Misophonia in ADHD: when everyday sounds feel like an alarm. 

Have you ever felt a sudden wave of irritation or even anger because of someone chewing, tapping a pen, or repeatedly sniffing, while everyone else in the room seems completely unbothered? For some adults with ADHD, this experience has a name: misophonia.

Misophonia literally means “hatred of sound,” but it is not about loud environments or general noise sensitivity. It refers to intense emotional reactions to specific trigger sounds, often repetitive and often human-generated. Chewing, lip-smacking, pen clicking, keyboard tapping, sniffing, or heavy breathing are common examples. The response can be immediate and powerful, ranging from irritation and disgust to anxiety or an urgent need to escape. Although misophonia is not currently recognised as a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), it is increasingly discussed in neuroscience and psychiatric research.

Many adults with ADHD report experiencing misophonia. While it can occur independently, there are several reasons why it may be more noticeable in ADHD.

First, ADHD is not only about attention regulation. It often involves differences in sensory processing. Many people with ADHD struggle with filtering out irrelevant sensory input. What should remain in the background does not fade away. Instead, the sound stays in the foreground, persistent and intrusive. Once the brain flags a trigger sound as important, it can be very difficult to un-flag it.

Second, ADHD is associated with heightened emotional reactivity. When a trigger sound appears, the emotional response can surge quickly, sometimes before there is time to cognitively reframe the situation. The intensity of the reaction may feel disproportionate, but it is driven by a nervous system that reacts rapidly and strongly. Even if the person appears calm on the outside, the internal experience can be overwhelming.

Third, ADHD is characterised by attentional lock-in. Hyperfocus does not only apply to tasks or interests. Attention can become stuck on a trigger sound. The more someone tries to ignore it, the more prominent it seems. The nervous system shifts into a state of alert, and remaining in that state is exhausting.

From the inside, misophonia can feel confusing and distressing. People often describe knowing that their reaction seems irrational, yet feeling unable to stop it. There can be a strong urge to leave the environment immediately. Sometimes the brain even interprets the sound as intentional, as though the other person is doing it “on purpose,” despite knowing logically that they are not. This is not a character flaw or a lack of resilience. It is a nervous system response.

Misophonia can quietly strain relationships and workplace dynamics. Partners may feel criticised for normal behaviours. Colleagues may feel judged. Children may feel shamed for everyday noises. At the same time, the person experiencing misophonia may be investing enormous energy in staying regulated and present. Understanding this shifts the narrative. What looks like overreacting may actually be sensory overload combined with emotional intensity.

There is no single solution, but many people benefit from practical environmental adjustments such as noise-cancelling headphones, background white noise, or thoughtful seating arrangements. Nervous system regulation strategies, including paced breathing and grounding techniques, can reduce escalation. Identifying patterns and separating the sound from perceived intention can also help. Some individuals explore adapted cognitive-behavioural approaches to gradually reduce distress linked to specific triggers.

If this sounds familiar, either personally or professionally, it may be worth considering whether irritability is truly the issue, or whether a nervous system is simply working overtime.