When Noise Annoys: Coping with Hypersensitive Hearing

By Stephanie Stephens







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Do sounds that don’t bother anyone else make you want to tear your hair out? Hypersensitive hearing is a fairly common mood symptom with bipolar.



When Lynn was younger, she realized that sometimes she would hear things at work that no one else could. It was all so unsettling: a rattle in the overhead air-conditioning unit, a cricket down the hall, cars on the highway late at night—and her house wasn’t even near the road.

Lynn says that before she was diagnosed with bipolar disorder at age 38, she attributed her heightened aural response to incidents that affected her hearing. There was that loud rock concert she’d attended, and, later, a car accident that resulted in sandy water inundating her left ear.

Yet the Florida woman “couldn’t account for the rage” that went along with her episodes of hyped-up hearing. After a decade of learning to manage her bipolar, she now sees a connection between her moods and noise sensitivity.

Anecdotal evidence suggests that a significant slice of people with bipolar experience an almost-painful reaction to noise, especially during mood episodes—usually mania. When it comes to scientific proof, however, no one’s doing the research that would validate that connection.

There’s occasional recognition in scientific circles, such as in a 2013 study at Baylor College of Medicine that was actually looking at a specific gene’s role in bipolar disorder.

Michael E. Thase, MD, a professor of psychiatry and director of the mood and anxiety program at the University of Pennsylvania’s Perelman School of Medicine, explains that during mania, “certain regions of the brain are biologically activated, receiving more blood flow as glucose is being burned off.”

As a result, he says, “colors are brighter, sex is enhanced, and you feel smarter. There’s a heightened openness to experience, so it doesn’t surprise me that there’s heightened sensitivity to sound. Meanwhile, almost the opposite happens with depression.”

As part of the overall revved-up reactivity that people experience in hypomanic and manic phases, “they’re more attuned and aware of ambient noise,” he notes.

For Kevin, it’s during downswings that noises become downright painful.

“My disorder affects my relationship to sounds—especially music—as much as it affects my mood,” he says. “When I’m depressed, I don’t want to hear music or any sounds at all, although I deeply love music.”

When he’s hypomanic, though, bring on the tunes: “I play music at a normal volume, and I sing along with everything,” says Kevin, a world-class sailor from New Zealand. If he escalates to mania, the volume control ticks upward, too.

“That makes it feel ‘concert loud’ in my head,” he says. “But I find it very distracting and frustrating if it’s someone else’s music, maybe coming from next door.”

As described in his memoir Black Sails, White Rabbits, Kevin struggled for a number of years after he was diagnosed with bipolar at age 20. He went on to medal in a half-dozen international sailing competitions, coach national teams in the US and Denmark, and represent the US in the 2004 Olympics.

Now 46, he’s also a happily married father of three. How he reacts to his children’s incessant drumming on the table also varies with his mood state.

“If I’m in a really good headspace, it doesn’t bother me and it’s cool to imagine the drumming as music,” he says.

If he’s not in a good space, the sound becomes torture.

“It’s not like it’s annoying, the way hearing that same song from the movie Frozen for the seventh time is annoying. It’s sharp and visceral and aggravating—more like a pain than an annoyance—and makes me want to scream or lash out or run.”

He avoids doing any of those things because he and his psychiatrist developed a coping plan.

“He reminds me to ask myself if I really think they’re doing it to upset me or if they’re doing it for fun or to manage their own inner world through activity,” Kevin reports. “The answer is usually—but not always—that they aren’t doing it to annoy me, which makes me tolerant.”

He adds, “I have to remind myself that because I’m a little depressed, it’s natural that I feel partly like the world just isn’t really being very nice to me.”

Heightened Awareness

One Nebraska woman has developed an array of coping techniques for her noise sensitivity. Jamie M., 58, has bipolar II with hypomanic episodes that tend toward irritability and hypersensitivity.

That makes it all the harder to endure the housing construction that’s been going on around her for almost three years. It began with cutting down a grove of trees, which broke her heart. Then came the seemingly interminable low-pitched noise of the grader, then street installation, then the sound of saws, hammering and framing, and much more to disturb her peace.

“My mind fixates on it—especially if it’s repetitive—and I can’t concentrate on reading, or focus on anything else,” she says. She closes all the windows and turns on music, but alas, “that’s one other thing to irritate me.”

