Misophonia
Misophonia: A Disorder That Exists Everywhere but on Paper
Misophonia exists but you won't find it in the pages of the DSM-5 or ICD-10.
Posted August 21, 2024 Reviewed by Davia Sills
Key points
- Misophonia is recognized in research literature as a real condition but is not in any diagnostic manuals.
- While labels for disorders are controversial, there is great power in diagnosis, including treatment options.
Despite being recognized as a distinct disorder in a consensus definition in 2022, misophonia is still not in any diagnostic manual, including the DSM-5 and the ICD-10. Many clinicians around the world rely on these manuals to diagnose mental and neurological conditions and, in some cases, provide coverage for their patients through insurance.
Sufferers of misophonia are often put between a rock and a hard place when they try to obtain care for their condition. In many cases, clinicians have never heard of the disorder, which causes a fight-flight-freeze response to otherwise normal stimuli.
Diagnosis is an important part of any health condition—it helps practically by providing legitimacy to the condition so that it can receive research funding and treatment options. Diagnosis is also a validating factor for persons with the disorder. For those who are struggling with misophonia, there are coping skills, such as a sensory diet and cognitive behavioral therapy, which can help mitigate the distress caused by misophonia.
Emma Green, a college student with misophonia, expresses her concern with the lack of diagnosis: “I go to class, and there are people chewing gum or clicking their pen… and when I tried to get accommodations, I was told I couldn’t because misophonia didn’t exist. I just want to be able to focus on my work like everybody else.” Emma goes on to say, “While I don’t think labels are great for mental health… I do think a lack of diagnosis is really hurting us.”
While those with misophonia await diagnosis, it can be important to recognize that their condition has been recognized in research as a distinct disorder and should be treated as such. Although there is no cure or diagnosis for misophonia, this does not mean that the distress sufferers feel is not real.
Sharon Burns, a Board member of The International Misophonia Foundation, when asked about the addition of misophonia to diagnostic manuals, said, “I suffer from misophonia and want the condition to be recognized in the DSM and ICD so I can get some help.” The International Misophonia Foundation has recently launched a petition to get misophonia recognized in diagnostic manuals.
For therapists treating patients with misophonia, it can be useful to use terms like anxiety when dealing with accommodation letters for misophonia. Since there is a fight-flight-freeze response involved in the condition, this would most closely relate to the conditions for which we currently have names. The difference, however, is that persons with misophonia do not seem to habituate to their triggers, whereas anxiety can be treated by exposure. Any attempts to mislabel misophonia as anxiety should be used as a way to help the client and not as a justification for interventions that have not been proven to be successful for misophonia.
While the DSM-5 and the ICD-10 are incredibly important texts that have improved the lives of many persons around the world, the lack of an appearance of misophonia in these manuals can lead to more struggles for persons who are not recognized by the system and yet are suffering nonetheless. Those with misophonia can find hope, however, in the growing body of literature surrounding misophonia.
References
Swedo, S. E., Baguley, D. M., Denys, D., Dixon, L. J., Erfanian, M., Fioretti, A., Jastreboff, P. J., Kumar, S., Rosenthal, M. Z., Rouw, R., Schiller, D., Simner, J., Storch, E. A., Taylor, S., Werff, K. R. V., Altimus, C. M., & Raver, S. M. (2022). "Consensus Definition of Misophonia: A Delphi Study". Frontiers in Neuroscience, 16, 1–16. https://doi.org/10.3389/fnins.2022.841816
Tremblay KL, Inoue K, McClannahan K, Ross B (2010) Repeated Stimulus Exposure Alters the Way Sound Is Encoded in the Human Brain. PLOS ONE 5(4): e10283. https://doi.org/10.1371/journal.pone.0010283
Schröder, A. Bögels, S. M., Brondolo, E., Clarke, S. B., Cuijpers, P., Goddard, E., Grodnitzky, G. R., Jastreboff, P. J., Paunovic, N., Pinto, A., Reid, A. M., Tyson, P. D., Abramowitz, J. S., Arrindell, W. A., Barlett, C. P., Edelstein, M. (2017, April 18). Cognitive behavioral therapy is effective in Misophonia: An open trial. Journal of Affective Disorders. https://www.sciencedirect.com/science/article/abs/pii/S0165032716321681…