If you’ve ever found yourself utterly overwhelmed by the sound of chewing, pen-clicking, or loud breathing—while also struggling to focus, stay still, or organize your thoughts—you might be experiencing a complex combination of neurological conditions: ADHD and misophonia.
While each on their own is enough to disrupt daily life, together they form a uniquely challenging duo.
This article dives deep into the reason these two conditions often coexist, their impact on mental health, and where to find quality treatment in New York City.
Understanding ADHD
What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is more than just being forgetful or hyperactive. It’s a chronic neurodevelopmental condition that affects millions of children and often continues into adulthood.
ADHD is characterized by patterns of inattention, impulsivity, and sometimes hyperactivity that interfere with daily functioning and development.
ADHD is typically divided into three presentations:
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Predominantly Inattentive: Trouble focusing, forgetfulness, disorganization.
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Predominantly Hyperactive-Impulsive: Fidgeting, restlessness, acting without thinking.
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Combined Presentation: A mix of both inattentive and hyperactive-impulsive symptoms.
People with ADHD often struggle to stay on task, follow through with plans, or sit still in situations where it’s expected.
These challenges can affect academic performance, workplace productivity, relationships, and self-esteem. CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) is a great resource if you’re seeking more detailed insights or professional support.
Common Symptoms and Challenges
While symptoms may vary between individuals, there are hallmark signs that indicate ADHD:
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Difficulty concentrating
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Forgetting appointments or tasks
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Easily distracted by noise or other stimuli
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Trouble following instructions or completing work
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Restlessness or fidgeting
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Interrupting conversations or blurting out answers
But it’s not just about forgetfulness or hyperactivity. ADHD impacts how the brain processes information, regulates emotions, and manages impulses. People with ADHD often report feeling overwhelmed in noisy environments, struggling with time management, and having difficulty filtering out distractions—a key connection with misophonia, as you’ll see.
Social relationships can suffer too. Impulsive comments, zoning out in conversations, or missing cues can lead to misunderstandings.
At work, performance issues may arise, not from lack of skill, but because of difficulty staying organized or meeting deadlines.
These challenges don’t disappear with age—they just evolve. While hyperactivity might lessen, issues with attention and executive functioning often persist into adulthood.
ADHD in Adults vs. Children
ADHD is commonly diagnosed in childhood, but adult diagnoses are on the rise. In children, signs are often physical—running around, trouble sitting still, daydreaming in class.
But in adults, ADHD tends to look more like chronic disorganization, difficulty sustaining attention during conversations or meetings, or emotional dysregulation.
Adult ADHD can interfere with career development, financial planning, and maintaining long-term relationships. It often leads to co-occurring conditions like anxiety or depression, especially when untreated.
Interestingly, many adults with ADHD are only diagnosed after one of their children is identified with the condition. Once they start recognizing similar patterns in themselves, the pieces finally start to fit.
Exploring Misophonia
Defining Misophonia
Misophonia—literally “hatred of sound”—is a condition in which certain everyday noises trigger extreme emotional or physical responses. It’s not simply annoyance; it’s an intense, almost visceral reaction to specific sounds like chewing, tapping, sniffling, or throat clearing.
Unlike hyperacusis (where all sounds are too loud), misophonia is selective sound sensitivity. Some individuals may only react to one or two sounds, while others may have a wide array of triggers. Reactions often include:
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Rage or panic
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Disgust or anxiety
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An overwhelming urge to escape or stop the noise
Although it’s not yet officially classified in the DSM-5, awareness is growing. Organizations like The Misophonia Institute are helping to advance research and raise awareness.
Triggers and Reactions
The most common triggers include:
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Mouth sounds: chewing, slurping, smacking
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Repetitive tapping or pen clicking
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Breathing or sniffing
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Keyboard clacking or mouse clicking
These sounds can provoke an intense fight-or-flight response. The sufferer may become agitated, feel the urge to flee, or even lash out verbally or physically. It’s not a choice—they genuinely feel like they’re under threat.
