Silence is golden. This phrase is often said to children, and even adults, to remind them of the value of being quiet. However, for the millions of people with acute auditory conditions, this phrase has much more meaning. Two such disorders in particular—tinnitus and misophonia—can have a debilitating impact on a person’s everyday life.

The Trouble with Tinnitus

At one point or another, we’ve all experienced ringing in the ears, commonly known as tinnitus. In fact, it has been an inconvenience throughout all human history: symptoms of tinnitus can be traced all the way back to the ancient Egyptians, and today it affects around fifty million Americans. Fortunately for most, that annoying, high-pitched tone, which we can only hear in our heads, usually goes away after a few seconds.

Now imagine the ringing—or perhaps whistling, buzzing, or hissing—happening every day or perhaps never ending. That’s what happens to the twenty million Americans with chronic tinnitus, who often experience a lesser quality of life. According to a survey by the American Tinnitus Association (ATA), over 60 percent of respondents said that this auditory condition significantly impacts their life.

For people with long-term tinnitus, it’s almost always the result of something else they have experienced, a symptom caused by damage to their ear. The ATA says that there are over two hundred different conditions that can cause tinnitus, but long-term exposure to loud noises is the most common cause. In addition, it can result from an injury (such as to the neck, jaw, or brain) or obstruction of the middle ear or sinuses. Not surprisingly, veterans are affected at an alarming rate: as of 2012, almost a million veterans had received approximately $1.5 billion in total disability payments for tinnitus.

Despite centuries of efforts, there is no cure. There is hope, though. Several treatments exist to help reduce the impact of the sounds, including masking devices, modified-sound devices, tinnitus retraining therapy (TRT), and, most recently, neuromodulation, to help promote a better quality of life.

If you feel like you have tinnitus, it’s important to visit your doctor for an examination and, if necessary, a follow-up exam with a hearing specialist or an ear specialist to determine the proper course of action for your unique symptoms.

Misophonia: The New Noise in Town

Here’s a fun question: What’s your auditory pet peeve—an unpleasant sound that makes your blood curdle? Someone smacking on chewing gum, perhaps? A pounding bass blaring from the car next to you? A loud breather? The sound of someone chomping on popcorn behind you at the theater?

We all have times when we instinctively want to cover our ears because of such sounds. Sometimes, frankly, it’s because they are annoying. Certain people, though, are extremely hypersensitive and reactionary to such everyday noises because of a condition called misophonia.

In contrast to tinnitus, misophonia is a relatively new condition in the medical field, having been discussed and debated by professionals for only about the past twenty years. Originally dubbed selective sound sensitivity syndrome by Dr. Marsha Johnson in the late 1990s, misophonia got its current name, which literally means “hatred of sound” in Greek, from a 2001 report by Drs. Margaret M. Jastreboff and Pawel J. Jastreboff. (The latter is also credited for discovering the TRT approach to tinnitus.)

This definition is not quite accurate, though—people with misophonia only hate certain sounds (and sometimes sights associated with those sounds), to the point of it overwhelming their everyday lives. For example, say one of your big triggers is lip-smacking sounds. Knowing someone in your family is a loud chewer, your heart might start racing even at the sight of that person sitting down to eat. Then, once the chewing begins, your emotions—such as intense anger, irritability, or sobbing—likely flare up because hearing the sounds is virtually unavoidable. Perhaps you even dart out of the room.

As you might imagine, such an existence can be taxing, if not downright depressing. People with misophonia often restrict their own lives to cope, choosing to stay at home, for example, rather than go to the movies or out to eat.

Doubling down on the misophonia problem is the fact that the medical community is still trying to come to a consensus about what it is, even though it affects an estimated 20 percent of the population. Misophonia is not listed as an official mental disorder, and many doctors have never even heard of it—which can have the unintended effect of a patient thinking that it’s all in his or her head.

Evidence seems to indicate that this may literally be true, though. A 2017 study suggests that the anterior insular cortex, which is vital to the connection between brain signals and emotional processing, may function differently during these misophonia episodes. Knowing that people with misophonia are wired differently may open the door for more much-needed research into understanding the condition and formulating a more standardized treatment protocol across medical disciplines.

As of now, cognitive therapy and deconditioning therapy are two primary ways that patients can get relief from this syndrome. In addition, antianxiety or antidepressant medications can help with the triggering effects, but prescriptions are not the recommended course of action. If the situation allows it, simply drowning out the noise can be particularly effective: wearing noise-canceling headphones at work, for example, or during meals.

Having an auditory-based condition such as tinnitus or misophonia can be emotionally and socially crippling, potentially leading to a lonely, angst-filled life where people can’t comprehend what you’re going through. But with more research and more discussion comes more understanding—and, hopefully, more peace by creating an everyday existence where those afflicted feel safe and sound.

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