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Disgusted to point of distress by classmates' gum chewing on rounds

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pepes1lv1a

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Ever since I was little, I've been absolutely disgusted to the point of rage when someone chews gum loudly around me. I've never really understood how other people tolerate it because it seems so offensive to me. Anyway, I am aware that this isn't normal but I'm really struggling with it on my current rotation because my attending chomps on his gum with his mouth open for the entire 4+ hours' worth of rounds. Many of my classmates do too, though most of them don't chew as offensively loudly as this attending. Obviously I can't ask him to stop. I don't know how to distract myself.

I've been diagnosed with depression and OCD in the past. I'm sure I would have been diagnosed with misophonia first and foremost if that had been in the DSM. My depression and OCD were pretty well controlled with SSRIs for several years, but I've never been in a situation where I can't avoid exposure to this insanely triggering stimulus. Does anyone have advice? Does anyone at least understand how disgusting the sound and sight are?
 
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lymphocyte

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Ever since I was little, I've been absolutely disgusted to the point of rage when someone chews gum loudly around me. I've never really understood how other people tolerate it because it seems so offensive to me. Anyway, I am aware that this isn't normal but I'm really struggling with it on my current rotation because my attending chomps on his gum with his mouth open for the entire 4+ hours' worth of rounds. Many of my classmates do too, though most of them don't chew as offensively loudly as this attending. Obviously I can't ask him to stop. I don't know how to distract myself.

I've been diagnosed with depression and OCD in the past. I'm sure I would have been diagnosed with misophonia first and foremost if that had been in the DSM. My depression and OCD were pretty well controlled with SSRIs for several years, but I've never been in a situation where I can't avoid exposure to this insanely triggering stimulus. Does anyone have advice? Does anyone at least understand how disgusting the sound and sight are?

Now that the jokes are out of the way (or maybe more to come... it is pretty funny about the one gross, chompy attending): it's surprisingly common. I'm sorry you're having to deal with it. And I'd imagine it sucks. There was an interesting article in the WSJ about it a few months back. I actually sent it to a OBYGN resident who had a similar issue. The title is a bit derogatory, but there are some practical tips to bring up with a professional. Good luck.

http://www.wsj.com/articles/annoyed-by-loud-chewing-the-problem-is-you-1445277757
 
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Crayola227

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there's probably some anonymous way to report this and he'll be told to stop - some hospitals have little patient questionnaires and you can take one and fill it out being like "Dr. Attending so and so chews so much gum so loudly I can hardly focus on what he's saying when he tells me to take my heart pills. It is unprofessional, he reminds me of a Valley Girl or Alicia Silverstone in that one movie."

I've seen it mentioned as a "not do" (gum chewing) in a lot of hospital policy do's and don'ts

the ideal thing for you personally and moving forward in your career is to learn to give less ****s, in general that's what more and more training tends to do to people luckily

just saying though, you're right, it is unprofessional and he shouldn't be doing it. That said, tread carefully because the lower you are in the hierarchy the less waves you should make. DONT address this in any way that can be linked back to you!!!!!!!!!!!!!
 

AshNiffler

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Ever since I was little, I've been absolutely disgusted to the point of rage when someone chews gum loudly around me. I've never really understood how other people tolerate it because it seems so offensive to me. Anyway, I am aware that this isn't normal but I'm really struggling with it on my current rotation because my attending chomps on his gum with his mouth open for the entire 4+ hours' worth of rounds. Many of my classmates do too, though most of them don't chew as offensively loudly as this attending. Obviously I can't ask him to stop. I don't know how to distract myself.

I've been diagnosed with depression and OCD in the past. I'm sure I would have been diagnosed with misophonia first and foremost if that had been in the DSM. My depression and OCD were pretty well controlled with SSRIs for several years, but I've never been in a situation where I can't avoid exposure to this insanely triggering stimulus. Does anyone have advice? Does anyone at least understand how disgusting the sound and sight are?


It makes me want to knock them the f*** out.
 
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Mad Jack

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As irritating as everyone around you is, you need to realize that it is your hypersensitivity to their behavior that is the issue, not the behavior itself. Such is the curse of OCD- bearing those around you that most break the sanctity of your environment. I would say you need to learn to deal, because realistically you're going to run into patients and colleagues like this for the rest of your life.
 