Interestingly, misophonia can also extend to visual triggers like leg jiggling or repetitive gestures. This cross-sensory annoyance makes public places like offices or classrooms extremely difficult for sufferers.
How Misophonia Affects Daily Life
Imagine being in a quiet office, and someone starts clicking their pen repeatedly. For most, it’s a minor distraction. For someone with misophonia, it can be unbearable—raising their heart rate, triggering sweat, or even leading to panic attacks.
Many misophonia sufferers go to great lengths to avoid triggers:
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Wearing headphones in public
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Avoiding family dinners or restaurants
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Preferring remote work over in-office settings
This constant avoidance can impact relationships, career choices, and overall quality of life. It’s not uncommon for individuals to isolate themselves or experience symptoms of depression due to chronic stress.
The Link Between ADHD and Misophonia
Neurological Overlap
At first glance, ADHD and misophonia might seem worlds apart—one a cognitive attention disorder, the other a sensory-emotional one. But dig deeper, and you’ll find striking neurological similarities. Both involve abnormal sensory processing and atypical emotional responses to environmental stimuli.
ADHD is rooted in differences in the brain’s executive functioning, particularly in the prefrontal cortex. This area also plays a key role in sensory gating—the brain’s ability to filter out irrelevant information. In people with ADHD, this filtering system doesn’t work as efficiently, which means everything can feel overwhelming: sounds, lights, even the buzz of a fluorescent bulb.
Similarly, misophonia is believed to involve heightened activity in the anterior insular cortex, which is responsible for processing emotions and integrating sensory inputs. This results in an exaggerated emotional reaction to very specific sensory cues. So, if you already have trouble filtering stimuli (as in ADHD), you’re more likely to find certain sounds intolerable, especially when your brain misinterprets them as threatening.
This shared dysfunction in neurobiological circuits—especially those related to emotion, attention, and sensory integration—explains why ADHD and misophonia often coexist.
Emotional Regulation and Sensory Processing
Both conditions also heavily impact emotional regulation. People with ADHD often experience what’s called emotional dysregulation, meaning their reactions to stress or frustration can be extreme and difficult to control. Add misophonia to the mix, and a simple noise like throat-clearing can send them into a rage spiral.
The same hypersensitivity to distraction that makes ADHD challenging can intensify misophonic reactions. For instance:
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A person with ADHD may already struggle to stay focused in a meeting.
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Add a trigger sound like gum chewing, and it becomes impossible to concentrate.
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The emotional response may snowball into irritation, anxiety, or even panic.
The overlap of sensory over-responsivity and impaired emotional inhibition is key. When your brain can’t filter out irrelevant noise and also can’t regulate your feelings about it, everyday life becomes a sensory minefield.
This explains why so many individuals with misophonia also report ADHD symptoms—and vice versa.
Why Coexistence is Common
While misophonia is not yet classified as a comorbid disorder with ADHD in diagnostic manuals, anecdotal and preliminary clinical studies suggest that the coexistence rate is high. Why?
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Sensory Overload: ADHD increases sensitivity to sensory input. Misophonia turns that sensitivity into aversion.
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Impulsivity and Reactivity: ADHD’s impulsivity may amplify the misophonic response, turning a normal annoyance into an unfiltered outburst.
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Poor Emotional Control: Both conditions struggle with emotional modulation, making it hard to “let go” of negative responses.
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Stress Magnification: Both conditions are worsened by stress, fatigue, or overstimulation—common in busy urban environments like NYC.
Understanding this connection is essential for treatment. Treating one condition without addressing the other often leads to incomplete results.
Challenges Faced by Individuals with Both Conditions
Social and Professional Impact
Living with ADHD is already challenging. Add misophonia, and suddenly the world feels like it’s working against you—especially in social and professional settings.
Imagine being in an open-plan office, trying to meet a deadline, when your co-worker starts tapping their foot. If you have ADHD, staying on task is hard enough. If you also have misophonia, that tapping becomes unbearable. You can’t think. You can’t focus. You may feel the need to leave the room or confront the person—both of which can appear rude or disruptive.
