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May 16, 2013 | By:  Kyle Hill
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Misophonia: Enraged by Everyday Sounds

Scitable is launching more than ten new blogs covering a wide range of topics including neuroscience, geology, oceanography, physics and more, next week. Until then, some of the new Scitable bloggers will be posting guest contributions here, on Student Voices.

Today, Jordan Gaines explains her battle with the unfocused rage stemming from sounds of people clipping their nails. Far from just being a quirk, this little understood misophonia might have roots in how the brain processes sound.


I consider myself to be a pretty tolerant person.

I'll eat just about any food you place in front of me. I'll read any book genre. I'll listen to any musical artist someone plays for me, even if I dislike it.

But there's one teeny little thing you can do around me that will set my teeth on edge. I'll sit, transfixed, unable to pay attention to the task and hand, my blood boiling and heart racing. I want to run. I want to scream.

But I can't, so I sit and count one, two, three...all the way to ten fingers. After ten, I know it's over.

I can't stand the sound of people clipping their nails.

Misophonia, or decreased tolerance to (in many cases, hatred of) certain sounds, is a newly-recognized phenomenon that remains poorly understand.

Sufferers are driven to distraction-even rage-by such insignificant sounds as chewing, tapping, breathing, whistling, scratching, humming, and footsteps. And, apparently, nail-clipping.

Worse yet, there is almost no research on the topic. A quick PubMed search reveals a few case studies and a handful of articles reiterating the above paragraph.

How common is this mysterious condition? It's not clear. Studies report prevalence of anywhere from 10% (of a general European population) to as much as 60% among those who also suffer from tinnitus, or "ringing in the ear." What's becoming somewhat clearer is its coincidence with certain anxiety disorders. A study published earlier this year reported that 52.4% of their misphonia sufferers met the criteria for obsessive-compulsive disorder (1).

Experts say the condition almost always begins in the early teens and worsens over time, where annoyance of one sound may expand to three or four sounds. Some also develop intolerance to watching others fidget or make repetitive movements out of the corner of their eyes. Others have a compulsion to mimic the sound or behavior.

It was only recently, in 2010, that a major textbook recognized misophonia as a nervous system condition (2).

Aage R. Moller, PhD of the University of Texas posits that the abnormality in misophonia sufferers is likely an issue in the brain's processing of the sound, not in physically hearing it. Why, for instance, might one specifically hate the sound of finger-tapping on a wooden desk, but remain unfazed by a woodpecker hammering on a tree?

Moller reasons that some sort of defect in central processing-our converging senses, memories, emotions, and cognition-is to blame. In other words, the problem may lie in how our brains perceive the sound, not how our ears physically convert sound waves into neural impulses.

But why are the particular noises that bother sufferers nearly always...bodily...in nature?

Sure, hearing a drill or hammer in the next room is irritating as anything, but why does the sound of something as silly as somebody clipping nails throw me into unfocused rage?

Anxiety is typically accompanied by a desire to escape and avoid. Could misophonia be evolutionary in nature-not unlike the sound of a baby's cries, designed to raise the stress of the parent until attended to? Or perhaps we relate more strongly to bodily sounds because we somehow feel like we're experiencing it, too (like the unpleasant sound of someone vomiting)?

As of now, it's all up to speculation. Luckily, active online groups and support forums help sufferers understand and cope with their, sometimes debilitating, distraction.

In the meantime, I'll continue to jam the earbuds a little deeper into my ears-but in the meantime, please, I beg of you, cut your nails at home!

--

(1) Schröder, A. et al. Misophonia: Diagnostic Criteria for a New Psychiatric Disorder. PLoS ONE 8, e54706 (2013).

(2) Moller, A.R. "Misophonia, Phonophobia, and ‘Exploding Head' Syndrome." In

Textbook of Tinnitus. New York: Springer, 2010.

