Misophonia: Triggers, causes, impact, and treatments

Reviewed by Brooks Baer, LCPC, CMHP

Written by

therapist.com team

Last updated: 06/16/2025

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Have you ever felt incredibly angry or anxious when hearing someone chew? Or wanted to run away when you hear heavy breathing? If your reactions feel much stronger than what others experience, you might be dealing with misophonia.

What is misophonia?

Misophonia is a condition where certain everyday sounds cause extreme distress. People with misophonia have a lower tolerance for specific sounds and their related cues.

These trigger sounds cause significant distress and make going about daily life difficult. When triggered, people experience intense physical reactions, negative emotions (like anger, anxiety, and disgust), and behaviors that look like fight, flight, or freeze responses.¹

Misophonia literally means “hatred of sound,” but it isn’t limited to just hating sounds or feeling angry. The reactions are more complex and involve multiple systems in the body and brain.

Misophonia triggers

Common misophonia triggers include:²

• Oral sounds: Eating, chewing, swallowing, slurping, lip smacking
• Nasal sounds: Breathing, sniffling, snoring, throat clearing
• Repetitive sounds: Tapping, clicking, typing, pen clicking³
• Environmental sounds: Paper rustling, clock ticking, sounds caused by pets or animals
• Other human-produced sounds: Footsteps, finger/nail tapping, humming

Oral and nasal sounds are the most common triggers. One study found that in a large sample of people with misophonia, most were triggered by eating sounds (96% of participants), nasal and breathing sounds (85%), repetitive tapping (74%), and mouth/throat sounds (60%).⁴

Triggers can vary widely from person to person, with each individual having a unique set of sounds that cause distress.

Misophonia symptoms

When triggered, people with misophonia experience intense distress. Common symptoms include:⁵

• Physical reactions (like increased heart rate and muscle tension)
• Strong negative emotions (anger, anxiety, disgust)
• Fight, flight, or freeze responses

How strong misophonic reactions are depends on context. Reactions are often stronger when sounds are made by family members or in situations where the sounds are deemed rude or out of place (like loud chewing in a quiet room).⁶

If you’re experiencing intense reactions to sound that interfere with your daily life, relationships, or well-being, consider speaking with a therapist who specializes in sensory processing issues. A qualified mental health professional can help you find the source of your reactions and create coping strategies that work for you.

Is misophonia a mental illness?

Misophonia is not officially listed in major psychiatric classification systems like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Researchers continue to debate whether it should be viewed and classified as a mental disorder, one piece of broader sensory intolerance patterns, or something else entirely.⁷

Some researchers have suggested it might be related to obsessive-compulsive disorders.⁸ Research has also found connections between misophonia and other conditions involving sensory sensitivities such as migraines and autism spectrum disorder (ASD).

To help standardize how we understand misophonia, experts across various fields recently proposed a consensus definition. Together, the group described misophonia as a disorder of decreased tolerance to specific sounds, regardless of how loud they are, which causes a strong negative reaction and emotional upset.⁹

The full definition goes into greater detail and will continue to evolve. But it’s an important step towards helping researchers and clinicians from different specialties create a unified understanding of the condition in the future.

What causes misophonia?

Scientists are still working to understand exactly what causes misophonia, but recent brain imaging studies have revealed some important clues.

Neuroimaging studies have identified abnormal brain activity during misophonic episodes.¹⁰ Key regions showing differences include the anterior insular cortex and the anterior cingulate cortex. These are the areas involved in the processing of emotions and bodily sensations, attention, and emotional regulation.

One interesting theory based on this information proposes that people with misophonia may have difficulty disengaging from sensory cues related to others’ movements.

Conditioning also seems to play an important role. Neutral cues (like chewing noises) may become associated with negative experiences, triggering strong negative responses like anger.¹¹ Over time, a person may avoid the situation associated with that sound, in turn reinforcing the idea that the sound is upsetting.

Some researchers are also investigating other possible mechanisms through which misophonia could develop, including genetics and maladaptive learning.¹²

How misophonia impacts daily life

Misophonia can significantly impact a person’s quality of life across multiple areas:

Relationships can suffer as people might isolate themselves from others as a means of coping.¹³ One study found that people with misophonia rated faces as less likeable when they had previously seen those faces paired with sounds they found highly uncomfortable.¹⁴ This suggests that if someone makes a sound that triggers misophonia, the person with misophonia might start to like them less.

Work and school performance can also be affected. Research shows that people with misophonia demonstrate impaired cognitive performance, deficits in selective attention, and reduced cognitive control when exposed to triggers.¹⁵ Imagine trying to take an exam while someone nearby is repeatedly clicking a pen. While some people might find it irritating, people with misophonia may find that it makes it nearly impossible to concentrate.

Daily activities may become limited due to avoidance behaviors.¹⁶ People with misophonia may go to great lengths to avoid triggers, which can lead to:

• Eating alone to avoid meal sounds
• Wearing headphones or earplugs constantly
• Avoiding social gatherings, restaurants, or movie theaters
• Missing work or school when triggers can’t be avoided

Misophonia treatment options

While there are currently no officially approved treatments specifically designed for misophonia, several approaches show promise.

Therapy for misophonia sometimes involves cognitive behavioral therapy (CBT), which some studies show to be the most effective approach so far.¹⁷ It can help people develop more helpful thoughts patterns around their triggers and practice calming strategies for when they’re exposed to them.

Treatment approaches that address emotional regulation are also effective. Research shows that difficulties with emotion regulation are significantly related to misophonia, even when controlling for anxiety and depression symptoms.¹⁸ Learning how to best manage your emotions when triggered appears to be a crucial skill.

Other approaches being explored include:

• Reducing ambiguity by introducing trigger sounds in a way that they can be prepared for¹⁹
• Educational counseling combined with auditory therapies²⁰
• In some cases, antidepressant or anti-anxiety medications

Treatment plans should be tailored to fit each person and may combine multiple approaches. What works well for one person may not work for another, which is why professional assessments are so important.

Finding help for misophonia

If you suspect you have misophonia, know that you’re not alone. While it can feel isolating, this condition is common, affecting up to 20% of some populations.²¹ Increasing awareness means more effective treatment options are becoming available.

Visit our therapist directory to find a healthcare provider familiar with misophonia—this might be an audiologist, psychologist, or psychiatrist. Because misophonia crosses multiple disciplines, you may need to specifically ask about their experience with the condition.