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Hearing Voices

Question:

Dear Dr. I am a mental health worker. I work with several clients that hear voices. Can you explain where these voices come from, and is there any treatment

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

Hearing voices is referred to as auditory hallucinations. People can have those and many other types of hallucinations such as visual, olfactory (smell), taste, and sensation (pain, etc).

Along with hallucinations people with a psychotic illness experience delusions. Delusions are disturbances in the way a person with a psychosis thinks. Just as hallucinations are not real, delusions are ways of thinking that are not based on reality.

For example, a person with a psychotic illness may hear voices telling them to do something. Along with the hallucinations they will have delusional thoughts that the FBI is out to arrest them or that someone in the neighborhood wants them poisoned. Delusions of this type are called paranoid because the patient falsely believes and lives in fear of harm being done to them. The auditory hallucinated voices may warn them to seek safety.

These delusions and hallucinations are the result of the brain malfunctioning. The human brain is made up of approximately ten billion neurons or nerve cells that have many functions one of which is to carry messages back and forth from the outside world to the inside and to many organs in the body and, most importantly, to and around the brain. The transmission of these messages is important because they allow us to see, hear, feel and adjust to things happening outside of our bodies and inside of our bodies. A complex system of brain chemicals called neurotransmitters help carry the messages across the ten billion nerve cells to the parts of the brain that make sense of the information. This is what happens when we read this page or when we speak to someone or watch television, etc.

In the case of psychotic illnesses we know that many of the ten billion neurons do not work correctly and that the chemicals or neurotransmitters are not correctly balanced in the brain. As a result all the information becomes distorted for these patients. One of the distortions is that these patients hear voices or have the other symptoms described above.

What it is important to understand is that because the neurons are sick and the chemicals are out of balance these patients really do hear voices just like you hear your friend speaking to you during a conversation. In other words, someone who hears voices does not imagine them but really, really hears them, and the same with the other types of hallucinations.

Very powerful anti psychotic medications are used to help these people no longer have hallucinations or to have them with less intensity. Along with individual and group psychotherapy, usually in some type of full day hospital or agency program these patients can learn to understand what is happening to them and to control their symptoms. However, even with medications these people remain fragile. They need to experience as little stress as possible or their symptoms can return even with medicine.

I hope this information helps and thank you for your important question.

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Comments
  • Carson Franklin

    Hello Doctor I started hearing voices 2 yrs. ago.I am 59 years old. These voices can go back in my memory bank and put me in a certin place when I hear a song. Exact feeling that I felt 40 yrs. ago. I guess what I am saying is What I felt like inside exactly 40 yrs ago. Same smell and feeling. This voice can imatate any movie starrs voice. I can't do this how can he. I am Bipolar and this voice is driving me nuts like I think about death alot. Could you explain how does it do this. One more thing this voice can rub me sexaully. I mean I don't move a mussle and it can do this. I could go on forever. Please write back. Thank You, Carson

  • Anders

    I hear voices when Im under pressure or concentrating really hard. They are always angry and I cannot hear what they are saying but they surround me and scream. This makes it very difficult to concentrate on what I'm supposed to be doing. I first heard them about a year ago when I had a nightmare and they were in it. Then I woke up and they were still there.

    I have exams approaching and I need to be able to concentrate. Can you help me?

  • Anonymous-1

    what if you can here people but they are far away like they are yelling but you cant make it out

    Editor's Note: Voices can sound faint like that, or they can be clearer, too.

  • Erika

    Does the medicine have anything to do with hearing voices? I stopped my medication (olanzapine) for 4 months then I went back again. I've been with my medication for a week now, and I just started hearing voices awhile ago. I wasn't hearing voices when I wasn't with my medication.

    Editor's Note: Generally, medications like Olanzapine (brand name Zyprexa) will reduce the intensity and frequency of hallucinations. If I understand correctly (translating your double-negative), however, you found that you experienced hallucinations while on the medication but not when you weren't taking it?

  • lisa

    i have suffered extremly violent hallusanations for 17 years no one can seem to diagnos my condition, i am on 4 different medications that do help but i still dont know whats wrong with me any ideas?

