Hearing Voices

Hearing voices is a common symptom of a mental illness. But not everyone that hears voices is unwell. This page looks at what it can be like to hear voices, why you might hear voices and how to cope with them.

Overview

  • Around 1 in 10 of us hear voices that other people don’t hear.
  • Another term for hearing voices is ‘auditory hallucinations.’
  • The voices can say positive or negative things
  • The negative voices can be hard to cope with and upsetting.
  • Hearing voices is not always a sign of mental illness.
  • Treatments for hearing voices can include medication, talking therapies and peer support.

About

What does the term ‘hearing voices’ mean?

Mental health professionals 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.

There are different types of auditory hallucinations. You may experience the following things.

  • People talking to you
  • People talking about you
  • Hearing music
  • Hearing animal noises
  • Hearing background noises, like people chatting

What is it like to hear voices?

Hearing voices can be different for everyone. The voice might:

  • be familiar to you or one you’ve never heard,
  • be male or female,
  • speaking a different language or have a different accent to the one you’re familiar with,
  • whisper or shout,
  • be a child or adult,
  • talk to you often. Or only say occasional words or phrases, and
  • talk at the same time as other voices. They may talk between themselves, or comment on what you are doing.

Hearing voices can be positive. You might find that the voices help you to understand more about your emotions. The voices may be encouraging and comforting. Or they may be helpful such as remind you to do things that you need to do.

You may hear voices that are negative and upsetting. They can threaten you and tell you to hurt yourself or someone else. They can 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 upsetting during difficult or stressful times.

Is hearing voices the same as intrusive thoughts?

No. But both can be upsetting and difficult to ignore.

If you hear voices, you will hear a sound. It will sound as though other people can hear it. But you will be the only one who can hear it.

An intrusive thought is an unwelcome thought or image that enters your mind and is mostly out of your control. It won’t sound as though others can hear it. It may be a disturbing thought such as harming people that you love.

Stevie's story

I’ve heard voices since I was young. They get worse if I’m worried about something or if something bad happens. I usually hear the same voice but sometimes random voices shout things. It makes it difficult to sleep or concentrate. I find that listening to music or watching TV sometimes helps. I didn’t tell anyone about the voices for a long time. As time went on I decided to speak to people about the voices. This helped me to accept what was happening.

Stevie

Causes & treatment

Do I have a mental illness if I hear voices?

Up to 1 in 10 people hear voices. Hearing voices is not as rare as we used to think.

Hearing voices may be a symptom of a mental illness. A doctor may diagnose you with a condition such as ‘psychosis’ or ‘bi-polar’. But 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.

You may find it helpful to have a diagnosis. But you may not identify with a diagnosis. You may find it more helpful to think of the voices as part of your personality. The same as someone may be ‘shy’ or ‘outgoing.’

You may have your own explanation for your voices. Some people have spiritual reasons or other beliefs to explain the voices they hear. For example, someone from a religious group may believe in demons. It maybe their belief that the voices mean that they are possessed. 

You can find more information about:

  • Spirituality, religion and mental illness by clicking here.
  • Psychosis by clicking here.
  • Schizophrenia by clicking here.
  • Schizoaffective disorder by clicking here.
  • Bipolar disorder by clicking here.
  • Personality disorder by clicking here.
  • Dissociation and dissociative disorders by clicking here.
  • Depression by clicking here.

How do I get help if I am hearing voices?

You may decide to get help if you don’t like hearing voices or you are concerned about them. You can get help from:

  • The NHS
  • Adult social services
  • Charities
  • Self help

How can the NHS help me?

You can speak to your GP about your concerns. They will be able to talk to you about treatment options and coping strategies. You don’t have to do what your GP thinks that you should do. But you should listen to them. Make sure that you understand the pros and cons of your treatment options before you make a decision.

Your GP should not give you antipsychotic medication without first talking to a psychiatrist. Your GP should refer you to a secondary mental health team if this is the first time that you have heard voices and asked for help.

You should be assessed quickly. A secondary mental health team will usually be called the:

  • early intervention team (EIT)
  • community mental health team (CMHT), or
  • crisis team.

In some areas of the country you can refer yourself to secondary mental health teams. They are NHS teams who help people that hear voices. EIT’s specialise in helping people who hear voices for the first time. But they aren’t available in all areas of England. To find your local secondary mental health team you can try the following.

  • You can ask your GP for their details.
  • You can call NHS 111.
  • Use an internet search engine. Use a term like ‘‘community mental health team in Cheshire’ or ‘early intervention in psychosis Camden’.

