Triggers and treatments for noise anxiety

Most people will experience some level of frustration at hearing certain sounds occasionally, such as the neighbor’s barking dog or incessant construction noise from the street. For some people, however, responses to certain sounds may include more intense or severe feelings such as anger, fear, and even pain. Noise annoyance, noise sensitivity, or noise anxiety can have a variety of triggers depending on the individual and any other mental or physical health conditions they may have. Read on to learn more about them and explore treatment options.

What is noise anxiety?

Those living with sound anxiety may experience extreme discomfort or emotional distress in crowded, noisy environments such as shopping centers or airports. They may even feel uncomfortable or disturbed in relatively quiet environments such as classrooms or offices, depending on their specific trigger sounds.

In some cases, noise annoyance is a symptom of other mental health conditions like depression, or it may coincide with some types of neurodivergence such as attention-deficit hyperactivity disorder (ADHD) or autism spectrum disorder. In others, it may be not caused by a psychiatric disorder, but physical conditions affecting the auditory system, such as physical injury or chronic migraines. In still others, it qualifies as its own disorder. Some noise-anxiety related disorders and conditions include:

Phonophobia

This is an anxiety disorder categorized as a specific phobia: the fear of sound. Specific phobias in general are fears that are persistent, unwarranted, and not caused by usual fear stimuli (such as things that are inherently dangerous). Those with phonophobia may fear sounds that are considered normal or hardly noticed by others, such as traffic or construction noise, the sound of someone cooking or cleaning, or particularly loud or excited speech. Risk factors for developing this disorder include a family history of anxiety disorder, exposure to trauma, and certain life events. Note that the word “phonophobia” can also be used to describe sensitivity to sound caused by migraines, which is not considered a sound anxiety condition. People with this condition may benefit from exposure therapy or other treatments.

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

Misophonia

Also known as selective sound sensitivity syndrome, misophonia is not currently officially classified as an anxiety disorder but is recognized as part of the decreased sound tolerance syndrome category. People who develop misophonia may have intense, spontaneous, and disproportionate reactions to specific sounds that are typically considered normal and/or non-threatening. Some of the most common triggers include the sound of chewing, heavy or loud breathing, the ticking of clocks, the high-pitched whine of a hearing aid, or the tapping of keys on a keyboard. While the general population may find these sounds annoying, reactions to these sounds from someone with misophonia can range from intense anger or aggravation to overwhelming discomfort or anxiety.

Hyperacusis

This is another decreased sound tolerance syndrome. It’s defined simply as an unusual physical sensitivity to sound. People with this condition experience physical discomfort and even pain when exposed to noise above a particular decibel threshold, which can vary from person to person. One person’s conception of loud noise isn’t necessarily another’s. This condition is often comorbid with tinnitus and is also a common symptom of Bell’s palsy, Meniere’s disease, multiple sclerosis, Lyme disease, and other illnesses.

Loud noises and other common noise anxiety triggers

Sound hypersensitivity conditions can be triggered by a wide range of sounds, even those that are considered innocuous or barely noticeable by others. These trigger sounds may include oral sounds such as breathing through the mouth or chewing, repetitive motions like finger tapping, the jingling of keys, or a dripping faucet. Other people may be triggered by louder but still generally non-threatening environmental noises, such as thunder, traffic, or sirens. These conditions can manifest differently for everyone, from significant anxiety to physical symptoms, so taking note of your own personal triggers if you experience noise annoyance may be helpful.

Diagnosis and treatment for noise anxiety and noise sensitivity

Noise annoyance as a whole has no specific diagnostic criteria for mental disorders per the DSM-5. To identify any of these conditions in an individual, a qualified healthcare provider will usually do the following:

• To diagnose phonophobia, the provider will follow diagnostic criteria for a specific phobia. 

• To diagnose misophonia, a provider may look for the presence of intense, impulsive, aversive physical reactions (such as aggression) paired with a loss of self-control, along with the recognition that the reaction is disproportionate and that it causes personal distress.

• To diagnose hyperacusis, pure-tone audiometry is typically used. It’s a behavioral test that uses medical equipment to send tones into the individual’s inner ear and measure for extreme sensitivity to certain noises, alongside a questionnaire that asks for details on symptoms.

The most common treatment for conditions related to sound hypersensitivity is some form of psychotherapy. Cognitive behavioral therapy, for instance, may be used to help an individual recognize and reframe distorted thoughts related to their sound sensitivity triggers, treat them for any anxiety disorders they may be experiencing, and generally work to improve their mental health. Exposure therapy may also be recommended, which involves slowly introducing triggering sounds to lessen reactions over time through desensitization. 

The therapist may suggest specific coping strategies to manage anticipatory anxiety and support well-being such as regular exercise, daily life journaling, and breathing exercises. They may also help them find support through in-person or social media groups for people with similar sensitivity to noise or common trigger sounds. 

If another condition is causing the person’s noise annoyance symptoms, this condition will typically be addressed first or in conjunction. A person living with hypersensitivity to sound may also find that certain accommodations can help them avoid triggers or their effects, such as the use of noise-canceling headphones, ear plugs, relaxation techniques, white noise machines, or scheduled low-stimulation time throughout the day.

Seeking support for noise annoyance issues with sound therapy

Even for those with lifelong conditions, seeking professional treatment for hypersensitivities can help you manage your symptoms and improve your quality of life. If you’re hesitant to pursue in-person care because of nervousness around triggers during your commute or at the provider’s office, online therapy might be a better option for you. 

With talk therapy from an online therapy platform like BetterHelp, you can meet with a licensed therapist via phone, video call, and/or in-app messaging from the comfort of your home, where you can control your surroundings. Studies suggest that online therapy can be just as effective as in-person therapy for treating phobias, anxiety disorders, major depressive disorder, and other psychiatric conditions, such as obsessive-compulsive disorder, while also being more cost-effective. In other words, professional support is available, regardless of the format you may choose. If you’re interested in online therapy, see below for client reviews of BetterHelp counselors. You can view our policy and the rights reserved before you sign up. 

Counselor reviews

“Rachael is very strong support, especially during tough, high-stress times, as she ensures and maintains a non-judgemental stance. She confidently tells her advice and recommendations to attempt to de-escalate the situation at hand and discusses and agrees on the next best steps to move forward. I would highly recommend her as she has been very kind and understanding”.

“Sam has been tremendously helpful to me, and I am so thankful that BetterHelp paired me with him. In just a few sessions, Sam has helped me get to the root of long-running anxieties, and because of our conversations, I am already living a less anxious and more joyful life. I appreciate that he offers his insights and impressions of what I’m dealing with, but he never pushes his views above what feels true to my experience. I trust him and feel I have made profound progress with his help”.