Your Perception of Sound is Valid
I think I've mentioned this already, but one of the problems of misophonia and hyperacusis is that they can be very isolating. Why? Because it's negatively warping your perception of sound in such a way that nobody else is hearing. And especially if the person has not yet realized that they have a hearing disorder, when they react negatively to the sound that nobody else even notices, it can drive them crazy! Because in their mind, they're being overwhelmed by sounds that other people have no problem with, not knowing that the perception is very different.
Here's the thing. Pain will already make you more sensitive to all of the different factors in your environment. But hyperacusis and misophonia both mean that your brain cannot filter out background sounds - it's focusing on them the same way to focuses on the sounds you're supposed to be hearing. So when your brain is getting all that feedback and information at once, it gets overwhelmed very easily in situations in which a person with normal hearing would have no problem.
Something interesting I've noticed about this factor is that people with hyperacusis and misophonia tend to have excellent hearing. Ironically enough, however, it will end up seeming like they have very bad hearing. I'm going to explain it the best way I can:
Imagine you're walking on the street with somebody that has hyperacusis. Assuming you have normal hearing, you're still hearing all of the sounds that are going on in the street, but they're not your focus. Your brain can successfully push these sounds to the back burner, so that you're aware of them, but not trying to actively process them.
A person that has hyperacusis either cannot do this at all or cannot do it at a high enough level. This means that all of the sounds in an environment - cars honking, doors opening, footsteps - they're all being heard on the same level as the conversation you're having with that person! They can't push sounds to the back burner. Either their back burner is too small, or all of their burners are in a row in front of them, and they have to look at all of them at once. They have no back burner.
Now, this is not to be confused with misophonia. In the case of a person that only has misophonia, they might be able to push sounds to the back burner - except for their trigger sounds. These sounds are on the back burner until they are noticed. They are then involuntarily pulled to the front burner so quickly that they spill on the person with misophonia, leaving them with scalding burns and a friend that wants to know "why you're being so dramatic, they're just eating."
So, to everyone with misophonia and hyperacusis: if anyone tells you you're being dramatic, or something's not that loud, or whatever, ignore them. Your hearing is different, so your perception is different. Perception is reality. They aren't experiencing what you're experiencing.
-Keep on feeling the love,