Hearing is one of the most sensitive perception channels. But what happens when ordinary sounds become sources of pain, fear, or stress? Hyperacusis is a condition that reveals deeper neuropsychological processes. In this article, we explore why some people are hypersensitive to sound, what underlies this sensory response, and how hyperacusis is related to brain activity. As noted by the Baltimore Chronicle, studying such conditions opens new horizons in understanding human perception.
What Is Hyperacusis and Why Does It Occur?
Hyperacusis is an abnormally high sensitivity to sounds that most people find moderate or even quiet. People with this disorder may experience pain from a phone ringing, a door creaking, or household appliance noise.
The causes of hyperacusis may be both organic and neuropsychological:
- malfunction of auditory nerves;
- altered sound processing in the brain cortex;
- consequences of traumatic brain injuries;
- prolonged exposure to loud noise;
- chronic stress or psychological conditions.
Interestingly, hyperacusis is often not associated with enhanced hearing acuity. It is rather a case of altered brain response to auditory stimuli.
How the Brain Processes Sound: A Neuropsychological View
Our brain doesn’t simply “hear” sounds — it interprets, filters, and prioritizes them. Normally, the brain dampens irrelevant background noise, focusing on what’s important. In hyperacusis, this mechanism breaks down.
Possible disruptions occur in the following brain areas:
- auditory cortex (sound processing);
- amygdala (threat response);
- prefrontal cortex (attention and emotion regulation).
In people with hyperacusis, perceived loudness increases not because of the sound’s volume, but due to neural hyperactivity. This is a kind of brain “fixation” on specific stimuli.
The Role of Neuroplasticity
Studies show that people with hyperacusis often have enhanced neuroplasticity — the brain’s ability to form new neural connections. This suggests that hyperacusis can result from brain “retuning” after trauma, stress, or chronic noise exposure.
Symptoms and Manifestations of Hyperacusis
The signs of hyperacusis vary between individuals and contexts. Core symptoms include:
- pain in the ears from moderate sounds;
- avoiding loud environments (restaurants, subways, concerts);
- heightened anxiety or irritability triggered by noise;
- headaches or fatigue after sound exposure;
- difficulty concentrating.
Types of Hyperacusis
- Sensory hyperacusis — causes physical discomfort.
- Emotional hyperacusis — triggers fear, anger, or anxiety.
- Neural hyperacusis — results from central nervous system sound processing disorders.
Who Is at Risk of Hyperacusis?
Hyperacusis affects people across age groups and professions. The most vulnerable include:
- people after traumatic brain injuries;
- musicians and industrial workers;
- individuals with autism or anxiety disorders;
- patients undergoing hearing treatments (e.g., cochlear implants).
Notably, hyperacusis often co-occurs with tinnitus (ringing in the ears), pointing to shared neural mechanisms.
Comparing Hyperacusis with Other Auditory Disorders
| Parameter | Hyperacusis | Tinnitus | Sound Allodynia (Misophonia) |
|---|---|---|---|
| Primary Reaction | Extreme sensitivity to sound | Perception of phantom sounds | Emotional reaction to specific sounds |
| Brain Areas Involved | Auditory cortex, amygdala | Auditory cortex | Limbic system |
| Typical Triggers | Household noise | Non-existent external sounds | Chewing, breathing, clicking |
| Prevalence | ~3–9% | ~10–15% | ~6% |
| Link to Emotional State | Strong | Moderate | Strong |
How Hyperacusis Is Diagnosed
Diagnosing hyperacusis requires consulting a neuro-otologist or audiologist. Common diagnostic methods include:
- Uncomfortable Loudness Level (ULL) testing;
- audiometry;
- psychological testing for anxiety and sensitivity;
- brain MRI (if organic causes are suspected).
Current Approaches to Treatment
Treatment for hyperacusis depends on the underlying cause. Common approaches include:
- Sound therapy – gradual exposure to safe sounds.
- Cognitive-behavioral therapy – reduces anxiety and reflexive reactions.
- Medication – antidepressants or anxiolytics.
- Attention training – learning to focus on neutral sounds.
What to Avoid
- Extended silence (may worsen sensitivity).
- Self-treatment using earplugs excessively.
- Ignoring symptoms — the condition can worsen over time.
Hyperacusis in the Context of Modern Neuroscience
Neuroscience views hyperacusis as an imbalance between sensory input and cognitive filtering. It’s not just a hearing disorder but a mirror of one’s emotional and cognitive state.
Recent neuroimaging studies have shown that individuals with hyperacusis exhibit heightened activity in brain regions responsible for emotional processing — including the amygdala, hippocampus, and anterior cingulate cortex. This confirms that responses to sound are not purely auditory but deeply emotional and psychological.
Living with Hyperacusis: Practical Advice
- Use white noise headphones in public spaces.
- Inform those around you about your condition — it reduces social stress.
- Practice breathing techniques when overwhelmed by sound.
- Keep a sound-trigger diary to better understand your reactions.
Earlier we wrote about what is PTSD.