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Restless, noise sensitive and can't even watch TV.
Jul 1, 2012

I've been HIV+ for about 12 years. I stopped taking my meds about one year ago due to severe depression. I recently got back on them (Sustiva and Epzicom). Even before restarting them, however, I experienced profound mental changes. I have become extremely sensitive to noise. Noises that don't generally bother most people (like the low hum of my neighbor's air conditioner) drive me crazy and agitate me to no end. Also, people's voices seem like nails on a chalkboard. As a result, I've withdrawn psychologically and socially.

Strangely, I cannot even watch TV or listen to music anymore. The sound just bothers me and makes me irritable, like it's an intrusion. My brain just doesn't seem to handle it well. After twenty minutes of TV, I have to turn it off. Crowds bother me. When I want to go out for a drink, I usually find a bar that has very few people in it and where the music is turned way down. I've also generated a bad case of social anxiety.

The bottom line is that I seem to have become painfully sensitive in all respects; I would call myself hypersensitive, to say the least. I just want to get away to as quiet a place as possible, but even then, I am bothered by a feeling of inner restlessness. I have no other physical symptoms (like headache or fever) other than an adrenaline rush (and rapid heartbeat) that occurs when I hear noise that bothers me or get into uncomfortable social situations. My "fight-or-flight" response seems to kick in quite regularly.

Two years ago, I returned to college as an adult student. The stress was utterly overwhelming for me, and I had terrible anxiety most of the time. I had been taking anti-depressants back then, but went off them because of some unpleasant side effects. I also smoked marijuana quite heavily for over a decade, and have had trouble staying away from it, as it is very effective at calming me and my emotions.

I always feel like I want to crawl inside a bark hole and hide from the world. Even when I sit still, I am not relaxed. Could this be related to my HIV, the meds, going off my anti-depressants, the long-term use of marijuana or something else? How did I develop such a heightened sensitivity?

Response from Dr. Fawcett

Thanks for writing. There are several varieties of the sensitivity to noise that you describe: misophonia (sensitivity to specific sounds ) and hyperacusis (difficulty tolerating everyday sounds), among others. Your symptoms seem more typical of the latter, although you should have an evaluation by an audiologist.

There is no evidence in the literature linking HIV with such disorders. They are more often linked to mood disorders, anxiety disor ders, and/or obsessive compulsive disorder. Individuals experiencing these sensitivities often develop the anxiety and social phobia that you describe, and stress can aggravate the symptoms. There are several types of treatments available: anxiolytic medications and several types of psychotherapy such as cognitive behavioral therapy and mindfulness. An assessment will help you better determine which route is best, but I would recommend one of the behavioral interventions first, simply because adding another drug to the mix (especially with a long history of marijuana use) isn't the best initial approach.

Good luck!

-David



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