  • Tony

    At the age of 20 I had a breakdown and was admitted (voluntarily) to psychiatric hospital for 3 weeks. I did not return to my university studies for a year. At the time I was having severe panic attacks (hyperventilation) to the point where I could not stand, my muscles would clench, and I would feel a hot prickly/tingling sensation all over - pins and needles. During these attacks I would be almost oblivious to surroundings and people who were trying to help me and talking to me seemed to be distant voices. I also heard other voices, not during the panic attacks, but on and off at any time of the day or night.

    They were sarcastic and threatening but in a matter of fact way. I would be talking with someone and they might say I'll see you in a fortnight - the voice would cut in and say (for example) "You'll be dead by then". I had regular suicidal thoughts and made one attempt - overdosing on my anti-depressant medication. The voices would mock me, or simply pass observation on events. After a while I just began to accept what the voices said and started to become detached from things I was doing, almost like I was an observer watching myself and continually being told that I would not be here much longer.

    At the age of 50 I again succumbed to severe depression. I went through a stretch where I had to continually resist suicidal thoughts. I was off work for more than 12 months and lost my job as a result. I am still on medication and objectively all the signs are that I am improving. But a week ago I was at a lecture. The lecturer said that a certain project would be completed within two years, and the voice that I had not heard for 30 years just jumped into my head and said "You'll be dead by then".

    I have a family to support and I am concerned that if I tell my psychiatrist and he starts changing medication again, I will go through more adjustment problems and lose the new job I have. I am hoping that if I ignore the voice and focus on getting better and off the medication it will just go away.

    I'd welcome your comments - and I acknowledge and understand the disclaimer on your web site and recognise that you are not in a position to offer me other than very general comments.

    Thankyou, Tony.

  • Karito

    hi i started hearing voices like 3 years ago, i had many surgeries which involved of not being able to have family in the future, i started by hearing a cry and then i heard children playing and i even felt them near me. But after a while a heard adult voices telling i was a bad person and that i will never have children i went to a psychologist (pardon my spelling) and he told me i had depression and told me to take a short vacation which i did, but i didnt help i still hear the voices and i hear babies crying, and even some of them tell me that they dont want to be my children because im evil, im scared of sleeping and from dark because i feel somebody watching me and laughing at me so i always sleep with the tv on and im going nuts i cry a lot during the night and feel like if im going crazy, because i dont know how to get this away from me... plz help

    ps: please if u can send me your reply to my e-mail

  • Anonymous-2

    sometimes when there is some event approaching that i am stressed about or when i am in a stressful situation i start to hear voices but its my own voice and its in my head. Its like my own thought are talking to me and screaming at me.. and even tho its my voice I can't control what it is saying. And then every noise that i hear sounds angry.. I don't know how to explain it, and when people talk to me it sounds like they are angry and screaming. It makes it so hard to concentrate and I can't make it stop.

  • Anonymous-3

    I have a 10 year old step son that was diognosed with adhd and add 2 yrs ago on schools advice,,, parents did not notice!!!!!!!!!!!!!! anyway, he hear voices, telling him to touch blades on knifes, and he can control fire, and that the telephone tower on our land is going to kill him cuz he cant control it, he recently was suspended from school for the" second" time this year because he threaten to KILL the teacher!!!!!!! yes,,, kil his teacher,,, twice, this year! , his mother didnt feel like he should be punished because ""he did not mean it"" my husband feels he needs the school to beat his but right then, but I feel there is a bigger problem and need your help to know what is best,he has been hearing voices since i have known him at age five but neither parent will admit this nor do anything about it!!!! they act as if hes this perfect angel who never needs disapline nor is there anything wrong with him ,,, but everone that meets him can tell hes not normal!!! his teachers said she is concerned about his behavier !!! are we headed for another calenbine??? how can I get help for these teachers and others around this child that no one will get help for???? I feel they have reason to be alarmed, and his mother and father are ignorant!!!!! I also have two children and they are exposed to his behavier, I get scared that these voices might tell him to kill his brother while hes sleeping???my step son is obsessed with death,,,,,, he talks about it offtin and" how scared he is to be killed"not die, but be killed he is so strange,,, how thes parents not see this???? please help me many more stories I know this child is not normal for lack of a better word something is wrong with him but I am they only parent wanted help for him,,, please give me some sort of advice??? and e-mail me. or tell me what he needs . why is hearing vioces???? and why the word "kill" so often in his volcabulary???are my children in danger??????????help???? concerned stepmother

