Misophonia, often described as a “hatred of sound,” is a neurophysiological condition characterized by strong negative emotional and physiological reactions to specific sounds. These “trigger sounds”—which are usually innocuous to most people, such as chewing, breathing, or tapping—can elicit intense anger, disgust, panic, and a fight-or-flight response in those affected. While initially dismissed by some, a growing body of peer-reviewed research confirms misophonia’s debilitating impact, including a concerning association with self-harm and suicidal ideation.
Recent studies have shed light on the severe psychological toll misophonia can take. A peer-reviewed study by Simner and Rinaldi (2022) examined a large birth cohort and found a significantly higher prevalence of self-harm and suicidal ideation among adults with misophonia. This association was particularly pronounced in females but also evident in males.
The pathways connecting misophonia to suicide risk are multifaceted:
- Intense Emotional Distress: The constant involuntary activation of extreme emotions like rage, panic, and disgust in response to everyday sounds is psychologically exhausting. This chronic distress can lead to feelings of overwhelm and hopelessness.
- Social Isolation and Withdrawal: To avoid triggers, individuals with misophonia often withdraw from social situations, including family meals, school, work, and public spaces. This self-imposed isolation can lead to profound loneliness, depression, and a sense of disconnection, all established risk factors for suicide.
- Comorbidity with Mental Health Conditions: Misophonia frequently co-occurs with other mental health conditions such as depression, anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). These conditions independently increase suicide risk, and the added burden of misophonia can exacerbate symptoms and further diminish coping abilities.
- Loss of Control and Hopelessness: The inability to control one’s reactions or to escape triggering environments can instill a deep sense of helplessness and despair. Life can feel like an unending battle against one’s own nervous system, leading to thoughts that escaping life is the only way to escape the triggers.
A case report by Alekri and Al Saif (2019) documented the case of an adolescent female whose misophonia was complicated by two non-fatal suicide attempts, providing a stark example of the potential severity of the condition’s impact.
You can find specific misophonia resources (not directly about suicide but coping) here:
https://misophoniafoundation.com/product-category/free-resources/
https://misophoniafoundation.com/treatment/
If You or Someone You Know Needs Help
If you are experiencing suicidal thoughts, please remember that you are not alone, and help is available. Reaching out is a sign of strength.
For Immediate Help, Please Contact:
North America
- Canada:
- 988 Suicide Crisis Helpline: Call or text 988 anytime. Available 24/7 in English and French.
- Crisis Services Canada: 1-833-456-4566 (24/7)
- Kids Help Phone: 1-800-668-6868 (for young people)
- United States:
- 988 Suicide & Crisis Lifeline: Call or text 988 anytime. Available 24/7.
- Crisis Text Line: Text HOME to 741741
United Kingdom
- Samaritans: Call 116 123 (free, 24/7)
- Papyrus HOPELINEUK: Call 0800 068 4141, text 07860039967 (for young people)
Australia
- Lifeline: Call 13 11 14 (24/7)
- Suicide Call Back Service: Call 1300 659 467
New Zealand
- Lifeline Aotearoa: Call 0800 543 354 or text HELP to 4357
- Samaritans: Call 0800 726 666 (24/7)
Ireland
- Samaritans: Call 116 123 (free, 24/7)
- Pieta House: Call 1800 247 247
South Africa
- SADAG (South African Depression and Anxiety Group) Suicide Crisis Line: Call 0800 567 567 or SMS 31393
- Adcock Ingram Depression and Anxiety Helpline: Call 0800 70 80 90
India
- Vandrevala Foundation: Call 1860-2662-345 or 1800-2333-330
- AASRA: Call +91-22-27546669
General International Resources
- Befrienders Worldwide: Visit Befrienders.org to find helplines in various countries.
Misophonia is a serious condition that deserves recognition and effective treatment. By understanding its impact and utilizing available resources, individuals can find strategies to manage their symptoms, improve their quality of life, and mitigate suicide risk.
A Clinician’s Guide to Misophonia and Suicidal Ideation
This guide is for clinicians working with clients who have misophonia and are also experiencing suicidal ideation. It emphasizes the need to integrate standard suicide prevention protocols with a critical awareness of how misophonia can uniquely contribute to a client’s distress.
