The Woman Who Couldn’t Stop Hearing Voices (Auditory Hallucinations)
Understanding Causes and Treatments
Auditory hallucinations—commonly known as hearing voices—are a reality for many, and for some individuals, these experiences can persist day and night, shaping nearly every aspect of life. Shanika Ranasinghe describes living with these voices since childhood, while others like Caroline Mazel-Carlton and Jeannie Bass have found ways to adapt to their ongoing presence. For many people, these voices are more than background noise; they can be vivid, insistent, and sometimes disruptive.
She tried a range of approaches, from medication to self-management and support from others with similar experiences. Hearing voices isn’t rare and can occur with a variety of mental health conditions, including schizophrenia, bipolar disorder, or even non-psychotic circumstances. This blog post explores one woman’s journey with auditory hallucinations, the impact on her daily life, and the lessons she’s learned while navigating a world that can’t always hear what she does.
Understanding Auditory Hallucinations
Auditory hallucinations are a type of sensory experience that affects perception, particularly involving the sense of hearing. Understanding what defines auditory hallucinations, how they differ from similar phenomena, and the types that exist can help clarify their impact on daily life.
What Are Auditory Hallucinations?
Auditory hallucinations involve hearing sounds, such as voices or noises, that do not originate from any actual external stimulus. These perceptions occur without any source in the person's environment.
The most commonly reported form is hearing voices. These voices may be perceived as coming from inside the head or from outside in the environment. The voices might be familiar or unfamiliar and can speak directly to the person or talk about them.
In some cases, individuals experience other kinds of auditory phenomena, like music or repetitive noises. Auditory hallucinations are not always associated with psychotic disorders; they may result from medical conditions, neurological disorders, lack of sleep, or high stress.
Differences Between Hallucinations and Delusions
Hallucinations and delusions are different types of symptoms in mental health. Hallucinations involve false sensory experiences, such as hearing, seeing, or feeling things that aren’t real. Auditory hallucinations fit within this definition when a person hears voices or sounds that no one else can hear.
Delusions, on the other hand, are strongly held false beliefs. These beliefs are not based on reality, and the person cannot be convinced otherwise, even with clear evidence. For example, a delusion might include believing that one is being watched or controlled without any real proof.
The table below summarizes the main differences:
Symptom Involves Senses? Main Feature Hallucination Yes False sensory perceptions Delusion No False, fixed beliefs
These differences are crucial in psychiatric assessment and diagnosis.
Types of Hallucinations
Hallucinations can affect any of the five senses. Auditory hallucinations are the most common in psychiatric conditions, but other types exist:
Auditory: Involves hearing voices, music, or random noises when no external sound is present.
Visual: Seeing people, shapes, or lights that are not actually there.
Olfactory: Smelling odors that have no physical source.
Gustatory: Tasting things without any real substance in the mouth.
Tactile: Feeling sensations, such as touching or crawling on the skin, when nothing is causing it.
Hearing voices is the most reported form, especially in conditions like schizophrenia, but it can also appear in severe mood disorders or as a temporary effect of sleep deprivation. The type and nature of hallucinations can provide important clues about their underlying cause.
Causes of Hearing Voices
Hearing voices—auditory hallucinations—can arise from several well-recognized medical and psychological conditions. The causes range from serious mental illnesses to specific neurological events and typically involve complex interactions between the brain and environmental factors.
Mental Illnesses Linked to Auditory Hallucinations
Several mental illnesses are closely linked to hearing voices. Schizophrenia is the most commonly associated condition; many people with this disorder hear voices that others do not. These voices may comment on the person's actions, give commands, or threaten them, often contributing to delusions and disrupted thinking.
Other psychiatric conditions—such as bipolar disorder, major depression with psychotic features, and severe trauma-related disorders—can feature auditory hallucinations. Stressful experiences like abuse or bullying are also linked to voice-hearing episodes, especially when associated with past trauma. Individuals may even hear the voice of someone who harmed them.
A lack of sleep or extreme hunger may make someone more vulnerable to these hallucinations, particularly in those with underlying mental health conditions.
Neurological Conditions and TIA
Certain neurological events can also trigger auditory hallucinations. A transient ischemic attack (TIA), often called a "mini-stroke," briefly disrupts blood flow to the brain, which may temporarily affect areas responsible for processing sound and speech. This disruption can lead to a person hearing voices or noises that are not present.
Other neurological causes include epilepsy, particularly temporal lobe epilepsy, and dementia. In these conditions, abnormal brain activity or degeneration of brain tissue can interfere with normal perception and lead to auditory experiences. In rare cases, brain tumors or infections that affect perception-processing regions—such as the auditory cortex—can also play a role.