This kind of hypersensitivity creates social landmines:
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Avoiding meals with friends or coworkers
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Appearing irritable or easily provoked
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Frequently using noise-canceling headphones (which can seem antisocial)
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Choosing isolation over interaction to avoid triggers
At work, it can hurt productivity and relationships. At home, it may strain marriages and parent-child dynamics. The internal stress of navigating these environments every day can be exhausting and demoralizing.
Mental Health Concerns
The emotional toll of managing both ADHD and misophonia is substantial. Many people report feeling:
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Chronically overwhelmed
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Easily agitated
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Hypervigilant in social situations
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Anxious or depressed
It’s not uncommon for individuals with this dual diagnosis to also experience Generalized Anxiety Disorder (GAD) or Major Depressive Disorder (MDD). The constant battle to control reactions, manage attention, and avoid triggers leads to burnout.
Over time, self-esteem can plummet, especially when others dismiss their experiences as overreactions or “just being sensitive.”
Sleep disorders are also common. A racing mind (thanks to ADHD) plus environmental sound sensitivity (from misophonia) can make falling or staying asleep extremely difficult. And of course, lack of sleep further worsens symptoms of both conditions.
Misdiagnosis and Underrecognition
One of the biggest hurdles for individuals with ADHD and misophonia is getting properly diagnosed. Many clinicians are familiar with ADHD, but few recognize misophonia as a legitimate concern. Misophonia sufferers are often dismissed as irritable, aggressive, or socially anxious.
Even when ADHD is diagnosed, the sensory issues are frequently overlooked, attributed instead to anxiety or trauma.
This leads to treatment plans that miss the mark—like prescribing stimulants without addressing sensory triggers or recommending behavioral therapy that ignores environmental adaptations.
If you live in NYC, finding a specialist who understands both conditions is crucial. The fast-paced, noisy nature of the city itself can worsen symptoms.
But thankfully, New York also has some of the best neuropsychologists, occupational therapists, and sensory specialists in the country.
Diagnosing ADHD and Misophonia
Diagnostic Criteria and Tools
ADHD is diagnosed based on a combination of behavioral assessments, self-reports, and clinical interviews using the criteria listed in the DSM-5. Common tools include:
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Conners Rating Scales
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Adult ADHD Self-Report Scale (ASRS)
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Behavior Assessment System for Children (BASC-3)
Misophonia, on the other hand, does not yet have a standardized diagnostic tool. However, some emerging resources include:
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Misophonia Assessment Questionnaire (MAQ)
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Amsterdam Misophonia Scale (A-MISO-S)
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Self-report surveys developed by audiologists and psychologists
Diagnosis requires a detailed history, symptom tracking, and sometimes collaboration between an audiologist and a mental health professional.
If you think you may have both conditions, document your symptoms and triggers thoroughly. Journaling reactions, environments, and coping strategies can help professionals identify patterns.
The Importance of Specialized Evaluation
Not all clinicians are equipped to spot the nuances of these overlapping disorders. A specialist evaluation can make all the difference. Look for professionals with experience in:
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Neurodevelopmental disorders
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Sensory processing sensitivities
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Behavioral health and emotional regulation
NYC is home to several top-tier clinics that offer multidisciplinary assessments, combining psychology, audiology, and neurology. These evaluations go beyond surface symptoms and help build a personalized treatment plan.
When scheduling, ask if the clinic has experience with misophonia or sensory processing issues in ADHD patients. It’s not just about ticking diagnostic boxes—it’s about understanding how your unique brain responds to the world.
NYC Clinics and Specialists
Here are some recommended resources and specialists in New York City:
Each of these clinics offers tailored assessments and interdisciplinary support, including therapy, medication management, and sensory interventions.
You’re not alone—and in NYC, help is closer than you think.
