If you are reading this, you probably suffer from OCD and/or misophonia. I am going to provide you with key information you can use to kick your OCDs, as if it was a soccer ball — far into thin air. The jewel of that information lies in human biology, thus is applicable to everybody (If you’re human, of course). Not only this article can help people with OCD, but it could shed light onto valuable information for OCD-free individuals as well; hence, reading this article is my general recommendation.

Before I start, I want to state that I do not intend to diminish or deny the necessity of your medication or appointments with certified medical practitioners, for I am not one; although after you read this article, frequency of your therapist appointments might shrink dramatically, hopefully, all the way down to zero – along with the associated expenses.

In this article, I cited and quoted various studies, articles and documents. My goal was not to write a huge essay with unique text, but provide readers with scientifically backed up and well referenced information. Trying to reinvent one thousand wheels would have been utterly absurd.

External material was referenced in a manner that provides a reader with maximum convenience : for instance, every small text section is referenced separately; making a strict scientific referent list at the end of the entire article, or even large section, would have resulted in heavy inconvenience.

The article follows a specific narrative structure, and you can always navigate through the links in the table of contents above.

My History with OCD and Misophonia

I have been living with OCD and misophonia for my entire life, and recall its manifestations since my early childhood. My conditions grew bigger as I aged, my behaviour and socialisation were becoming increasingly corrupted. In my early teens, my invisible companions have officially announced themselves, giving sense and ‘official’ shape of my various weirdnesses.

Around my year 8 in school, OCD starts being severe.

Countless rituals kept me busy for hours; never-ending hygiene procedures : hours of showering and wash-ups resulted in chemical skin corrosion.

That was definitely a fun merry-go-round, although this was only the superficial part. If you suffer from OCD severe enough, you probably know that the worst part lies within the mind itself. What makes it even worse, is the fact that it is inescapable.

Thought looping feels like malfunctioning code that constantly returns errors, while looping repeatedly and corrupting life perception, the gameplay. I could almost see red strings, returning errors.

At this point, not only my movement coordination was corrupted and loaded with full of unreasonable, conditional movements, but also the cognitive processing was running swarms of “bugs”, brain was almost being fried, headaches were common. Life no more simply lacked joy. It was full of suffering.

Not to mention that people, especially those, who did not know me well enough, just saw me as an idiot, a freak, doing its freaky rituals with a random item (like poking freaking mangoes in the supermarket). At first, I postponed school until I could manage myself to some decent degree.

I was prescribed some medicines by a local psychiatrist (cipralex, buspar, aripiprex, cogintol — if I remember it correct), and it was at a later point in life, when one medical practitioner told me that it was not correct to prescribe me such a combination — straight away and in such early age. Of course, that did not turn out really well. There was no reasonable progress, and I felt like a boiled turnip, so I stopped taking the medication. “Cold turkey”.

I returned to school, and I am glad I did so.

Months, years went by. I managed to achieve certain milestones. Tons of non-stop mental work and development, a few psychologist appointments and meditative techniques, along with esoteric practices — milestone by milestone I made it to the point where I controlled myself well enough to have a faint kind of a normal life.

Every day and every instance of existence felt like a fight for survival, with myself. It was extremely hard for me to concentrate and process information, and hence, study; but with help of my comrades, friends and teachers who understood me, accepted me and helped me to progress, I made it – year after year, class after class.

Although, of course, not everyone is willing to understand conditions.

There is one good quote out there —

“The worst part of having a mental illness is that people expect you to behave as if you don't”

Sadly, mostly this is true.

As time went by, I managed to become better at controlling my glitching tempestuous beast.

I graduated school, enrolled into university, and that’s where things started shapeshifting weirdly.

OCD and Misophonia Overview;

Connection Between OCD and Misophonia

OCD

Here’s how OCD is described on WebMD portal :

“Obsessive-compulsive disorder (OCD) is a mental illness that causes repeated unwanted thoughts or sensations (obsessions) or the urge to do something over and over again (compulsions). Some people can have both obsessions and compulsions.

