When Soup Slurping and Gum Popping Push You Over the Edge
Do you ever get angry with someone for clicking his pen or scratching his arm? There’s a name for that — misophonia — and it’s a condition that many with ADHD can relate to.
Have you ever heard of misophonia? I hadn’t, until a few months ago when a colleague of mine, Teresa Kohlenberg, M.D., a brilliant child psychiatrist in my group, told me about it.
At first it sounded like a sham. I couldn’t believe that it was a real condition. Then I reminded myself, that’s what people used to say about ADHD.
So what is this condition with an odd name that most people have never heard of? It is the dislike or hatred of little sounds. (Not loud sounds; that’s another condition, called hyperacusis.) It’s little sounds that drive some people crazy — the sound of someone chewing food or gum, the sound of a person’s breathing, the sound a dog makes when licking its paws, the sound of a pen clicking, or even the popping noise a person makes when enunciating the letter “p,” as in “Please pass the peas.”
A person with misophonia may fly into a rage and assault the chewer of the gum, popper of the p’s, or clicker of the pen. Short of attacking, the person with misophonia might sit, fists clenched, and stare daggers at the maker of the tiny noise. It is an involuntary and uncontrollable reaction, almost like a seizure, during which the sufferer has virtually no control over his or her reactions.
Does it make any sense? Not at all. But a seizure makes no “sense” either; it is an electrical explosion in the brain. The misophonia sufferer’s response is also like an explosion in the brain — unwanted and uncontrollable.
Sounds That Incite
People who have ADHD are often hyper-reactive in one sensory domain or another: smell, touch, sound, sight, even taste. Some of us wear only cotton, for example, and find all other fabrics too scratchy. Or the taste of a carrot makes us gag. Or headlights cause us to feel terror and to close our eyes (dangerous!). Or we cannot abide the smell of a floral bouquet or a pine dresser, smells that most people love. Or we overreact to various sounds, be they faint or loud. This is not true of misophonia, although those of us with ADHD can understand the condition better than others, perhaps, because of our own hypersensitivities.
Joyce Cohen wrote the first important mainstream article about misophonia in the New York Times in 2011. She brought attention to this previously unheard-of condition. Since then, support groups have arisen, and there is now an annual convention of the Misophonia Association. The fourth annual gathering took place in Las Vegas in 2017 (see misophonia-association.org or misophonia.com).
I can imagine how isolating this condition can be, and how wonderful the sharing must have been at the Las Vegas meeting. These are brave people, trying to make their way in a world that doesn’t understand them. They don’t even understand themselves as they cope and suffer.
How to Bring Relief
As of now, there is no proven cure or effective treatment for misophonia. There are various remedies people try. Two medications — Lyrica and Klonopin — have helped some sufferers. The usual psychological treatments for everything these days have also been known to help some cases: CBT, DBT, mindfulness training, hypnosis, and meditation. Certain physical treatments have helped some people: acoustic therapies; alpha-stim; chiropractic; and EMDR. The usual array of lifestyle modifications have also improved symptoms in some people: rigorous exercise, getting enough sleep, eating healthy meals, and wearing sound protection.
Just by being aware of the condition, we can help those who suffer from it. By understanding their challenges and not blaming them, we can bring relief. This goal should be familiar to all of us with ADHD.