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Common repetitive sounds made by other people -- chewing, crunching, slurping, sniffing, or lip smacking, for example -- can be unbearable for people with misophonia. They may trigger a flight-or-fight response, feelings of panic, disgust, or anger. Left untreated, misophonia can make it hard to carry out activities of daily life and can lead to social isolation. Fortunately, Duke is a global leader in misophonia research and treatment. We use individualized, proven approaches to care so you can get back to enjoying life.

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About Misophonia

Misophonia is a newly recognized disorder; the causes are unknown. With misophonia, your brain and nervous systems respond automatically and uncontrollably to “triggers” in certain situations, for instance, at meals with your family. It can affect people of any age but often begins during the preteen years and becomes problematic when you are a teenager or young adult. Misophonia can occur alone or with other medical or mental health problems. Some people cope well with their symptoms, which can range from mild to severe, while others are unable to spend time with their loved ones, work, or go to school. 

Duke Psychiatry at Civitan Building

Learn about the care offered here so you can prepare for your appointments.

Misophonia Assessment

As experts in misophonia research and treatment, Duke specialists have developed a questionnaire and interview guide for assessing misophonia symptoms and functional impairment. These tools are used by providers around the world to identify misophonia and recommend targeted treatment. There is still much to learn about the disorder, and currently there is no formal medical diagnosis.

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Misophonia Treatments

Our psychologists, psychiatrists, and other mental health professionals take a two-pronged approach to treating misophonia. We diagnose and address any existing mental health problems, tailoring treatments around your misophonia. 

Cognitive Behavioral Therapies

If appropriate, we offer cognitive behavioral therapies (CBTs) to minimize symptoms. By developing new patterns for thinking, managing your emotions, communicating, and reacting to triggering situations, you can reduce emotional distress related to misophonia and improve everyday functioning. 

Individualized Specialty Care 

Depending on the severity of the disorder and whether other conditions -- like multi-sensory over-responsivity, anxiety disorders, or depression -- are present, you also may be referred to one or more specialists for your care.

  • Audiologists assess your hearing and can use sound generators to neutralize triggering noises so the response to them is diminished. 
  • Occupational therapists provide personalized multi-sensory therapy to improve functioning around triggering cues to help you handle everyday encounters in a healthy way. 
  • Neurologists can rule out or address underlying issues that might be contributing to misophonia symptoms.


In some cases, medications may be used to help address existing mental health conditions and the emotional and behavioral problems associated with misophonia. Our psychiatrists are skilled at managing medications and adjusting dosages to find what's most effective for you.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

Why Choose Duke

Misophonia Pioneers

Duke is one of the few centers with the experience and expertise to care for people with misophonia. Our providers are global leaders who treat patients and conduct research to determine underlying causes and innovative treatments. 

Access to Specialists

Because misophonia can occur alone or in combination with one or more psychiatric, auditory, or sensory processing conditions, we take a team approach to assessment and treatment. We collaborate with a wide range of providers at Duke -- from neurologists to audiologists -- who provide individualized care based on your needs.

This page was medically reviewed on 08/07/2022 by