Ever heard a voice inside your head that wasn’t your own? You may have experienced an auditory hallucination.
The voice might have sounded like someone you knew, making you do a double-take to check they hadn’t come up behind you. Or maybe it sounded like a stranger, striking up a conversation or commenting on your choice of clothing.
However the voice sounded, you might have felt a little confused, possibly even concerned about your mental health.
You might have kept it to yourself, knowing that people often associate seeing or hearing things that aren’t there with schizophrenia and other serious mental health conditions.
Yet auditory hallucinations are more common than many people realize, especially among children and adolescents.
Auditory hallucinations don’t sound the same for everyone.
For instance, they may:
- sound like a friend
- speak kindly or compliment you
- talk about private things you’ve never told anyone
- say unkind things or criticize you
- comment on your activities
- offer guidance, including spiritual guidance
- urge you to do potentially dangerous things
- sound like music or other sounds, rather than voices
These auditory hallucinations can happen with or without other mental health symptoms.
In fact, research explains that auditory hallucinations not only have various causes, but they can also occur without any underlying condition.
The authors of that report urge mental health professionals to avoid diagnosing schizophrenia, or any psychotic disorder, when someone reports hearing voices without other symptoms.
- start slowly and intensify, then end gradually rather than all at once
- last longer
- seem to come from an external source
- accompany or contribute to delusions
- get in the way of everyday life
Still, voices that happen with schizophrenia and other conditions can vary quite a bit.
In a sample of 20 people who reported hearing voices and met criteria for schizophrenia, the study found:
- people in California tended to describe the voices as unreal intrusive thoughts
- people in West Africa tended to say the voices were powerful and morally good or bad
- people in West India were most likely to hear voices of relatives or voices offering advice
Wondering if intrusive thoughts count as auditory hallucinations?
Typically, no. Intrusive thoughts tend to show up as distinct thoughts, so you “hear” them in your own mental voice just as you would any other thought.
With auditory hallucinations, you hear the voice of someone else or a distinct sound.
While it’s absolutely possible to hear voices without any underlying condition, auditory hallucinations sometimes have a specific cause.
You could hear voices:
- after losing your hearing
- when grieving a loved one
- after experiencing a head injury
- when under a lot of stress
- while using substances or alcohol, or during withdrawal
Auditory hallucinations can also show up as a symptom of some medical and mental health concerns.
Schizophrenia spectrum disorders
Schizophrenia and related conditions typically show up in early adulthood. They’re characterized by a disconnect from reality, which usually includes auditory or visual hallucinations as well as delusions.
Other common symptoms include:
- trouble concentrating
- a tendency to self-isolate
- loss of interest in usual activities
- disorganized thinking or speech
- trouble sleeping
- difficulty expressing emotions
You’ll want to talk with a healthcare professional if you:
- have trouble falling asleep or wake up often
- feel fatigued during the day or need naps to function
- have trouble breathing while sleeping
- notice difficulty concentrating on daily tasks
- notice daytime anxiety, irritability, or depression
- can’t maintain your desired sleep and wake schedule
- frequently talk or move in your sleep
Post-traumatic stress disorder (PTSD)
Some people hear voices after experiencing a traumatic event. PTSD often causes extreme physical and emotional distress, so it can have a big impact on daily life.
Along with hallucinations, you might experience:
- flashbacks or nightmares
- difficulty focusing
- anger and irritability
- feelings of guilt, blame or self-blame, or depression
- disinterest in your usual activities
- anxiety, uneasiness, or panic
Other mental health conditions
It’s possible to have auditory hallucinations with many different mental health conditions, though not everyone with these conditions will ever hear voices.
- Depression involves a persistent low mood, along with feelings of sadness, hopelessness, or emotional numbness.
- Bipolar disorder is characterized by episodes of extreme mood. Along with hallucinations, you’ll experience episodes of mania (highs), episodes of depression (lows), or a combination.
- Borderline personality disorder involves instability in emotions, sense of self, and relationships. You might also have fears of abandonment or feelings of emptiness.
- Dissociative identity disorder is characterized by a person’s identity being split into two or more separate identities. You could hear people talking in your head or notice significant memory gaps.
