Extreme sound sensitivities in primary classic misophonia are most often aversions to “mouth” noises such as eating, chewing, lip smacking, licking, breathing, whistling or the sound of certain speech sounds. Body sounds can also trigger misophonia, which perhaps the most famous person associated with misophonia, Dr. Pawell Jastreboff, called “somatosounds.”
In most cases, these reactions to certain sounds begin in response to only certain individuals, usually parents or siblings. Sometimes non-speech sounds are problematic, such as keyboard clicks, pen clicking, rustling paper, etc.
In many cases, simply an environmental setting that is non-auditory, or other sensory inputs can act as triggers, such as particular rooms (like a kitchen or dining room) or even objects in rooms. Many patients report being in an uncertain or agitated state even before encountering a sound or visual trigger. This appears to be part of a heightened monitoring attention process or hypervigilance, which activates the limbic system in the brain. Some individuals that have multi-sensory hypersensitivities can also have reactions to odors, light, the feel of certain objects, and even the sight of certain objects.
• Obsessive compulsive disorder (OCD)
• Autism spectrum disorder or Asperger's syndrome• Tinnitus
• Multi-sensory hypersensitivity
• Hearing loss
• Family relational problems
• Intermittent explosive disorder (IED)
• Tonic tensor tympani Syndrome (TTTS)
• Acoustic shock
• Major depressive disorder
• Anxiety disorders, including post-traumatic stress syndrome (PTSD), generalized anxiety disorder, social anxiety disorder, and agoraphobia
• Bell’s palsy
• Ramsay Hunt syndrome
• Traumatic brain injury (TBI)
• Superior canal dehiscence syndrome
• Perilymph fistula
• Lyme disease
• Williams syndrome
• Lacunar stroke
• Narcotic and benzodiazepine withdrawal
• Head injury
Misophonia Testing and Treatment
A multidisciplinary treatment approach appears to be the best solution, and in most cases is essential for the patient to progress. There must first be a thorough evaluation as well as sufficient counseling for the patient and family members to comprehend the condition and understand how it may be treated.
Clinically significant misophonia almost always involves changes in behaviors not only from the suffering patient but also within the whole family, since the entire family attempts to cope with the reactions that are occurring. Since most misophonia triggers involve family interactions, the misophonia condition is properly considered as a whole family affair.
In some cases, involving mental health or behavioral professionals, or a licensed psychotherapist may be helpful in misophonia treatment, as well as those who specialize in family or individual therapy can be very helpful. Professionals of this nature are qualified and trained to identify key difficulties in behavior and family relationships that may be relevant to the misophonia issue, before, during or as a result of reactions to triggers.