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Goro

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take two of these:

upload_2016-7-12_7-30-20.jpeg
 
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pepes1lv1a

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This is the reaction I get from most people. Even my friends make jokes about it because they don't realize how much it sucks. I really hope misophonia becomes more widely recognized as a neuropsych disorder because it can be every bit as disabling as classic OCD. The suffering it causes isn't funny.


That being said, SouthernSurgeon's comment made me lol despite myself.
 
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lymphocyte

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This is the reaction I get from most people. Even my friends make jokes about it because they don't realize how much it sucks. I really hope misophonia becomes more widely recognized as a neuropsych disorder because it can be every bit as disabling as classic OCD. The suffering it causes isn't funny.


That being said, SouthernSurgeon's comment made me lol despite myself.

I'm all on board the empathy train, and the suffering isn't funny, but just to be clear: the problem is definitely your problem. If only for practical reasons.

The disregard for unipolar depression and other relatively well-evidensed psychiatric diseases is incredible. So for something like "misophonia," you'll probably get a lot of eye-rolling and giggles. And people make noises. Sometimes loudly. They will for the rest of your life. It's more about coping with what you can control.

I put misophonia in quotes not to mock, but only because I'm not sure if a professional has given you that diagnosis (if such a diagnosis even exists). My point being: if you're having trouble during rotations, check-in with a professional sooner rather than later.
 
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Angry Birds

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I absolutely hate loud gum chewers especially those that chew for an eternity. In my opinion, there should be a five minute rule. You get five minutes to chew gum in order to freshen your breath. After that spit it out.

I had to take a test next to a loud gum chewer and I wanted to slam his head in the table.

And in my opinion, the best solution is to tell them in a hyperbolic joking fashion: "Holy [email protected]@@ I'm gonna bash my head in if you chew gum any louder. I love you bro but God damn you're killing my ears! I'm going nuts."

And no, the problem is NOT you. It's the gum chewer, who deserves the death penalty or at least life imprisonment.

You just gotta wait till you're an attending. Then you can just ban gum, or institute a five minute quiet chew rule.
 
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Goro

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Misophonia, literally "hatred of sound," is a putative disorder of uncertain classification in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "soft sound sensitivity syndrome," "select sound sensitivity syndrome" ("4S"), "decreased sound tolerance," and "sound-rage."[1][2] Misophonia is not recognized as a disorder by standard diagnostic criteria in the DSM-5 or the ICD-10, and there is no evidence-based research on its prevalence or treatment.[1]




This is the reaction I get from most people. Even my friends make jokes about it because they don't realize how much it sucks. I really hope misophonia becomes more widely recognized as a neuropsych disorder because it can be every bit as disabling as classic OCD. The suffering it causes isn't funny.


That being said, SouthernSurgeon's comment made me lol despite myself.
 
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lymphocyte

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Misophonia, literally "hatred of sound," is a putative disorder of uncertain classification in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "soft sound sensitivity syndrome," "select sound sensitivity syndrome" ("4S"), "decreased sound tolerance," and "sound-rage."[1][2] Misophonia is not recognized as a disorder by standard diagnostic criteria in the DSM-5 or the ICD-10, and there is no evidence-based research on its prevalence or treatment.[1]

There's controversy in the literature about "misphonia" as a symptom of OCD, a symptom of something else, a syndrome, or just a variant of normal--if it indeed exists at all. Wikipedia is generally not considered part of the literature. And psychiatry is not the DSM or ICD.

I just don't get this. OP says he/she is "really struggling" and "suffering." Maybe OP is acopic. Maybe not. Take the suffering at face value, poke some fun if you want, offer advice, and move on.

Cavanna AE, Seri S. Misophonia: current perspectives. Neuropsychiatr Dis Treat. 2015;11:2117-23.
 
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StrongIslandDoc

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As irritating as everyone around you is, you need to realize that it is your hypersensitivity to their behavior that is the issue, not the behavior itself. Such is the curse of OCD- bearing those around you that most break the sanctity of your environment. I would say you need to learn to deal, because realistically you're going to run into patients and colleagues like this for the rest of your life.

