Hearing voices

This section may help you if you hear voices, or if you know someone who does. Hearing voices is a very common experience. Hearing voices can be a symptom of some mental health problems, but not everyone that hears voices are unwell. This section looks at what it can be like to hear voices, why you might hear voices and how to cope with them.

If you would like more advice or information you can contact our Advice and Information Service by clicking here.

Download Hearing voices factsheet

Overview

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

Need more advice?

If you need more advice or information you can contact our Advice and Information Service.

About

What does the term ‘hearing voices’ mean?

Mental health professionals often call hearing voices ‘auditory hallucinations’. A hallucination is something you see, taste, smell or hear, that other people cannot.

If you hear voices, this means you hear something that other people cannot.

There are different types voices. Everyone’s experiences are different. Some things you may experience are:

voices talking to you,
voices talking about you,
hearing music,
hearing animal noises, or
hearing background noises, like people chatting, or the sound of a car going by.

What is it like to hear voices?

Hearing voices is a different experience for everyone. The voices might:

be familiar to you or ones you’ve never heard,
be male or female,
feel like they’re inside your head,
feel like they’re outside of you, as if someone is speaking over your shoulder,
speak different languages or have different accents to the ones you’re familiar with,
whisper or shout,
be children or adults,
be sounds, such as the sound of a car or of animals,
talk to you often. Or only say occasional words or phrases, and
talk at the same time as other voices. The voices may talk between themselves or comment on what you are doing.

Some people find hearing voices as a positive experience. 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.

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

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.

Intrusive thoughts are also common for people who have obsessive compulsive disorder (OCD).

See our webpage on Obsessive compulsive disorder (OCD) for more information.

Treatment & causes

Do I have a mental illness if I hear voices?

Up to 1 in 10 people hear voices. Hearing voices is a very common experience.

Hearing voices may be a symptom of a mental illness. A doctor may diagnose you ‘psychosis’ or ‘bipolar disorder’. But you can hear voices without having a mental health diagnosis. Research shows that many people hear voices or experience other types of hallucinations. It is not always a sign of being unwell.

It is also common for people from different cultures to experience hearing voices differently.

You may find it helpful to have a diagnosis. But you may not identify with a diagnosis.

You may have your own explanation for your voices. Some people have spiritual or religious reasons to explain the voices they hear. For example, someone from a religious group may believe they hear voices due to demon and that they are possessed. It’s important to note that many churches agree that hearing voices is not due to demons.

For more information see our webpages on the following:

How do I get help if I am hearing voices?

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 should listen to what the GP says. But you don’t have to act on their advice. It’s your choice what you do. 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 mental health team if it’s your first time hearing voices and asking 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.

Early intervention teams 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 the mental health helpline: www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline
Use an internet search engine. Use a term like ‘‘community mental health team in Cheshire’ or ‘early intervention in psychosis Camden’.

Look at the next section, ‘What treatment should the NHS offer me?’ for more information

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 if I hear voices?

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 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 0808 801 0525 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 read more about self-help further down this page.

See our webpage on NHS Mental Health Teams (MHTs) for more information.

What causes someone to hear voices?

Nobody knows exactly what causes people to hear voices. And it’s not understood why some people hear voices and others don’t. It’s 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 because of difficult experiences you’ve faced. In particular, abuse or other traumatic experiences.

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

trauma, including physical and sexual abuse,
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 after bereavement,
divorce or separation, and
tiredness.

Genetics

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

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) recommends 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. Sometimes the first antipsychotic that you try may not help. This may be frustrating. Please know this is normal. There are lots of different antipsychotics to try because people respond differently to different medications. You might need to try more than one before you find one that helps.

Doctors should explain the benefits and side effects of each drug. In the past, some antipsychotics had negative side effects. Some people find that the side effects of newer antipsychotic drugs are easier to manage.

If you have been on an antipsychotic for a few weeks and the side effects are too difficult to cope with, you should ask your doctor about trying a different one. NICE state that people who have not responded to at least 2 other antipsychotic drugs should be offered clozapine.

The main issue with taking medication is that they can sometimes have bad side effects. A common side effect is weight gain or feeling drowsy.

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 with the voices. 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, and
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.

