What Are Auditory Hallucinations?
Auditory hallucinations are when you hear voices or other sounds that no one else hears. They can be stressful, especially if the noises never stop or the voices say mean things to you. But auditory hallucinations aren’t always scary.
Examples of auditory hallucinations include hearing:
- One or more voices (auditory verbal hallucinations)
- Music
- Nature sounds
- Animal noises
You may also hear general background noise, and the voices or sounds may be loud or quiet.
Schizophrenia and Auditory Hallucinations
Schizophrenia is a serious mental health condition that affects how you think, feel, and experience the world around you. When you’re awake, you may have trouble telling what’s real from what’s not.
Up to 80% of people with schizophrenia say they have auditory hallucinations, with hearing voices being the most common. These are usually different from the inner voice that nearly everyone has. These voices may sound like someone is trying to have a conversation with you or around you.
Auditory hallucinations with schizophrenia are often threatening or abusive but can sometimes even be pleasant or encouraging. You may hear godlike voices or those of public figures. Some may ask you questions or order you to do things.
Other Causes of Auditory Hallucinations
Schizophrenia is one of the most common causes of auditory hallucinations, but there are many other reasons you might hear things that aren’t there, including:
Other mental illnesses. Hearing voices can sometimes happen with other mental illnesses as well, including:
- Anxiety disorders
- Bipolar disorder
- Borderline personality disorder
- Dissociative identity disorder
- Major depressive disorder
- Posttraumatic stress disorder (PTSD)
- Schizoaffective disorder
Alcohol. Heavy drinking can cause you to see things that aren’t there. You might also hear things as you drink or when you quit after you’ve been drinking for many years.
Alzheimer’s disease and other types of dementia. You’re more likely to hear things in the later stages of Alzheimer’s. A similar condition called Lewy body dementia can cause it, too. But it’s more common to see things (visual hallucinations) than hear them with this type of dementia.) For some people, the voices seem so real, they talk back to them.
Brain tumors. Hearing things doesn’t mean you have a brain tumor. But it could happen when a tumor is in the part of the brain that deals with hearing. You might hear anything from random sounds to actual voices.
Drugs. Certain street drugs, such as ecstasy and LSD, can make you see and hear things that aren’t there. It can happen while you’re using them or when you quit after using them for a long time.
Epilepsy. When seizures from epilepsy affect the brain area that controls hearing, you might hear a buzzing sound or voices. In some cases, it warps how you hear things, so they’re not as loud or clear.
Hearing loss. People with hearing loss in one or both ears may hear anything from odd sounds to music and voices, none of which are really there. You’re more likely to have auditory hallucinations with more severe hearing loss.
High fevers and infections. Some infections, such as encephalitis and meningitis, can also make you hear things, along with the other symptoms. The same is true for high fevers. Older people who get urinary tract infections (UTIs) sometimes also get auditory hallucinations.
Intense stress. Serious stress, such as that after a traumatic experience, can cause hallucinations. It’s especially common to hear the voice of a loved one after their recent death.
Migraines. Often, if you get migraines with auras, you see things. But some people, including those who have migraine without aura, hear things instead. Usually, it’s voices. And that may be more likely if you also have depression.
Parkinson’s disease. You’re more likely to see things that aren’t there when you have Parkinson’s. But in some cases, you may also hear things that seem to come from the scenes you’re seeing.
Side effects from medicines. Starting a new medicine or increasing the dose can also sometimes make you hear voices. It most often affects older adults. Also, the more medications you take, the higher the risk.
Sleep issues. It’s pretty common to hear a sound just as you fall asleep or wake up. And it’s usually not something to see your doctor about. But if you fall asleep randomly (narcolepsy) or have a hard time falling asleep (insomnia), it’s much more likely to happen.
Thyroid disease. Myxedema is a rare condition where your thyroid is not making enough hormone and your levels get dangerously low. It’s a life-threatening condition that can also make you hear things — a condition called myxedema psychosis.
Tinnitus. Doctors don’t think of the usual ringing or hissing of tinnitus as a hallucination. But this condition can raise your risk of hearing voices or sounds (like music). It may be more likely if you also have depression.
Diagnosing Auditory Hallucinations
Not all auditory hallucinations are linked to a psychiatric disorder or medical issue. Sometimes, there’s no clear explanation. However, do consult your doctor to check for any health issues that might need attention.
To diagnose auditory hallucinations, a doctor or therapist may ask questions such as:
- Do you hear voices? What do they say?
- Do you hear other kinds of sounds? How often?
- Does hearing voices or sounds affect your daily life?
- Does anything bring on your hallucinations?
- Do you feel unsafe when you hear voices?
Other steps they may take include:
Medical history and physical exam. They’ll want to know about any current or past health problems. Bring up any personal or family history of schizophrenia or similar mental health conditions.