Holy living f**k - our program does an anonymous end-of-year thing where we are required to choose 10 other students to provide "feedback" to (and yes, the administration sees this as well) - it typically becomes a drill in bullying because people use it as an opportunity to talk complete **** about one another with absolutely no consequences to bear for it whatsoever, so I usually just pick 10 random people and think of something awesome about them so that they may have some reprieve from the sleuth of drama inevitably coming their way....anyway, I think I'm going to copy-paste this in next years because I'll be god damned if this doesn't sum up exactly how I feel about some people, I've just always been at a loss for words but I swear I go to medical school with some of the most hypersensitive people I have ever met....like jesus christ we're supposed to the steadfast support for others in this profession, how are medical students so emotionally labile? I should have just gone to medical school in Dubai....no emotions, just Money, Medicine, and Maseratis.

Also, I let the popcorn burn in my microwave because I wanted to finish writing this so now I'm eating burned popcorn :( #soemotional
 
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Just tell yourself it's the opportunity cost of six figures for the rest of your life...the piper must be paid
 
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pepes1lv1a

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As irritating as everyone around you is, you need to realize that it is your hypersensitivity to their behavior that is the issue, not the behavior itself.

That's a good point. I've heard misophonia being described as hyperconnectivity between thalamic auditory relays and the limbic system before. I have no evidence to back that up except that it fits perfectly with the reality I've lived with since I was a child--the rage, the wanting-to-bash-heads-against-a-brick-wall, the anxiety and immediacy of the urge to stop the stimulus NOW. It does help to think about it in terms of other people just not having those abnormally wired connections, because I guess it makes their behavior seem less malicious to my frontal cortex even though my lizard brain is still flipping the f*** out. It also takes a hell of a lot of effort and focus, but I suppose that's why so many people with the same issue have found CBT helpful.

Misophonia, literally "hatred of sound," is a putative disorder of uncertain classification in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "soft sound sensitivity syndrome," "select sound sensitivity syndrome" ("4S"), "decreased sound tolerance," and "sound-rage."[1][2] Misophonia is not recognized as a disorder by standard diagnostic criteria in the DSM-5 or the ICD-10, and there is no evidence-based research on its prevalence or treatment.[1]

With all due respect, Goro, it's disappointing to see you copypaste Wikipedia as a knee-jerk invalidation of my OP. I'd expect that from some of the jabronis on here, but people value your opinion. I certainly valued your opinion even when you told me I had no chance of getting into a USMD school with a 2.99 GPA. This is a 3rd year rotation at my USMD school. I just got a step score back that I'm super proud of, and other than the recent depression and "sound sensitivity" issues, I'm doing very well here. Things aren't necessarily as set in stone as you think they are. There are no evidence-based treatment protocols, but there is plenty of current literature about it:

Andrea E Cavanna, S.S., Misophonia: current perspectives. Neuropsychiatric Disease and Treatment, 2015. 11: p. 2117-2123 [available open-access, doi:
10.2147/NDT.S81438] Lymphocyte already linked this one, but I'm guessing you didn't read it. It's a good overview of the current state of misophonia-related research.

Arjan Schroder, N.V., Damiaan Denys, Misophonia: Diagnostic Criteria for a New Psychiatric Disorder. PLoS ONE, 2013. 8(1). [also available open-access, doi: 10.1371/ journal.pone.0054706]

The latter represents an observational study, n=42, where the authors developed what they're calling the "Amsterdam Misophonia Scale" derived from features of existing psych disorder inventories like the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Yes, it's an observational study. You have to walk before you can run. Visibility, grant funding, and public awareness (clearly) hasn't reached a point where it's feasible to run larger-scale, more rigorous types of trials about misophonia. However, the claim that there is no evidence-based research is false. Schroder et al conclude:

"In the present study we investigated 42 patients with misophonia. A specific acoustic cue, produced by a human being, provoked an impulsive aversive physical reaction with irritability, disgust and anger. The intensity of these emotions provoked a fear of uncontrollability with subsequent avoidance which was evaluated with the concept A-MISO-S. Patients showed aspects of OCPD. Hearing tests did not reveal any underlying deficits. Misophonia cannot be classified under current disorders within DSM-IV-TR and ICD-10 and should be delineated as a separate psychiatric disorder. We propose diagnostic criteria which could improve recognition by health carers and encourage scientific research."

Maybe it'll make it into the DSM someday. I hope so. Until then, everyone, chew as loudly as you want--but know that there might be someone nearby who wants to bash your head in.
 