OCD comes in many forms, but most cases fall into at least one of four general categories:

Checking, such as locks, alarm systems, ovens, or light switches, or thinking you have a medical condition like pregnancy or schizophrenia
Contamination, a fear of things that might be dirty or a compulsion to clean
Symmetry and ordering, the need to have things lined up in a certain way
Ruminations and intrusive thoughts, an obsession with a line of thought. Some of these thoughts might be violent or disturbing.”

I could also add compulsions to the list — urges to do certain actions, sometimes miniature — that visually could look like tics.

“Many people who have OCD know that their thoughts and habits don’t make sense. They don’t do them because they enjoy them, but because they can’t quit. And if they stop, they feel so bad that they start again.” Source : WebMD

And to someone who does not have OCD this may seem weird and irrational — can’t they just stop it ?

However, it is quite not that easy for the affected mind. It’s crucial to understand that OCD is a neuropsychiatric disorder, and as such, it has a neurobiological cause (read on for more information).

Misophonia

Again, I will refer to WebMD portal to aid my elaboration :

“Misophonia is a disorder in which certain sounds trigger emotional or physiological responses that some might perceive as unreasonable given the circumstance. Those who have misophonia might describe it as when a sound “drives you crazy.” Their reactions can range from anger and annoyance to panic and the need to flee. The disorder is sometimes called selective sound sensitivity syndrome.

Individuals with misophonia often report they are triggered by oral sounds -- the noise someone makes when they eat, breathe, or even chew.”

Highlighting the “chew” part (with ‘even’) rather than, for instance, saying “even breathe” is a funny marker.

I mean, what can you expect from those sick misophonia people, who cannot even tolerate someone breathing ?! Sick-sick misophoniac people, right ? Should be isolated !

Because eating like a human being is apparently hard.

“Other adverse sounds include keyboard [or mouse clicking] or finger tapping or the sound of windshield wipers. Sometimes a small repetitive motion is the cause -- someone fidgets, jostles you, or wiggles their foot.

Similarly, people with misophonia also say they often react to the visual stimuli that accompanies sounds, and may also respond intensely to repetitive motions. [Here, I should add that visual stimuli, which are not even related to the sound, could trigger a “visual misophonia” as well.] Researchers believe that those with misophonia may already have issues with how their brains filter sounds, and that one of the features of “misophonic sounds” may be their repetitive noise. That repetition then exacerbates the other auditory processing problems.

The disorder appears to range from mild to severe. Individuals report a range of physiologic and emotional responses, with accompanying cognitions. If you have a mild reaction, you might feel:

Anxious
Uncomfortable
The urge to flee
Disgust

If your response is more severe, the sound in question might cause:

Rage
Anger
Hatred
Panic
Fear
Emotional distress

The disorder can put a cramp in your social life. Those with the misophonia have been known to develop anticipatory anxiety when going into situations where trigger sounds may be present. You might avoid restaurants or eat separately from your spouse, family, or roommates.

Over time, you may also respond to visual triggers, too. Seeing something that you know may create the offending sound may elicit a response.” Quotes source : WebMD

Do Not Confuse Misophonia and Other Conditions

There is this thing called Sensory Processing Disorder (SPD), which can bug a person with symptoms, similar to misophonia; even with tactile triggers. However, SPD and Misophonia aren’t same. You can refer to the following links for detailed elaboration :

It was at this point I understood that I have SPD as well.

Then there’s hyperacusis, although this is more of an ear issue, rather than the brain itself :

“Hyperacusis is a type of reduced tolerance for sound. People with hyperacusis often find ordinary noises too loud, and loud noises uncomfortable or painful. The most common cause of hyperacusis is damage to the inner ear from ageing or exposure to loud noise.

Hyperacusis is often associated with tinnitus (buzzing, ringing or whistling noises in the ears) and distortion of sounds. Usually both ears are affected, although it is possible to have it in only one ear.