    Editor's Note: If this child is hearing voices, his issues are more extensive than ADHD (which never involves voices). Voices, which are auditory hallucinations are most commonly symptoms of a psychotic disorder (such as schizophrenia or schizoaffective disorder). This child should be evaluated as soon as possible by a psychiatrist who may prescribe medications which have a good chance of lessening the intensity of the voices, and hopefully, the intensity of the violent thoughts as well. Tell the psychiatrist about the violent themes in your son's thoughts so that this material can be taken into account.

  • MArlboro

    i am hearing voices from 3 years everyday i am sick off them anyways to remove them

  • beth

    I have BiPolar and am in remission. My partner is Paranoid Szisophrenic (sp). We have been together for 3 years now. On top of her hearing voices she also suffers from migrains. Going into the dr every day for a shot of hydromorphone is something I am not comfortable with. As a caretaker for her more than anything right now how can I stablize her to the point of her being able to get some kind of relief for these.

  • Anonymous-4

    My 16 year old daughter was diagnosed with adhd at the age of 11. The doctor also suggested that she may have Aspergers Syndrome. She has shared with me that she is hearing voices in her right ear. She can't make out what they are saying but she will try and ask them what they want or will try to make them go away. The only thing that she can make out of what they are saying is her name. She is very immature for her age and is very uncomfortable in social situations. It is very difficult for her to make friends and she is isolating herself. I am very worried for her. Is she at risk for schizophrenia? What can I do to help her? Thank you.

  • Anonymous-5

    One night about a year and a half ago I awoke to find that the left side of my body was numb. I didn't try to move, but lay there thinking "is this the end". I remember being very calm throughout the experience. I can't be sure how long I lay there before the sensation gradually faded away, but afterwards I was able to get out of bed and walk to the kitchen without difficulty to get myself a drink of water. I then returned to bed and fell back to sleep.

    In the weeks that followed I began to notice that I was having problems with my speech, often slurring words if I spoke quickly. I simply adapted by slowing down and being very aware of my speech. Then sometime later I was lying in bed just looking up at the ceiling waiting to fall asleep when I suddenly became aware of what sounded like someone’s voice, although I could not make out what they were saying. I wrote the experience off to being tired and reading too much into the sound of the ceiling fan above my head.

    Jump ahead to the present. I now hear voices all the time. My perception is that many people are taking turns talking to me, with the majority of the conversations occurring in the background noise around me. At times these voices have been close to my ear and matched the quality of sound and clarity one would expect if a person were actually speaking to me, but rarely do these instances of realistic sounding speech last for more than just a few words.

    Sometimes the voices sound like they are coming from inside my head as if they were my own inner voice, but words are directed towards me, as if someone else were speaking them to me.

    The voices have been those of men, women and children. They seem to vary in age and race. They are all English speaking, although some have accents, both regional and ethnic.

    I often awake in the middle of the night to find they are talking to me, and may have even been the reason I woke up.

    In the beginning I felt very stressed by the experience. I felt that I could not be sure whose voice I was listening to, theirs or my own inner voice. Rather than let the experience have a negative effect on my life I chose to take the position that all internal voices I hear are not my own, and that I do not respond to the voices, I do not answer them nor do I ask them questions. Odd as this may sound, it puts me in the position to observe what is being said and to make judgments as to what I believe or do not believe. I should make it clear that the voices are not negative in fact they tend to focus on my self-improvement more than anything else.

    I have considered seeking medical assistance, but decided against it for fear that I would be diagnosed before I could even try to relate my experiences. I am currently attending a university studying engineering and do not want to jeopardize my future job opportunities.

    I found my peace by taking a positive attitude towards my experiences. Perhaps I will even switch majors from engineering to psychology.

