Treatment of Misophonia

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) does not classify misophonia as a discrete disorder. Psychiatrists, physicians, psychologists, social workers, and occupational therapists all use the DSM-5. Although Misophonia is not considered a psychiatric illness, the DSM-5 still applies. It guides procedure, insurance concerns, general practice, and treatments.

Why are people sensitive to some sounds?

The exact cause of misophonia is unknown. Therefore, there is no completely effective treatment for misophonia. But, this does not mean that one cannot get help. There are some effective coping methods that can be very useful.
 

What can be done for misophonia?

Some proposed treatments are the ones used for similar disorders. This includes tinnitus retraining therapy (TRT). TRT teaches people to tolerate certain noises. Also used is cognitive behavioral therapy (CBT), which involves changing negative thoughts. Adding background noise to a person’s environment is a predominate treatment. It helps people ignore/tolerate their trigger sounds. Other less used approaches to treatment have included desensitization techniques, deconditioning, and medications.
According to Wikipedia, misophonia has no current evidence-based treatment available. Many other sources agree.
 
Misophonia.com strives to provide relative and current information on misophonia. And, we recognize that misophonia is still in the initial stages of study. Keeping an open mind may serve us well when seeking treatment options. There is no definitive course of action. But, research indicates that treatment will be addressing sensory and neurological matters.
 
Supporting research is worthwhile. Viable treatments get discovered when research is active well-funded.
 
Misophonia.com promotes participation in online support groups as part of self-help. These groups are helpful to many people and offer camaraderie and support. The members of the Facebook group report that connecting with others is very helpful.

The internet offers different misophonia treatments.

It is sensible to evaluate information before accepting it as fact. Managing one’s misophonia-related issues requires caution. This is because misophonia is not well-studied. It has no definitive cause or standard treatment. At this point, there are early small-scale studies that have not yielded definitive results. A statement released by Duke University said: “There are no single specific behavioral or device-based treatments that have been rigorously tested scientifically and shown to efficaciously treat misophonia.” In other words, buyer beware.

 We should expect answers from providers about their proposed treatment plans. One should have some idea about the treatment’s components. For example, which interventions will the provider use? And, what is the rationale for their approach? Is it based on any scientific study or evidence? Lastly, are there any potential risks involved with the proposed treatment?

Documentation is important!

Roxanne Dryden-Edwards, MD, a psychiatrist, 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.” Since the article doesn’t mention the source of this claim, a search for more detailed documentation on desensitization is in order. The page ends with this ambiguous phrase: “Medically Reviewed by a Doctor on (insert date here).” Also, each page’s footer also contains a disclaimer. It reads: “MedicineNet does not provide medical advice, diagnosis or treatment.

Should we discount all the information on MedicineNet.com? No, not altogether. But one may wish to get more detailed information.

Similarly, WebMD.com also states that it does not “provide medical advice, diagnosis or treatment.” It presents a limited explanation of misophonia using only one audiologist’s opinion. This audiologist treats tinnitus and hyperacusis. But, the information in the article appears to be reasonable. It mirrors suggested treatments found elsewhere. (e.g., psychological counseling, sound masking, use of medication) But this is still only one audiologist’s opinion. It’s not scientific or medical consensus.

Who Can Help?

Audiologists

An audiologist may help by evaluating whether a person has misophonia or some other audiological issue. Audiologists can suggest the use of earplugs and fit them to an individual. These can be made to supply white noise or other sounds to mask problem noises.

Psychologists

Psychologists can help people by evaluating and studying behavior and mental processes. A plan for reducing stress and coping with the symptoms of misophonia could be developed by a psychologist familiar with the condition.

Psychiatrists

A psychiatrist is a medical practitioner specializing in the diagnosis and treatment of mental illness. Although misophonia is not a psychiatric condition, psychiatrists can prescribe medication to treat the symptoms of anxiety, insomnia, rage, and depression.

Neurologists

A neurologist is a doctor with specialized training in diagnosing and treating diseases of the brain, spinal cord, peripheral nerves, and muscles. Most of the time, a primary care doctor refers patients to a neurologist if they have symptoms that indicate a neurological condition.

Occupational Therapists

An occupational therapist may help with assessing treatments to develop, recover, or maintain the daily living and work skills of people with a physical, mental, or cognitive disorder.