Other types of reduced tolerance to sound include ‘loudness recruitment’ and ‘phonophobia’.” Source : Better Health Channel

Connection Between OCD and Misophonia

“Sound sensitivity can be common among individuals with OCD, anxiety disorders, and/or Tourette Syndrome. This co-occurrence has led clinicians and researchers to look into whether misophonia is related to these disorders, including potential overlaps in how the brain is affected (i.e, neurobiological overlaps). This suggests possible overlap in neuropathology. While the prevalence of misophonia is unknown, recent studies suggest high rates of SOR* among youth with OCD and anxiety. The rate of misophonia among individuals with tinnitus (a condition that causes ringing in the ears) is also elevated.” Source : International OCD Foundation

SOR* — Sensory over-responsivity (SOR)—responding too much, for too long, or to stimuli of weak intensity—represents a major disruption in these processes and is exhibited by sensitivity to or avoidance of sensations such as loud or unpredictable noises, visually stimulating environments, or scratchy clothing tags.

Conservative Treatments and Support;

Disease Nature

OCD

Officially, there is no cure for OCD and misophonia, however, a few official approaches are usually taken and proven to be effective at sending OCD into remission and/or keeping it ‘ at bay’: medicine and cognitive behavioural psychotherapy (CBT) for OCD, and various behaviour therapies for misophonia.

“The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP), which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs.”

“Traditional talk therapy (or psychotherapy) tries to improve a psychological condition by helping the patient gain “insight” into their problems. Talk therapy can be a very valuable treatment for some disorders, but it has not been shown to be effective at treating the active symptoms of OCD.

While talk therapy may be of benefit at some point in OCD patient’s recovery, it is important to try ERP or medication first, as these are the types of treatment that have been shown through extensive research to be the most effective for treating OCD.” Source : International OCD Foundation

“What happens in CBT with ERP is you learn how to navigate your experience differently, how to confront your fears and how to choose different behaviors in response to your thoughts, feelings, and sensations than you might instinctively choose.” Source : Sheppard Pratt

You can also read on about OCD-related CBT or ERP therapies here.

That was a brisk overview of OCD and its traditional treatment options. Regarding the nature of the disorder, in short, OCD is currently considered a neuropsychiatric disorder.

“The cause of OCD is not known, but as is the case with many psychiatric conditions, thought to be multifactorial. Research indicates that OCD is a neurological brain disorder.” Source : Boston Children’s Hospital

Read on for more information regarding OCD nature, possible causes etc.

Misophonia

Unlike OCD, there are no officially used medications to treat misophonia.

“There is currently no cure or pharmaceutical treatment for misophonia. Some people might be prescribed an antidepressant or anti-anxiety medication to help reduce symptoms or address co-occurring mental health issues. There are also various therapeutic approaches to help manage symptoms.”

“Therapy might focus on helping a person manage the fight/flight/freeze response initiated by a trigger, control the anger that arises, and develop positive ways of talking to family, friends, and co-workers about monitoring triggers they are responsible for. A therapist may encourage the person with misophonia to experiment with calming imagery, soothing noises, and meditation—especially when confronted with a triggering sound. In a process called counterconditioning, the therapist leads a person through a cycle of exposure to triggers and positive reinforcement, eventually diminishing the negative trigger response.” Source : Good Therapy

And so we’re talking about dealing with people and asking them to adjust their behaviour, but there a few problems, a couple of which are : 1) There is only a tiny fraction of people, who would actually care to adjust their routine behaviour even in the slightest bit necessary, and even those who will, might not take it seriously, and/or do so partially, superficially and/or for a brief period of time 2) You can’t inform every instance of your immediate surroundings about your problem; only the ones in your usual disposition.

The issue with certain health conditions is that unaffected individuals, as always, do not care about things that do not burden them personally. Even people who experience and/or oppose discrimination and injustice themselves, and are vividly radical about their movement, might not care about problems that are not of their own nature.

It is me, highlighting people’s common pharisaism. If you are not willing to uptake any adaptations into your routine regarding the person you live, work with, or interact in other ways — then at least have balls to clearly state your intentions, instead of giving a void word, a worthless statement. Keep track of your claims.

