Misophonia: The sound sensitivity syndrome

The sound people make while chewing sugarcane makes my eyes water. In fact I am almost convinced that if I was tied to a chair and made to listen to that sound for 10 minutes, I would have a heart attack. It is my own personal version of the infamous Nalufenya chair. However, my friend loves her sugarcane and cannot understand how the sound she makes causes me so much discomfort. There are so many sounds that irritate people including ordinary sounds such as chewing, slurping, breathing, yawning, whistling and the biggies; the squeaking of a chair being dragged on cement and nails dragged across the chalkboard.
Doctor Emilio Ovuga, a professor of psychiatry and mental health at Gulu University, reveals that the problem is not with the ears but the way sound affects the brain. “What happens is that your auditory messages are misinterpreted within the central nervous system resulting in an inappropriate reaction such as disgust, anxiety and rage. Some people feel the urge to flee or attack the source of the sound and in some extreme cases suicidal thoughts,” Dr Ovuga explains.

What causes misophonia?
Misophonia, according to Dr Noelin Nakasujja, a psychiatrist at International Medical Centre in Kololo, usually starts at a tender age or in children between the ages of nine and 13, especially among girls. “From childhood, people develop a strong hatred for particular sounds such as the grilling sound that the machine(s) at the dentists’ make, resulting in a lifelong dread of dentists,” she explains.

Dr Nakasujja says the exact cause of misophonia is still unknown and it was not even considered as a medical condition until recently.
She notes that it is sometimes mistaken for anxiety or bipolar or obsessive-compulsive disorder.

In fact, some doctors think it should be classified as a new disorder.
But Dr Maurice Osire Tukei, a clinical psychologist at International Hospital Kampala, says this condition (misophonia) and its symptomatology do not fit into DSM-IV-TR (The Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association that offers a common language and standard criteria for the classification of mental disorders) or ICD-10 classifications for disorders.
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD).
It is a medical classification list by the World Health Organisation.

Causes
Although doctors and other physicians are not sure what causes misophonia, they say it has nothing to do with one’s ears as it is partially mental and partly physical. It could be related to how sound affects your brain and triggers automatic responses in your body.
If untreated, severe cases of misophonia lead to a number of complications such as becoming defensive against certain situations, changing one’s lifestyle to avoid experiences that may trigger symptoms, for instance if snoring affects someone, he or she will separate rooms with their spouse and also, to avoid one’s loud chewing, a “misophone” will try to stay away from a particular person or people during meals, in order to avoid this particular experience.

No cure
Since the condition does affect daily life, doctors say one can easily learn to live with it because there is no universally effective treatment for it. According to Dr Norbert Bwana Akantorana, a physiotherapist at Physique Centre in Kamwokya, the condition can be controlled by therapy and counselling.
“Therapies include; Tinnitus retraining therapy TRT), Cognitive behavioural therapy (CBT),” he says.
Dr Akantorana explains that (TRT) entails teaching people with misophonia how to improve their ability to tolerate certain noises, while CBT involves changing the negative thoughts that may contribute to the patient’s suffering.
However, stress management is one of the ways through which one can counteract the condition.

This can be done by regular exercise and ensuring one gets plenty of sleep. You can also wear ear plugs and headsets to tune out sounds. If possible, avoid the noises that outrage you or where necessary, adopt coping strategies.
Dr Nakasujja says another treatment involves adding background noise to the person’s environment in an effort to help them ignore their triggers for negative reactions.
“Other treatments include talk therapy and antidepressants. Research shows that 80 per cent of misophonia patients can experience significant relief from symptoms if treated” she adds.
Apart from coping mechanisms, there is no specific globally recommended treatment for misophonia.

Is it genetic?
Mary Bayingwa, 47, recounts her mother’s inexplicable anger at various household noises. “She would complain about most sounds but scraping a saucepan with a spoon in her hearing was a sure way of getting oneself a sound beating. At that time I did not mind the sound but with time it has come to irritate me to but of course not to my mother’s level,” she explains.
Misophonia seems to occur more frequently in a person with a higher level of anxiety, stress, or compulsive behaviour.

The reaction often develops first to a parent or family member where the person has a high level of anxiety or distress (physiological state of distress) and they repeatedly hear the sound. It also seems to happen when a person cannot escape from the sound, such as at the dinner table, in a car, or even laying in bed. In rare cases, the original misophonia trigger has been a repeating visual image (body movement).
With most sounds, the sound is taken into the brain and then the person makes a thoughtful response. The person considers the meaning of the sound and then responds. This is called a “high road” response. (It goes through the higher part of the brain before the person reacts.) For example, a person says to you, “I hate you.” You have to first think about the words and the meaning. You then respond based on the meaning. In this case, if words are a reply to “your feet stink,” then you know it is joking or name calling, and you do not have a negative emotional response. If you perceive the person as serious and the person is important to you, then you may have a strong, negative emotional response, such as crying.

[email protected]