Mental Health Impact
Auditory hallucinations can heavily disrupt a woman's daily life and general mental well-being. Persistent voices may increase anxiety, cause distress, and make routine activities more challenging.
Effects on Daily Life
Hearing voices can significantly interrupt concentration and the ability to follow tasks at home, work, or in social situations. Many individuals experience difficulties maintaining employment or stable relationships because of frequent distractions or confusion.
Routine responsibilities might become overwhelming if the voices are persistent or commanding. For some, sleep is affected, leading to fatigue and less resilience against stress.
Social isolation is common, as some women withdraw to avoid embarrassment or misunderstanding. In severe cases, coping strategies may include avoiding public places or relying heavily on routines to maintain a sense of control.
Common Impacts on Daily Functioning
Activity Possible Difficulties Work/School Trouble focusing, absenteeism Relationships Misunderstandings, withdrawal Self-Care Neglect due to distraction Social Activities Avoidance, isolation
Emotional and Psychological Consequences
The emotional burden of hearing voices can include heightened anxiety, fear, and persistent worry about losing control. Many women report feelings of shame or guilt, sometimes leading to low self-esteem.
Long-term distress caused by these auditory hallucinations increases the risk of depression and, at times, a catatonic state. Strong emotional reactions, such as panic or confusion, may be triggered by the content or tone of the voices.
For some, the fear of judgment or disbelief from others makes seeking professional help difficult. Suicidal thoughts and a sense of hopelessness can develop, especially when the voices are negative or commanding. Managing these psychological effects often requires structured support and targeted mental health interventions.
Women and Auditory Hallucinations
Auditory hallucinations—hearing voices or sounds that are not present—impact both men and women, but key differences exist in women’s experiences, distress levels, and associated risks. Some mental health conditions unique to women, such as postpartum psychosis, are strongly linked to the onset of these symptoms.
Unique Challenges Faced by Women
Women experiencing auditory hallucinations often report higher levels of distress and a longer persistence of voices compared to men. Research suggests that women may also internalize these experiences more, leading to increased anxiety and depressive symptoms.
Common triggers include sleep deprivation, trauma, hormonal shifts, and life events such as pregnancy or menopause. These factors can increase vulnerability, especially when combined with pre-existing mental health conditions. Some women describe the voices as critical or commanding, which can affect daily function and relationships.
Support networks are critical. Many women benefit from a combination of therapy, peer support groups, and medication. The stigma around hearing voices may make women more reluctant to seek help, emphasizing the need for understanding and accessible resources.
Postpartum Psychosis and Postpartum Depression
Postpartum psychosis is a rare but severe mental health emergency that can occur within days or weeks after childbirth. Women may experience intense auditory hallucinations, delusions, confusion, and mood swings. Immediate medical intervention is necessary, as the risk for harm to self or the baby is significantly increased.
In postpartum depression, auditory hallucinations are less common but can occur. When present, they typically intensify feelings of guilt, inadequacy, or hopelessness. These symptoms may be mistaken for other conditions, delaying necessary treatment. Prompt evaluation by a mental health professional is vital to ensure the safety of both mother and child, and early treatment greatly improves outcomes.
Diagnosis and Assessment
Accurate diagnosis of auditory hallucinations requires a careful and structured approach. Understanding the underlying mental illness and differentiating it from other possible causes is essential for planning effective treatment.
Clinical Evaluation Process
The clinical evaluation for persistent auditory hallucinations usually begins with a comprehensive psychiatric interview. Clinicians gather detailed information about the onset, frequency, and nature of the voices. They often ask questions about accompanying symptoms, such as delusions, mood changes, or cognitive difficulties.
A thorough medical and psychiatric history is collected to rule out other causes. These may include neurological conditions, substance use, and medication side effects. Physical exams and laboratory tests may be performed if an organic cause is suspected.
Standardized assessment tools, such as the Positive and Negative Syndrome Scale (PANSS) or the Auditory Hallucination Rating Scale, help to quantify symptom severity and monitor changes over time. Differential diagnosis is critical for distinguishing schizophrenia, bipolar disorder, or schizoaffective disorder from other mental health problems with similar symptoms.
Role of the Psychologist
A psychologist plays a key role in both the assessment and ongoing management of auditory hallucinations. They conduct psychological testing to evaluate thinking patterns, emotional functioning, and insight into the hallucinations.
During sessions, psychologists may use structured interviews and validated questionnaires to assess the impact of voices on daily life, social functioning, and stress levels. This helps tailor treatment approaches to the individual's needs.
