Dear Dr. Debbie,
Our pediatrician has suggested we look into getting an assessment and follow up treatment for misophonia for our daughter. She’s eight. He says it’s a newly recognized disorder, not fully understood.
Meanwhile she’s eating by herself in the kitchen with noise cancelling earmuffs on.
Awaiting an Appointment
Dear AaA,
According to the Misophonia Institute website, the disorder was first identified in 1997 and is not yet included in the Diagnostic and Statistical Manual of Mental Disorders (the DSM-5). Cleveland Clinic notes that there may be a genetic component and possible connection to ADHD, autism spectrum disorder, depression, obsessive-compulsive disorder, post-traumatic stress disorder and or borderline personality disorder. It is sometimes associated with hearing loss, tinnitus, or sensitive hearing (hyperacusis). The Misophonia Research Fund found that 4.6% of individuals in a study of 4,005 adults had the disorder and 78.5% of the people in the study were “sometimes bothered by one or more sounds”.
There are strategies and treatments that can diminish the negative effects this disorder can have on daily living. Further attention is needed.
Description
Misophonia is characterized by an emotional response to a specific sound trigger such as chewing, loud breathing, or tapping. The Flight or Fight response kicks in with an increase in heartrate, perspiration, and muscle tension often accompanied by desperate thoughts of escape (flight) or aggression (fight).
Nerve Pathways
The brain somehow gets conditioned to processes a particular sound as a threat. When the sound occurs, the person experiences strong emotional pain. The condition may come on suddenly, usually in late childhood or adolescence, and may persist lifelong. Most cases begin before age 25. It occurs more often in girls than in boys. Severe cases occur in 1% of the population.
A pattern develops such that the individual becomes anxious in certain situations knowing that the sound is about to occur. In the extreme, there are impulsive reactions of anger, including trying to stop the sound. The person learns to fear the anticipated distress and the social discomfort that their unusual behavior may provoke.
Coping Strategies
Your family has already identified a practical approach to getting through family meals: your daughter can keep a distance between herself and other people’s chewing and she can use a sound barrier. You might also employ a white noise machine, fan, or aquarium filter to buffer the sound of chewing in the dining room.
Consider which foods are more likely to be disturbing – crunchy foods such as tacos, slurpy foods such as soup. And stick to a quieter menu.
Managing Anxiety and Stress
With continued usage, muffling, reducing, and distancing herself from the offending trigger sounds will give your daughter some control. This can decrease the anticipatory anxiety that only makes things worse. By the way, headphones and earplugs are used more and more in schools and workplaces for a variety of reasons including enhanced concentration.
The psychological underpinnings of this disorder suggest that strategies for stress reduction would be beneficial. Deep breathing. Regular exercise. Yoga. Walking in nature. Restful sleep. Calming music. Creative expression through visual art or dancing. Laughter. Predictable routines. Hugs.
Being a rare disorder, and one that promotes distancing oneself from others, the condition can be isolating. Family members and close friends who understand your daughter’s needs can be game-changing. Look for an online support group for parents. Regular visits with a mental health provider can further help your daughter to manage all the stressors in her world. Medications may be prescribed to alleviate the impact of an underlying mental health disorder.
Misophonia is getting more recognition with attention to research and effective treatments. The goal is to help to redirect the neural pathways that are causing otherwise harmless sounds to fire up an overblown emotional response.
Dr. Debbie
Write your question to Dr. Debbie! Please include age(s) of your child(ren) and other details about the situation or concern.
Deborah Wood, Ph.D. is a child development specialist and founding director of Chesapeake Children’s Museum, located at 25 Silopanna Road in Annapolis.
CCM is open from 10 am to 4 pm daily, including November 27th. Online reservations are available or call: 410-990-1993. Walk-ins are welcome. Art and Story Time with Mrs. Spears and Puppy the Puppet is on Monday mornings at 10:30 am. There is a Nature Walk on Thursday at 10:30 am.