Then she may start to snap at the people in her life. All in all, it ruins the day and “keeps me from being able to enjoy other things,” she explains.

It’s not only the dull roar of construction that pushes her buttons—which is why she’s learned to limit her exposure to noisy places such as concerts, sporting events, and large family gatherings.

“I tend to be very selective about what I go to,” she explains. “For example, there might be a lot of excellent concerts coming up, but I’ll just pick one or two of my favorites to see. Or I’ll attend performances in smaller venues: fewer people equal less noise.”

She also loves to dine out, but sometimes finds herself irritable and distracted “when people are talking and laughing loudly at a table next to me.” As a result, she explains, “my husband and l like to go out to dinner at less busy times, or he’ll get takeout that we can enjoy in the quiet of our home.”

In addition to recognizing her triggers and making “wise decisions” to minimize them, Jamie proactively pursues self-nurturing activities: “I spend a portion of each day enjoying silence as I read, meditate, cook, or hang out with my dog.”

She notes that with both sides of the equation covered—avoiding triggers and practicing self-care—“I keep better balanced, with fewer ups and downs.”

Turning It Down

Lynn also steers away from places when her intuition signals that noise might aggravate her symptoms. And she’s come up with defenses to deal with things like cranky air conditioners, bothersome crickets, whooshing traffic, and the like.

Lynn began playing her radio at night so she could sleep better. Before she took medical retirement, she wore earplugs or earphones at work to quash intrusive sounds.

She’s adapted that plug-her-ears approach as a way to keep calm in restaurants, stores, libraries, and other trouble zones. She knows that noise is just a part of life, and that managing how you react is the key.

“In the end, the best you can do is really all you can do,” she says.

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How to Deal with Noise Sensitivity

Here are coping suggestions from people who grapple with noise sensitivity, whether individuals or medical experts:

Be prepared. Do some problem-solving with your therapist and make a plan for the next time noise intrudes into your life.

Know your triggers. Once you understand what sets you off, you can do your best to avoid those situations or at least “mute” the effects. For example, use earplugs to eliminate unwanted noise, or earphones to listen to something you find more pleasant. (Something neutral like white noise or the sound of a waterfall may be especially helpful.)

Check your state of mind. When sounds are starting to bother you, analyze where you are mood-wise. Putting your noise intolerance into the context of symptomatic hypersensitivity may highlight the need for some overall self-care.

Consider the source. If someone, not something, is creating an intolerable noise, try to ask yourself if the person actually intends to aggravate you. Chances are, the answer is no. Remembering that may help keep you from overreacting.

Set up quiet zones. Create a designated area in your home where silence reigns supreme.

Noise Sensitivity from the Medical Perspective

Unwanted noise can be a real pain in the ear. In the medical field, noise sensitivity (or noise intolerance) is called hyperacusis. According to the American Academy of Otolaryngology–Head and Neck Surgery, hyperacusis arises from a problem in the way the brain’s central auditory processing center perceives sounds.

As a result, noises that don’t seem loud to someone else will feel overpowering. Something as innocuous as shuffling papers or running a faucet could be as jarring as a jackhammer. High-frequency sounds may be especially troublesome.

In the general population, hyperacusis may be caused by exposure to a loud noise, some medications, and a few medical conditions. Although it hasn’t been formally linked to bipolar disorder, there is a recognized association with other neurologic conditions such as depression, post-traumatic stress disorder, extreme fatigue, and migraine headaches. (Migraines, by the way, have a significant crossover with bipolar).

There’s also a body of research that ties stress and emotional exhaustion to hearing problems. In 2013, scientists at the Karolinska Institute and Stockholm University’s Stress Research Institute in Sweden found that women with chronic emotional exhaustion were especially susceptible to stress-induced hyperacusis. After brief exposure in the lab to a physical, mental or social stressor, those women experienced the sound level of a normal conversation as uncomfortably loud.

Misophonia is a separate kind of sound sensitivity—specifically, “selective sound sensitivity syndrome.” In misophonia, someone has an intense dislike of a sound or group of sounds. An extreme negative reaction (anything from anxiety to violent rage) may be triggered by something like gum chewing or foot tapping, or even someone breathing.

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Printed as “When noise annoys,” Summer 2016