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Goro

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Meh; I grabbed the wiki definition just to get some lay background. I have family members who have mental health issues, and indeed, I have had to deal with depression myself, and have been on anti-depressants 2x in my life.

But frankly, your complaint makes me wonder if every possible thing in the world is now being pathologized.

So my take is, if people can overcome vasovagal responses to, say blood or spiders, by cognitive behavioral therapy, so can you with the chewing gum. A caveat that jumps to mind is how the makers of Prozac are pitching shyness as a condition to be treated with medication!

As an aside, I have learned from the experiences of SDNers like you to have a more realistic spin on chances, after learning that reinvention is indeed rewarded by MD schools. I am happy for your success!


With all due respect, Goro, it's disappointing to see you copypaste Wikipedia as a knee-jerk invalidation of my OP. I'd expect that from some of the jabronis on here, but people value your opinion. I certainly valued your opinion even when you told me I had no chance of getting into a USMD school with a 2.99 GPA. This is a 3rd year rotation at my USMD school. I just got a step score back that I'm super proud of, and other than the recent depression and "sound sensitivity" issues, I'm doing very well here. Things aren't necessarily as set in stone as you think they are. There are no evidence-based treatment protocols, but there is plenty of current literature about it:

Andrea E Cavanna, S.S., Misophonia: current perspectives. Neuropsychiatric Disease and Treatment, 2015. 11: p. 2117-2123 [available open-access, doi:
10.2147/NDT.S81438] Lymphocyte already linked this one, but I'm guessing you didn't read it. It's a good overview of the current state of misophonia-related research.

Arjan Schroder, N.V., Damiaan Denys, Misophonia: Diagnostic Criteria for a New Psychiatric Disorder. PLoS ONE, 2013. 8(1). [also available open-access, doi: 10.1371/ journal.pone.0054706]

The latter represents an observational study, n=42, where the authors developed what they're calling the "Amsterdam Misophonia Scale" derived from features of existing psych disorder inventories like the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Yes, it's an observational study. You have to walk before you can run. Visibility, grant funding, and public awareness (clearly) hasn't reached a point where it's feasible to run larger-scale, more rigorous types of trials about misophonia. However, the claim that there is no evidence-based research is false. Schroder et al conclude:

"In the present study we investigated 42 patients with misophonia. A specific acoustic cue, produced by a human being, provoked an impulsive aversive physical reaction with irritability, disgust and anger. The intensity of these emotions provoked a fear of uncontrollability with subsequent avoidance which was evaluated with the concept A-MISO-S. Patients showed aspects of OCPD. Hearing tests did not reveal any underlying deficits. Misophonia cannot be classified under current disorders within DSM-IV-TR and ICD-10 and should be delineated as a separate psychiatric disorder. We propose diagnostic criteria which could improve recognition by health carers and encourage scientific research."

Maybe it'll make it into the DSM someday. I hope so. Until then, everyone, chew as loudly as you want--but know that there might be someone nearby who wants to bash your head in.
 
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Mad Jack

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That's a good point. I've heard misophonia being described as hyperconnectivity between thalamic auditory relays and the limbic system before. I have no evidence to back that up except that it fits perfectly with the reality I've lived with since I was a child--the rage, the wanting-to-bash-heads-against-a-brick-wall, the anxiety and immediacy of the urge to stop the stimulus NOW. It does help to think about it in terms of other people just not having those abnormally wired connections, because I guess it makes their behavior seem less malicious to my frontal cortex even though my lizard brain is still flipping the f*** out. It also takes a hell of a lot of effort and focus, but I suppose that's why so many people with the same issue have found CBT helpful.



With all due respect, Goro, it's disappointing to see you copypaste Wikipedia as a knee-jerk invalidation of my OP. I'd expect that from some of the jabronis on here, but people value your opinion. I certainly valued your opinion even when you told me I had no chance of getting into a USMD school with a 2.99 GPA. This is a 3rd year rotation at my USMD school. I just got a step score back that I'm super proud of, and other than the recent depression and "sound sensitivity" issues, I'm doing very well here. Things aren't necessarily as set in stone as you think they are. There are no evidence-based treatment protocols, but there is plenty of current literature about it:

Andrea E Cavanna, S.S., Misophonia: current perspectives. Neuropsychiatric Disease and Treatment, 2015. 11: p. 2117-2123 [available open-access, doi:
10.2147/NDT.S81438] Lymphocyte already linked this one, but I'm guessing you didn't read it. It's a good overview of the current state of misophonia-related research.

