Pen clicking. A simple act of boredom when your fingers can’t find anything else to do. An annoying habit to some, an unforgivable crime and cause for multiple fits of rage to others. Why? Because it can trigger a very specific sensory condition called misophonia. Perceived as more than just a little irritation when someone taps their foot in line, misophonia can cause extreme blow ups over sounds that don’t bother most people.

It’s not unusual to feel the burning glare of someone else’s eyes on you when you tap your fingers against the table one too many times. The dreaded embarrassment as you quietly retreat and try to find another (more silent) way to fidget is a godsend to someone with misophonia. Although the condition only grips a small number of people, between 6 to 20 per cent, its effects are anything but miniscule.

@ellaellaw

Do you have misophonia? #misophonia#autism#autismawareness#synesthesia#femaleautisim#fyp#siamovie#viral#harrypotter#autismcheck#bi

♬ original sound - Ella Willis

So, to all the people who hate ASMR—and find it horrible and repulsive to hear people even breathe up close—I feel your pain. But why does the sound of simply chewing—with a recent study claiming ‘loud chewing’ to be the most hated one—send people into a blind rage sometimes, and why exactly does it affect some more than others?

There are a lot of eye roll-inducing sounds that make us wince, like someone chewing loudly at the dinner table. However, misophonia is more than just a tiny grimace.

The term, also known as selective sound sensitivity syndrome, relates to a condition in which individuals can experience intense negative emotions caused by specific sounds. These emotional and psychological reactions are abnormally strong and cause feelings of extreme panic, anxiety and rage. This often translates to anger and disgust when they are confronted with sounds made by other human beings. The National Health Service (NHS) explains the triggers of the condition as “if some sounds make you angry,” coupled with phonophobia (when sounds make you anxious)—like the dreaded Microsoft Teams call that sends your heart racing.

@loewhaley

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Though a lifelong condition, symptoms of misophonia usually develop around the age of 12 or 13. It is more common in girls but there is no evidence that the condition is caused by a specific event in their childhood.

Now, you may be thinking that this condition doesn’t actually ‘exist’ and that it’s “all in your head.” I mean, haven’t we all wanted to kick the kid who used to click their pen during class tests? And most people will say chewing out loud is rude and a sign of bad manners—something that, understandably, is also considered to be an annoyance. But what is the difference between a common annoyance and chewing being one of the many triggers of misophonia?

For starters, misophonia causes extreme and intense distress, discomfort and irrational rage over sounds. Some people purposely try to avoid such triggers, while others face difficulties in completing daily tasks due to the anxiety induced around certain sounds. According to NYU professor Doctor Barron Lerner, misophonia is “awful—like your blood is starting to boil.” The condition comes with an array of physical sensations like “heart racing and stomach-ache,” he told Healthline.

Doctor Hashir Aazh, an audiologist and specialist in tinnitus misophonia rehabilitation has spoken at length about the condition. Aazah runs a private tinnitus clinic in Surrey and his upcoming book, Misophonia and Hyperacusis: Neuro-Psycho-Audiological Perspectives, details accounts his patients shared about the emotional turmoil that comes with the medical problem.

“I remember that I often stormed out of the room to eat my dinner on my own. As one would expect, my behaviours and words often offended my parents and started further arguments and unhappiness within our family,” a patient recounted.

It also has a profound effect on the relationships of those who have it. In an article featured on Refinery 29, Sammy Jones stated how her misophonia, caused by loud music, ruined some of her relationships with ex-boyfriends. She also shared the experiences of others with misophonia and how it impacted their interpersonal relationships. “It got to the point where I thought of him as disgusting, even though he wasn’t a disgusting person.” one person told Jones while another one said, “If I could explain properly what it feels like—an instantaneous flick over to rage—then it would be taken more seriously, I think.”

Misophonia only got its name a few years ago as many doctors are still unaware it even exists and it is still yet to be included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The condition is often confused with symptoms of other mood disorders, such as ADHD and autism due to its characterisation and sensory nature. While many do indeed suffer with anxiety or depression alongside misophonia, that isn’t always the case. There is still a lot of debate on whether it should be considered its own disorder or not—however, a 2019 research study published in Nature showed misophonia is associated with altered brain activity.

