more sensitive to your situation that you can interact with? Is an alternate low-trigger location available?

For optimal health, a lower stress level is best. Many people report that the effects of triggers get intensified when one is under stress. So, avoiding known triggers will help keep your general stress level down.

Is this selfish? Is it OK to avoid certain people? Only you can decide. You can choose to suspend the usual social niceties when doing so will improve your health.

Escaping comes in different forms. Yes, it can mean a literal escape as in leaving a situation in which you’re triggered. It can also mean coming into the situation prepared. As mentioned, earplugs and headphones are great at isolating environmental sounds. Managing a bus or train ride without earplug or headphones can be dicey.

Communication can provide an escape. When people understand what’s going on, they may choose to be helpful. They can stop making the offending noise or reduce the frequency or loudness of a trigger for you. In the best-case scenario, they’ll have become educated about misophonia. They may remember what they can do in similar situations in the future.

In the end, everyone’s needs are different. You may not want to avoid certain people. And one can’t always avoid all triggering environments. Managing misophonia requires some finesse. One has to find the compromises that best meets one’s needs. Over time, you’ll develop coping skills that will serve you well.