Arjan Schroder, N.V., Damiaan Denys, Misophonia: Diagnostic Criteria for a New Psychiatric Disorder. PLoS ONE, 2013. 8(1). [also available open-access, doi: 10.1371/ journal.pone.0054706]

The latter represents an observational study, n=42, where the authors developed what they're calling the "Amsterdam Misophonia Scale" derived from features of existing psych disorder inventories like the Yale-Brown Obsessive-Compulsive Scale, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Yes, it's an observational study. You have to walk before you can run. Visibility, grant funding, and public awareness (clearly) hasn't reached a point where it's feasible to run larger-scale, more rigorous types of trials about misophonia. However, the claim that there is no evidence-based research is false. Schroder et al conclude:

"In the present study we investigated 42 patients with misophonia. A specific acoustic cue, produced by a human being, provoked an impulsive aversive physical reaction with irritability, disgust and anger. The intensity of these emotions provoked a fear of uncontrollability with subsequent avoidance which was evaluated with the concept A-MISO-S. Patients showed aspects of OCPD. Hearing tests did not reveal any underlying deficits. Misophonia cannot be classified under current disorders within DSM-IV-TR and ICD-10 and should be delineated as a separate psychiatric disorder. We propose diagnostic criteria which could improve recognition by health carers and encourage scientific research."

Maybe it'll make it into the DSM someday. I hope so. Until then, everyone, chew as loudly as you want--but know that there might be someone nearby who wants to bash your head in.
I've got a theory that it is actually driven by the same pathways as OCD, but with an external stimulus functioning as the obsessive component (which is why it doesn't fit in the current OCD model), causing a compulsion that is socially unacceptable and thus leads to ever increasing levels of internal discomfort, as it is the compulsion that normally provides relief, but without an outlet, everything just builds. It also fits with CBT being an effective therapy, given its successful employment in OCD.

You should seek therapy, in any case. SDN isn't the place for psychiatric advice.
 
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lymphocyte

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Meh; I grabbed the wiki definition just to get some lay background. I have family members who have mental health issues, and indeed, I have had to deal with depression myself, and have been on anti-depressants 2x in my life.

@Goro: Mad respect for mentioning that. It may or may not seem like a big deal, but it goes a long way to breaking down stigma coming from someone like you.
 
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RadOncDoc21

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Misophonia, literally "hatred of sound," is a putative disorder of uncertain classification in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "soft sound sensitivity syndrome," "select sound sensitivity syndrome" ("4S"), "decreased sound tolerance," and "sound-rage."[1][2] Misophonia is not recognized as a disorder by standard diagnostic criteria in the DSM-5 or the ICD-10, and there is no evidence-based research on its prevalence or treatment.[1]

What's it called when you hate seeing animals lick their ass? I have a cat and I literally throw something at it every time she does it.
 
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JustaDO

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Ever since I was little, I've been absolutely disgusted to the point of rage when someone chews gum loudly around me. I've never really understood how other people tolerate it because it seems so offensive to me. Anyway, I am aware that this isn't normal.
Until then, everyone, chew as loudly as you want--but know that there might be someone nearby who wants to bash your head in.

I'd expect that from some of the jabronis on here

Disgusted to the point of rage, and we should be aware someone may want to bash our heads in...the only "jabroni" is you with your unresolved anger problems.

Furthermore, the selection Goro posted, though from Wikipedia, is accurate. No, Wikipedia isn't part of the literature, but the 2 statements in his post is cited directly from literature is it not? Or is literature like your condition selective too?
 
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lymphocyte

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Disgusted to the point of rage, and we should be aware someone may want to bash our heads in...

You picked up on something very key. Read what the other poster said they feel too: rage, often in great disproportion to the stimulus.

This phenomenon is actually something being noticed in the literature. Some have even called misphonia "mastication rage."

I don't want to get into the semiotics of diagnosis or how diagnoses come to develop as medical entities, but when a group of people keep reporting the same problem in the same way... maybe something is going on.

Bruxner G. 'Mastication rage': a review of misophonia - an under-recognised symptom of psychiatric relevance?. Australas Psychiatry. 2016;24(2):195-7
 
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pepes1lv1a

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Disgusted to the point of rage, and we should be aware someone may want to bash our heads in...the only "jabroni" is you with your unresolved anger problems.