Though there isn’t significant waves of research being made about the condition, there are researchers who are dedicated to finding out more about it. Doctor Marsha Johnson, an audiologist in Portland who specialises in misophonia was one of the first to identify it after she noticed how some of her young patients had symptoms that could not be easily categorised as hearing difficulties or other psychological problems. Speaking to NPR, Johnson explained, “They were perfectly developing normal kids until the certain period of time from like 7 or 8 years old through about 13 or 14—and mostly girls.”

The term selective sound sensitivity syndrome was originally coined by Johnson in 1999, who has since then admitted she has issues with the name misophonia, used after a paper published in 2001 describing decreased sound tolerance seemed to touch upon the same condition. Since misophonia means ‘hatred of sound’, it isn’t entirely accurate to the symptoms those who have it experience. “It’s like a tsunami of negative responses” and “most of these people don’t hate sound; they only hate particular sounds,” she said.

Alongside her research into the area, Johnson has also created a network, The Misophonia Association, to aid people impacted by misophonia and connect them with psychologists and therapists. The non-profit organisation was founded in 2013 after the first Misophonia Convention ever was held in Portland and completed research into the condition as well as possible ways of diagnosing the issue like the Duke Misophonia Questionnaire.

Largely, according to Johnson and other specialists, “the problem is, the whole field currently lies undefined,” although the outcome of a study completed by the University of Newcastle published in the Journal of Neuroscience may offer some more insight into what is really happening inside the minds of those who have misophonia. Lead author Sukhbinder Kumar, said of the study, “Our findings indicate that for people with misophonia there is abnormal communication between the auditory and motor brain regions—you could describe it as a ‘supersensitized connection’.”

Many people with misophonia describe it as sounds that drive them crazy and are triggered by oral sounds (from themselves and others) such as chewing, breathing, slurping, burping, eating—even the faintest lip-smacking sound someone makes when they talk can get under their skin.

Any sound could trigger the condition, especially daily/mundane sounds that most people are unaffected by—for me it’s knuckle cracking and crunchy crisp packets. Windshield wipers, styrofoam, keyboard clicking and even the sound of rustling clothes appear on my list. Some people with the condition are also particularly affected by visual stimulation that occurs alongside these triggers, such as repetitive motions. According to WebMD, “Researchers believe that those with misophonia may already have issues with how their brains filter sounds and that one of the features of ‘misophonic sounds’ may be their repetitive noise. That repetition then exacerbates the other auditory processing problems.”

While treatment options for the newly recognised condition are still limited, there are ways to understand why they occur, how to avoid certain triggers and thus make it easier to cope with them. Many resort to wearing earplugs to help with their sound sensitivity—with some wearing noise-cancelling headphones or playing music to drown out triggers.

In an interview with The Independent, Doctor Aazah said, “A specialised version of cognitive behavioural therapy (CBT) can help the individual to minimise the stress caused by their initial reaction to the trigger sounds and stop from escalating to a level that damages their quality of life.” Researchers such as Kumar have said that “some people with misophonia can lessen their symptoms by mimicking the action generating the trigger sound, which might indicate restoring a sense of control. Using this knowledge may help us develop new therapies for people with the condition.”

TikTok, though not always a trustworthy medical resource, has allowed people with the condition to find community with one another. With #misophoniagang and #misophoniaawareness having thousands of videos attached to them, the video-sharing app has allowed for people to find others just like them who have difficulty with the disorder.

The community has chronicled its journeys with misophonia and the struggles members encounter, as well as providing helpful tips to handle their triggers and become more comfortable in triggering social situations—while also managing to find humour in the condition. One creator, Lindsay, has used the app to talk about her condition as well as the progress she made in dealing with it through therapy.

@mis_ingout

Follow along for my ~journey~ #misophonia #misophoniaawareness #misophoniadisorder #misophoniatips

♬ original sound - MissingOut (Lindsey)

The world and all of its sounds can be distracting, distressing and downright annoying at times. So instead of judging that friend that always blows up over small noises or gets at you for chewing ‘too loudly’ next to them, try to be a bit more considerate. Patience and understanding from those around a person suffering with misophonia is key and crucial to helping them get through it.