21 Comments

  1. “A neurologisdt is a doctor with specialized training in diagnosing and treating diseases of the brain, spinal cord, peripheral nerves, and muscles.”

    Just wanted to let you know about this typo!

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    • My 13 yo daughter was recently diagnosed with Tourette’s Syndrome (TS) (tics + OCD+ anxiety = TS) plus she suffers from misophonia. Her triggers are mouth noises, the way her daddy (and other people) breaths, coughs, grunts. These all feed her anxiety, which causes her tics, and it is a viscous cycle. She is being treated by a Neurologist (to the TS), a Psychologist (for cognitive behavior therapy), and ENT doctor which includes an audiologist (to be fitted for a tinnitus blocker that is a hearing aid device that allows her to control some background noise to cover up some of her sound triggers) , and she use to see a Psychiatrist but now her Neurologist handles all her meds which alleviated the need for that doctor.

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      • I have to add that my daughters misophonia has become so bad she doesn’t leave her room when her daddy is home and only comes out if he is at work. He cannot attend any of her sporting events because now she anticipates the noises he will make and it has really started to effect our home life. I am hopeful the ENT device and the CBT (cognitive behavior therapy) will help her to be able to re-engage with the family.

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        • The same with my daughter and myself (her father). Trying to find solutions.

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  2. My son seems to have this problem he cannot eat at the same table as my husband who makes a bit of a noise when he is eating. Sometimes other things trigger my sins anger as scraping bowls and plates. Do we need to go to the doctors to get my son some cognitive help.

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  3. My husband and family just think I’m a “drama Queen.” It’s very frustrating they don’t take this serious. That just adds to the rage with the triggers. If there’s ever more studies funded…… I’m happy to volunteer. I’d love to see my synapses firing!

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    • Yes! Me too! Whatever will help me with this! It’s debilitating!

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  4. Does anyone have any coping mechanisms that do not involve meeting with a professional that help in class? I am almost unable to sit through a class and require a distraction to keep my mind off of my tics. I have a professor that smacks his lips and I can’t even hear what he says because I have no choice but to flex my entire body and tally how many times he does it. I can’t have an official diagnosis of this with my profession, so I am struggling immensely with this. Sniffling is my absolute worst tic but hearing my professor smack his mouth this much, he may surpass what I thought was my worst trigger.

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    • In lectures, I use earplugs or slight noise canceling headphones (the ones for monster truck or race car events work well but are not always practical). They block out smaller noises like coughing and breathing but I can still hear people talking. This may also work for the lip smacking.

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  5. I have been bothered by sounds for years, but only recently have seen this could be misphonia, but have not been diagnosed. I experience anger, extreme anxiety, and remove myself from the situation, if I can. If I hear someone eating, hearing the utensil in their mouth, hitting their plate with the utensil, and smacking their mouth. This includes chewing gum, tapping of fingers on a table or using a pen or pencil to tap. Sniffling gets me too. Just annoying sounds drive me crazy. The weird thing is I can listen to music I like at full volume and it doesn’t bother me a bit, but relaxes me.

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  6. The sounds that are the hardest for me are dogs or cats licking or eating drinking. Or children making slurping sucking sounds. It started 20 some years ago, only half my life so I wonder if there is a medical reason. Its horrible and hard to be around my kids or pets…

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  7. After studying ”sensitivity to noise” and other possible ailments. I’m almost convinced this is some kind of neurological issue. After being treated for c-ptsd using EMDR (failed badly). I have developed terrible dislikes for certain ‘non-issue’ sounds. Almost to the point of losing my bloody mind. I’ve become over reliant on silicon ear plugs.

    I am no doctor by any means. But, having something like ptsd/c-ptsd in my case, has made me so ‘in-tune’ with all my senses. I personally think that, conditions like: OCD/PTSD/c-PTSD and even TBI (traumatic brain injury) could cause or accompany Misophonia. Even auto-spell check hasn’t recognised it as a condition yet, lol.

    Like I said. I am no doctor, however, I strongly believe the only way to combat this horrible affliction. Is to very gradually expose your ears to each annoying sound. The other thing which I strongly believe will come to pass is; NIR or Near-Infrared light therapy. I’m talking about the IR that can penetrate tissue, bone and brain in the 808-830nm range, btw. Big Pharma is quaking in their boots, trust me!

