Dear Doctors: Ever since I was little, I have absolutely hated the sound of other people chewing. Whenever I try to explain this to someone, they think I’m overreacting or even making it up. Is this something you have come across before? Does anyone know why it happens?
Dear Reader: You are describing a condition known as misophonia. The term comes from the Greek word “misos,” which means dislike or hatred, and “phonia,” which derives from the Greek word for speech or sound. The condition is marked by a powerful aversion to certain commonplace sounds. These can include mouth sounds such as chewing, swallowing, yawning, burping, breathing or throat clearing, and repetitive sounds, such as finger tapping, typing or the clicking of a pen. Hearing the specific sound triggers feelings of anxiety, disgust, anger and, in some cases, even rage.
For people who don’t experience misophonia, these sounds don’t even register, let alone provoke a reaction. As a result, as you have repeatedly experienced, trying to explain the condition can be frustrating.
Although it may not be widely known, misophonia is actually somewhat common. It is estimated that between 10% and 20% of people experience it. It appears more often in women, with between 15% and 25% being affected. It is also more likely to occur in people living with autism spectrum disorders, obsessive-compulsive disorder and those affected by post-traumatic stress. Genetics are also believed to play a role. The condition can develop at any age, but often emerges in early adolescence. Some people have just a single sound that incites a response, while others can have multiple triggers.
The cause of misophonia is not yet understood. Recent research points to possible structural anomalies in an area of the brain known as the anterior insular cortex. This is a type of processing center, located deep in the brain, that receives sensory input from multiple areas of the body. Among its many and complex roles is contributing to emotional response and aiding in the integration of sound. Brain scans have shown that when people with misophonia are exposed to their trigger sounds, activity in the anterior insular cortex spikes, and is significantly higher than in people without the condition.
There is no cure for the condition at this time. Instead, the focus is on management. Many people find that adding music, a sound machine or background TV to group mealtimes can successfully mask the mouth sounds that act as triggers. When out in public, using ear plugs, ear buds or sound-canceling headphones can be helpful. Various forms of psychotherapy, such as cognitive behavioral, group and talk therapy, can help ease the emotional stresses of the condition. Some people derive benefit from the use of certain medications, including beta blockers. These blunt the fight-or-flight symptoms of anxiety, sweating, muscle tension and increased heartbeat that often accompany misophonia.
Because the effects of misophonia are so unusual, it is possible to have the condition and not realize it. If anyone finds that the symptoms or circumstances we have discussed relate to them, don’t hesitate to bring them up with your health care provider.
(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
