What about the treatment of misophonia?
The DSM-5 and ICD-10 do not yet classify misophonia as a discrete disorder. This is significant because the Diagnostic and Statistical Manual of Mental Disorders is the authoritative guide to classifying and diagnosing mental disorders. Psychiatrists and other physicians, psychologists, social workers, nurses, occupational and rehabilitation therapists, and counselors all use the DSM-5. Misophonia it is not generally considered a psychiatric illness but the DSM-5 still applies in guiding procedure, insurance concerns, general practice and treatment modalities.
It is important to note that the exact cause of misophonia is unknown and for now there is no completely effective universally effective treatment for misophonia. However, this does not mean that there are not efficient coping methods that could prove beneficial to sufferers.
Some proposed treatments are used for disorders similar to misophonia. This includes tinnitus retraining therapy (TRT) which teaches people to improve their ability to tolerate certain noises, cognitive behavioral therapy (CBT) that involves changing negative thoughts that may help alleviate the adverse effects of a sound sensitivity and the process of adding background noise to a person’s environment in an effort to help them ignore/tolerate their trigger sounds. Other less used approaches to treatment have included desensitization techniques, deconditioning and medications.
The internet contains a lot of information on the treatment of misophonia and it seems sensible to thoroughly evaluate the information one finds there before accepting it as fact. Managing one’s misophonia-related issues requires caution because misophonia is not well-studied and has no definitive cause or treatment. However, there is not enough evidence to conclude that any of these methods will have significant impact on the disorder. The following statement was released by Duke University:
“There are no single specific behavioral or device-based treatments that have been rigorously tested scientifically and shown to efficaciously treat Misophonia. At this point, there only are early small scale uncontrolled and pilot studies that have not yielded definitive results. Accordingly, as consumers of treatment services, patients seeking services for Misophonia are encouraged to ask treatment providers to disclose (a) which interventions will be used to help treat Misophonia, (b) the rationale for such approaches in light of available scientific evidence, and (c) any potential risks a particular treatment may pose.”
The Internet contains a lot of information on the treatment of misophonia and it seems sensible to thoroughly evaluate the information one finds there before accepting it as fact. Managing one’s misophonia-related issues requires caution because misophonia is not well studied and has no definitive etiology or treatment.
A general search for information on misophonia will currently produce these results (as of July 2016):
Roxanne Dryden-Edwards, MD, a psychiatrist with a distinguished resume, wrote an article for MedicineNet.com. She states: “Since it is thought that this illness develops at least partly as the result of the misophonia sufferer developing a conditioned response to certain noises, an approach that has had some success is the process of deconditioning people with this disorder.” The article doesn’t mention the source of this claim. A search for more detailed documentation on the research done on desensitization may be indicated. Interestingly, each page ends with this ambiguous phrase: “Medically Reviewed by a Doctor on (insert date here)” and each page’s footer also contains this disclaimer: “MedicineNet does not provide medical advice, diagnosis or treatment.”
Should the information on MedicineNet.com be discounted? Probably not altogether but without the source of the information available, it might be prudent to continue searching for more detailed and documented facts and figures.
Similarly, WebMD.com also states that is does not “provide medical advice, diagnosis or treatment” and it presents a limited explanation of misophonia predominately using only one audiologist’s opinion (who treats tinnitus and hyperacusis) as its cited source of information. The information in the article appears to be reasonable as it mirrors the suggested treatments found elsewhere: psychological counseling, sound masking and use of medications. But again, one audiologist’s opinion should not be considerd the same as proven scientific evidence.
Wikipedia is a collaborative effort. The people who use it are its authors therefore one would hope that it would contain accurate information. The general description and basic information it presents on misophonia also appears to fall in line with current generally accepted theories on symptoms, diagnosis and treatment. According to Wikipedia, misophonia has no current evidence-based treatment modalities.
Misophonia.com strives to provide relative and current information on misophonia and recognizes that misophonia is still in the initial stages of study. Keeping an open mind may serve one well when seeking treatment of this difficult disorder as there is no definitive course of action. Participating and supporting research is worthwhile as is bringing sound sensitivities to the awareness of the public. Support groups are helpful to many people and offer comradery and support.
The members of the message board and Facebook group reported that increased general knowledge about misophonia and suggestions for coping with specific issues was invaluable.
What Medical Professionals Could Help and How
An Audiologist with proper training may help by evaluating if a patient has Misophonia, although there is no approved “test” for Misophonia yet and it is not in any diagnostic manual. Audiologists may provide patients with earplugs that have been personally fitted. These may or may not generate non-offending noise to mask the noises that bother a patient.
Some cognitive psychologists feel that Misophonia should be classified under Obsessive Compulsive and Related Disorders (previously termed “OCD” in the DSM-IV-TR) in the DSM-5. While there may be neurological and behavioral overlaps, there is no compelling evidence that this overlap exists, or that OCD treatment will help patients. Psychologists may help a patient by helping them to find coping mechanisms that lessen the impact of triggers.
Psychiatrists can prescribe medication to treat symptoms and conditions that may accompany the condition (such as anxiety, insomnia, feelings of rage/fear/depression, etc.). However, there are no medications that have been tested or considered for the disorder.
Anyone who has sudden onset of any changes in mood or sensory perception, should see a neurologist to rule out other disorders. While there is no current cure or diagnosis for Misophonia it is important that patients suffering from these symptoms are properly evaluated and not simply passed-off as having “anxiety issues”.
An OT (Occupational Therapist) may be beneficial for sufferers of sensory over-load. Many OTs have been trained to understand SPD (Sensory Processing Disorder) and understand techniques to help children, teens, and even adults with the disorder. While OTs do not cure sensory conditions they are invaluable in helping patients to cope and live a relatively normal life.