Paying for Peace and Quiet: The Cost of Misophonia

As I abandon my undergraduate meal plan and join the ranks of the overworked, underpaid graduate student population, naturally, my change in budget has caused some anxiety to arise. Stipends only stretch so far, after all. Considering all my costs and allocating earbud and music streaming fund has sent me down a particular train of thought: How much does my misophonia cost me? 

Adulting is hard, and misophonia doesn't make it easier. Without considering the emotional burden of misophonia—how do you calculate the cost of quality of life lost?—the bare minimum coping mechanisms are worth a sizable chunk of change. Opting to "suck it up," as so many misophones have unfortunately heard from less empathetic people in their lives, does not bode well either, as exposure therapy—especially unlicensed, socially ordained forms—may make symptoms worse. Avoidance, while often difficult and costly, allows for many with misophonia to navigate the noise-filled expectations of industrial life. And since stress has the potential to exacerbate misophonia symptoms, people with misophonia may need to prioritize self-care more than their neurotypical peers would. Thus, living with misophonia can contradict our modern understanding of productivity. 

In discussing the potential economic difficulties that impact people with misophonia, I'll first take the Walden-esque approach and disclose how misophonia impacts my own finances before addressing ways that I've envisioned it affecting others. However, I won't be including expenses that are not related to misophonia; I'm pointing out the actual cost, not how it relates to a particular budget or income. As my post about tiny houses would suggest, I do try to live modestly, and I don't always prioritize my own well-being as much as I probably should. And experiences with misophonia vary; the list of current and imagined expenses that I've accumulated based on my own activators, severity of symptoms, and coping preferences might not apply to you at all—misophonia is not a one-size-fits-all disorder.

I'll start with the stereotypical: earplugs, earplugs, headphones, and white noise machines. For people with auditory activators, finding and protecting that perfect spread of sound-reducing devices can be essential and incredibly expensive. (#EarplugRizz) The unfortunate rule of thumb for headphones and such is that the cheaper the product, the more often you'll have to replace it. And if you’re prone to losing your earbuds like I am, pay on a scale of how confident you are that you won’t lose track of them. (Miso-tip: buy a brightly-colored case or use neon duct tape to make it easier to spot your earbuds when they’re misplaced.)

If you're looking for recommendations, I have yet to find models for earbuds and headphones that I'd call home about. Heck, I'm even on the fence about whether to use ones designed for noise cancelling after a pair of earbuds treated me to some high-pitched feedback after six months of use.

CJ's 2023 Audio Costs: $336

Earplugs: $6

Earbuds: $219

Skull Candy Sesh ANC: $88

Lost one earbud, still using the other alongside second pair

Skull Candy Sesh Evo: $55

Lost

Skull Candy Sesh ANC: $76

high-pitched feedback, still usable when paired with the earbud from the other Sesh ANC

  Headphones: $94

Skull Candy Riff: $61

headband broke at the extender; still usable with two strips of plastic and binder clips to hold in place

JLab Studio: $33 

White Noise Machines: $17

Another expense that I leaned on for a long time was a subscription to a music streaming service for uninterrupted music and white noise. I paid for the student plan for Spotify for my first few years of college, but I've decided to cancel my plan since my auditory activators do not affect me much at this time. That being said, I've certainly been in situations (usually transportation-related) where I've needed constant noise, so I would suggest having some sort of in- or over-ear uninterrupted sound available. Purchasing certain albums to have downloaded on your phone or in an MP3 player might save money in the long run, but phone storage space is limited. Plus, MP3 player production has diminished over time, and you might need wired headphones to use them. But I’d think you’re cool.

While more options are out there, I'd recommend these two streaming services, and I've listed their prices for a year for a standard premium plan:

Spotify: $130 OR

Pandora: $120

While I do have other physical tools that I use in coping with misophonia, I do not often purchase nor replace these items, such as fidget toys, silent clocks, and paper plates. This category in particular may vary depending on the kinds of activators a person has.

Miscellaneous: $10

One of the largest yet proportionally impactful expenses related to misophonia is housing. Living on my own and knowing that I have a safe space to recover from activator-related distress makes a huge difference in my overall well-being, even if it eviscerates my funds. Since single rooms are a continued hot commodity in college dorms and I did not have sufficient documentation—which I'll touch on shortly—to justify priority room assignment, I shared a 16.5' x 10' (roughly 5 m x 3 m) space with a roommate for my first two years of college, and suffice it to say, those years seemed long.

While as an adolescent I had never lived alone, I always had a place in my house where I could escape from activators. In my dorm, my options stopped with the common area and the shared bathrooms. So, the coping continued past the classroom, and it quickly and regularly wore me down. Similarly, an apartment might be safest for some people with miso when they rent it alone.

Regardless, locating eligible roommates requires more fine-tuning. As might be expected, a single dorm room costs more, but the price can climb even steeper if single spaces are taken and you have to buy out a double: 

FHSU Single Dorm Room Cost Difference per year: $684

FHSU Double Dorm Room Cost Difference per year: $3903

Estimated Hays 2-Bedroom Apartment Added Cost w/o Roommate per year: $4800

Since classrooms are a likely setting for the presence of activators, students with misophonia may struggle to focus in their classes. Virtual learning environments may make it easier to mute or cover up activators. The pandemic encouraged the development of online programs, but they still lack the same resources—such as the increased scholarship support—of a traditional, in-person program. Online programs may in some cases be more competitive, and credit hours for online courses may cost more than on-campus ones:

FHSU Difference per credit hour: $55

Estimated FHSU Difference per year: $1664

FHSU Lost Scholarship Support per year: $1500-$15475  

Misophonia does not have a successful, evidence-based treatment at this time, but people with misophonia might benefit from seeking a mental health professional regardless to assist with other factors that may exacerbate their symptoms. And in applying for accommodations, some schools and workplaces might be picky about the types of documentation that they're willing to accept. soQuiet can help by writing an advocacy letter.

The Misophonia Provider Network provides a modest list of providers in a range of disciplines, including psychology and counseling, but not every state is represented. Though many of those mental health providers are available via telehealth, they can only offer their services to clients who are in the states for which they are licensed. And depending on the provider, insurance might not cover your appointments. If you are unable to locate a provider who is familiar with misophonia, find one who is open-minded enough to learn; a decent therapist should respect the research around misophonia once you present it to them even though the disorder is not in their diagnostic manual. Cost of care will vary depending on your insurance plan, chosen provider, and type of treatment needed.

Year of Biweekly Therapy w/o Insurance: $2340-$3900

The expenses that I've discussed here are by no means all-inclusive. For instance, I didn’t include added costs I haven’t yet needed for expenses like airplane ticket upgrades or at-home physical therapy, and people living in cities may have to pay more for personal space and consider differences like using a car instead of public transportation. 

More broadly, the income of a person with misophonia might be reduced because they have opted for a career with less exposure to activators, but life choices are more difficult to measure as they involve many factors unrelated to misophonia. In some cases, people with misophonia may even spend less than their neurotypical peers in avoiding social gatherings like concerts and movie theaters and making adjustments like cooking and cutting their hair at home.

Thus, the takeaway from these added expenses is not that misophonia is an irrefutable economic burden but rather that people with misophonia may have unique challenges when it comes to balancing their checkbooks and that areas like housing, healthcare, and education could stand to improve in their ability to accommodate misophonia, even in their pricing. Space and quiet are not yet a right, but as misophonia advocacy continues, perhaps more available, equitable options will arise.

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A response to the preprint of “Family Accommodation in Children and Adolescents with Misophonia”