Voices a Sign of Schizophrenia?

By Kristina Randle, Ph.D., LCSW

I am a 22 year old woman who has dealt with mental health problems for most of her life. I was diagnosed with depression at a young age and still get depressed from time to time. My question though, is about recently problems. I have been having internal auditory hallucinations for a long time. They are like real loud thoughts, but each has its on unique sounding “voice”. Sometimes these voices are silly or give commentary on things, but sometimes they can criticize me or repeat words like “freak” or “your stupid”. I also have had these strange fears at night. For example, I kept thinking about the singer Kurt Cobain one night. I started to get worried that he would be mad at me and that I would see him in my room. I am always worried that i will see dead bodies or that ghost will come after me. I know that these fears are irrational most of the time. I have a family history of mental illness and psychosis. When I told my psychiatrist about it he said it sounded like anxiety or OCD. I see a therapist regularly and have been prescribed celexa, and seroquel to help with depression and the voices. My worry is that, since there is a family history of psychosis, that my symptoms will develop into a severe illness like schizophrenia. Do my symptoms sound like the beginning of schizophrenia, or do you agree with my doctor that this is a form of anxiety or OCD. Thank you so much for taking the time to read this I know you must be very busy. Your advice is greatly appreciated !

A. This is a difficult question to answer. Many people describe having an “inner voice” that they hear on a regular basis. It is quite normal. On the basis of a short letter, it is difficult to distinguish that inner voice from the voices associated with psychosis.

Individuals with schizophrenia (or other psychotic disorders) who hear voices often describe them as being external. In other words, the voices they hear are not their own. They seem to be the voices of others. They also tend to be derogatory in nature. The voices you hear are sometimes derogatory and critical. The latter would be consistent with the types of voices heard by individuals with schizophrenia or other psychotic disorders.

Having said that, you are presently being treated for depression and other symptoms. Anxiety commonly occurs with depression and OCD. Low self-esteem is also related to depression, anxiety and OCD. The derogatory nature of the voices could be related to depression, anxiety or OCD.

Having family members with serious mental illness can increase the likelihood of your also developing one but generally speaking the risk is slight. Whether or not you will develop a mental illness can depend on many factors, such as biology, drug use, traumatic experiences, environmental conditions, and so forth.

In summary, it is possible that the voices you hear are a sign of schizophrenia or other psychotic illnesses. Your treating professionals (who are familiar with your case) do not think so. They do not believe that you are developing a psychotic disorder and I find this to be good news.

I would encourage you to read more about the experiences of individuals with anxiety, OCD, depression, and psychotic disorders. It might help to answer your remaining questions. I hope this helps. Please take care.

Dr. Kristina Randle

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Last reviewed: By John M. Grohol, Psy.D. on 26 Jun 2011

APA Reference
Randle, K. (2011). Voices a Sign of Schizophrenia?. Psych Central. Retrieved on December 20, 2014, from http://psychcentral.com/ask-the-therapist/2011/06/26/voices-a-sign-of-schizophrenia/