Hearing voices is a common symptom of a mental illness, but not everyone that hears voices are unwell. This page looks at what it can be like to hear voices, why you might hear voices and how to deal with them.
- Around one in 10 of us hear voices.
- Another term for hearing voices is auditory hallucinations.
- Hearing voices can sometimes be positive.
- Sometimes these voices can be negative and upsetting.
- Research shows that hearing voices is not always a sign of mental illness.
- Treatments for distressing voices can include medication, talking therapies and peer support.
What does the term 'hearing voices' mean?
Your doctor or support worker may call hearing voices an ‘auditory hallucination’. A hallucination is where you might see, hear, taste, smell or feel something that exists only in your mind.
The experience of hearing voices can be different for everyone. People who are not unwell can hear voices.
The voice might be one you know or one you’ve never heard. It can be female, male, in a different language, or have a different accent to the one you’re familiar with. The voice may whisper or shout. You might just hear occasional words or phrases. You might hear voices every now and then, or you might hear them all of the time. You may hear several voices at once.
What is it like to hear voices?
Hearing voices can be positive. However, they can be negative and upsetting. They can threaten you and say hurtful or cruel things about you or someone you know. This can be frightening.
You may find that your voices change at different times. They may become more distressing during difficult or stressful times.
Do many people hear voices?
Up to one in ten people hear voices. Not everybody who hears voices gets a medical diagnosis. Hearing voices is not as rare as we used to think.
You can hear voices without having a mental illness. Research shows that many people hear voices or have other hallucinations, It is not always a sign of being unwell.
In some cultures, hearing voices is considered normal. Some people have spiritual reasons or other beliefs that explain voices. There are different reasons why someone might hear voices, and you may have your own explanation for yours.
What are the different kinds of voices experienced?
The experience of hearing voices can be different for everyone. Hearing voices does not mean you are unwell.
There are different types of auditory hallucinations. You can hear music, animal noises, background noise like people chatting, people talking directly to you or about you. There are all different types. If you think you are hearing something that other people can’t hear then you should consider talking to a professional or someone you trust.
Causes and treatment
What causes someone to hear voices?
There are different reasons why some people hear voices. One suggestion is that the brain makes your thoughts sound like voices coming from somewhere else.
You may hear voices as a way to cope with difficult emotions and traumatic experiences. This may be part of a dissociative disorder.
Other things can make you hear voices or make your voices worse. These include:
- stress, anger or anxiety,
- drugs and alcohol,
- serious physical illness or following an operation,
- grief, divorce or separation,
- old or recent trauma, and
- extreme hunger or tiredness.
How are they treated?
If you speak to your doctor about hearing voices, they may suggest some of the following treatment options.
Anti-psychotic medication can help with hearing voices. They may not make symptoms go away but can make voices seem distant or less noticeable. They do not work for everyone and can have side effects. You might need to try more than one drug before you find one that helps.
You can find more information in our factsheets ‘Antipsychotics’ and ‘Medication – Choice and Managing Problems’.
Cognitive behavioural therapy (CBT) is a type of talking therapy that can help if you hear voices. CBT can help you to manage your voices and to notice any patterns. This can help you learn what triggers the voices and also how to ignore them.
Voices may say things that you think about yourself. CBT can help you be more positive about yourself which can help lessen your negative voices. Stress can trigger voices. CBT can help you find ways to deal with your stress.
CBT can be combined with Mindfulness. This is a form of meditation which helps you to focus on the present moment. This may help you to identify what your voices are distracting you from, in a safe environment.
If you have experienced childhood trauma, your voices may be part of your way of dealing with this. This can be called disassociation. This is something which can be treated with talking therapy. The therapist will help you to understand the root causes of your voices. They will explore ways to over-come and control difficult voices.
You could ask your GP about talking therapy. If you are under a mental health team, speak to your psychiatrist or care coordinator instead.
Although more and more professionals are using therapy to help with hearing voices, it may depend on what is available in your area.
You can find more information in our factsheets ‘Talking Therapies’ and ‘Complementary and alternative treatments’.
What treatment should the NHS offer me?
NICE (National Institute for Health and Care Excellence) recommend that everyone experiencing psychosis should be offered antipsychotic medication and talking therapy.
Health professionals may offer you ‘family intervention’. This is a type of talking therapy. You and your carer and family will do this therapy together. It looks at education, support and what treatment will work for you.
NICE also recommend art therapy to treat on-going psychotic symptoms.
If you continue to hear voices, you should ask your doctor to do a medication review. You might need to try a few different medications before you find the right medication and dosage for you.
Your doctor may refer you to specialist support services such as community mental health team (CMHT), or home treatment team (HTT).
Risks and complications
What risks and complications can voices cause?
It can be common to hear negative, critical voices or unkind voices. This can have an impact on your sense of self worth and motivation. Voices can interrupt the thought process making concentration difficult. They can be overwhelming and intrusive, which can make it difficult to communicate or focus on activities. This can lead to social isolation. Intrusive voices can interrupt sleep leading to insomnia and additional health problems.
Sometimes voices can be demanding instructing you to do things you don’t want to. These are known as ‘command’ voices. In extreme cases voices can instruct people to harm themselves or others. The stress, isolation and associated with hearing voices can also increase the risk of suicide.