Furthermore, the selection Goro posted, though from Wikipedia, is accurate. No, Wikipedia isn't part of the literature, but the 2 statements in his post is cited directly from literature is it not? Or is literature like your condition selective too?

Sounds like jabroni talk to me
 

JustaDO

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You actually picked up on something very key. Carefully read what the other poster said they feel too: rage, often in great disproportion to the stimulus.

You also noted something very key : maybe something is going on. From your own article: Misophonia is maybe an under-recognised condition of psychiatric relevance. Some thought the Earth maybe is flat, but we know that not to be true right?

Carefully read when OP stated his co-morbidities: "I've been diagnosed with depression and OCD in the past."

Another phenomenon is noted: The Association of Anger with Symptom Subtypes in Severe Obsessive-Compulsive Disorder Outpatients. : http://www.ncbi.nlm.nih.gov/pubmed/26953572
Anger attacks in obsessive compulsive disorder : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3530280/

Without going into a long drawn out debate over the actualities of whether this is a subset or not, seeing as you and I are not psychiatrists, I will leave it at this. Goro posted something cited from literature, and OP had his feelings hurt, and as research demonstrated/expected, reacted with anger and called people "jabronis" after stating he wanted to bash people or whatever *****ic statement he made.

Much like his claimed disease, he is not only selective about particular noises, he is very selective about certain literature, which is very convenient.
 
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lymphocyte

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You also noted something very key : maybe something is going on. From your own article: Misophonia is maybe an under-recognised condition of psychiatric relevance. Some thought the Earth maybe is flat, but we know that not to be true right?

Carefully read when OP stated his co-morbidities: "I've been diagnosed with depression and OCD in the past

1. If you want to argue down a slippery slope to the extreme, that's fine, but don't expect anybody to take that argument seriously.

2. I already acknowledged that it could be a symptom of OCD--or nothing at all. The debate is still ongoing, active, and absolutely fascinating (this is how diagnosis gets "made"--something similar happened when "metabolic syndrome" became vogue). It's a cool thing to see and appreciate as a clinical student.

3. The DSM and ICD are not the literature; one is a research manual and diagnostic reference, and the other is largely an administrative tool. There are lots of reasons why things get left out or put in, and sometimes not just for good medical reasons.

4. The way you parrot my words and unnecessarily made this personal about OP is a little insulting. Lots of people chimed in with helpful advice or were at least funny. Nothing is convenient about OP's situation.

5. Realistically, I'm not going to convince you of anything, and I think we're just making more heat than light at this point.
 
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pepes1lv1a

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1. If you want to argue down a slippery slope to the extreme, that's fine, but don't expect anybody to take that argument seriously.

2. I already acknowledged that it could be a symptom of OCD--or nothing at all. The debate is still ongoing, active, and absolutely fascinating (this is how diagnosis gets "made"--something similar happened when "metabolic syndrome" became vogue). It's a cool thing to see and appreciate as a clinical student.

3. The DSM and ICD are not the literature; one is a research manual and diagnostic reference, and the other is an administrative tool. There are lots of reasons why things get left out or put in, and sometimes not just for good medical reasons.

4. The way you parrot my words and unnecessarily made this personal about OP is a little insulting. Lots of people chimed in with helpful advice or were at least funny.

5. Realistically, I'm not going to convince you of anything, and I think we're just making more heat than light at this point, so feel free to have the last word.

Lymphocyte, seriously, thank you for being in this thread. All arguments about whether misophonia is its own diagnostic entity aside, people have ridiculed this problem enough in my past to give me a really bleak view on how compassionate people are (not) in the face of something they don't understand. It means a lot to hear someone respond kindly.
 
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JustaDO

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3. The DSM and ICD are not the literature; one is a research manual and diagnostic reference, and the other is an administrative tool. There are lots of reasons why things get left out or put in, and sometimes not just for good medical reasons.

Fascinating, except I never said anything about DSM / ICD, but you keep on repeating that same line. Also, your pretentious way of trying to lecture others is downright laughable, so find some of your own peers to pretend to care.

4. The way you parrot my words and unnecessarily made this personal about OP is a little insulting.

Being patronized must be tough. Oh wait.
upload_2016-7-15_19-33-49.png


Nothing is convenient about OP's situation.

