Generality
Misofonia is the term that indicates a form of acoustic intolerance, on the part of a person, against specific noises emitted by third parties.
To the perception of the sounds or noises towards which he is intolerant, the subject with misophonia can react in various ways: feeling discomfort or discomfort, manifesting gestures of anger or irritability, becoming agitated, developing aggression, etc.
At present, there is no specific therapy against misophonia.
In fact, the treatments used by doctors are sound therapy - which is specifically indicated for the treatment of tinnitus - and cognitive-behavioral psychotherapy.
What is misophonia?
Misophonia is intolerance to specific sounds, emitted by third parties (whether these people or things).
Because of negative emotional and physical reactions, misophonia is an alleged acoustic disorder, the subject of controversy among experts and not yet included in a precise pathological category.
Differences with hyperacusis
Misophonia is different from hyperacusis, which is hypersensitivity to sounds that normally do not cause any discomfort in the ear of a human being.
Hyperacusis is a recognized medical condition.
ORIGIN OF THE NAME
Misofonia is a word of Greek origin, fruit of the union between:
- The term "misos" ( μῖσος ), which means "hate", e
- The term "fonos" ( φόνος ), which means "sound" or "voice".
So, literally, misophonia means "hate for sound".
Epidemiology
According to some statistical surveys, at least 60% of people with tinnitus (or tinnitus ) would suffer from misophonia.
At the general population level, it seems that the misophonia affects about 20% of people.
Misophonia can affect people of any age, although it is worth pointing out that, for reasons that are still unclear, the subjects most at risk are prepubertal women.
Causes
There is still little clarity about the possible causes of misophonia.
Doctors and experts in the field are inclined to believe that the disorder is, in some way, connected to a malfunction of the central auditory system (or apparatus), present at the level of the brain; while they exclude that at the origin there are specific problems of the ear (for example, at the level of the vestibular apparatus) or anatomo-structural alterations of the brain.
Symptoms and Complications
Symptoms of misophonia are behavioral responses to specific sounds and / or noises. Thus, these sounds or noises can be considered as the so-called " trigger " of reactions and gestures of intolerance.
The most common behavioral responses of misophonia consist of:
- Discomfort or discomfort
- Episodes of panic, sometimes even uncontrolled
- Episodes of rabies
- agitation
- Aggressiveness and irritability
- Tendency to move away from the source of sound towards which there is intolerance
- Anxiety attacks, with physical symptoms of attack-flight reactions (muscle tension, sweating, rapid heart beat, etc.)
- Disgust
As for the so-called "triggers" of misophonia, the most common triggering sounds are:
- Oral sounds, like eating, sipping a drink, kissing, sucking through a straw, swallowing food, biting your nails, spitting, licking, flossing, chewing, scraping teeth on cutlery, brushing teeth, crunching crunchy foods, grinding teeth, cracking the jaw, etc.
- The voices from the nasal tone, buzzing, muffled or hissing, the off-key songs and the vocal sounds emitted during the interjections "ah!", "Eh!", "Oh!" etc.
- The nasal sounds, that is, emitted from the nose. This category includes the noises produced on the occasion of: deep breaths, puffs, whistling with the nose, snoring, difficulty breathing, congested breathing and hiccups.
Remaining in this area, the nasal sound of yawning, sneezing and the act of "sniffing" deserve a special mention.
- Animal sounds . They can be objects of intolerance: the barking of dogs, the chirping of birds, the croaking of frogs, lapping and whining of dogs and cats etc.
- The sounds emitted with body movements, such as: the articulation of the joints (ex: neck, hands, legs, etc.), the noise emitted by the nails that strike a table or the noise produced by certain types of footwear (eg heeled shoes)
- The sounds made by young children when they cry, stutter, scream, etc.
- The environmental sounds, such as: cell phone ringtones, clock ticking, the sound of crockery bumping between them, the sound of chainsaws, the rustling or tearing of paper, the sound of lawnmowers, the banging of doors and windows, vehicle horns, too much radio or TV volume, background noise emitted by refrigerators, computer keyboard noise, rubbing of certain objects on certain surfaces, compression of plastic bottles, etc.
COMPLICATIONS OF MYSOPHONY
In extreme cases, misophonia can affect the social sphere, with the affected person avoiding certain places, workplace, school, family environment etc., so as not to hear the annoying sound, cause of intolerance symptoms .
From this, the complications that can derive from it are mainly two: tendency to isolation and difficulty in establishing and / or maintaining interpersonal relationships .