If you experience any of these problems, speak to your GP, call 999 or attend a local Accident and Emergency.
What if I am not happy with my care or treatment?
Patient Advice and Liaison Service (PALS)
If you are unhappy with your care or treatment, you could call your local PALS. They can try to help answer your questions about the complaints procedure. You can find PALS’ details at www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-(PALS)/LocationSearch/363.
An advocate is independent from mental health services. They can help you to voice your opinion and resolve problems. They may be able to help you to write letters or go to appointments or meetings with you.
If you are unhappy with your diagnosis, you could ask for a second opinion. You do not have a legal right to a second opinion, but it is important to ask if it is important to you.
If you cannot resolve the problem, you can make a complaint to have your concerns investigated in more detail.
Click the links below to find our more about:
- Second Opinions
What are the self care and management techniques?
People deal with voices in a different ways. It is important to find a way that works for you. You might need to try different things before finding something that works.
Talking to others or joining groups
Speaking to other people who hear voices may help you to accept and understand the voices you hear. This may help you feel less alone and boost your self-confidence. Stress can make voices worse. Talking about your voices to other voice hearers may help to reduce feeling stressed about having voices.
The Hearing Voices Network gives people the chance to talk about hearing voices. It offers practical help and support.
Taking control of the voices
When you hear voices you could talk back. Some people find this helps to take control. You might be worried about talking back in public. Some people pretend to use the phone. You may find it helps to control when you engage with your voices. You could set a time each day to listen to and answer the voices.
If you hear more than one voice, try to focus on the positive ones.
Some people find that listening to or talking back to their voices can make them worse. Listening to music, the radio or an audio-book may help you focus on something else.
Concentrating on a task such as a household chore or hobby can help to distract you from your voices.
You could keep a diary of your voices. This could help you keep an eye on how often they happen. You may notice if anything you are doing is making them worse. This can help you find new ways of coping with them. It may help when talking about it with your therapist.
Researchers have been looking into how a new computer based treatment may help with treatment resistant auditory hallucination. This treatment is known as avatar therapy. In this therapy you create a character and pick a voice from a database which is like the one you hear. The therapist can control the avatar using special software. So far it seems that it works for someone people. They need to do more research into it to make sure it does before they offer it to people. You can read about the study on if you follow the link below. You can keep up to date with what is happening with it.
Avatar Therapy UCL webpage: www.phon.ucl.ac.uk/project/avtherapy/
Your doctor may offer you peer support. Peer support is when you work with someone who is trained in how to best support you. They will have experienced psychosis or schizophrenia in their life. They should be able to offer advice and support with:
- side effects,
- recognising and coping with symptoms,
- what to do in a crisis,
- meeting other people who can support you, and recovery.
Health professionals may offer you help to manage your condition on your own. Managing your condition on your own is called a self-management programme.
You can try some of the suggestions below to manage or cope with upsetting or negative voices:
- Speak to a supportive, friend, family member or someone else who hears voices.
- Try relaxation techniques and breathing exercises.
- Use complementary therapy such as meditation, reflexology or aromatherapy.
- Stick to a sleep pattern, eat well and look after yourself.
- Keep a diary of what the voices say and how they make you feel.
- Set small goals such as going out for a small amount of time everyday. Reward yourself when you achieve a goal.
- Do a little exercise every day such as walking, swimming, yoga or cycling.
- Start a hobby, activity or volunteering.
- Treat yourself to hot baths or going for a massage.
- Try visualisation to control voices.
You can get some self help online. Below are some sites you can use.
Get self help
This has worksheets to help with voices and paranoia. One of them is the ABC of Voices which helps you write out what triggered the voice, what you think about it and what it makes you feel. These can be useful if you have had some talking therapies already. It may be hard to do this on your own and it may make you feel worse. They have an Early Warning Signs for Psychosis worksheet that will let you write down what the signs are. You can keep this to help you manage if you are getting unwell. You can share it with people close to you so they know what to look for. They have a whole booklet called Personal Recovery & Maintenance plan which you can fill in. You should always discuss these with your GP or mental health service if want to do these.
Website : www.get.gg/psychosis.htm
Northumberland, Tyne and Wear NHS Foundation Trust
This NHS trust has a lot of self help materials on a different areas including hearing voices.
Telephone: 0191 223 2545 Email: firstname.lastname@example.org
Support for you
If you are a carer, friend or relative of someone living with PTSD, you can get support.
You could get in touch with carer support groups or sibling support groups. You can search for local groups in your area or the Rethink Mental Illness Advice Service can search for you.
You can ask your local authority for a carer’s assessment if you need more practical support to help care for someone.
As a carer you should be involved in decisions about care planning. There are rules about information sharing and confidentiality which may make it difficult for you to get all the information you need in some circumstances.
Supporting the person you care for
You might find it easier to support someone who hears voices if you understand their symptoms, treatment and self management skills. You can use this information to support and encourage them to get help and stay well.
You should also be aware of what you can do if you are worried about someone’s mental state or risk of self harm. You should have details of their mental health team and also discuss a crisis plan with them.
You can find out more information about:
- Supporting someone with a mental illness
- Getting help in a Crisis
- Helping someone with suicidal thoughts
- Responding to unusual behaviours