Misophonia is the judge, jury, and executioner, sitting behind my shoulder on public transport, scraping away at my eardrums by leading a symphony of coughing, sniffling, and speaker phones, while I try to block it out with heavy metal playing over the sound of rain in a white noise app.

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I realized I had it when I was quite young. I was sitting in my corner bedroom in my childhood home when I heard my brother walking around in his bedroom above mine. Thump, thump, thump. It was rhythmic, like clockwork, and the dull thud echoed through the thin flooring into my tiny room, encapsulating every inch of airspace.

The repetitive thumps, over and over and over, drilled into my head. At first it was just being hyper-aware of the noise, constantly knowing “Oh, my brother’s awake,” but that led into “When will he go to sleep? This is loud.” And finally into “This is driving me insane,” except with more expletives and anger that only a 12-year-old boy would know.

As a kid, my family and I called it “The Annoying Thing.” As an adult, we now know it as misophonia.

What is Misophonia?

The simplest way I describe misophonia is “the feeling of nails on a chalkboard,” except for us, it’s just someone sniffling. Or coughing. Or chewing. Or really anything else. Sometimes it’s only a certain person chewing (sorry mom), but for some people, it’s their partner with a wet mouth, their dog’s chew toy, active upstairs neighbors, or their seating neighbor on a bus who’s never heard of a tissue.

Formally, this 2022 expert consensus defines it as decreased tolerance to specific sounds or associated stimuli, producing unusually strong emotional, physiological, and behavioral responses.

What seems like nothing to you sends shockwaves through those of us with misophonia.

What are These Triggers?

Everyone’s a little different, but some common triggers show up again and again.

Chewing is a big one for many of us. It’s the slurping, crunching, mashing, gnawing, snapping, popping, and clicking that comes from teeth tearing apart and breaking down food. It’s squishy, animalistic, and wet. It’s that instinctual sound of a wolf tearing apart its prey that tells us “this noise isn’t mine and it’s gross” that makes us repulsed by someone simply eating a meal.

Gum? Oh god, don’t get me started on gum chewers. Ew.

And then there’s sniffling. The repetitive, wet snorts that sound like someone trying to inhale a meal through their nose. The loud, heavy, wet sniffles that always have me on the edge of my seat waiting for them to get a tissue.

Of course, with sniffling usually comes sneezing and coughing. The three of these together create the added effect of wondering if we’ll get sick next.

If the noise doesn’t kill us, then the untreatable condition they have will, surely!

Places where I can’t have my headphones in are a layer of hell. Waiting to be called in for my doctor’s visit while someone else sniffles as they wait for their sick visit is enough to make me want to come back another day. Movie theaters with someone sniffling due to the dry air for two-plus hours make me want to leave and look up spoilers instead. Restaurants with spicy food? Oh no, dude, please stop sniffling. It’s not that spicy.

Loud phone calls and speakerphones are becoming a more common annoyance. It’s a weird one for me to justify. People talking in person doesn’t bother me, but people talking on the phone does. Maybe it’s that slightly different voice people use on the phone call that’s on the cusp of unnatural that bothers me, or how people tend to speak slightly higher and louder than they would with someone next to them in person. A bass becomes a baritone, and an alto becomes a soprano.

Okay, so noises suck. Why?

It’s More Than Being Annoyed

The difference for us is that these noises are distressing and debilitating. While someone without misophonia may find chewing with their mouth open gross, we find it a hindrance to our well-being at that time. The chewing can ruin dinners, stress us out, cause us to lose our appetite, and make us want to flee into another room.

In one 2024 study, 78.5% of adults reported at least some sensitivity to misophonic sounds, but 4.6% met the study’s threshold for clinical-level misophonia.

From a fight-or-flight, evolutionary perspective, it’s almost like these are noises that our brains think are trying to kill us. Noises of the monsters and the uncanny. Our brains aren’t simply registering these noises as “someone is chewing nearby.” Our brains react in a more primitive way, saying “Something is wrong, get away from it.” The threat is no longer a sabertooth tiger — it’s some guy on the bus eating a sandwich. Apples and oranges, right?

Still, it’s unfortunately a relatively new — and incredibly confusing — condition. Misophonia still isn’t recognized as a standalone diagnosis in the DSM-5-TR. Thankfully, Misophonia International is trying to get that changed.

Misophonia translates into “hatred of sound,” which is the simplest way of describing it. Though for many, anger isn’t the only symptom, with many noise-haters also feeling anxious, depressed, stressed, agitated, or even aggressive. We’ll twitch and feel our muscles tense up with the desire to shut someone’s mouth when we hear them chewing loudly with their mouths open. We don’t do it, but the desire is certainly there.

There’s also a related condition called misokinesia, which translates to “hatred of movement.” For many diagnosed with misokinesia, it’s common to be bothered by people fidgeting or repeating movements. I’m a leg shaker, much to the annoyance of some former coworkers and family members. But for those of us with misophonia, we’ll often be visually bothered by an audio stimulus, such as watching someone yell on speakerphone, chew with their mouths open, or cough into their elbow over and over.

With that, I’ll often get preemptively annoyed when I see someone speaking on their phone in public transport, but at least I’ll know to walk away and find a seat elsewhere. I’ll sometimes even move to a completely different train car if there’s time to move.

It sounds like a made-up condition sometimes; I’ll be the first to admit it, but it’s still real to us. But since it’s not fully defined yet — and often undiagnosable (my MyChart official diagnosis is auditory hyperacusis, even though that’s a different thing) — many researchers only have theories about what misophonia really is.

