Hearing voices is a form of auditory hallucination common in some psychiatric disorders, such as schizophrenia.
Hearing things that aren’t there happens. Our minds are talented at tricking us sometimes, filling in the gaps when we catch only bits and pieces of sensory input.
Thinking someone called your name when they didn’t, for example, can just be the result of natural acoustics. It doesn’t necessarily mean you’re living with a mental health condition.
However, when you experience auditory hallucinations in the absence of external factors, more than a trick of sound waves may be to blame.
Auditory hallucinations, aka paracusias, occur when you hear sounds that aren’t actually there. These sounds could be in the form of voices, or they may be everyday noises such as a television playing in the background.
Hallucinations are a primary symptom of psychosis — a condition that occurs when your brain experiences a break from reality. They can also be a symptom of mental health conditions such as schizophrenia and dementia.
Auditory and visual hallucinations are the most common types of hallucinations.
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Any sound without stimuli can potentially be an auditory hallucination.
Common forms of auditory hallucinations include:
- background noises
- incoherent sounds
- garbled words
- distant speaking
- threatening or hostile voices
- self-harm voices
- whispers
- shouting
If you’re living with schizophrenia, your auditory hallucinations may represent internal thoughts and emotions.
According to 2003 research, voices experienced by those living with schizophrenia are often the externalization of internal conversation. This can become more pronounced in later stages of the condition.
The exact cause of auditory hallucinations is still being explored.
Changes in the brain may influence your chances of experiencing an auditory hallucination.
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Researchers are still unclear why auditory hallucinations shift over time, happen spontaneously, or eventually stop completely.
There’s also no indication of why hearing voices is predominantly seen in some mental health conditions such as schizophrenia, as opposed to other neurological conditions such as Parkinson’s disease or epilepsy.
In a 2021 study, researchers noted a number of factors in schizophrenia that could be involved beyond those affecting the auditory and language areas of the brain.
These factors include:
- genetics
- changes in your levels of glutamate, a neurotransmitter that sends messages in the brain and nerves
- electroencephalographic (electrical energy) alterations in the brain
- changes in the white matter of the brain
- cortical structure (the outer layer of the cerebrum, the largest and topmost portion of the brain)
If you’ve experienced an auditory hallucination, speaking with a healthcare or mental health professional can be essential to learning whether it’s a singular occurrence or if there’s an underlying cause.
During your initial evaluation, the professional may ask you questions related to:
- your experience
- current mental well-being
- factors occurring around you at the time
- your medical history
- substance use
- trauma exposure
- family mental health history
To rule out physical factors, a healthcare professional may suggest laboratory testing, such as blood tests, or diagnostic imaging.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), a mental health condition may be present if hallucinations:
- are present for the majority of time during a 1-month period
- consist of a voice with running commentary on thoughts of behavior
- involve two or more voices conversing with one another
- cause significant impairment in daily function
- are continuous for at least 6 months, including 1 month of consistent symptoms
- are not the result of substance use or physiological factors
Treatment for hallucinations often involves addressing the underlying mental health condition.
While you work with a mental health professional on a strategy for managing your symptoms, certain treatment aids — such as antipsychotic medications — can also help diminish your symptoms.
Other treatment options that might help include:
- cognitive behavioral therapy
- transcranial magnetic stimulation
- electroconvulsive therapy
Hallucinations can be a challenge to manage. Many times you may not know that what you’re hearing isn’t real in the moment.
Realizing you’re experiencing auditory hallucinations is often key to managing them. You can start to question what you’re hearing, especially if it seems out of place given the situation.
If you live with schizophrenia, you can try to manage auditory hallucinations by:
- taking all medications as directed and on time
- having go-to distraction options (e.g., painting, listening to music, playing a game)
- reminding yourself you may be experiencing an auditory hallucination
- calling a friend and telling them the voice is currently active
- practicing rational responses to what you hear
- using a voice diary
- reminding yourself you don’t need to do anything the voices say
- writing down positive affirmations about yourself
Auditory hallucinations are sounds, voices, or noises that occur in the absence of stimuli.
If you live with schizophrenia, auditory hallucinations such as hearing voices are not uncommon. With treatment and support, you can learn to manage and reduce the severity of your symptoms.