Many of us have had the experience of turning around because we thought someone said our name, only to find no one there. When this happens we tend to shrug it off and continue on with our day, it is only when our experience of hearing voices goes beyond this that we tend to feel concerned.
Hearing voices when no one else is present, or hearing voices that other people cannot hear can be incredibly disconcerting to the listener. These are generally considered auditory hallucinations, however they are not necessarily abnormal.
There is a range of different reasons as to why someone may be hearing voices; some of them may be down to mental illness, others may not. On this page we'll look into the various experiences of hearing voices, the possible causes and how you can find support.
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I hear voices in my head
In the past, when someone uttered the phrase 'I hear voices in my head' the immediate assumption was that they had a mental illness such as schizophrenia or psychosis. These days however, we are more attuned to the nature of auditory hallucinations and understand that it is a complex subject that has many different causes. There is also far more support and understanding for those who experience voices, hopefully showing that they are not alone.
The experience of hearing voices differs from person to person. Some people hear the sound through their ears, just as if someone is speaking. Others hear the voice from inside their head. There may be one voice or several. The voices can be encouraging and supportive or malevolent and intimidating. You may recognise the voice as someone in your life - or it may be an entirely new voice.
Some people believe they can hear other people's thoughts, while others may feel threatened by their voices. In some cases, the voices try to tell people what to do which can be incredibly frightening for the listener.
The important thing to remember is that admitting that you hear voices in your head is not an admission of insanity - it is an important starting point to help you regain control.
What causes voices?
As we have mentioned, there are many different causes for hearing voices and typically the causes fall into one of two camps: those triggered by a mental health problem and those caused by human experience.
Mental health problems
The following list is of mental health issues that can cause auditory hallucinations. This list in not exhaustive and you may experience the mental health problem without hearing voices at all:
Bipolar disorder – During a manic phase, those with bipolar disorder may experience voices telling them they can do anything and encouraging them to be reckless. The voices may also occur during depressive phases and can be negative and threatening.
Depression – Those suffering from depression may hear voices that are derogatory or negative. In some cases these voices can be so intense that the listener feels they have no way out and may experience suicidal thoughts.
Dissociation – Certain conditions with dissociative symptoms (for example, dissociative identity disorder) can cause auditory hallucinations. These voices may include alternative identities which can be either positive or negative depending on your individual experience.
Eating disorders – Many people who have eating disorders report that they hear a voice telling them not to eat or binge. These voices are usually negative and may call the sufferer names.
Post-traumatic stress disorder (PTSD) – In some cases, those who have experienced a trauma and develop PTSD may hear voices or sounds in the form of a flashback. They may hear sounds that happened at the time of the trauma, or they may hear voices reminding them of what happened.
Psychosis – Two of the main symptoms of psychosis are hallucinations (both visual and auditory) and delusions. Those diagnosed with psychosis may struggle to differentiate reality from fantasy, and hearing voices can make this infinitely harder.
Schizophrenia – Hallucinations are one of the symptoms often experienced by those with schizophrenia. Again, the distinction between reality and fantasy may be blurred and voices can induce paranoia.
If you have been diagnosed with a mental illness, it is important to get support. Our advanced search allows you to search for counsellors and psychotherapists in your local area, simply read through their profiles and get in touch with those who resonate with you to find out more.
In some cases, auditory hallucinations occur for other reasons. Again, this list is not exhaustive, but it should give you a good idea of other causes:
Abuse – Physical, emotional and sexual abuse can all lead to hearing voices. The voice may be that of the abuser, or it may be another voice that either comforts or harasses you.
Bereavement – It is quite common for those who have experienced a loss to hear the voice of the person who has passed speaking to them. This experience can be comforting and may make those first few days of bereavement less painful.
Bullying – If you are being bullied or were bullied in the past, you may hear the voice of the bully when they're not around. This is often a negative experience and can make you feel anxious and frightened.
Drugs/alcohol – Using drugs and alcohol can lead to both visual and auditory hallucinations. Hearing voices may also be a side effect of certain prescription medications. If you have an addiction, you may also experience voices when detoxing.
Hunger – If you are extremely hungry or even at the point of starvation, you may become somewhat delirious and hear voices.
Physical illness – Having a high temperature can lead to delirium and may cause you to hear or see unusual things.
Spiritual – Some people hear voices as part of a spiritual experience. It may be that you hear the voice of an angel or an evil spirit. If the voices upset you, seeking help from a spiritual advisor and a counsellor could help to rule out other issues.
Tiredness – Sometimes, simply being over-tired can trigger the perception of voices. As you fall asleep or wake up, you may also hear or see things that aren't there - these are called hypnopompic hallucinations and happen because your brain is still partly in a dreaming state.