Brain and nervous system disorders
You could hear voices with health conditions that affect the brain or nervous system, including:
Symptoms of these conditions may include:
- sudden, persistent head pain
- numbness and tingling
- vision changes
- trouble with memory or concentration
- weak or rigid muscles, muscle tremors
- slurred speech or difficulty speaking clearly
Hearing voices isn’t always a cause for concern. You probably don’t need to worry if:
- you don’t feel disconnected from reality
- auditory hallucinations don’t affect your everyday life
- you don’t have other symptoms
- the voices don’t bother you or encourage you to hurt anyone
- you hear voices very rarely
Hearing voices that say cruel or unkind things, however, can affect your sense of self-worth and emotional well-being.
Even if you don’t have other symptoms, a trained therapist can offer non-judgmental guidance and support (more on this later).
Hearing voices can be confusing, distracting, or even upsetting — especially if the voices say critical or unkind things or if they make you feel bad about yourself.
Not knowing why the voices happen might add to your distress.
These strategies may not always make the voices go away, but they can help you cope with them.
Keep a journal
Some people find it helpful to keep a log of auditory hallucinations they experience.
Recording what the voices say, when you hear them, and how they make you feel can offer more insight into potential causes or triggers of the voices and common themes you notice.
For example, you might only hear them at a specific time of day or when you feel a certain way, like tired or angry.
If you decide you want to talk to a therapist about the voices, this recorded information could be the key to identifying what’s going on.
Talk about them
You might hesitate to tell loved ones that you’re hearing voices, but opening up to someone you trust can help.
Try talking to someone who has a history of offering non-judgmental support, like a best friend or close sibling.
Simply telling someone about your experience can help ease distress, and knowing you have support can help you feel less alone.
If you’re hearing voices while under a lot of stress, or after a loss or traumatic event, talking about those underlying triggers may help you get the support you need to cope. In time, this could help the voices go away entirely.
Not ready to talk about hearing voices to anyone you know? That’s absolutely OK.
You can also try peer support groups for people who hear voices, like:
It often helps to acknowledge that hearing voices isn’t uncommon — plenty of people hear voices from time to time.
Accepting these voices as part of your experience can help you feel less distressed, and, over time, you might notice them less and less.
While some people find it most helpful to ignore the voices, talking back could help you accept them and regain some control.
- Speak calmly and compassionately, even if the voices say negative things.
- Try a “Thanks, but no thanks” approach. Acknowledge the voice by letting it know, “I hear what you’re saying, but I’m not going to focus on it right now.” Then return your attention to what you were doing.
Even if you hear a voice occasionally, increased mindfulness can make it easier to acknowledge it and let it go.
Relax and practice self-care
Taking care of yourself and making time for relaxation can help boost well-being. This can, in turn, ease the effects of stress and mental health symptoms.
Self-care might include things like:
- eating a balanced diet
- getting regular physical activity
- sleeping 7–9 hours every night
- getting outside
- spending time with loved ones
- participating in hobbies or social events
- taking up creative pursuits, like art and music
- reading, journaling, or watching movies
Hobbies and other enjoyable activities can also offer a distraction from voices and other sources of stress.
Music, another great relaxation strategy, can do more than help ease stress. Some people also find it helps tune voices out.
Along with your favorite playlists, you can also try:
- relaxing sounds, like rain, waterfalls, ocean waves
- instrumental or ambient music
Get professional support
When voices do occur alongside other symptoms, cause distress, or happen frequently enough to affect daily life, it’s important to talk with a healthcare professional to discuss diagnosis and treatment options.
If you hear voices that encourage you to hurt yourself or anyone else, get support as soon as possible to stay safe.
A therapist or other health professional won’t call you “crazy” or immediately diagnose a specific condition.
- ask questions about other symptoms to help rule out medical concerns
- help you explore the voices and any potential triggers or underlying causes
- offer guidance on treatments and coping skills
A doctor or other healthcare professional can offer more guidance when you experience physical symptoms rather than mental ones.
Experiencing auditory hallucinations may not automatically mean you have a mental health condition, but it can still feel unsettling and frightening.
If you can’t seem to turn the voices down or tune them out, a therapist can offer compassionate guidance and support.
Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.