Image Credit:

Unpleasant noise by Lmbuga Galipedia

Nail clippers by J. Ash Bowie

7 Comments
Comments
July 26, 2013 | 01:25 PM
Posted By:  Judith Krauthamer
A new book has been published summer 2013. It’s called, Sound-Rage. A Primer of the Neurobiology and Psychology of a Little Known Anger Disorder (Chalcedony Press, 210 pgs) and is available from amazon.com.uk and amazon.com.

The book provides compelling evidence that “misophonia” is a developmental, neurological disorder, and presents detailed information about trigger expansion, emotions, cognitions and therapies.

In Section I, Symptoms, Stories, Diagnoses, it describes the lives of sufferers as they confront triggers throughout the day. Section II, Neurobiology, presents an overview of how the brain processes information, specifically the triggers. The thoughts and associations that accompany the anger and pain are addressed in Section III, Emotions, Cognitions, and Therapies.


May 21, 2013 | 12:06 PM
Posted By:  Khalil A. Cassimally
I so totally get mad when people make noise when they eat food in general, though crisps in particular. But what am I supposed to say? Swallow the crisps!?

Doomed ):
May 20, 2013 | 10:18 PM
Posted By:  Anne Berryessa
Thank you for your informative and thoughtful article. Onset of my misophonia started when I was about 11 years old with a severe fight or flight adrenaline response to eating and breathing noises. This has plagued me for over 50 years. I have had every imaginable treatment: psychotherapy, exposure therapy, hypnosis, CBT, anxiety medications, epilepsy drugs, alternative medicines, meditation, etc. After 50 years of treatment, I am very well adjusted in most areas, but I remain with the same triggers that I had when I was 11 years old. Thanks so much for bringing this disorder to the attention of your readers, and hopefully it will help in bringing scientific research to help the sufferers of this debilitating condition.
May 20, 2013 | 07:20 PM
Posted By:  Hilda Johannes
Low repeating sounds bother me. For ex: birds, typing, etc. All too familiar to many misophonians, all around the world. Builds up unbearable anxiety until we find a way not to hear it and the anxiety suddenly goes away. The cries of babies is for attention. The sound I hear is not for any type of attention, just that my hearing attends to pick up certain sounds unintentionally and unintentionally I blowup. But there have been times that I hear certain sounds, I start doing something immediately thereafter and it just goes away. But this does not work with certain sounds, like gum chewing, etc. So I do agree with Dr. Moller. Thanks for the post.


May 20, 2013 | 01:10 AM
Posted By:  leslie dombroski
Chewing food, slurping soup, gum snapping, whistling, humming, forks on teeth, sniffing, coughing, throat clearing, sneezing, seeing people touch their face or hair, bouncing feet, tapping fingers.....These are just a few of the triggers my child suffers from. The rage can be unbearable and uncontrollable. Accompanied by OCD and GAD, several modifications have been needed to make school a tolerable place to be. After many thousands spent on OT, audiologists, ENT specialists and therapy including CBT, we are already making preparations in our future planning for the possibility of disability. Something MUST be done to help those who suffer as the condition has an impact on entire families as well.
May 19, 2013 | 10:21 PM
Posted By:  Adah Siganoff
Thank you so much for "coming out" and educating others: this is most important right now to garner attention and get research. There are many of us suffering; especially those higher on the MAS-1.
In my opinion, after several years of my own (amateur) research, Dr Moller is correct in seeing thisais a hard-wired condition. We have been diagnosed as everything from phobic to OCD and as epileptic to psychotic and have been prescribed everything from anti-seizure meds to thorazine yet nothing is effective in alleviating the panic and rage response.
I understand this disorder to be, like you indicated, a defect in the brain "wiring". The instant ,reflexive nature of the fight-or-flight response to triggers and the fact that psychotherapy does not decrease symptoms indicates that this is neurological in nature and not a psych disorder in the truest sense of both words.
Again - THANK YOU for publishing this well-thought out piece.
May 17, 2013 | 01:04 AM
Posted By:  Ilona Miko
that image of the nail clippers is enough to make me hear the sound! hmnn....what is that phenomenon? :):)
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