When Sounds Trigger Rage, Anxiety—or Tingly Euphoria

McKenna Princing Fact Checked
© Garage Island Crew / Stocksy United

If you live in Seattle, there are certain sounds you’re familiar with. You probably enjoy sitting by a window, listening to rain pitter-patter on the glass. You might even like the grind and whirl of the espresso machine at your favorite coffee shop. Yet, some city sounds—like construction noise—have a decidedly less positive effect, making you cringe or reflexively put earbuds in.

But has a sound ever made you enraged or panic-stricken? Or, has a sound ever made your head tingle in a relaxing way?

Misophonia is a little-understood condition that involves extreme aversion to certain sounds. On the opposite end of the spectrum is a phenomenon known as autonomous sensory meridian response, or ASMR, where sound can create an almost euphoric feeling of relaxation (yes, involving head tingles).

Though there is not much scientific research behind either misophonia or ASMR, one recent study surveying more than 300 misophonics found that half of them also experienced ASMR, perhaps suggesting some people are more attuned to sound—both the good and the bad.

Misophonia and ASMR have two important things in common. First, both are potentially tied to a condition known as synesthesia, a mingling of the senses. Synesthetes might see a particular color when someone says the word ‘dog’, or get a certain taste in their mouth when they hear violin music. One study found a higher-than-average percentage of people who experienced ASMR also had synesthesia, and other research has linked synesthesia with misophonia.

Both misophonia and ASMR also involve triggers, something that sets off the brain’s response. In this case, the triggers are (primarily) auditory. For people with misophonia, the sound of someone else chewing, drinking and even breathing can trigger intense anger, fear or anxiety. For people who are sensitive to ASMR, mundane sounds you may never pay attention to—like tapping or whispering—provoke a pleasant tingling sensation in the head, down into the neck and spine, and sometimes into the extremities.

Some ASMR triggers also involve things like repetitive motions (towel-folding, for example) or receiving personal attention, like getting a massage or a haircut; however, most videos made to trigger ASMR involve a pronounced audio component.

The sounds that hurt

Misophonia is somewhat of a mystery. There is currently no consensus regarding its cause, unlike many other hearing-related problems, says Kelly Tremblay, Ph.D., a neuroscientist who heads the Brain and Behavior Lab at the University of Washington.

There could be a link between misophonia and mental health conditions, including posttraumatic stress disorder, according to results of the study with 300 misophonics. Other studies report links with obsessive-compulsive disorders and disorders like autism and ADHD. Some experts believe there may be reason to classify misophonia as its own disorder in the obsessive-compulsive spectrum.

In a different study, scientists used MRI and fMRI to scan misophonic brains and noticed abnormal brain activity in the anterior insular cortex (AIC), an area implicated in emotional processing, as well as unusual interaction between the AIC and the hippocampus and amygdala, along with other brain areas. (The study was disputed by other researchers for potentially over-representing its findings, however.) Other studies have suggested misophonia runs in families.

There are also unresolved questions about misophonia. How do our sensory responses to sound interact with the emotional centers of the brain? There are no clear answers, Tremblay says, because the lines between biology and psychology are often blurred.

“Everything is psychological in the sense it involves the brain,” she says. “For example, listening to Mozart might evoke feelings of anxiety associated with practice and performance. Or, it might evoke feeling of joy, as you anticipate the next few notes and the crescendo. In other words, the same piece of music will elicit physiological responses in the ear and in auditory portions of the brain, which are similar across people, but the psychological reaction to those same sounds may differ based on someone’s prior history with that sound.”

Since there is no identified cause, misophonia can be difficult to treat, Tremblay says. She gives an example of a similar but more common auditory problem: tinnitus, or a ringing in the ears. It is like misophonia in that it can also make someone feel upset or anxious, though with tinnitus the sound is generated within your own body rather than externally.

Tinnitus can result from damage to the inner ear system by chemicals, medicines and exposure to loud noise, Tremblay says. “This means it is possible to predict when you are risk for getting tinnitus, but I can’t predict who might experience misophonia,” she says. Yet, treatment for both tinnitus and misophonia can be equally elusive.

The sounds that heal

Even though there is little science to support ASMR, there are now many YouTube artists (or ASMRtists, as they call themselves) who create videos of mic brushing and fingernail tapping that are watched by millions of ASMR-sensitive fans.

ASMR-sensitive people claim the tingling is accompanied by a sense of euphoria or sleepiness. Of course, for those who don’t get tingles, the videos are pretty dull. So why does ASMR only affect some people—and what is it, exactly?

The truth is, no one really knows. There is very little research about ASMR, and the studies that do exist don’t attempt to find an explanation for the phenomenon. One study of 290 people who experience ASMR found they tend to share similar traits on the Big Five Personality Inventory, including higher levels of neuroticism and lower levels of extraversion, among other things. People claim ASMR helps ease insomnia and anxiety and promote feelings of wellbeing, but there is no scientific explanation for this.

“There are way more questions than answers,” says Nate Watson, M.D., a sleep medicine specialist. If ASMR is indeed therapeutic, it may be worth looking into as a potential treatment for insomnia, Watson says—though, even then, it’s unclear how many people would benefit from it, since no one knows how many people experience ASMR.

Still, since 10 percent of the adult population experiences chronic insomnia—according to the American Academy of Sleep Medicine—an additional way of helping them wouldn’t be unwelcome, Watson says.

“The fact that so many people claim to experience it and its popularity on YouTube suggests there’s something there,” he says.