For those curious, hyperacusis generally means that sounds feel louder than they really are, leading to physical discomfort, whereas misophonia involves a person having intense reactions to noises, regardless of their volume.

Then there are the louder days. I still remember the headache from Thanksgiving a decade ago, as I was sick with the flu, and my entire family was yelling, chewing with their mouths open longer than usual, blasting the TV, and so on. A party! When I was sick! Could you believe that?

Theories About Misophonia

Researchers aren’t denying that misophonia is a very real thing that can negatively impact a person’s life. Though they aren’t entirely sure why it’s a thing.

Some say it’s primarily a neurological disorder, with evidence in a recent research report by Fatima T. Husain et al pointing out that the brain does indeed show neurological indicators of distress in those with misophonia. They found that the brain will activate and show clear signs of distress, disgust, anger, etc.

Other researchers have focused more on the psychological and behavioral side of things, which may overlap with other conditions like OCD, ADHD, anxiety, and/or autism.

One common theme seen in most people with misophonia is that it begins in childhood or adolescence, and that’s where the debate comes in hot. Some folks say it happens during neurological development, and others say it’s due to conditioning or learned associations.

I’m still not entirely sure if it’s neurological or psychological though I think there’s a strong argument that it’s a little from column A and a little from column B. I’ll admit that my biggest triggers of talking loudly on the phone, open-mouth chewing, and hearing people walk above me are all things that relate to my childhood, so that’s one statistic for a future researcher. You’re welcome, doctor.

There’s plenty of research being done, so I’m confident that we’ll start getting clarity eventually.

What’s a Day in the Life of Misophonia?

On long train rides, I look around, making eye contact with the snifflers and yellers, while I try to find the ideal seat away from the noise. For that reason alone, I tend to stick to the corners by virtue of fewer seats surrounding me. Sometimes I’ll get up and walk to another car, even if I’m carrying multiple overnight bags, just to escape the sneezing. Not the germs, but the noise. The wet, sloppy noises.

On local subways or buses, I do my best to be normal. Normal, as in someone who doesn’t jump right into fight-or-flight mode when someone’s phone goes off. It’s not so bad if I’m alone, where I can freely move around or increase the volume on my headphones, but with others, it’s a gamble. I’m growing weary of having to explain why I can’t focus when someone’s talking to their mother six time zones away on speakerphone.

I’ve told only select people in my life about misophonia and what I need to be comfortable. I made sure to tell my partner early on so she wouldn’t be alarmed later on when I preemptively hand her a tissue every time she sneezes. Love is strong, but it can’t make me handle your sniffles.

I can’t stand the heat, yet I’ll happily live in a top-floor apartment so I don’t have to deal with upstairs neighbors, even if it means higher temperatures and rising heat. Air conditioners can fix the temperature, but nothing can fix the thumping, dropping, pacing, slamming, and constant shuffling of people living above you.

I’ve figured out how to hear nothing in public, especially at cafes or longer train rides. I turn on a white noise app with a steady, heavy rainfall, and overlay it with music that doesn’t have too many gaps or quiet moments. I’ll hear virtually nothing, which is usually a blessing, though on more than one occasion it’s taken a kind stranger on the train to nudge my shoulder and wake me up.

Some noises are lovely to me, even if annoying to others. I hate the heat of summer, but I love having a loud air conditioner so I don’t hear my neighbors slamming their doors. Fans and air purifiers are on 24/7. I truly love fans over stoves, as much as they annoy some friends. These plus reusable earplugs make it so I can actually eat with family in near-peace.

Don’t even get me started on how many foam earplugs I’ve used over the years. (Actually, I looked into my Amazon purchase history, and I’ve bought at least nine containers of fifty pairs, so you do the math.)

Classrooms, offices, and cafes? Don’t even get me started. College was a struggle. Art history in particular, since there was one guy who sat next to me who I think made it his goal to sniffle every fifteen seconds, like clockwork. Sniffling, like clockwork. Really?

Are Treatments Available?

Unfortunately, there are no clear or tried-and-true methods to treat misophonia. Some folks have done well with environmental changes (my approach), whereas some others have seen success with cognitive behavioral therapy or other therapeutic techniques.

I haven’t personally tried therapy for this, but I can at least speak to environmental changes that work for me. Invest in reusable earplugs for daily use, find a white noise app on your phone to play while listening to music, aim for top-floor apartments or bedrooms, and keep those fans and white noise machines running year-round.

Most importantly, talk to the people close to you about it. I’m thankful that my partner, family, and close friends have all been super accommodating. It’s not an easy discussion to have, especially since so many people haven’t even heard of the word misophonia, but an awkward conversation can prevent even more awkward meals, car rides, train trips, and sleeping arrangements.

The fan, indeed, does stay on even on the coldest nights.

A Life Beyond Earplugs

I truly want to curse misophonia. I have depression, OCD, and asthma, yet those are all treatable with medicine, therapy, and lifestyle changes. My treatment for misophonia is earplugs, avoidance, white noise, and top-floor apartments.

I may keep reusable earplugs with me at all times, always have headphones on in public transport, and only seek out apartments if there are no upstairs neighbors, but those are just annoyances.

As of writing, there’s no magic cure for how much I hate chewing, sniffling, and speakerphones. It’s become a part of my daily life, but I’m getting better at figuring out how to live my life around these annoyances. I’ve learned how to block out the noises, maneuver around them, and have the conversations that need to happen with the important people in my life.

There’s a life beyond earplugs, and for all of us allergic to noise, there are ways around it.

Until then, please silence all cellphones and enjoy the show.