Treatment Approaches for ADHD and Misophonia
Behavioral and Cognitive Therapies
When dealing with both ADHD and misophonia, behavioral interventions are often the first line of defense. These therapies help rewire the brain’s response to external stimuli and improve emotional regulation. Cognitive Behavioral Therapy (CBT) is especially effective for managing the emotional rollercoaster triggered by both conditions.
For ADHD, CBT helps individuals develop:
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Time management strategies
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Organization skills
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Coping mechanisms for impulsivity and distractibility
For misophonia, CBT works to:
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Reduce the emotional response to trigger sounds
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Reframe negative thought patterns
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Practice desensitization techniques
An emerging therapy called CBT-M (Cognitive Behavioral Therapy for Misophonia) combines sound exposure therapy with emotional regulation.
This method helps individuals become less reactive to trigger sounds by slowly increasing their exposure in a controlled, supportive environment.
Dialectical Behavior Therapy (DBT) is also gaining traction for people dealing with intense emotional swings. It teaches mindfulness, distress tolerance, and emotional control—crucial tools for both ADHD and misophonia sufferers.
Group therapy can provide additional support, helping individuals realize they’re not alone and offering a space to exchange coping strategies.
Medication Management
Medication is a core part of ADHD treatment. The two main types include:
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Stimulants like Adderall or Ritalin, which improve attention and reduce hyperactivity by increasing dopamine and norepinephrine in the brain.
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Non-stimulants such as Strattera or Intuniv, often used when stimulants aren’t tolerated.
But when misophonia enters the mix, medication management becomes a bit more nuanced. While there’s no medication approved specifically for misophonia, treating ADHD effectively can reduce the cognitive overload that intensifies sound sensitivity.
Some doctors may explore off-label options for misophonia, including:
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SSRIs (Selective Serotonin Reuptake Inhibitors) to address underlying anxiety
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Beta-blockers for physical symptoms like heart palpitations during trigger exposure
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Anti-anxiety medications used in specific, high-trigger situations
It’s essential to work with a psychiatrist familiar with both conditions. Medication that sharpens focus but increases anxiety (a side effect of some stimulants) can worsen misophonia symptoms. Finding the right balance takes time, patience, and ongoing monitoring.
Sound Therapy and Sensory Tools
Sound therapy isn’t just for hearing loss anymore. For people with misophonia, it’s a vital treatment approach.
Audiologists often recommend tinnitus retraining therapy (TRT) or misophonia retraining therapy, where patients are exposed to neutral background sounds—like white noise or nature sounds—to help “cover” the trigger sounds.
The goal is twofold:
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Desensitize the nervous system over time
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Help the brain categorize trigger sounds as non-threatening
Personalized sound generators or ear-level devices are available and can be worn discreetly during high-risk situations. These devices emit soft, ambient noise that masks background triggers.
Additional tools include:
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Noise-canceling headphones
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White noise machines
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Meditation apps like Calm or Insight Timer to reduce baseline anxiety
Occupational therapy can also be helpful, especially for children, by integrating sensory integration techniques that improve tolerance to environmental inputs.
Lifestyle Adjustments and Coping Strategies
Daily Habits That Make a Difference
While therapy and medication are important, day-to-day habits can also play a massive role in managing both ADHD and misophonia. These lifestyle adjustments create a calmer internal and external environment.
Routine is everything for ADHD. A consistent schedule helps manage executive dysfunction. Try:
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Daily planners or digital task apps
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Visual schedules or reminder boards
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Blocking out time for breaks to avoid burnout
For misophonia, reducing noise exposure is essential, but total avoidance can increase sensitivity over time. The key is to balance exposure with self-care:
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Choose restaurants with ambient noise or outdoor seating
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Use earplugs in unavoidable trigger environments
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Practice calming techniques like deep breathing before entering social situations
Diet and exercise play a role, too. Foods that stabilize blood sugar can minimize energy dips that exacerbate ADHD symptoms. Regular physical activity boosts dopamine, aiding focus and emotional regulation. Even a 20-minute walk can reduce sound sensitivity by lowering baseline anxiety.