Blood tests. Your doctor may order a round of routine blood tests to check for conditions that may cause auditory hallucinations, including thyroid problems, alcohol, and drug use, or any medications that may cause schizophrenia-like symptoms.
Brain imaging. Your doctor may use MRI or CT scans to look for tumors or other changes that might cause you to have auditory hallucinations.
You may need other tests, including an assessment for hearing loss.
Auditory Hallucinations Treatment
Treatment for auditory hallucinations depends on what’s causing them. You may need:
Medications for auditory hallucinations
Your doctor might prescribe medication to help control the condition that’s causing you to hear voices or sounds, including:
- Antipsychotics. These medications block dopamine, a brain chemical linked to hallucinations. They’re usually the go-to treatment for mental health conditions such as bipolar disorder and schizophrenia.
- Antidepressants and mood stabilizers. These can sometimes ease auditory hallucinations caused by serious depression or mania.
Psychotherapy
These types of talk therapy are commonly used to manage auditory hallucinations or how you relate to them:
- Cognitive behavioral therapy (CBT) for psychosis
- Compassion focused therapy (CFT)
- Acceptance and commitment therapy (ACT)
- Trauma-related therapy
- Mindfulness-based cognitive therapy (MBCT)
Talk therapy can help reduce anxiety, stress, or confusion about auditory hallucinations, even if the voices or sounds don’t completely go away. A therapist might also teach you ways to respond to the voices, a technique sometimes called voice-dialoguing, talking with voices, or CBT for voices.
Distraction techniques
You may notice your auditory hallucinations less if you pay attention to something else when you hear them. This is also called attentional avoidance or attentional focusing.
Here are some things you can do to distract yourself:
- Try to relax. Take slow, deep breaths, or count them if it helps.
- Listen to something else. Turn on music, a podcast, or an audiobook.
- Stay busy. Cook, exercise, watch TV, or focus on another activity.
- Be creative. Draw, take pictures, write, paint, dance, or play an instrument.
You can also try grounding exercises, such as the 5-4-3-2-1 technique: List 5 things you can see, 4 things you can touch, 3 things you can hear (other than your voice), 2 things you can smell, and 1 thing you can taste.
Hallucination-focused integrative treatment (HIT)
This is a specific type of therapy for hearing voices. It combines medication, coping strategies, CBT, family therapy, and other methods to help you manage your hallucinations in a safe and supportive environment.
Treatment for other medical conditions
Your auditory hallucinations might stop if your doctor finds and treats what’s causing them. This could involve helping you get enough sleep, fixing hearing loss, adjusting medications, or, in some cases, surgery to remove a brain tumor.
If drug or alcohol use is the cause of your hallucinations, substance use treatment may help get rid of them.
Auditory Hallucinations Complications
If left untreated, auditory hallucinations may cause problems in your life or the lives of your loved ones. Some complications may include:
- Isolating yourself from friends and family
- Trouble concentrating
- Depression or anxiety
- Paranoia
- Self-harm or suicide
- Hurting others
People who hear voices sometimes lose control over their actions. Tell a loved one or get medical help right away if you think you might hurt yourself or someone else. Call 911 or the 988 Suicide & Crisis Lifeline to reach someone 24/7.
Takeaways
Auditory hallucinations can have many causes. Not all of them are serious. But if they’re new or don’t go away, it’s important to talk to your doctor about them. Your symptoms could be linked to a mental health condition, such as schizophrenia or another hidden medical issue.
No matter the cause, there are ways to manage auditory hallucinations. Treatment for hearing voices or sounds that aren’t there might include medication, talk therapy, or coping strategies.
Auditory Hallucination FAQs
What is the cause of auditory hallucinations?
You’re more likely to hear voices or sounds that aren’t there if you have a condition that affects how your brain processes sound. This may happen with mental illnesses such as schizophrenia or medical conditions like brain tumors, dementia, Parkinson's disease, migraine, or hearing loss. Traumatic experiences may also cause them.
Why am I hearing voices?
You might hear voices if you have a condition that affects how your brain works, including schizophrenia spectrum disorders, bipolar disorder, Alzheimer’s disease, or other dementias. But not all auditory hallucinations indicate a psychiatric problem. Drugs and alcohol, certain medications, brain tumors, and hearing problems can also cause you to hear voices that aren’t there.
What is an example of an auditory hallucination?
You may hear a voice talking to you or giving you orders. Some people hear music, animal calls, or nature sounds.
How do you treat auditory hallucinations?
Treatment depends on the cause. Antipsychotics are often used to manage auditory (or visual) hallucinations caused by mental health conditions like schizophrenia. Treatment also includes talk therapy, distraction techniques, hallucination-focused integrative treatment (HIT), or addressing another medical problem.
Is hearing voices in your head common?
Around 10% of people may have experienced hearing voices at least once in their lifetime. This kind of thing is more common in kids and teens than in adults. And it’s usually not a cause for concern unless it disrupts your life or keeps happening.