Nowadays it is trendy, and at times, obligatory, to follow the “first world’s” rules :

For instance, keeping incredibly loud, and often, ostentatious borders of acceptance and respect for minorities, such as with non-traditional sexual orientation, women (feminism) or people with increased skin pigmentation.

It is undeniably good, to see the world scales more balanced, to have a more equalised community. It is wonderful, that people worldwide are starting to accept other people for who they are. However, just make sure this trend does not stop there, and unpopular causes that are out of scope of rage of the global tolerance uprising are not ignored.

Or toss out that goddamn green ribbon you pin on your chest.

(I highlight that I DO NOT in ANY WAY negate or oppose the aforementioned and not aforementioned people/communities in any way; I, however, point out that all people and their respective reasonable causes must be respected/accepted/tolerated).

The thing is, global tolerance is rising statistically with accordance to the number of directly involved or uninvolved supporters.

A large fraction of the world does not have traditional sexual orientation; huge part of the world has skin colour other than white; about half of the Earth’s population are women.

See the pattern ?

Then there are largely outnumbered groups, who are taken much less seriously : ecology volunteers, vegans etc. (Animals and trees, are of course, abundant, but they can’t speak for themselves, can they ?)

Then there’s a tiny fraction of people with severe OCD and/or misophonia. Who is going to stand up for them ? For us ?!

Well, at the moment, I am. That is why I am telling you all this.

Be cautious about your footprints in this world.

Qui ventum seminat, turbinem metent.

Besides, if you learn to eat like someone, who deserves to be called Homo sapiens sapiens, then it’s probably for your own good.

Well, enough of the lyrical digression. Back to misophonia now.

“Though there are not yet therapeutic approaches specific to misophonia, established modalities such as cognitive behavioral therapy seem to have a positive impact in reducing symptom severity in people with misophonia. Mindfulness-based therapies and treatments for anger management also seem to work for alleviating emotional overwhelm related to misophonia. Researchers theorize that introducing these therapies to adolescents who are exhibiting anger issues may help reduce misophonia severity or a person’s likelihood of developing misophonia later in life.

Because research on misophonia is lacking and it is not yet included in the Diagnostic and Statistical Manual (DSM-5), public reaction isn’t always accepting of the condition or those who live with it. But the more people discuss misophonia, the more the field of psychotherapy and individual therapists may acknowledge and respect the process of helping people achieve more peace with the condition and live more fully.” Source : Good Therapy

Although misophonia is not yet listed in any of the contemporary psychiatric conditions classification systems, research, published in 2017 found out that misophonia has a genuine neurological basis. Hence, Misophonia is a neurological disorder.

“…Researchers have conducted brain scans on those with the condition, and found physical differences as to how their brains are wired. Using 22 participants, the scientists played them a range of different noises while tracking their brains in MRI scanners. The sounds were either neutral (such as rain), unpleasant (like a baby screaming), or the individual's trigger noise, which could be anything ranging from eating crisps to sneezing.

What they found was that the region of the brain that links our senses with our emotions was connected differently, and often sent into overdrive when those with misophonia hear their trigger sounds. It is this that causes these people to not just feel annoyed by the noises, but to have genuine anger or hatred, feel threatened, panicked, or stressed when they hear them.” Source : IFLScience

“The best way to classify misophonia is as a neurophysiological disorder with psychological consequences.” Source : ENT & Audiology News

Hereby, both OCD and misophonia can be called neuropsychiatric disorders.

Of course, it is important to note that neurological disorders do not share equivalent basis, as psychiatric disorders do *1 , although psychiatric conditions do have biological causes as well. *2

Remember, mental illnesses are complex; biology, psychiatry and psychology intertwine and overlap. Contemporary science still lacks answers to many questions. Mental disorders have to be addressed comprehensively. Refer to *1 and *2 for more information.

*1 Read more on differences, similarities and overlaps of neurological and psychiatric disorders :

Article (common) : Why Do We Separate Psychiatry and Neurology ?

Articles (science) :