While for some people, hearing voices is not a significant part of their lives and is easy enough to deal with, others find it difficult to cope. If you are hearing voices in your head that are upsetting or intimidating you - it is worth seeking help. There are many different options for those who hear voices and in some cases just speaking to someone who understands can help.
The support you receive could help you to get rid of the voices for good, or it may simply help you to regain control and live with the voices. If you are worried about hearing voices, seeking help from your doctor should be your first port of call. They will then be able to refer you to a specialist who can point you in the right direction for support.
Some of the options you may be offered include:
Support groups can take place in person or online. Some people prefer to discuss their problems on an online forum while others enjoy the social aspect of face-to-face groups. Whichever you choose, speaking to people who understand what you're going through can be incredibly helpful. You may be able to share tips on how to cope and you may even make some new friends.
Talking therapies usually involve you speaking to a counsellor or psychotherapist about your thoughts and feelings. There are different types of talking therapies that could help you to understand your voices better. Some of the therapies that may be offered to you include:
- Psychotherapy/psychoanalytical therapy - This can be particularly helpful if you feel your voices are caused by something that happened in the past.
- Cognitive behavioural therapy (CBT) - This type of therapy may be able to help you change the way you think and react to the voices. The aim is to help you regain control and feel less anxious about the voices.
- Mindfulness - This approach can help you to stay grounded in the present moment and can be especially helpful if you find you are losing track of what is real and what isn't.
In some instances you may be prescribed medication to help you, this could include antipsychotics and/or antidepressants. Medication may only be required for a short amount of time until you learn other ways of coping, or you may require them long-term.
What can friends and family do to help?
If you are a friend or relative of someone who hears voices, it can be difficult to know what to do. One of the most helpful things you can do initially is to accept that the voices are real to the listener. Telling someone you hear voices in your head is an incredibly brave thing to do, so it is important to recognise this when they tell you. Reassure them that support is available and encourage them to get help if the voices are bothering them.
Look to support them in making their own choices and be there for them if they choose to open up to you about the voices. Avoid telling them that the voices are all 'in their head' or that they must be 'mentally ill' - there are lots of different reasons for auditory hallucinations and it is important not to jump to conclusions.
Most of the time just being there and not judging can make all the difference. Be sure to take care of yourself too and if you are struggling, make sure you seek support.
Advice for those hearing voices
Learning more about your voices and gaining an understanding of them is often a key first step to dealing with them. We would always suggest seeking support from your doctor or a counsellor to help you do this, as it can sometimes be hard to gain clarity when you are alone. The following advice should help:
Accepting your voices and the fact that they are real is incredibly important. Accepting that they come from you and that they belong to you is also key. Once you accept your voices and stop battling with yourself, you will be in a better position to understand them.
Once you have found a supported and safe way of working (for example with a psychotherapist), it is helpful to ask yourself some questions including the following:
- What was happening in my life when I first heard the voices?
- How did I feel at the time?
- Where was I?
- What did the voice(s) say?
- Were they positive or negative?
- What issues do the voices represent?
You may find it helpful to keep a diary, noting down when you hear the voices and your feelings/circumstances at the time. The more you begin to understand about your voices, the more likely it is that you'll regain control.
There are different ways you can gain control over your voices. The following tips may help:
- Distract yourself from the voices, some people do this by listening to music through their headphones.
- If you want to, starting a dialogue with the voices can help. Try telling them that you want to wait before doing what they say.
- Try allocating a certain amount of time to listening to the voices and don't listen at any other times.
- If the voices are threatening you, try standing up to them and telling them that they have no power over you.
- If you find you are getting confused about what is real and what isn't, try grounding yourself by touching something solid or doing an everyday task. This can help to bring you into the present and keep you in touch with what is really happening.
Looking after yourself
When you are going through a tough time emotionally, it is very easy to forget to look after yourself physically. There are many studies out there that highlight the importance of a healthy diet and exercise in regards to mental health so do take it into consideration. You may find physical exercise, like running, helps you to feel more energised and alert. A healthy diet will also help to keep you physically well while potentially improving your mood.
Getting enough sleep is also very important. Often those who hear voices say that they get worse when they are tired or stressed, so getting enough sleep can be imperative.
What should I be looking for in a counsellor or psychotherapist?
Currently there are no laws that stipulate what level of training or qualifications a counsellor needs for treating someone who hears voices. However, the National Institute for Health and Care Excellence (NICE) have developed a set of guidelines that provide advice about the recommended treatments for those with psychosis and/or schizophrenia, including the following:
If you have a first episode of psychosis, you should be offered both:
- antipsychotic medication and
- psychological therapies called cognitive behavioural therapy (or CBT for short) and family intervention (for you and your family).
If you have another episode, you should be offered the same treatment (antipsychotic medication, CBT and family intervention) as for a first episode, or a review of your current treatment.
Read the full NICE Guidelines:
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