- Understanding the Link Between Misophonia and Suicide Risk
Misophonia, or “hatred of sounds,” is a condition characterized by a strong emotional and physiological aversion to specific sounds, often human-generated ones like chewing or breathing. Research extensively documents a significant link between misophonia and elevated rates of self-harm and suicidal ideation (Rinaldi & Simner, 2022). A large birth cohort study found that adults with misophonia had significantly higher rates of suicidal ideation and poorer well-being, with female misophonics being at particular risk (Rinaldi & Simner, 2022). A separate case report detailed an adolescent female with misophonia who made two non-fatal suicide attempts, highlighting the potential for severe cases (Palumbo et al., 2017).
For individuals with misophonia, the constant, unpredictable nature of trigger sounds can lead to intense negative emotions, including anger, disgust, and anxiety. Clinical sources confirm that this activates an involuntary “fight-or-flight” response, accompanied by physiological reactions such as an increase in heart rate, blood pressure, and muscle tension (Edelstein et al., 2013). This profound distress can lead to social isolation, strained relationships, and a sense of hopelessness, all of which are established risk factors for suicide. It is crucial for clinicians to recognize that misophonia is not just an annoyance; it is a source of immense suffering that can directly impact a client’s mental health and quality of life.
- Incorporating Suicide Risk Assessment Scales
While standard suicide prevention and treatment protocols should always be followed, the use of a formal suicide risk assessment scale is a critical step. These scales provide a structured way to evaluate a client’s risk level and inform a safety plan. The Columbia-Suicide Severity Rating Scale (C-SSRS) is a widely recognized and evidence-supported tool for this purpose (Columbia Lighthouse Project, n.d.).
Clinicians should administer such scales and, in addition to standard questions, explore how misophonic triggers and their effects contribute to the client’s suicidal thoughts. For example, a clinician might ask, “Have your thoughts of suicide increased after an exposure to a trigger sound?” or “Do your suicidal feelings come from a sense of hopelessness about ever escaping these sounds?”
- Recommended Treatment Approaches
Based on the resources from the Misophonia Foundation, a comprehensive approach to treatment should focus on coping skills. The foundation does not endorse “one-size-fits-all” cures or exposure therapy, but rather a practical approach to help clients manage the impact of misophonia (Misophonia Foundation, n.d.). While research on specific treatment protocols is limited, studies and systematic reviews suggest that a range of therapeutic strategies can be beneficial in helping clients manage their symptoms (Mattson et al., 2023).
Key elements of a misophonia-informed treatment plan could include:
Psychoeducation: Help the client understand that their reaction is a recognized phenomenon, which can reduce feelings of shame and isolation. Sensory and Cognitive-Based Coping: Teach strategies such as using noise-canceling headphones, creating “safe spaces,” and cognitive restructuring to reframe their thoughts about trigger sounds. The goal is to provide tools that help clients alleviate their suffering and better navigate daily life. Social and Communication Skills: Since misophonia often strains relationships, help the client develop effective ways to communicate their needs to family and friends. Safety Planning: As part of the suicide risk assessment, a collaborative safety plan should be developed. This should not only include general steps like identifying warning signs and coping strategies but should also specifically address what the client can do when a misophonic trigger leads to an escalation of suicidal thoughts. This may include using a distraction technique, reaching out to a support person, or using a specific coping skill to de-escalate their emotional response to the sound.
Note: The information provided here is for guidance and does not replace professional medical advice. Clinicians should always adhere to their professional standards and seek supervision when necessary.
Sources
Columbia Lighthouse Project. (n.d.). About the Protocol. Retrieved from https://cssrs.columbia.edu/the-columbia-scale-c-ssrs/about-the-scale/ Edelstein, M., Brang, D., Rouw, R., & Ramachandran, V. S. (2013). Misophonia: physiological investigations and case descriptions. Frontiers in Human Neuroscience, 7(656).
Mattson, S. A., D’Souza, J., Wojcik, K. D., Guzick, A. G., Goodman, W. K., & Storch, E. A. (2023). A
Misophonia Foundation. (n.d.). Misophonia Treatment.
Palumbo, D. R., Fenwick, K. H., & Mcloughlin, L. B. (2017). Misophonia in an Adolescent with a History of Self-Harming and Suicidal Behavior: A Case Report. Journal of Pediatric
Rinaldi, L. J., & Simner, J. (2022). Misophonia, self‐harm and suicidal ideation. PCN Reports, 1(1), 1-8.