Nothing is convenient except literally, when Goro posted something that was cited, that it was "disappointing", but OP's citations are ok however. That's not convenient?

It's funny too, OP just made a post about how people ridicule her, and that people aren't compassionate, but earlier, called people that would post cited resources "jabronis". Very Mother Theresa of her.
 
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lymphocyte

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Fascinating, except I never said anything about DSM / ICD,

Nothing is convenient except literally, when Goro posted something that was cited, that it was "disappointing", but OP's citations are ok however. That's not convenient?

It's funny too, OP just made a post about how people ridicule her, and that people aren't compassionate, but then proceeded to call people that would post cited resources "jabronis".

What Goro cited was Wikipedia which cited the DSM, ICD, and an Australian paper that supported the recognition of misphonia.

Nobody should be calling people Jabronis (I never thought I'd write that sentence in my entire life). But think about things from OP's perspective. If misphonia (or even anger, as the literature you cited suggests) is indeed a symptom of OCD... then it kinda sucks to be mocked over something you don't have much control over--especially from doctors who should be trying to help. But life is like that, and that's why I recommend getting help rather than waiting to be accommodated.

To each their own. I didn't mean to talk down to you (or anybody), and I'm sorry if I did. I wanted to defend somebody who is suffering (even if we don't understand why, or think it's appropriate) and also provide some discussion for those interested in psychiatry as clinical students. I wish you (and OP) the best.
 
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FindMeOnTheLinks

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I have this too. It really sucks, and I wish I could do something to change it. For some reason it's not as bad for me if its a random person, but when my family chews gum it's so aggravating. One thing that has helped me is to not look at their face. This is probably hard to do when you're on rounds and trying to be sociable.

If you stop and think about it though, the way people chew gum is actually very rude. Popping, smacking, etc with their mouth open would all be considered extremely rude if done at the dinner table, but for some reason it's considered the norm with gum in the office, when trying to have a conversation etc??????? Somebody please explain that to me


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pepes1lv1a

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I have this too. It really sucks, and I wish I could do something to change it. For some reason it's not as bad for me if its a random person, but when my family chews gum it's so aggravating. One thing that has helped me is to not look at their face. This is probably hard to do when you're on rounds and trying to be sociable.

If you stop and think about it though, the way people chew gum is actually very rude. Popping, smacking, etc with their mouth open would all be considered extremely rude if done at the dinner table, but for some reason it's considered the norm with gum in the office, when trying to have a conversation etc??????? Somebody please explain that to me


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For what it's worth, it's exactly the same weird thing for me: the more I like a person, the more I'm able to tolerate their horrible noises--and the more I dislike them already, the worse their chewing noises are. It's bizarre. And likewise, looking at their jaw working up and down makes me cringe almost as much as the actual sound, so even if I have noise-canceling headphones on, I have to keep my head down and conscientiously avoid catching sight of the offender. I guess it's a thing.
 
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pd1112

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You picked up on something very key. Read what the other poster said they feel too: rage, often in great disproportion to the stimulus.

This phenomenon is actually something being noticed in the literature. Some have even called misphonia "mastication rage."

I don't want to get into the semiotics of diagnosis or how diagnoses come to develop as medical entities, but when a group of people keep reporting the same problem in the same way... maybe something is going on.

Bruxner G. 'Mastication rage': a review of misophonia - an under-recognised symptom of psychiatric relevance?. Australas Psychiatry. 2016;24(2):195-7

Or it could just be word association familiarity after one person published a specific descriptor & subsequently everyone followed suit.
 
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lymphocyte

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Or it could just be word association familiarity after one person published a specific descriptor & subsequently everyone followed suit.

Doubt it. Many people who attend clinic aren't exactly keeping up with latest literature and still give similar phenomenological accounts.

But it's always something to be mindful of. People sometimes try to shoe themselves into things, and that's why it's always best just to see a well-trained professional.
 
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pd1112

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Doubt it. Many people who attend clinic aren't exactly keeping up with latest literature and still give similar phenomenological accounts.

But it's always something to be mindful of. People sometimes try to shoe themselves into things, and that's why it's always best just to see a well-trained professional.
They don't have to keep up with any literature. A few minutes of google searching and almost every top hit includes the word.
 
