Managing misophonia and OCD

Are there certain noises you really can’t stand? Maybe the sound of chewing, crunching, or a pen clicking causes you to flee the room or lash out. You might also dwell on these triggers or go to great lengths to avoid them. For some people, this may mean they have co-occurring misophonia and obsessive-compulsive disorder (OCD). 

Misophonia literally means “hatred of sound.” It goes beyond typical annoyance with sounds we all experience from time to time. Misophonia is related to OCD, with symptom overlap between the two in both adult and child populations.  

While misophonia isn’t a clinical mental health condition, the experience can disrupt your life and relationships. Additionally, OCD might result in you obsessing over your noise triggers, which can make it hard to function. 

With the support of a mental health provider, you can explore the connection between misophonia and OCD while developing tools to address each condition. 

How misophonia and OCD are connected

Obsessive-compulsive disorder is a diagnosable and treatable mental health condition. It involves obsessive and repeated thoughts followed by acts, or compulsions. These compulsions are an attempt to feel better or prevent an unwanted outcome.

People who experience misophonia are more likely to have obsessive-compulsive characteristics. Though not everyone who has misophonia and obsessive-compulsive characteristics will be diagnosed with OCD.   

With people who have both misophonia and OCD, common experiences include: 

• Depression: Research shows misophonia can be associated with depression. Additionally, OCD and depression commonly co-occur. 
• Anxiety: If you have misophonia, you might also experience anxiety. For some people, the two can co-occur. Similarly, anxiety disorders often show up alongside OCD.
• Sensory sensitivity: Sensory issues can occur with both OCD and misophonia, making it difficult — or impossible — to tune out everyday noises.
• Avoidant behavior: Some experts think misophonia could fit under the umbrella of obsessive-compulsive spectrum disorders. The need to avoid triggers, like upsetting noises, in misophonia is thought to be similar to compulsions in OCD.

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What misophonia feels like for people with OCD

Many people can go about their daily lives without noticing noises that might trigger someone with misophonia. But for someone with OCD, even routine sensory experiences — like the sound of typing, a ticking clock, or the feeling of certain textures —  can lead to intense discomfort or overwhelm. This can worsen when misophonia is involved. 

Similarly, people with misophonia often react to particular sounds with severe emotional distress like rage and disgust. Other common misophonic symptoms can include avoidance and aggressive outbursts. It’s thought that misophonia occurs due to a malfunction between the parts of the brain that regulate emotions, control involuntary functions like breathing, and manage hearing and interpretation of sounds.

When misophonia interacts with OCD, it can result in experiences like:

• Obsessive thinking: The sound of paper or plastic rustling triggers your misophonia, and, so, you have obsessive and intrusive thoughts like, “I can’t visit grocery stores because I won’t be able to handle it.” 
• Compulsions: Imagine you’re in a coffee shop and hear someone cough. This may not bother you. But for someone with misophonia and OCD, a cough or a sneeze may trigger a strong urge to perform a handwashing ritual. With OCD, these rituals are called compulsions — repeated actions to relieve discomfort or anxiety caused by intrusive thoughts or sensory triggers. 

Triggers for misophonia and OCD are similar. They can include eating and drinking noises, breathing and throat noises, repetitive or loud noises like a pen clicking or loud talking, and mechanical sounds like a microwave heating up a meal. 

Daily life with misophonia and OCD can feel like an obstacle course as you weigh what people and places to avoid. This can be exhausting. It can also strain your relationships, as, for instance, you may lash out at a loved one when a trigger presents itself. 

Ways to manage the impact of OCD and misophonia

OCD and misophonia can be challenging. The combination might make you feel like you can’t go to certain places or deepen the relationships you care about. Fortunately, there are steps you can take to manage these symptoms and gain control over your life. 

Try these practices to lessen the impact of OCD and misophonia: 

• Mimicking trigger sounds: Research suggests that people with misophonia find it helpful to recreate their trigger sounds themselves, which can act as a coping strategy. This is a similar concept found in exposure and response prevention therapy (ERP), which is the first-line treatment for OCD. 
• Breathing through the triggers: Breathing exercises can move the focus from the trigger to your breath. This can distract you from the discomfort you’re feeling. While it might not work the first time, with repeated practice you may find your brain becomes relaxed and less agitated when you incorporate intentional breathing. 
• Talking positively to yourself: Research shows that a positive internal dialogue can help with misophonia. You might think something like, “I can get through this,” or, “This noise isn’t going to last forever.” Similarly, there’s evidence that metacognitive therapy can help people with OCD. It involves learning what thoughts you have and challenging unhelpful ones. 

If you need professional support, cognitive behavioral therapy (CBT) is effective for both misophonia and OCD. In fact, ERP is a type of CBT.

Find care with Rula

Managing both misophonia and OCD can be tough. But you don’t have to navigate it alone. A qualified mental healthcare provider can provide support, from pinpointing your triggers to teaching emotional regulation to handling everyday noises and OCD symptoms. 

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we’re here to help you make progress — wherever you are on your mental health journey.

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