Is there a way to stop being so sensitive to noise?

Dear Reader,

Sounds like this ventilation system has your ears ringing. Before considering if and how you can reduce your hearing ability, it may be best for you to meet with your health care provider or an audiologist (i.e., a provider who specializes in hearing and balance disorders) as they’re the best equipped to assess your situation and explore strategies to alleviate your discomfort. There are a few conditions — misophonia, phonophobia, hyperacusis, and recruitment — that could explain your highly sensitive hearing. Though there aren’t cures for these conditions, you may be able to manage your symptoms by using an auditory distraction such as white noise or noise-canceling headphones, ear protection, and cognitive behavioral therapy. Additionally, it may be effective to engage in sound exposure by systematically listening to the sounds that trigger your discomfort to become more acclimated them, which will hopefully help you tune these sounds out over time. If you want some relief while you wait to meet with your provider, you might want to try some of these strategies in addition to stress management techniques, or speaking with a mental health professional to help relieve your anxiety and further reduce your distress.

One condition that may be causing your discomfort is misophonia, also called selective sound sensitivity syndrome. This is a condition in which the person has a strong dislike or discomfort with certain trigger sounds that the average person is unaffected by. Common misophonic triggers include the sound of someone breathing, chewing, yawning, eating, tapping, or even speaking. When hearing these sounds, people with misophonia tend to experience a fight or flight stress response, which can make them feel anxious, fearful, angry, or experience a skin-crawling sensation. It’s worth noting that the symptoms and associated discomfort with misophonia vary from person to person, with some people finding it unpleasant but somewhat manageable, while others find it outright unbearable. In fact, misophonia shares common overlaps with obsessive-compulsive disorder (OCD) with regards to its spectrum of severity. Studies suggest that misophonia tends to be more common in adolescents who already have OCD and generalized anxiety disorder (GAD); however, not all people with misophonia have OCD or GAD. 

While misophonia isn’t officially considered to be a neurological or psychiatric disorder, there’s evidence to suggest that it has some ties to dysfunctions within the brain and reduced emotion regulation abilities. There’s research that shows affected individuals tend to have abnormal functional connectivity in the part of the brain that regulates emotions, the anterior insular cortex (AIC); as such, their abilities to appropriately respond to or ignore certain stimuli is hindered. Research suggests that people with misophonia have a higher amount of myelination in their medial frontal cortex, which may potentially be responsible for the hyperactive sensitivity they experience.

Another condition, phonophobia, is a unique case of misophonia where fear is the dominant feeling a person may have in response to specific trigger sounds; this fear may arise in anticipation of a loud noise or when there is an unexpected loud noise. Typical trigger sounds include those which are commonly present within a person’s environment, or noises that they have a personal connection with or have attached a specific meaning to them. For example, a trigger sound could be the sound of an alarm, fireworks, or ambulance sirens. The exact cause of phonophobia isn't understood, but it may be caused by childhood trauma or a single traumatic event. In addition, phonophobia may be caused by genetic factors, as those with a family history of anxiety disorders may be more likely to develop phonophobia. 

Sensitive hearing can also develop from a couple of other conditions, including hyperacusis, and recruitment. Hyperacusis, or hypersensitivity of hearing, is a rare hearing disorder in which affected people have a significantly lower tolerance to ordinary or everyday levels of sound or noises. Consequently, they’re able to hear these sounds as uncomfortably loud and intense and may also have tinnitus, or ringing in the ear, which can cause them severe emotional distress. Otherwise, people with hyperacusis have normal hearing. Relative to misophonia, the manifestation and symptoms experienced with hyperacusis tend to be more severe and extreme in nature. Potential causes of hyperacusis include post-traumatic stress disorder (PTSD), brain injury, or Lyme disease. Recruitment is a condition that involves hearing loss or an inability to hear soft sounds; however, if people with recruitment hear any noises at all, they tend to be intense and loud, causing discomfort or pain. 

With all of this said, it’s best to first check in with your health care provider to determine if your hearing sensitivity is due to a disease or illness. If it’s not, they’ll be able to refer you to an audiologist to help you understand if you have a hearing condition and how you can best manage or treat your symptoms. Your audiologist may suggest non-medical treatment options, such as behavioral counseling and sound therapy, which usually involve using noise-generating instruments to retrain your brain's signals to your ears so that your hearing becomes less sensitive. If your health care provider and audiologist are unsure of what’s causing your sensitivity, or are unable to treat or manage your symptoms, they might recommend that you see an ears, nose, and throat (ENT) specialist who can further examine your ears, and suggest treatments, if necessary.

Hopefully with support and advice from your providers, you’ll be well on your way to manage your sensitive hearing and restoring your peace of mind.