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dozitgetchahi

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I, too, utterly hate the sound of people chewing...but I can tolerate it. If I'm in a cafeteria or restaurant etc, then I'm not bothered at all...but if I'm in a library or quiet office or something and someone starts eating, it is often excruciating. Sometimes I have to leave the room because I'm not going to be able to get anything done while that's going on. Gum chewing, however, doesn't bother me at all unless somebody is chewing with their mouth wide open and/or smacking the gum, at which point I'm generally tempted to smack them in the face.

That said, OP, if you can't handle this how are you gonna be a doctor? This issue is by far one of the very least annoying things I face on a daily basis.

PS (funny story): when I was a 3rd year on IM, I dealt with this jackass intern who came up to me minutes before rounds started one day and was all like 'spit out that gum. It's trashy and it makes you look like you don't give a crap.' I spit the gum out. 5 minutes later, the attending shows up chewing gum and proceeds to offer everyone a piece of gum before rounds start.
 
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lymphocyte

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They don't have to keep up with any literature. A few minutes of google searching and almost every top hit includes the word.

Fair. But maybe it's a cue to ask more sensitive and specific questions that can't be Googled.

Just as an aside, there was an incredible discussion on the psychiatry subforum about how nuanced and tricky even the most routine diagnoses can be. Nobody goes off buzz words or DSM alone. Lots of gems to impress your attendings in there.

http://forums.studentdoctor.net/threads/inquiring-about-bipolar-d-o.1211502/
 
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pd1112

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Fair. But maybe it's a cue to ask more sensitive and specific questions that can't be Googled.

Just as an aside, there was an incredible discussion on the psychiatry subforum about how nuanced and tricky even the most routine diagnoses can be. Nobody goes off buzz words or DSM alone. Lots of gems to impress your attendings in there.

http://forums.studentdoctor.net/threads/inquiring-about-bipolar-d-o.1211502/
haha too late; finished with my one & hopefully only psych rotation.
 
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Meowgical

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I'm really sorry that you're going through this. Just thought I'd chime in to say that you're not alone. For the longest time I thought I was the only one that experienced stuff like this. I suffer from it too. Not just with gum-chewing... Eating, drinking, talking, banging, any sound associated with Styrofoam (also hate the texture). It can be pretty much any unexpected or unwanted noise that puts me into an internal rage. When I was younger I had similar feelings when my brother or mom would touch something "softly". It's superrrrrrrrrrrrrr weird. I'm still working on how to deal with it all. The sounds bother me most when the sound is from a family member or someone I don't like.

I usually fix it by listening to some music or rain sounds with headphones. I've never really had something like this affect me in a public place. If there's enough background noise to drown it out that helps. Humming while blocking my ears or ear plugs also work in a pinch.

I've been reading more about misophonia recently by chance. I wonder if this is more of a neurological than psychiatric issue. I even started to think that I could be on the autism spectrum due to the hypersensitivity... but I literally know nothing because I'm not even a medical student yet.
 

Psai

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I, too, utterly hate the sound of people chewing...but I can tolerate it. If I'm in a cafeteria or restaurant etc, then I'm not bothered at all...but if I'm in a library or quiet office or something and someone starts eating, it is often excruciating. Sometimes I have to leave the room because I'm not going to be able to get anything done while that's going on. Gum chewing, however, doesn't bother me at all unless somebody is chewing with their mouth wide open and/or smacking the gum, at which point I'm generally tempted to smack them in the face.

That said, OP, if you can't handle this how are you gonna be a doctor? This issue is by far one of the very least annoying things I face on a daily basis.

PS (funny story): when I was a 3rd year on IM, I dealt with this jackass intern who came up to me minutes before rounds started one day and was all like 'spit out that gum. It's trashy and it makes you look like you don't give a crap.' I spit the gum out. 5 minutes later, the attending shows up chewing gum and proceeds to offer everyone a piece of gum before rounds start.

Did you accept with alacrity and chew the gum slowly in front of that intern with a smug smile on your face?
 
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dozitgetchahi

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Did you accept with alacrity and chew the gum slowly in front of that intern with a smug smile on your face?

Pretty much...in fact the resident (who, as I found out later, had seen all of this but had said nothing) glanced at the intern and said something like 'sure ya don't want a piece?'
 
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PL198

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I don't understand why people do this. Chewing with your mouth open is disgusting in any setting.
 
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