RACHEL MARTIN, HOST:
The sound of someone chewing or smacking gum can be annoying, but for some people, these noises trigger instant rage or panic. This is not just an eccentricity. It is a real condition, and it's called misophonia. Here's NPR's April Fulton.
APRIL FULTON, BYLINE: When 18-year-old Ellie Rapp sits down to dinner, this happens.
ELLIE RAPP: My heart begins to pound. I go one of two ways. I either start to cry, or I just get really intensely angry.
FULTON: That's because the sound of her family chewing creates an automatic and extreme emotional response. She has to eat in another room.
E RAPP: It's really intense. I mean, it's as if you're going to die.
FULTON: And she's been experiencing this intense reaction to certain noises since she was a toddler. But it wasn't until middle school, when her mom showed her an article about something called misophonia, that she was able to put a name on it.
E RAPP: I said, this is what I have. This is it.
FULTON: She started seeing Jaelline Jaffe, a psychotherapist in Los Angeles who specializes in misophonia. Jaffe says the most common triggers for people like Ellie are mouth noises.
JAELLINE JAFFE: Chewing is almost universal. Gum chewing is almost universal. They also don't like the sound of throat clearing, coughing, sniffing.
FULTON: It could also be humming, tapping or pen clicking. Sometimes just the sight of someone chewing is enough to cause a panic attack.
JAFFE: It's as if the survival part of the brain thinks somehow it's being attacked.
FULTON: And this prompts the fight or flight reaction. Now, not much is known about misophonia. It was only given a name a few years ago, and people who have it often think they're going crazy. Many doctors have never heard of it. And if people do talk about their symptoms, they're dismissed or diagnosed with a mood disorder. But a small study published recently suggests that the brains of people with misophonia actually react differently to certain sounds. Phillip Gander studies how the brain makes sense of sound at the University of Iowa.
PHILLIP GANDER: We - pretty convinced that we found some very good evidence for relating this disorder to particular patterns of brain activity.
FULTON: When researchers put people in an MRI scanner and played trigger sounds like chewing and eating, he says you could see the difference.
GANDER: In the misophonia group, the activity was far greater in particular areas of their brain.
FULTON: And they showed classic signs of stress.
GANDER: Their heart rate increased, and also, their palms were sweating more.
MARSHA JOHNSON: It was phenomenal. It was the first piece of research that showed our population that they - what they have is real.
FULTON: That's Marsha Johnson. She's an audiologist in Portland, Ore. She was one of the first to recognize the disorder in the 1990s. She says misophonia is really devastating to families.
JOHNSON: If you're a mother and your child has - is a misophonic person and the sibling is the trigger, you're trying to stop this one from eating and this one from reacting. It's just absolutely awful.
FULTON: The National Institutes of Health calls misophonia a chronic condition, and the cause is unknown. More research is needed to understand it. But for people who have misophonia, they need strategies now. Johnson says for one, don't force everyone to sit around the dinner table together.
JOHNSON: Have a buffet-style - everybody eats where they want. But why don't you plan the big event of a family day called taking a hike, going up to a waterfall, going bowling?
FULTON: Of course, people suffering from misophonia can't totally avoid their trigger noises. So Johnson suggests, try wearing headphones to flood the ears with pleasant sounds, or mindful breathing. But the most important advice comes from Ellie's mom, Kathy Rapp. If your child complains of these symptoms, don't dismiss them.
KATHY RAPP: It sounds bizarre, but it's very real. And a family's help, I think, is critical to helping somebody live a fuller life.
FULTON: April Fulton, NPR News, Los Angeles.
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