How can social services help me?

Your local authority is responsible for your social care and support. The social services team are part of the local authority.

If you need help and support to look after yourself then you can have an assessment by social services. For example, you may need support so that you can:

  • get out of the house,
  • keep in touch with friends and family,
  • get a job or take part in education,
  • clean your house,
  • prepare meals or go shopping,
  • keep safe,
  • manage your money,
  • take part in leisure activities, or
  • contribute to society (e.g. volunteering, being in a club or group).

What other help is available?

Charities

In some areas, charities will support people who hear voices. This may be through support groups where you can talk to other people who have mental health issues. Or there may be a different service available, such as employment or isolation support.

Some of the main national mental health charities are:

  • Rethink Mental Illness,
  • Mind,
  • Richmond Fellowship,
  • Together, and
  • Turning Point.

You can look on their websites to see what support they offer in your area. If you would like us to look for you please contact our advice line on 0300 5000 927 and let us know what sort of support you are looking for.

Self-help

There are things that you can do to help manage your mental health. This is called ‘self-help.’ You can find more information about this in the 'Problems with treatment' part of this webpage.

You can find more information about:

  • Community mental health team by clicking here.
  • Early intervention team by clicking here.
  • Crisis team by clicking here.
  • Social care assessment - under the Care Act 2014 by clicking here.

What causes someone to hear voices?

Nobody knows exactly what causes people to hear voices. And it is not understood why some people hear voices and others don’t. It is thought that many people hear voices, either partly or completely because of life experiences. Which are largely out of our control.

Life experiences

You may hear voices as a way to cope with difficult experiences. In particular abuse or other traumatic experiences.

Other life experiences can make you hear voices or make your voices worse. These include:

  • stress, anger or anxiety,
  • drugs and alcohol,
  • homelessness,
  • delirium. This is a state of mental confusion which may follow a serious physical illness or an operation,
  • grief, divorce or separation,
  • tiredness.

Genetics

Research does suggest that mental illness can run in families. But at the moment it isn’t possible to separate genetics and life experiences to work out the cause of mental illness.

Research suggests that changes to your brain chemistry can cause you to hear voices.

What treatment should the NHS offer me?

The National Institute for Health and Care Excellence (NICE) recommend that you should be offered antipsychotic medication and talking therapy if you hear voices. If you decide not to take medication you should still be offered talking therapy.

NICE produce guidelines for how health professionals should treat certain conditions. You can download these from their website at www.nice.org.uk.

Your GP may refer you to a specialist mental health team such as the early intervention team (EIT), community mental health team (CMHT), or crisis team.

Medication

Antipsychotic medication can help with hearing voices. Medication may not make symptoms go away but it can make voices seem distant or less noticeable. Try not to be too upset if the first antipsychotic that you try doesn’t help. There are lots of different antipsychotics to try because people respond to different medications. You might need to try more than one before you find one that helps. The main negative with medication is that it can have bad side effects. A common side effect is weight gain.

Talking therapies

There are different types of talking therapies recommended for people who hear voices.

Cognitive behavioural therapy (CBT)

CBT can help you to manage your voices and to notice any patterns. This can help you learn what is your trigger for the voices. And how to cope with them. For example, for some people stress can trigger voices. CBT can help you find ways to deal with your stress.

Voices may say things that you think about yourself. CBT can help you be more positive about yourself which can help reduce your negative voices.

What is CBT?

CBT is a talking treatment.

It is there to try and help you to:

  • understand links between your thoughts, feeling and actions,
  • understand your symptoms and how they affect your day to day life,
  • look at your perceptions, beliefs and reasoning.

CBT aims to:

  • help you to be aware of signs that your thoughts, feelings or behaviours are changing,
  • give you a way of coping with your symptoms
  • reduce stress, and
  • improve your functioning.

Family intervention

Family intervention is where you and your family work with mental health professionals to help you to manage your relationships. This should be offered to people who you live with or who you are in close contact with.

The support that you and your family are given will depend on what problems there are and what preferences you all have. This could be group family sessions or individual sessions. Your family should get support for 3 months to 1 year and should have at least 10 planned sessions.

Family intervention can be used to:

  • learn more about your symptoms,
  • improve communication among family members.

Family intervention could help you and your family to:

  • learn more about your symptoms,
  • understand what is happening to you,
  • improve communication with each other,
  • know how to support each other,
  • think positively,
  • become more independent,
  • be able to solve problems with each other,
  • know how to manage a crisis, and improve mental wellbeing.