ASSOCIATED CONDITIONS
For reasons that are still unknown, many people who show symptoms of misophonia are people suffering from: the so-called obsessive compulsive disorder, the so-called obsessive compulsive personality disorder, various forms of depression, bipolar disorder, Tourette's syndrome, anxiety disorders or disorders food.
Diagnosis
For a correct diagnosis of misophonia, the following are fundamental: the objective examination, a questionnaire related to the so-called "triggers" of intolerance reactions and, finally, the tests that allow to exclude all those recognized medical conditions, responsible for similar symptoms ( differential diagnosis ).
It is during the diagnostic phase that those who visit the patient notice if the latter also suffers from tinnitus.
What is tinnitus, also known as the plural term tinnitus?
The term tinnitus defines an annoying ringing in the ears, in the absence of external sound sources.
On some occasions, tinnitus is a temporary and totally reversible phenomenon; in other situations, on the other hand, it constitutes an almost recurring, almost invalidating disorder, which can also have negative repercussions on normal daily activities.
WHO TAKES CARE OF DIAGNOSIS?
Various specialists have the skills necessary to identify misophonia, including: doctors who are experts in the field of audiology, psychiatrists, language therapists and psychologists.
SOME DETAILS ON DIFFERENTIAL DIAGNOSIS
The conditions under observation during the differential diagnosis include: hearing loss linked to aging, hyperacusis and disorders that cause acoustic hallucinations.
Treatment
Accomplices also the uncertainties concerning the problem, doctors and experts in the field of audiology have not yet developed a specific therapy against misophonia. However, in the course of their numerous experimental trials on patients, they were able to note, curiously, that the so-called sound therapy, adopted for the treatment of tinnitus, is useful to improve the tolerance level of certain sounds and reduce the degree of intolerance.
Furthermore, it is somewhat recent discovery that some particular cases of misophonia also benefit from cognitive-behavioral therapy, ie a very common psychotherapy technique.
SOUND THERAPY: THE BASIC CONCEPTS
The purpose of sound therapy, also known as TRT ( Tinnitus Retraining Therapy ) is the patient's acoustic desensitization . In medicine, the term desensitization refers to that set of processes aimed at reducing (or, at best, resolving) a state of abnormal aversion / sensitivity to certain substances.
In practical terms, these processes consist in administering progressively increasing doses of the offending substance to the patient (ie the one towards which the patient is highly sensitive), in such a way as to trigger an adaptation process.
Clearly, in the case of acoustic desensitization for the treatment of misophonia, the "substances" to be "administered in increasing doses", with the aim of reducing intolerance and accustoming the ear to hearing them, are annoying and unbearable noises and sounds.
Note: the desensitization technique is particularly suitable in case of allergies. In these situations, the term substance is appropriate, because it refers to the allergen to which the patient is hypersensitive.
MODALITIES AND TIMES OF SOUND THERAPY
Sound therapy involves applying a sound dispenser to the patient's ear.
This particular instrument can emit noises of adjustable intensity; the possibility of adjusting the sounds allows the desensitization treatment to be carried out precisely.
Exposure to annoying noises must occur daily: in the initial phase, the daily treatment hours range from 6 to 8; at a later stage they may even become less than 6, provided however that the therapy is effective.
Initially, the intensity of the sounds delivered by the instrument is at levels that do not cause the patient any discomfort. Moreover, if I were not like this, the treatment would be completely useless.
COGNITIVE-BEHAVIORAL THERAPY
The purpose of cognitive-behavioral therapy is to educate the patient about the ailment he is suffering from, so that he can somehow dominate it.
Generally, this particular treatment is reserved for mental illnesses (as mentioned, it is a psychotherapy technique); however, doctors have noted that it is also effective against various acoustic disorders - including misophonia and hyperacusis - characterized by panic attacks and growing anxiety disorders.
ARE THERE EFFECTIVE DRUGS AGAINST MYSOPHONY?
Several doctors have tested different classes of drugs on people with misophonia, with the intent to understand if there was one or more pharmacological substances capable of having any therapeutic effect.
These experiments did not produce the desired results. So, from a pharmacological point of view, misophonia is not curable.
Medicinal products tested for the treatment of misophonia include: anxiolytics, antidepressants and dietary supplements based on vitamins, minerals or fish oil.
Prognosis
According to reliable statistical studies, with the appropriate treatments, 80% of people with misophonia recover from the disorder, without relapses.
Therefore, in general, the prognosis in case of misophonia tends to be more than positive.
To get good results, it is important to act quickly and before the condition gets complicated.
Prevention
At present, doctors ignore whether there is a way to prevent misophonia. Certainly, they agree that a timely treatment of the misophonia avoids the resulting complications.
