The Dangers of Misdiagnosing Misophonia

Why Are So Many Women Being Misdiagnosed? | Glamour

If you Google “Misophonia” you may come across a small number of articles, generally describing misophonia as the “hatred of sound” – and while this is the literal translation of the word “misophonia”, it belies the true struggles of the disorder.

The term itself was only coined in 2000 and it was only recently recognized as a condition. Herein lies the problem, Misophonia has yet to be added to the Diagnostic and Statistical Manual (DSM). Because Misophonia has yet to be formally recognized, most clinicians will have little to no knowledge of the disorder. Here is where it can become damaging:

Persons with misophonia may present with symptoms that align with any number of mental disorders, auditory disorders, or neurological conditions. So when a patient presents with symptoms like:

  • extreme reactions to specific sounds
  • disgust turning to anger
  • becoming verbally aggressive to the person making the noise
  • anxiety
  • panic
  • rage
  • depression

…they could end with any number of other diagnoses. It’s important for clinicians to be able to recognize Misophonia as separate from OCD, mood disorders, sounds phobia, hyperacusis, tinnitus, and so on.

Without a proper diagnosis, patients and families can experience invalidation, confusion, hopelessness, and may receive improper treatment for misophonia.

 Let’s dig into each of these a little more:

1. Invalidation: If a patient brings their own research of Misophonia to a clinician as a proposed diagnosis and that clinician has never even heard of the disorder, the patient will likely be dismissed.  *I myself have experienced this time and again. Most recently, I posed a question to my neurologist, whom I see for a migraine disorder. I asked, “is there any possibility of, or research on a possible relationship between misophonia and migraine disorders?” She stared at me blankly, furrowed her brow, and then briskly said “no”. It was clear to me, someone who is rather experienced in discussing this rarely recognized disorder, that she had never heard the word “misophonia”. But, even after all my experience of explaining the disorder to confounded faces, I found this discouraging and troublesome. * This brings up an issue for another time, clinicians should grow comfortable with acknowledging that they may not have enough information to make a clear decision and they will get back to you once they have consulted their resources. *   

2.     Confusion & Hopelessness: Few people know enough about the various possible disorders on the medical, neurological , and psychological spectrums to spot a mismatch between their symptoms and their diagnosis. And fewer still would readily question the judgement of their clinician. Misdiagnosis of misophonia can result in the patient becoming confused and potentially hopeless when they are assigned a treatment course that is unsuccessful or feels misaligned with their experience of misophonia. 

3.     Improper treatments and management of symptoms: At worst, a misdiagnosis could exacerbate the symptoms of misophonia.  During my elementary school years, I was misdiagnosed with a literal phobia of specific sounds. My psychologist determined that the best course of action was exposure therapy. As such, I was forced to sit in a room for 20 minutes twice every day and listen to a recording of my worst trigger sounds on repeat. This treatment resulted in an increased response to trigger sounds, an increase in number of overall trigger sounds, and a significant decrease in my mental well-being. Since then, some studies have confirmed that exposure therapy can indeed worsen the condition.

It is critical to patient well-being that Misophonia become formally classified into the DSM.

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