Hearing voices or auditory hallucinations are one of the most common symptoms of schizophrenia. People with schizophrenia often hear voices, with an estimate of 70 to 80 percent hearing voices. It may sound as if someone is calling your name, arguing with you, or threatening you; these voices can originate from within or from outside; they may start suddenly and become louder over time.
Hearing voices is also experienced by people who suffer from mental illnesses such as bipolar disorder, borderline personality disorder, major depression disorder, post-traumatic stress disorder and schizoaffective disorder.
It is not as rare as we once thought for audio perception to be fooled. Approximately 10 percent of the general population report having heard their names called, especially in twilight hours as they fall asleep (hypnagogic) or awaken (hypnopompic).
Read: Split-Brain Syndrome
Is auditory hallucination normal?
Auditory hallucinations usually won’t be a cause for concern if you’re experiencing them just as you fall asleep (hypnogogic hallucinations) or as you wake up (hypnopompic hallucinations). Most people experience some type of hallucination at some point in their lives.
When you’re wide awake and experiencing auditory hallucinations, it could be a sign of a mental health or neurological problem, but that’s not always the case. If you are experiencing hallucinations or other symptoms, speak with your healthcare provider.
Schizophrenia and auditory hallucinations
Auditory hallucinations, typically hearing voices, are experienced by 75% of schizophrenia patients.
Psychotic disorders include schizophrenia as well as a spectrum of related conditions. Essentially, these conditions occur when a person feels disconnected from reality. It is possible for disconnections to manifest themselves in a number of ways, including hallucinations.
There are several characteristics of schizophrenia:
- Psychosis (disconnection from reality)
- Delusions (false beliefs)
- Behavioral and speech disorganization
- Having difficulty reasoning and solving problems
- Social and occupational dysfunctions
Several phases can occur during schizophrenia, although the duration and pattern of the phases may vary. The active phase of schizophrenia is more likely to be characterized by hallucinations.
Hearing impairment and hallucinations
Approximately 16% of adults with hearing loss experience auditory hallucinations, which can be classified as simple (tinnitus) or complex (speech and music).
Research shows you’re more likely to experience auditory hallucinations if your hearing impairment is severe.
Types of auditory hallucinations
Auditory hallucinations sometimes occur suddenly in some people. T.M. Luhrman, a Stanford professor of anthropology, described the experience of a young man who heard rats scratching behind his ears. His auditory hallucinations began rapidly and soon after he destroyed a number of rats’ nests.
Another young man heard a woman screaming that she was raped and asking for help outside his apartment. It is common for the voices to begin gradually and can sometimes appear as vague or fleeting impressions of hearing your name or someone talking to you. It could have been “someone called my name” or “people were talking in the hallway,” or, “I thought I heard something, but then I wasn’t sure.”
Schizophrenia patients hear voices and noises that become louder, meaner and worse over time.
Some examples of sounds you may hear include:
- Rattling sounds with repetitive repetitions
- Terribly loud, thumping music themes
- People yelling mean orders or comments
- Other people talking about you as if you weren’t even there
Read: False Memory Disorder
Research psychologist Eleanor Longden, who is diagnosed with schizophrenia, explains that hearing voices can tell you absurd things, such as pouring water over your head.
Voices with a repetitive, incessant, irritating quality can make people deeply distracted so that they will choose to follow their orders.
Those who give orders to harm themselves or others should be approached with extreme caution. Auditory hallucinations can be extremely frightening because the orders are usually screamed continuously.
People sometimes hear voices threatening death or harm from a secret organization, for example. These voices can be frightening and may make a person more likely to self-harm or act violently.
Causes of auditory hallucinations
It is not unusual for auditory hallucinations to be caused by mental illness, but there are a number of other reasons, including:
- Alcohol: When you drink heavily, you might see things that aren’t there. When you drink or stop drinking after drinking for a long time, you might hear things, too.
- Dementia and Alzheimer’s: The last stages of Alzheimer’s often result in hearing things. This is also a symptom of Lewy body dementia. The voices can sound so real that they appear to talk back to some people with this type of dementia. It’s more common to see things — visual hallucinations — than hear them.
- Brain tumors: Being able to hear things is not an indication of having a brain tumor. However, it is possible for a tumor to affect hearing if it is located in the hearing part of the brain. In some cases, people have reported hearing voices.
- Drugs: You can hear and see things that aren’t there when you’re under the influence of some street drugs, such as ecstasy and LSD. You can experience it when using them or when you stop using them after long periods of usage.
- Epilepsy: Epilepsy seizures can cause a buzzing or melodic sound to be heard when the brain area responsible for hearing is affected. You can sometimes hear things less clearly or loudly when you’re affected by it.
- Hearing loss: Hearing loss can result in a variety of bizarre sounds, including music and voices that are not real.
- High fevers and infections: Encephalitis and meningitis can cause hearing problems as well as other symptoms. High fevers can also cause hearing problems.
- Intense stress: Hallucinations can be caused by serious stress, such as when you have gone through something traumatic. Hearing a loved one’s voice is especially common after they have recently died.
- Mental illness: People with schizophrenia often hear voices. The voices may sound like they’re coming from within or outside of your head, like from the TV. They might tell you what to do, argue with you, or just explain what’s going on. It can also happen when you have another mental illness, such as:
- Migraines: You often see things when you have migraines with auras. Other people hear sounds instead. Usually, they hear voices. Depressive people are more likely to hear voices.
- Parkinson’s disease: Parkinson’s may cause you to see things that aren’t there. Occasionally, you may hear things from what you see.
- Side effects from medicine: Changing a medicine or having your doctor increase the dose of something you already take could cause you to hear things. People who take more medicines are more likely to develop this illness and it most often affects older adults.
- Sleep issues: A sound may be heard just as you are falling asleep or waking up. Usually, it’s nothing to worry about. If you suffer from narcolepsy or insomnia, falling asleep randomly is more likely to happen.
- Thyroid disease: Myxedema is a rare disorder in which your thyroid does not produce enough hormones, resulting in dangerously low levels. You can also hear things when you’re suffering from this life-threatening condition.
- Tinnitus: Tinnitus isn’t thought of as a hallucination by doctors when they hear the usual ringing or hissing. Still, you may be at risk of developing it. Depressed people are at a higher risk of developing it.
Hearing voices treatment
Those with schizophrenic voices typically require a combination of medication, therapy, and other procedures if treatment is resistant.
- Antipsychotics: Studies have shown that these antipsychotic medications can significantly reduce auditory hallucinations.
- Cognitive-behavioral therapy (CBT): CBT can help people cope with and quiet schizophrenic voices when used in conjuction with medication to lessen the emotional stress caused by the voices. When the voices begin, for instance, hum “Happy Birthday” or read a paragraph backward.
- Repetitive transcranial magnetic stimulation (rTMS): With repetitive TMS, a tiny magnetic device is placed directly on the skull. People with schizophrenia have reported fewer auditory hallucinations when taking the drug.
- Electroconvulsive therapy (ECT): ECT is a last-resort treatment used to reduce the severity of auditory hallucinations, and it is applied by applying a short electrical pulse to the scalp to induce a seizure.
For caregivers and loved ones
It can be difficult to cope with a loved one who struggles with schizophrenic voices but does not give up hope. You may be able to help your loved one control this condition with the right treatment. It may also be beneficial to explore family therapy, which can provide the support you need to identify and cope with these auditory hallucinations.