You may be offered a type of CBT called CBT for psychosis (CBTp). This is for people with psychosis or schizophrenia. You can read the NICE guidelines for CBTp here:
www.nice.org.uk/guidance/qs80/resources/psychosis-and-schizophrenia-in-adults-pdf-2098901855941

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, and
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. This can help with feeling less isolated by being able to share experiences with others. It can also help with building self-esteem and confidence, being creative, and expressing yourself. Art therapy aims to help you to:

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

Therapy for trauma
We understand that many people who experience trauma may hear voices. This is something which can be treated with counselling or psychotherapy. Your therapist can help you to understand the root causes of your voices. Your therapist will explore ways to help manage difficult voices.

The NHS does not usually offer counselling or psychotherapy to people who hear 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.

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

For more information see our webpages on the following:

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 0808 801 0525, 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-advice-and-liaison-services-(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 NHS Complaints Advocates. They are free to use and don’t work for the NHS.

For more information see our webpages on the following:

Managing the voices

What can I do to manage the voices?

People deal with voices in different ways. You might need to try different things before finding something that works for you.

Support groups

You could join a support group. A support group is where people come together to share information, experiences and give each other support. Hearing about the experiences of others can help you feel understood. This may help you feel less alone and boost your self-confidence.

You might be able to find a local group by searching online. The charity Hearing Voices Network have face to face support groups in some areas of the country. Their contact details are in the ‘useful contacts’ at the end of this factsheet.

Rethink Mental Illness have support groups in some areas. You can find out what is available in your area, or get help to set up your own support group if you follow this link:

www.rethink.org/help-in-your-area/support-groups/

Or you can call the Rethink Mental Illness Advice Service on 0808 801 0525 for more information.

Recovery College

Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. They can help you to take control of your life and become an expert in your own wellbeing and recovery. You can usually self-refer to a recovery college. But the college may tell your community mental health team.

Unfortunately, recovery colleges are not available in all areas. To see if there is a recovery college in your area you can click on this link:
www.mindrecoverynet.org.uk/search/

Or you can use a search engine such as Google, by typing ‘Recovery college [your location]. You can also contact the Rethink Mental Illness Advice Service on 0808 801 0525.

Taking control of the voices

When you hear voices, you could:

Talk back to them
Distract yourself
Ignore them
Focus on the voices you like
Set a time each day to attend to them
Stand up to them
Keep a diary to understand your voices
Use a mobile app

Talk back to them
You may find that talking back to your voices helps you take control.

It may be helpful to respond to voices in a way that you would like to be spoken to. For example, if your voice is stressed you could try speaking to it in a calming voice. Some people find it helpful to visualise the voices.

If you are worried about talking back to your voices in public, you could pretend you are speaking to someone on the phone.

If you start to talk back to the voices, you may find that they don’t like the change. Standing up to voices that frighten or bully you can be tough. You may find it helpful to have talking therapy to help you to take the power away from the negative voices.

Distract yourself
Listening to music, the radio or an audiobook 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.

Ignore them
Blocking out the voices can work for some people. For example, you could listen to music, or do an activity that distracts you from your voices. You might need to try a few different activities to see what works for you.

You could try to focus on the voices that you like. You could talk more to these voices, rather than the voices that are unkind.

Set a time each day to attend to them
You could set a time each day to listen to and answer the voices. It might help to explain to the voices that you don’t want to speak to them until your set time. This might help you to manage when you hear the voices.

Stand up to them
Sometimes standing up to the voices can be helpful. If they are unkind.

Standing up to voices that frighten or bully you can be tough.

If you start to talk back to the voices, you may find that they don’t like the change. You may find it helpful to have talking therapy to help you to take the power away from the negative voices.

Keep a diary to understand your voices
You could keep a diary of your voices. You may want to keep a record of the following.

How many voices you have?
When did the voices start?
What was happening in your life when they started?
How often they talk to you, or each other?
Do they usually show up at certain times?
What are they saying?
How they make you feel?
What you do to cope with each voice?

Keeping a diary may help you to notice patterns and if anything that you’re doing is making them worse. This may help you to find new ways to cope with them.

A diary may also help you to talk about your voices with your therapist.

Peer support through the NHS

Your doctor may offer you peer support. Peer support is when you work with someone who has lived experience of hearing voices. And who is now in recovery. They should be able to offer advice and support with:

side effects of medication,
recognising and coping with symptoms,
what to do in a crisis,
meeting other people who can support you, and
recovery.