Mindfulness and Stress Reduction
Mindfulness techniques are powerful tools in managing both disorders. By increasing awareness of thoughts, bodily sensations, and environmental cues, people can respond more intentionally rather than reactively.
Popular practices include:
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Breath-focused meditation
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Progressive muscle relaxation
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Body scans
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Mindful listening
Apps like Headspace or Simple Habit offer guided practices tailored to stress reduction and focus.
Journaling is another effective strategy. By tracking what triggers your misophonia and what days ADHD symptoms are worse, you start noticing patterns—perhaps poor sleep or a skipped meal worsens symptoms.
The idea is not to eliminate symptoms but to create resilience against them.
Support Systems and Advocacy
Family and Workplace Communication
Having both ADHD and misophonia means your brain processes the world differently. That’s not a flaw—it’s just a different operating system. But explaining that to others can be tough.
In families, honesty is key. Let loved ones know:
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What your triggers are
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That your reactions are involuntary
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How they can support you (e.g., reducing noise at dinner, using coasters to avoid table tapping)
At work, consider disclosing your condition under ADA (Americans with Disabilities Act) protections. Reasonable accommodations could include:
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A quiet workspace
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Noise-canceling headphones
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Flexible scheduling
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Remote work options
Use resources like ADDA (Attention Deficit Disorder Association) for guidance on how to communicate your needs effectively.
Online Communities and Peer Support
Living with overlapping neurological conditions can feel isolating. Thankfully, online communities offer support, validation, and practical tips. Great places to start include:
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ADHD Alien – a relatable comic blog that breaks down complex ADHD experiences
These communities not only provide emotional support but also highlight the latest treatments, coping strategies, and research developments. You’ll realize you’re not alone—and that understanding your brain is the first step to mastering it.
Conclusion
ADHD and misophonia are challenging on their own—but when they coexist, the hurdles multiply. From struggling to focus amid distracting noises to emotionally reacting to seemingly innocuous sounds, people dealing with both conditions face a unique kind of daily battle.
Yet understanding the underlying neurological links between ADHD and misophonia offers clarity, hope, and direction.
Awareness is growing. More clinicians are beginning to recognize misophonia as a serious concern, and integrative treatments are emerging that tackle both sensory sensitivity and cognitive regulation.
Whether it’s through a custom therapy plan, medication, sound masking tools, or mindfulness practices, progress is possible.
If you live in a city like New York—an environment full of stimulation and noise—it’s even more vital to find support tailored to your unique needs.
Luckily, NYC offers a broad network of professionals and clinics that specialize in these overlapping challenges.
No, this journey isn’t easy. But with knowledge, the right tools, and a solid support system, you can create a life where your brain doesn’t feel like it’s working against you—but with you.
FAQs
1. Is misophonia a symptom of ADHD?
Not exactly. Misophonia is not a core symptom of ADHD, but the two conditions often coexist due to shared neurological features like sensory processing issues and emotional regulation challenges.
2. Can treating ADHD help reduce misophonia symptoms?
Yes. Treating ADHD can reduce cognitive overload and emotional reactivity, which may indirectly help lessen misophonia triggers or improve your ability to cope with them.
3. Are there specific therapies designed for people with both ADHD and misophonia?
Yes. Therapies like Cognitive Behavioral Therapy (CBT), CBT-M (for misophonia), and Dialectical Behavior Therapy (DBT) can address symptoms from both conditions. Multidisciplinary treatment plans are often most effective.
4. Can I get accommodations for misophonia at work or school in NYC?
Absolutely. Under the ADA, you may be eligible for reasonable accommodations such as quiet workspaces, noise-canceling headphones, or flexible schedules. Speak to your HR or school’s disability services coordinator.
5. Where can I find a specialist in NYC who treats both ADHD and misophonia?
Look into centers like NYU Langone, Mount Sinai’s ADHD Center, or Dr. Jennifer Jo Brout’s clinic.
These facilities offer multi-disciplinary support from audiologists, psychologists, and psychiatrists.