Psychologists often collaborate with psychiatrists and other mental health professionals. Their expertise ensures that hallucinations are accurately understood within the context of the person's overall mental illness, supporting effective intervention strategies and psychoeducation for both the patient and their support network.
Treatment Options for Auditory Hallucinations
Managing auditory hallucinations often requires a combination of therapeutic approaches and medication. The most effective treatments address both the psychological and medical aspects of conditions like schizophrenia and other mental health disorders.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) is a structured, goal-oriented form of talk therapy. It helps individuals recognize and challenge unhelpful thinking patterns related to the voices they hear. In practice, CBT teaches coping skills to reduce distress caused by auditory hallucinations.
Therapists work with patients to identify triggers and patterns, such as stress or lack of sleep, that may intensify hallucinations. Role-playing and practical exercises allow individuals to test strategies in a safe setting. CBT can lead to a reduction in the impact and frequency of voices for some people.
CBT is not a cure for the underlying condition causing auditory hallucinations but is effective in improving day-to-day functioning. It often complements other treatments and has substantial evidence supporting its use, especially in schizophrenia-related hallucinations.
Medication and Support Strategies
Antipsychotic medications are the primary pharmaceutical treatment for persistent auditory hallucinations in schizophrenia and related mental health conditions. These medications target brain chemistry, particularly dopamine pathways, to reduce or eliminate hallucinations.
Common antipsychotics:
Risperidone
Olanzapine
Quetiapine
Aripiprazole
Medication choices are tailored to each individual, considering side effects and overall health. Support strategies also play a crucial role. These include structured sleep routines, avoiding alcohol and drugs, and connecting with peer support groups.
Family education and community support can improve adherence to treatment plans and provide additional stability. Combining medication with daily life adjustments significantly increases the chances of managing symptoms effectively.
Living with Auditory Hallucinations
People who experience auditory hallucinations often navigate a daily reality shaped by persistent voices. Managing these symptoms involves practical strategies, community resources, and clear information about available support.
Coping Mechanisms
Effective coping mechanisms can improve quality of life for individuals who hear voices. Some find that keeping structured daily routines reduces stress and helps them anticipate when symptoms may worsen. Others practice mindfulness or grounding techniques, such as focusing on sensory details in the present moment, to create distance from distressing voices.
Cognitive behavioral therapy (CBT) specifically tailored for psychosis can help people develop a better understanding of their experiences and challenge negative beliefs about the voices. Journaling and tracking triggers may reveal patterns related to mental health, making it easier to avoid known stressors.
Listening to music, engaging in creative activities, or using headphones in public spaces can also be helpful for some. Medication is sometimes used, particularly antipsychotics, but not everyone responds the same way, and treatment choices are personal and varied.
Support Networks and Advocacy
Peer support groups play an important role in helping individuals connect with others who have similar experiences. Hearing Voices Networks are found in many countries and offer safe spaces for people to discuss what they hear without judgment. Family members and close friends can provide encouragement, but need clear information about auditory hallucinations to offer effective support.
Mental health professionals such as therapists, psychiatrists, and support workers are central figures in many people’s support systems. Advocacy organizations, including Mind and others, work to raise awareness and reduce stigma around hearing voices, making it easier for individuals to seek and receive appropriate care.
Table: Key Support Resources
Resource Type Examples Peer Support Group Hearing Voices Network, local groups Mental Health Services Therapy, psychiatry, crisis helplines Advocacy Mind, national mental health charities
Outlook and Future Directions
The understanding of auditory hallucinations continues to advance with new research and lived experiences. Approaches to treatment and support now extend beyond medications to include therapy, peer support, and social inclusion.
Influential Directions:
Culture and Society: Cultural factors are being recognized as shaping how people experience and interpret voice-hearing. Some communities value and accept these experiences, which may affect how individuals cope.
Voluntary Control: Studies indicate that developing voluntary control over voices is linked with better functioning and quality of life.
Increased attention is being given to personal narratives. Hearing from those living with auditory hallucinations, such as Marija and Caroline, guides professionals to offer more personalized care and practical strategies.
Future research priorities include:
Focus Area Example Questions Cultural Impact How does local culture shape symptom meaning? Treatment Innovations What non-medical supports are most effective? Lived Experience How do personal coping strategies develop?
The Hearing Voices Movement and similar initiatives promote acceptance and voluntary management of voice-hearing. These perspectives challenge stigma and encourage more diverse, supportive interventions.
Collaboration between clinicians, researchers, and people with lived experience is likely to drive future progress in understanding and addressing auditory hallucinations.