Art therapy

You may get art therapy if your voices keep coming back. Art therapy may be more useful if you have depressive symptoms, such as withdrawing from people or losing interest in things that you used to enjoy.

You will have arts therapy with a therapist. It will usually be in a group. It is there to mix different communication techniques with creativity. Art therapy aims to help you to:

  • learn new ways of relating to other people,
  • show how you are feeling,
  • accept your feelings, and
  • understand your feelings.

Therapy for trauma

If you have experienced trauma, your voices may be part of your way of dealing with this. This is something which can be treated with counselling or psychotherapy. The therapist will help you to understand the root causes of your voices. They will explore ways to over-come and control difficult voices.

The NHS do not usually offer counselling or psychotherapy to people who are hearing voices. But they should listen to you if you ask for it. Especially if other therapies like CBT, family intervention and arts therapies, are not available locally.

You can find more information about:

  • Antipsychotics by clicking here.
  • Medication. Choice and managing problems by clicking here.
  • Talking therapy by clicking here.
  • Psychosis by clicking here.

Fiona's story

Therapy helped me to understand that the negative male voice was part of me. It’s taken a long time, but the voice no longer holds any power over me. I listen to the voice now because I understand that, because the voice is a part of me, I’m actually listening to myself. I now show respect to the voice and he is now more likely to show me respect. What this means is that I am being more caring and forgiving towards myself.

Fiona

Risks & complications

What risks and complications can hearing voices cause?

Negative voices

It can be common to hear negative, critical voices or unkind voices. Sometimes voices can bully you and tell you to do things you don’t want to. In extreme cases voices can instruct people to harm themselves or others.

This can have an impact on your sense of self-worth and motivation.

Thought processes

Voices can interrupt the thought process and make it difficult to concentrate. They can be overwhelming and intrusive, which can make it difficult to communicate or focus on things you are trying to do.

Look at the previous section, ‘How do I get help if I am hearing voices?’ if you would like support.

Relationships

Hearing voices can have a negative effect on relationships. There’s lots of different reasons that this could happen. Support such as family intervention and support groups can help your friends and relatives to understand you and how to best support you.

Sleep

Voices can interrupt your sleep. This can cause problems with getting enough sleep. Not getting enough sleep can make you feel more emotional. For example, you may feel more irritable or angry. Lack of sleep can cause other health problems.

The Mental Health Foundation have made a guide called, ‘how to Sleep better.’ Look at the ‘further reading’ at the bottom of this page for more information.

Increased risk of suicide

People who hear voices are a higher risk of suicide.

If you feel that you want to harm yourself or other people, you should get help right away. You can do this by:

  • contacting your local mental health team or local crisis team,
  • ask to see your GP urgently,
  • call the NHS 111 service,
  • go to your local accident and emergency department at hospital, or
  • call 999 and ask for an ambulance

You can find more information about ‘Suicidal thoughts – how to cope’ by clicking here.

Problems with treatment

What if I am not happy with my care or treatment?

If you are not happy with your treatment you can:

  • talk to your doctor about your treatment options,
  • ask for a second opinion,
  • get an advocate to help you speak to your doctor,
  • contact Patient Advice and Liaison Service (PALS) and see whether they can help, or
  • make a complaint.

There is more information about these options below.

Treatment options

You should first speak to your doctor about your treatment. Explain why you are not happy with it. You could ask what other treatments you could try.

Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you are not given this treatment, ask your doctor to explain why it is not suitable for you.

Second opinion

A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis.

You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion.

Advocacy

An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard.

There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like.

You can search online to search for a local advocacy service. If you can’t find a service you can contact the Rethink Mental Illness Advice Service on 0300 500 927, we will look for you. But this type of service doesn’t exist in all areas.

The Patient Advice and Liaison Service (PALS)

PALS is part of the NHS. They give information and support to patients.

You can find your local PALS’ details through this website link:

www.nhs.uk/Service-Search/Patient%20advice%20and%20liaison%20services%20(PALS)/LocationSearch/363

Complaints

If you can’t sort your problem, you can make a complaint. Your concerns investigated in more detail.

You can ask an advocate to help you make a complaint. Advocates that do this are called Independent Health Complaints Advocates. They are free to use and don’t work for the NHS.

More Information

Information for family, carers, friends

If you are a carer, friend or relative of someone who hears voices, you can get support.

How can I get support?

You can do the following.

  • Speak to your GP about medication and talking therapies for yourself.
  • Speak to your relative’s care team about family intervention. For more information about family intervention look at the previous section 'What treatment should the NHS offer me?'.
  • Speak to your relative’s care team about a carer’s assessment.
  • Ask for a carers assessment.
  • Join a carers service. They are free and available in most areas.
  • Join a carers support group for emotional and practical support. Or set up your own.