    Alas, I digress lol. All the best my fellow Misophoniaites and recovery is in your grasp.

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  8. My spouse has been managing misophonia for decades. I have adopted some realistic mitigation techniques that have positively impacted our mealtimes. For instance, background music & earplugs with dinner. I primarily eat with a nice bamboo silicon spoon or hefty quality plasticware and precut foods like steaks on a cutting board then plate it, which significantly reduce plate scraping trigger noises. Run stove exhaust fan while cooking and feeding our dog. We utilize a host of other easy, considerate adaptations that help us enjoy quality time together. I’m happy to share my experience as an encouragement to others if there is an interest in the spouse/partner/family perspective. Feeling like “you’re the trigger” is horribly exasperating, but together you can experiment with some adjustments to help your loved one cope. – Kristen in NH

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  9. It is extremely relieving to read everyone’s comments and to see I’m not alone! When I first heard about misophonia/ 4S a few years back, I was so astounded, I cried.

    My family think I’m an absolute nutcase, due to my mother’s constant (40+ years and counting!) cough and throat-clearing every few minutes – which I am compelled to mimic – plus my father’s loud eating noises which sound like a raw steak being slapped against a wall! Much as I love them both, the sounds infuriate me so much I have punched walls in the past, in fury. Then, for at least ten minutes after the trigger, I actually hate them. This is extremely distressing, as a so-called functioning adult. It feels childish but I can’t help it. I try to cover up my reactions but it is difficult, especially when there are other people around and this problem has had a major impact upon my life. If somebody else reads this and realises they’re not mad, it’s An Actual Thing, then I hope it helps!

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  10. Blanca
    I have just found that actually what I have been through all my life has a name. Misophonia. I could not believe I was not alone. I have suffered from this since I was a little girl and the trigger was always the way my brothers ate. They use to do it in purpose because it was funny for them, for me, I used to fight and hit them. While I grow up more noises were added to the eating like the chewing gum. In the adolescence, I have to withdraw any time from my family and friends, I have to grow mostly alone to avoid disturbances. As an adult the problem grew, more noises were making me mad like people walking upstairs, the barking, the cars passing by, people talking loudly or playing music, etc. I have to move many times and start my life many times, I did choose to work at night as this helps me a lot. Nowadays my ears ache a lot, and the trigger is the bass or the volume of my neighbor’s sound devices, even the smallest I can hear from my house. I am now into the caving and that relieves the pain in my ears and the stress in my brain. Working from home as I can not cope with many noises now but fighting a lot with my neighbors. Never been tested or diagnosed.

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  11. Even as a kid I was teased mercilessly by both peers and adults alike for my “weird” aversion to some common sounds. I would isolate myself to read in trees (truly) and sleep with a pillow over my exposed ear (I still do this). My husband thinks I am nuts the way I can’t stand to watch or listen to him scrape his plate, chew, etc. in fact, the best thing that has ever come along for my “noise problem” is Apple AirPods Pro. I pop these things in and immediately my stress levels drop even before I put on music.

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    • Again thank you all – just reading your messages is amazing. Trying to explain this to my 45 yr husband he can’t imagine that I never said anything about it before. I also have PTSD & SAD issues that come up he’s somewhat aware of. He asks why didn’t tell him before and all I can say is I didn’t want to think he was married to a nutty woman. His first wife of 13 yrs had problems with alcohol and their first child had brain damage. So he’s suffered a lot and carried on. He’s the best thing that happened to me and I wanted to act “normal” for him but was not always successful. He is a fixer and wants to know how to “fix” this and I don’t know how. I realize I didn’t go to college or have children because of this disorder and I’m laid low about this reality. Depressed enough by current sh#& going on. Starting EMDR tomorrow & one writer said it failed so I’m optimistic. I see a a PhD also 6 yrs & neither had heard Of this. I’d love to turn myself in at NYU docs—group rate.?? Anybody….bless you all for helping me with your stories. Gigi