Self-management techniques

Managing voices on your own is called self-help. Health professionals may offer you help to manage your condition on your own. They may call this 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.
Call and emotional support line to talk about how you’re feeling.
Try relaxation techniques, mindfulness and breathing exercises.
Do things that you find relaxing such as having a bath
Try a complementary therapy such as meditation, massage, reflexology or aromatherapy.
Stick to a sleep pattern, eat well and look after yourself.
Set small goals such as going out for a small amount of time everyday. Reward yourself when you achieve a goal.
Do regular exercise such as walking, swimming, yoga or cycling.

For more information see our webpages on the following:

Risks and complications

What risks can hearing voices cause?

Negative voices

It can be common to hear unkind, negative and critical. Sometimes voices can bully you and tell you to do things you don’t want to. This can have an impact on your sense of self-worth and motivation.

In some cases, voices can instruct people to harm themselves or others. If this is happening to you, it’s really important you share this with someone.

You can tell your GP, call your local mental health helpline, or call 999 if it’s urgent. Mental health professionals are understanding of this.

Increased risk of suicide

People who hear voices are at a higher risk of suicide. This may be because sometimes people hear voices that tell them to harm themselves.

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,
asking to see your GP urgently,
calling your local mental health helpline: www.nhs.uk/service-search/mental-health/find-an-urgent-mental-health-helpline
going to your local A&E department at hospital, or
calling 999 and asking for an ambulance

See our webpage on Suicidal thoughts – how to cope for more information.

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 above, ‘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. For example, the voices may tell you things about people you care about, and you may stop trusting them. 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 drained, which can have an effect on your emotions. 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’ section at the bottom of this page for more information.

You can find more ideas about how to sleep better on the Rethink Mental Illness website here: www.rethink.org/advice-and-information/living-with-mental-illness/wellbeing-physical-health/how-can-i-improve-my-sleep/

Information for family, carers and friends

Information for family, carers and 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 above, ‘What treatment should the NHS offer me?’ for more information.
Speak to your relative’s care team about a carer’s assessment.
Ask for a carer’s 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. Either in person or online.

What is a carer’s 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 carer’s assessment through your local authority. To get a carer’s assessment, you need to contact your local council. You can ask for a carer’s assessment. Or for a combined assessment for the person you care for, and yourself. You can find your local council’s website by typing your postcode here: www.gov.uk/apply-needs-assessment-social-services

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. You can find all of our peer and carer support groups here: www.rethink.org/help-in-your-area/support-groups/

Or you can call our Advice Service on 0808 801 0525 (Monday to Friday, 9.30am – 4pm, excluding bank holidays). You can email us too at advice@rethink.org. We can 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.
Expect and accept mixed emotions from them about their experience of hearing voices.
Complete the short free online course, Caring for People with Psychosis and Schizophrenia: www.futurelearn.com/courses/caring-psychosis-schizophrenia
Help them to manage practical things such as their finances, if they ask for help.

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.

For more information see our webpages on the following:

Useful contacts

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 up to 25 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

Action on Postpartum Psychosis
A national charity for women and families affected by postpartum psychosis. They run a peer support service, provide information, training to health professionals, do research and promote awareness.

Phone: 0203 322 9900
Address: c/o Action on Postpartum Psychosis, PO Box 137, Swansea, SA3 9BT
Email: app@app-network.org
Website: www.app-network.org

Need more advice?

If you need more advice or information you can contact our Advice and Information Service.

Hearing voices

If you would like more advice or information you can contact our Advice and Information Service by clicking here.

Overview

Need more advice?

About

What does the term ‘hearing voices’ mean?

What is it like to hear voices?

Stevie's story

Stevie

Is hearing voices the same as intrusive thoughts?

Treatment & causes

Do I have a mental illness if I hear voices?

How do I get help if I am hearing voices?

How can the NHS help me?

How can social services help me?

What other help is available if I hear voices?

What causes someone to hear voices?

Life experiences

Genetics

What treatment should the NHS offer me?

Medication

Talking therapies

Fiona's story

Fiona

Problems with treatment

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

Treatment options

Second opinion

Advocacy

The Patient Advice and Liaison Service (PALS)

Complaints

Managing the voices

What can I do to manage the voices?

Support groups

Recovery College

Taking control of the voices

Peer support through the NHS

Self-management techniques

Risks and complications

What risks can hearing voices cause?

Negative voices

Increased risk of suicide

Relationships

Sleep

Information for family, carers and friends

Information for family, carers and friends.

How can I get support?

How can I support the person I care for?

Further reading

Useful contacts

Need more advice?