Prognosis for Misophonia

f a person has misophonia, what’s the prognosis? I will provide hope later in the book (please have hope). With
treatment (and lots of work) it is reasonable to expect a 50% reduction in misophonia severity, but first let me provide you with an overall view of misophonia without treatment. For one thing, misophonia doesn’t just go away with time or getting older. Generally the severity of misophonia remains the same or gets progressively worse16. However, in our recent large survey a third reported that their misophonia had previously been worse. It can be stable for years and then escalate. Sometimes it will remain at that elevated state for years and then escalate even more. It does seem to lessen at certain times. The upheaval associated with misophonia tends to lessen as the teen matures into adulthood, because they learn that they are going to be triggered and there’s no other choice. They are just going to have to deal with this unpleasant reaction, and many people learn to suffer in silence. A child may scream and yell at her mom, but it doesn’t get any better. She may scream and yell at her friends and be ostracized.
Eventually the child learns that acting out only makes it worse and that she must cope. She learns to suffer in silence. One lady said that when she was triggered too much, she would just go into another room and cry. And people also learn to modify their life to cope with misophonia. On my 2015 survey, I asked the question Has your misophonia ever been worse than it is now? One third responded yes. The reasons varied, but the most common reasons for the improvement were good management techniques and not being exposed to as many triggers. The most common age for maximum severity was in the teens and 20s.

Many people with misophonia would never go to a movie theater because the popcorn crunching is there, and they would find it intolerable. They also modify their work conditions. I know of one case where a person couldn’t handle the trigger sounds in the classroom so he dropped out of a prestigious engineering university and became a machinist. Although the classroom noises triggered him, the sounds in the machinery created a triggerfree environment for him.

Unfortunately, we find that misophonia can be very detrimental to relationships. It really takes a caring, patient person to deal with a spouse who is triggered by the sounds they make.

Another situation that heightens misophonia is that triggers develop with prolonged experience with a particular person. A spouse or significant other may not trigger you at first, but with time, triggers develop. The same thing happens with children. It would be most unusual for your baby to trigger you, no matter how loud they ate. But with time, those cute little eating and breathing sounds change into the lip smacking and sniffling of an elementary school kid, and can become full strength triggers. We will talk about how to reduce the risk of developing new triggers in later chapters How Misophonia Develops, How Triggers Spread, Misophonia Management, and Treatments for Misophonia.