For as long as she can remember, Suzanne Belasik has been a prisoner to sound. Gum cracking, crunching and the clanking of silverware against plates are just a few of the unbearable noises that make her distracted, irritated and even enraged.
While some say she is "overly sensitive," Ms. Belasik, 24, of Ross, recognizes that she has a condition called misophonia, or selective sound sensitivity syndrome.
"It's not common, but it's more common than you would think," said Melanie Herzfeld, an audiologist at the Hearing and Tinnitus Center in Woodbury, N.Y., who provides sound management therapy to four or five new misophonia patients each month.
The term misophonia was coined in 2001 by New York-based neuroscientists Pawel and Margaret Jastreboff, who are originally from Poland. Research has been limited, and few specialists around the country provide misophonia therapy. None is in Pittsburgh.
While there is no cure, neurologists speculate on the cause. Eric McDade, an osteopathic physician at the University of Pittsburgh's department of neurology, said he believes misophonia is caused by an abnormally strong connection between the auditory and limbic systems in the brain.
The limbic system produces emotion and the "fight or flight" response that causes individuals with misophonia to become increasingly agitated when exposed to a trigger sound or to remove themselves from whatever is producing the sound.
Misophonia usually develops in childhood, which Dr. McDade attributed to some miswiring in the brain that caused an emotional response to a particular sound.
"It's a rather limited repertoire of sounds that provokes this very strong response," he said, adding that some individuals with misophonia might also have anxiety or obsessive-compulsive disorder.
While most people get annoyed while listening to others chew with their mouths open, people with misophonia have a more extreme reaction to what many would consider ordinary noises. Reactions range from disgust to rage to panic -- and oftentimes a combination of all three.
For sufferers of misophonia, one minute of listening to someone chewing gum is comparable to one hour of listening to nails on a chalkboard.
Ms. Belasik, a former front desk supervisor at a local hotel, finds it difficult to cope with misophonia almost every day. Friends, family members and patrons are all potential triggers, she said.
"Just the other day there was a guy sitting up here at the bar and he was eating a bag of chips," she said. "The crinkling of the bag, the way he was chewing and then he started licking his fingers -- I had to just walk away. Removing myself from the situation is probably the best way I deal with it."
She believes her symptoms are worsening as she ages, with new trigger sounds causing her higher levels of frustration.
"I think what happens is once this becomes an emotional response, it can become a more cognizant response," said Dr. McDade. "The limbic system is now geared up and ready to respond to things even more easily."
Most children who develop misophonia have difficulty coping with the sounds made by a family member. As they grow older, it begins to encompass more sounds and more people. For some, it also includes visual triggers, like leg tapping or the sight of someone's jaw moving while chewing.
The condition is starting to gain some recognition. Ms. Belasik learned about misophonia from a New York Times article in September 2011. Shortly afterward, NBC's "Today" show broadcast a segment on the disorder, and Kelly Ripa discussed her own struggle with misophonia on ABC's "20/20" last May.
While neurologists and audiologists research the condition, people who suffer from misophonia want a cure.
"For years these people have seen psychologists and psychiatrists, and they have not been able to come up with a solution that works," Ms. Herzfeld said.
She has found that some techniques used to treat tinnitus (ringing in the ear) and hyperacusis (extreme sensitivity to certain frequency ranges of sound) can reduce the effects of misophonia.
One type of sound management, she said, encourages people with misophonia to change the way they think about their trigger sounds.
"If you don't like the sound of somebody clipping nails, then you might take the time to imagine that instead of clipping nails, somebody is cutting roses," she said. "By mingling the sounds with new sounds, we give them the opportunity to be able to reimagine this."
She recommends that these methods are paired with cognitive behavioral therapy, a form of psychotherapy that stresses the importance of analyzing one's feelings and behaviors.
Some people cope by mimicking the trigger sound (for example, if the sound of gum chewing is bothersome, the agitation may be reduced if you also chew gum), wearing ear plugs or adding background noise, such as music or television.
A list of misophonia specialists by region can be found on The Misophonia 4S Provider Network at www.misophonia-provider.com.
Emily Petsko: firstname.lastname@example.org or 412-263-1468.