Long before I knew there was a name for it, I had a mild case of misophonia. Small, repetitive sounds irritated and distracted me. Things like the blinker in my mother’s car that she forgot to turn off after changing lanes, or a kid clicking a ballpoint pen during class—his nervous habit making me nervous. Snapping gum, long fingernails tapping on keyboards, teeth scraping on forks—these things have been lifelong irritants, but I had strategies to manage them. Until 2020. This year has pushed many of us to discover new truths about ourselves, and for me, the coronavirus pandemic has brought my misophonia to its breaking point.
Researchers first named misophonia as a condition in 2001. The word translates to “hatred of sound” in Greek, but that description isn’t quite accurate, Patrawat Samermit, Ph.D., of the University of California, Santa Cruz, tells SELF. Samermit says it’s not really hatred—it’s more of an overwhelming fight-or-flight response. It can involve physical and emotional manifestations of irritation, anxiety, rage, and more. And it’s not exactly just sound because that may be overgeneralizing. Misophonia triggers often have multi-sensory aspects that go beyond noise, like visual and tactile components, for instance.
Misophonia is not in the DSM-5, which is the manual mental health experts use to diagnose mental illnesses. Instead, at present, many experts consider it more of a neurological condition than a psychiatric disorder. One benefit of adding misophonia to the DSM-5 is that it could be easier to get insurance coverage and reimbursement related to misophonia treatment (though just because insurance may not cover misophonia treatment doesn’t make the condition any less real).
Prior to lockdown, my boyfriend, Martin, and I were always on the move. It wasn’t unusual for several days to pass without us having a synchronized mealtime. Before we started eating every meal together in our quiet dining room, it hadn’t occurred to me how much the ambient noise of restaurants and meals with friends diffused the sound of his chewing. Now, after eating countless pandemic meals, snacks, and desserts together over the past six months, my boyfriend’s chewing has me feeling irritated and edgy, almost at the end of my rope. It’s not that he’s chewing with his mouth open or spilling soup down his chin—Martin does neither of those things and actually has excellent manners. But having misophonia means that the sound of chewing is going to trigger a wave of negative feelings for me, no matter how pristine his manners are. The thing about misophonia is that although it can feel uncontrollable, there are actually ways to try to manage it. Here are some tips and strategies I’m using to cope that may also work for you.
1. Find like-minded people.
If you think you have misophonia, the first thing to do is find other people who have it, too. Having misophonia can be isolating. In addition to feeling like you’re the only person who has these reactions, misophonia can also prompt you to avoid social situations and places that might be rife with triggers, like movie theaters, concerts, and restaurants. Even now that we’re not able to enjoy these types of settings the way we could before the pandemic, virtual meetups can also be loaded with misophonia triggers, like the person who slurped noodles while we talked on Zoom or the one who filed her fingernails on video, not knowing that both the sight and sound of it sends shivers up my spine. Misophonia often also leads to feelings of shame as a result of the anger involved. It’s unknown exactly how many people have misophonia. M. Zachary Rosenthal, Ph.D., clinical psychologist and director of The Duke Center for Misophonia and Emotion Regulation, says some research estimates that at least 10-15% of the general population have the condition. A 2014 study in the Journal of Clinical Psychology of 483 undergraduate students found that nearly 20 percent of participants self-reported “clinically significant misophonia symptoms.”
Even though it’s unclear how many people experience misophonia, you can still find support on social sites likes Facebook and Reddit. Instagram provides an abundance of information via accounts from research-based organizations like Misophonia International and from blogs like misophonia.blog. Listening to other people talk about their experiences with misophonia can be validating too, perhaps surprisingly. The Misophonia Podcast is one place to do that. In addition, if you have misophonia and live with others, offering them suggestions for education and support will hopefully help everyone coexist with less strain.
2. Educate yourself about the condition.
A Google search for misophonia brings up a lot of information, but not all of that information is evidence-based. The condition lacks expert consensus on the definition or a proven treatment protocol. So lots of people make claims that certain things can help treat misophonia—like apps that cost money—but before you spring for something like that, keep in mind that researchers are still learning a lot about the condition.
To do your due diligence when it comes to research, I suggest starting with The Misophonia Research Fund, which launched in 2019. The Misophonia Research Fund has given over $2 million in the form of grants to various universities, including Duke (which is home to the aforementioned hub The Duke Center for Misophonia and Emotion Regulation). The center’s website is full of resources and even offers a preliminary questionnaire as a starting point for individuals who suspect they may have misophonia but aren’t sure.
