For some of us, it is fingernails scratching against a chalkboard that sets our teeth on edge. For others, it's the sound of smacking and chewing when someone eats. Still, others can't stand the sound of a beeping alarm clock or a baby's cries.

Misophonia and hyperacusis both go well beyond simple discomfort or annoyance, however. People suffering from either of these conditions have an extreme and visceral response to certain sounds—or even sound in general. If that sounds debilitating to you, that's because it most definitely is.

The good news is that both conditions are generally treatable. It's simply a matter of isolating and addressing the cause of the hypersensitivity. Do note, however, that both cause and treatment will differ depending on which of the two you're experiencing.

Because although both misophonia and hyperacusis can be broadly categorized as sound hypersensitivity when you drill down a bit, they're very different conditions.

What is Misophonia?

Have you ever had to leave a video call because you became enraged at the sound of someone chewing? Did you end up experiencing a panic attack due to someone repeatedly clicking their pen? Do certain noises seem to just … paralyze you, temporarily shutting down your faculties?

If you answered yes to any of these questions, then there's a good chance you suffer from misophonia, a condition where certain noises elicit a pronounced, highly negative emotional response. In some cases, this may even include physical symptoms such as increased heart rate, sweating, or trembling. Every individual with misophonia has a slightly different response, and their condition is triggered by a different sound or set of sounds.

What is Hyperacusis?

Whereas misophonia involves an extreme emotional response to sound, an individual suffering from hyperacusis will experience physical pain. The severity of this pain may vary from mild discomfort to substantial enough to be disabling. Hyperacusis frequently accompanies hearing loss, and tinnitus is a common comorbidity with the condition.

Generally, hyperacusis is triggered by one of the following:

  • All sound above a certain volume
  • Low-frequency sounds
  • High-frequency sounds

Hyperacusis may also manifest as severe pressure or a tinnitus episode extreme enough to cause pain.

How Do Misophonia and Hyperacusis Differ From One Another?

Generally, hyperacusis symptoms can be traced back to physical trauma such as a blow to the head or exposure to traumatic noise. With that said, any damage to the mechanisms of the inner ear can result in hyperacusis symptoms. Although scientists are not yet clear on what specifically causes hyperacusis, it's suspected that it may be a disorder of the auditory nerve. In other words, hyperacusis has clear physical symptoms and a suspected physical cause.

Misophonia, on the other hand, is entirely psychological. It may be due to trauma associated with a particular noise or a symptom of an underlying mental illness. Although the anxiety, panic, or anger accompanying an episode of misophonia can manifest certain physical symptoms, it's generally accepted that misophonia is a psychological condition rather than a physical one.

Another noteworthy difference between the two is how long an individual episode lasts. With misophonia, symptoms rarely last for more than an hour or two. Hyperacusis, meanwhile, can linger for days, sometimes weeks or even months after exposure.

Misophonia generally results in a fully-body response—in many cases, exposure to a triggering noise could result in a panic attack. Hyperacusis rarely manifests in any meaningful way outside the ears. Hyperacusis is also distinct in that the condition can be present in only one ear rather than both.

Finally, as one might expect, the two conditions tend to be treated differently. Hyperacusis is usually best addressed through a prescription hearing aid or sound therapy to help 'reprogram' one's auditory system. It's a similar principle to tinnitus treatments in that you're conditioning your brain to either ignore the sound or regard it as mundane.

For misophonia sufferers, counseling is generally the best approach. Speaking to a trained therapist can help one determine exactly why a sound causes such an extreme emotional response. From there, treatment often consists of cognitive behavioral therapy paired with sound therapy.

Before we wrap things up, there's one last thing we need to say. Neither misophonia nor hyperacusis is somehow more 'legitimate' than the other. Both are genuinely debilitating and diagnosable conditions.

And if you look down on someone with misophonia because it's 'all in their head,' then you've completely missed the point of this piece.