What is a carers assessment?

NICE guidelines state that you should be given your own assessment through the community mental health team (CMHT) to work out what effect your caring role is having on your health. And what support you need. Such as practical support and emergency support.

The CMHT should tell you about your right to have a carers assessment through your local authority. To get a carer’s assessment you need to contact your local authority.

How do I get support from my peers?

You can get peer support through carer support services or carers groups. You can search for local groups in your area by using a search engine such as Google. Or you can contact the Rethink Mental Illness Advice Service and we will search for you.

How can I support the person I care for?

You can do the following.

  • Read information about hearing voices or psychosis.
  • Ask the person you support to tell you what their symptoms are and if they have any self-management techniques that you could help them with.
  • Encourage them to see a GP if you are worried about their mental health.
  • Ask to see a copy of their care plan. They should have a care plan if they are supported by a care coordinator.
  • Help them to manage their finances.

Remember that not everyone who hears voices will have a mental illness. They may also not feel the need to get treatment for their voices. The person you care for may only choose to get help for their voices if they don’t like them or if they are concerning them.

What is a care plan?

The care plan is a written document that says what care your relative or friend will get and who is responsible for it.

A care plan should always include a crisis plan. A crisis plan will have information about who to contact if they become unwell. You should be given information about what to do in a crisis. You can use this information to support and encourage them to stay well and get help if needed.

Can I be involved in care planning?

As a carer you should be involved in decisions about care planning. But you don’t have a legal right to this. The healthcare team should encourage the person that you care for to allow information to be shared with you.

You can find out more about:

  • Supporting someone with a mental illness by clicking here.
  • Getting help in a crisis by clicking here.
  • Suicidal thoughts. How to support someone by clicking here.
  • Responding to unusual thoughts and behaviours by clicking here.
  • Carers assessment by clicking here.
  • Confidentiality and information sharing. For carers, friends and family by clicking here.
  • Money matters: dealing with someone else’s finances by clicking here.
  • Worried about someone’s mental health by clicking here.
  • Benefits for carers by clicking here.
  • Stress by clicking here.

Eleanor Longden – The voices in my head

This video tells Eleanor’s story about the voices she hears. She talks about her journey back to better mental health. And she makes the case that by learning to listen to her voices she was able to survive.

Website: www.ted.com/talks/eleanor_longden_the_voices_in_my_head

The BBC – Why do people hear voices in their heads?

This BBC radio programme looks at what causes people to hear voices. You can listen to it online or download it.

Website: www.bbc.co.uk/programmes/w3csvtc3

Northumberland, Tyne and Wear NHS Foundation Trust

This NHS trust has a lot of self-help materials on different areas. They
have a leaflet called, Hearing voices and disturbing beliefs.’

Website: www.ntw.nhs.uk/pic/selfhelp

Mental Health Foundation: How to sleep better.

Website: www.mentalhealth.org.uk/publications/how-sleep-better

Avatar Therapy

Researchers have been looking into how computer-based treatment may help with hearing voices. This treatment is known as avatar therapy. Avatar therapy is not available at the moment.

In this therapy you create a computer-generated face with a voice which is like a voice you hear. This is called an ‘avatar’. You work with a therapist to talk to the avatar and gain more control over the voice you hear. Results show that this therapy is helpful for some people. But there is more research taking place. You can read about the study by following the link below.

Avatar Therapy UCL webpage: www.phon.ucl.ac.uk/project/avtherapy/

The Hearing Voices Network (HVN)
HVN give information, support and understanding to people who hear voices and those who support them. They also support people who have visual hallucinations and people who have tactile sensations. It gives information and support through its website and self-help groups across the country.
Address: National Hearing Voices Network (HVN), 86-90 Paul Street, London, EC2A 4NE
Email: info@hearing-voices.org
Website: www.hearing-voices.org

Intervoice
Intervoice are a charity. They encourage people all over the world to share ideas through their online community. You can also find information about hearing voices through their articles and resources.
Address: c/o: Mind in Camden, Barnes House, 9-15 Camden Road, London, NW1 9LQ, UK
Email: info@intervoiceonline.org
Website: www.intervoiceonline.org

Voices network
This is a UK wide, London based project supporting children and young people who experience voices. They also offer advice and support for carers, family members and professionals.
Telephone: 020 7911 0822
Email: info@voicecollective.co.uk
Website: www.voicecollective.co.uk

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