3. Try to avoid your triggers.
Prior to the pandemic, Martin and I had busy lives outside our 1,200 square foot cottage, but now most of it happens under one roof—work, exercise, virtual coffee with friends, telehealth visits—all of it. We’re lucky to have a small yard and hiking trails nearby, but while getting outside is helpful, it’s not always possible due to weather and other environmental factors.
Even when I can’t physically get some space to avoid the sound of my boyfriend eating, I have some other ways to cope. For example, if I hear the pantry door squeak followed by a bag of chips popping open, it’s usually time for me to do what I can to situate myself before the chips cascade into a bowl and the crunching begins. Other options are to go into another room and close the door or just put on noise-canceling headphones and continue what I was doing. I might hop in the shower, go pull some weeds, or hang laundry on the line so I don’t feel my misophonia is controlling me, which is emotionally important for me as I deal with this condition.
4. Make the most of white noise.
Despite my increased struggles with misophonia, Martin and I enjoy cooking and sharing meals together. I can’t just listen to him chew. Playing news, podcasts, or audiobooks doesn’t create enough of a buffer as there are too many pauses, but playing white noise simultaneously fills the gaps so Martin can continue chewing when the speaker takes a breath, and my skin doesn’t prickle with frustration.
I like having a little bit of white noise in every room. Sometimes that’s just the dishwasher running or the low hum of an aromatherapy diffuser, but other times it’s more intentional, like white noise machines or fans.
I’ve also discovered a white noise app I really like: White Noise Market. Not only are there already hundreds of sounds to download, but users also upload and share sounds they record—everything from their dog lightly snoring to the hum of a busy Grand Central Station—so there’s always something new, including a recording for those who miss the buzz of mornings in a coffee shop. For me personally, I’ve discovered two recordings that immediately do the trick when regular white noise isn’t enough: heavy rain on car windows and train sounds.
When we sit down to eat, I let Martin choose and ask him, “Rain or train?”
Jennifer Jo Brout, Psy.D., L.P.C., is director of the International Misophonia Research Network and also has misophonia herself. She has been leading much of the charge with misophonia research. Brout writes a Psychology Today blog called “Noises Off,” and one of my favorite posts is a recent one where she reminds people with misophonia (and anyone, really) that moving the body is often an effective way to shift the emotions.
I’ve always loved to run, hike, or walk, but now I realized that it’s not just about enjoying these physical activities. Moving my body is actually a key component to maintaining good mental health. Another bonus of physical activity is increased respiration. Tapping into the breathing process—whether through yoga, meditation, or sprinting up a hill—can help calm a stressed out nervous system.
6. Consider therapy if you can.
Rosenthal treats patients with misophonia at Duke using cognitive behavioral therapy (CBT), which isn’t a specific protocol, but rather a family of treatments that the therapist and patient choose based on the patient’s specific needs.
Rosenthal explained to me that when treating people who have misophonia, process-based CBT therapy may be a useful strategy to personalize treatment for people with misophonia using evidence-based processes. The goal is to help the person with misophonia identify where they already have coping mechanisms in place and where they need additional tools. For example, one person may need help learning to turn attention away from possible triggers, whereas another may need help regulating emotions or communicating better when triggered. Others may need evidence-based treatment that targets both misophonia and co-occurring conditions like anxiety or mood disorders.
Rosenthal is optimistic about scientific advancement for the treatment of misophonia in large part due to the recent influx of funding through philanthropy and a grant-providing family foundation without which most of the current studies wouldn’t be possible, he says. And although data are currently limited, the science is catching up. Rosenthal says a committee of experts from around the world is currently working on a consensus definition which will help with next steps in the quest to demystify misophonia, including multi-disciplinary approaches to treatment.
In the meantime, experts are doing their best to help people with misophonia based on what they know so far. “We still have a lot of work to do,” Rosenthal says, “but people are suffering and we have to help them now using humility and our available evidence-based approaches.”
Before reporting on this story, I didn’t realize how many people struggle with misophonia or how much research experts are conducting to find treatments and strategies to help us cope. I feel so much less alone now. Learning about the wide variety of ways that people experience misophonia allowed me to see myself with more compassion, and diving deeper into my specific triggers helped me to see that those around me aren’t intentionally trying to irritate me. I now realize that I’m more in control of my environment than I thought, and using the tools I have available to me—white noise machines, noise-canceling headphones, meditation, and more—is empowering. Managing misophonia triggers takes work, and it’s a commitment both to ourselves and for those we spend time with, but the tradeoff—trading shame and blame for peace and tranquility—is beyond worth it.