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  12. Hi
    I am a medical doctor and also suffers from misophonia.I was always ashamed of my condition and never discussed it with many people.I once,while in high school discussed it with my best friend but he could not understand it at all.
    The problem was with my father’s false teeth,which was very loose.It started when I was about 12 years old,after my sister mentioned my dad’s snapping teeth.I was sitting right next to him.
    This condition led to all the symptoms described,and eventually led to childhood depression.I also suffered from ADHD.All these conditions were unknown during this time.
    During my varsity years I had to share rooms with roommates,and the one ate with his mouth open and the other was smacking his lips.This nearly distroyed me as well as my medical career.Up to this day they do not know how much suffering they unknowingly caused me.
    Durng my childhood my sibliings and family thought I was just “otherwise”.I think some of them silently enjoyed my suffering!!
    Up to this day I cannot understand why my parents did not move me to the other side of the table.It destroyed my whole teenage life.
    I harbour no bitterness towards them,but It did destroy my relationship with my father untill his death.I always harboured guilt,but now I realise things was mainly out of my controll.
    I somehow managed to finish my medical degree and the miso sometimes still interfere in my normal life,but I’m managing it in a way.
    Recently,while visiting my family far away,my brother mentioned to me that he cannot understand that I was years ago so upset about my father’s teeth as my son was sniffing so much.
    This obviously triggered another problem.My son,35,is understanding and is trying his best to help me…
    So my message to all of you is to try and think positively,try to occupy your mind by reading and studying.Do regular excercise,if possible try to avoid the triggers by all means,and build yourself up,so that you can develop self esteem.
    Unfortunately the majority of peopke would not ever know what you are talking about,or what you are going through.But this does not matter.At least you know now that there is a name for the beast,and you are not fighting an unknown/unnamed enemy any more.And that there are other people who also know about the enemy,that you are not alone
    Pieter age 63

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  13. Hi,
    I’m pretty sure my 11 year old son has misophonia. He can’t stand people eating, lip smacking and more recently breathing sounds. I can see he’s trying so hard to manage it, but it is becoming more and more difficult for him and us to live with. He’s constantly monitoring people, criticising and telling us to not do things we can’t help, getting angry and yelling, and has hit his brother and himself.

    My heart breaks for him because I can see he can’t help it, but I don’t know what to do. I recently heard about misophonia and we’ve looked it up together. He thinks this is what he has, but I don’t know what action to take. I’m worried he is going into high school next year and this is going to make social connections harder than they already are, because of how this impacts on him.

    Any advice about treatment and how to support children please?

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  14. Oh thank you all above! I am familiar with everything you mention. I can’t believe I found you and I’m terrible on the computer at 77. I have a theory not mentioned above and that is about very early sexual abuse Pre-cognition. You know what I mean by the noises. I always thought because we had to sit silently and hear/ watch the predatory stepfather chew, swallow, and click his false teeth. I think we all disassociated, he was also had road rage& we thought we could die any time. My sister later admitted she felt he could kill us at any times w/guns in the house. On a lighter note, my now 45 year husband & kids got sweet corn for dinner when we had just met and when they all started eating I felt like disassociating, but loved them all, so grabbed my own ear and started chopping or else start screaming. I love my “car dancing music” loud but have walked to neighbors houses at night like a crazy lady to ask them to turn down the music OR bring their constantly howling dog in the house.I see a PhD and starting EMDR
    who knew nothing about this. We aren’t crazy people–we’re smart, intelligent, creative, sensitive people. OK, I have a problem with alcohol & working on that. But otherwise pretty damn great!

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  15. Am so relieved to learn this is an actual thing! I have a super intolerance to tv sounds / bass/ muffled voices through the wall, ever since I was a teenager and never had a name for what my insensitivity is. it’s made it really hard in apartment living, as I can pick up on the smallest of sounds and it brings terrible anxiety with it. I get angry, anxious, heart pounding – all of it. It’s ok if I’m making the noise, but can’t stand other people’s. I am about to move into a new place and am so worried about the noise – I use earplugs and noise cancelling headphones ( I can’t sleep in them though!) and am considering my own sound-bar for the tv purely so I can mask the irritating noises from upstairs. I live in a flat where there is no insulation between floors, so it’s been tricky navigating these sounds over time. Does anyone have any advice on how they’ve handled similar intolerances to these type of sounds? I dread every time I move apartments for years or traveling in hotel rooms.

    Reply

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