  • Rach

    When i was about 5-6 I started to hear voices somethimes when I was going to bed, or reading or in the middle of the night. They were always yelling at me, alot of different angry voices,( I think they were putting me down, but I'm not sure) they pretty much stopped by the time I was fourteen. My 6 yr old son has been having nightmares but always says he can't remember them. I have just found out they are the same, I was hugging him and he was telling me they are still here. he seems reasured that the same thing happened to me. what could be causing this? In my case it also came with a feeling of heaviness and a hightened sense of hearing - like when the pages of a bookwas turning the sound was magnified

  • joe peach

    I hear these noises or music all the time. Some times I even get out of bed and search the whole house for the source. Needless to say I find no source of the music. This is real annonouying and drives me crazy because no one else can hear it. So whats wrong? oh yeah Ido not hear anything telling me hurt myself or any one else. I thought you might what to know this. Thanks will wait for your responce. e-mail ok too. (this is my wifes e-mail ok?)

  • Sarah

    Hi

    I searched hearing voices on this page because I was interested in what used to happen to me when I was a kid and heard voices in the night. There's a few people here that have talked about hearing faint voices or like a radio is playing. Both me and my mother have heard voices like this when we were suffering from extreme anxiety, I believe insomnia has a part to play? It's just that I've talked to a lot of anxious people that are terrified when they begin to hallucinate and think they are schizophrenic so I wanted to add this. Dr, am I right to say that hearing voices can be the result of many, many things and bad anxiety is one of them?

    When I was a kid, (from about 4 to 10) I would hear voices when I went to bed. In my mind's eye, I could see llashcards coming up with numbers on them. At first I sort of accepted it as real, like you do in a dream, but my eyes were open and I was awake. In my head, I would read the flashcards out. When I did that, around 5 or 6 echoey adult voices would repeat the number. It was easy at first, but then the cards would swap faster and faster and faster and when numbers like 1,345,987,348,609 started coming up, for example, I couldn't do it. At this point the voices would start shouting at me very quickly. Screaming random numbers at me, angry that I couldn't keep up. I would run downstairs in tears to see my parents and the numbers would continue for a while until I was able to focus my attention on my mother's voice and they would fade away. At the same time as all of this, I had a strange disconnected feeling. I could barely hear things on the outside of my body, they'd be drowned out by the loud noises in my head. Sounds on the outside were distorted. Sounds like rustling when someone touched a plastic bag or something was painfully sharp while sounds like other people's voices sounded extremely distant.

    I always wondered what this was and I wonder if anyone here could tell me. I was reminded of it recently when I read a newspaper interview about sleep and a radio presenter described hearing voices just like mine when he was young, but said they'd been replaced as an adult by his own anxious thoughts chattering away, which he feels powerless to stop. This is exactly my experience.

    So my reason for writing this was that I believe voices does not equal schizophrenia exactly and that hallucinations can have many causes. But I'm also very interested to know - for kids like I was, is that just the beginning of anxiety? I have suffered anxiety all of my life but my childhood symptoms were more alarming (I had visual hallucinations sometimes to but these were rare) and they slowly faded away to be replaced by normal anxiety symptoms when I was in my preteens.

    Thanks

  • Anne

    My 18-yr-old daughter is now in her 2nd clinical depression and has had to drop out of university. She has been hospitalized several times, as a result. She has been hearing an abusive, threatening male voice sometimes, and she identifies it as some sort of dissociative voice. The voice tells her to kills herself or to hurt her loved ones. She tries to ignore it but is very frightened by it, especially because she knows that it comes from her own psyche. She is a smart girl and so she feels very panicked about what the existence of this voice must indicate about her sanity.

    Obviously, we are afraid that this is the early stage of schizophrenia. Could you please explain whether there are any other possible causes? Could it be the depression itself that causes this?

  • Miss kimberley Nelson

    Hi

    Im hearing whispering in my bedroom i thinking i may be going mad im diagnosed with severe diagnoise but i dont think i have i went through two abuses neglected unloved all my life had my children taken through a family member lying about me i was forced to drugs years ago am i going mad at night where i live im hearing whispering in my bedroom but theres no one there i darent tell anyone if i do who ever i tell think im crazy i do have a pychatrits. i dont know what to do.

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