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Misophonia is when specific human-made sounds trigger intense emotional reactions such as anger or disgust.

Neuroimaging studies of misophonic patients show altered connectivity in the brain’s salience network.

Trait-level psychology, particularly distress tolerance, helps determine the severity of misophonic reactions.

For up to 1 in 5 people, specific ordinary sounds—such as chewing, breathing, or repetitive tapping—can trigger immediate and intense emotional reactions, including rage and disgust.

This condition is known as misophonia. While it’s well described and moderately prevalent, it does not currently have a dedicated DSM or ICD code, and many questions remain about how it should be understood and treated.

Misophonia can be defined as a condition in which certain sounds trigger disproportionately strong emotional and physiological reactions, often including anger, anxiety, or disgust.

Many people with misophonia report an immediate urge to leave the environment or stop the sound, sometimes accompanied by physical signs of stress such as muscle tension, increased heart rate, or sweating. This differs from hyperacusis, in which ordinary sounds are perceived as excessively loud.

Clinically significant symptoms are estimated to affect about 10% to 20% of the population, though the degree of severity varies. While the average age an adult with misophonia seeks care is in the mid-30s, the age of symptom onset is typically between 9 and 13 years. Many patients are in their teenage years when they present to my clinic.

The most common triggers are human-generated orofacial sounds; chewing (~95%), breathing (~85%), and throat sounds (~65%). Repetitive human-made sounds (tapping, pen clicking) can also serve as triggers (~55%) [1].

Interestingly, misophonic triggers are often more intense when produced by family members than by strangers.

Why Misophonia Is Difficult to Classify

Misophonia patients are often referred back and forth between specialists, reflecting the condition’s overlap between auditory and psychological domains.........

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