Auditory hallucinations involve hearing sounds that have no external source. In other words, individuals who experience auditory hallucinations hear a sound with no observable cause.

While this symptom occurs fairly often in people with schizophrenia, it can also occur in a range of other psychiatric conditions, such as depression. It may also stem from nonpsychiatric conditions, such as seizures.

Treatment entails addressing the underlying cause. For instance, if the cause of auditory hallucinations is schizophrenia, doctors usually treat it with second-generation antipsychotics.

Keep reading to learn more about the types, causes, and treatment of auditory hallucinations.

People in the sunShare on Pinterest
Dream Lover/Stocksy

Another term for auditory hallucinations is paracusis. A person with this symptom hears words that no one has spoken or sounds that do not come from a stimulus. In other words, their mind creates sounds.

According to a 2022 research article, the prevalence of paracusis ranges from 5–28% in the general population, 9% in children, and 5–16% in adolescents.

There are two types of auditory hallucinations — psychiatric and nonpsychiatric — reports the National Center for Rehabilitative Auditory Research.

Psychiatric

Psychiatric auditory hallucinations can involve:

  • voices
  • noises
  • cries
  • music

Nonpsychiatric

Nonpsychiatric auditory hallucinations can include:

  • voices
  • noises
  • music

These can be unformed sounds, which sound distorted, or formed, which sound clear.

Evidence indicates that auditory hallucinations may happen in the following conditions:

Schizophrenia

Auditory hallucinations have strong links to schizophrenia and related psychotic conditions, and 75% of people with these conditions experience them. The particular kind of auditory hallucinations they have is mostly verbal, meaning they involve voices.

Other psychiatric conditions

Psychiatric conditions other than schizophrenia that cause auditory hallucinations include:

  • Depression: A persistent feeling of severe despair or sadness.
  • Bipolar disorder: A condition of extreme mood swings or emotional highs and lows
  • Personality disorders: These disorders involve a way of behaving or thinking that differs from cultural expectations or that causes problems in functioning. A schizotypal personality disorder is one of these that may involve illusions or unusual perceptions, which can also include auditory illusions.
  • Parasomnias: Sleep disorders that involve undesirable events, such as sleepwalking or talking during sleep.

Neurological conditions

There are neurological conditions that may be responsible for auditory hallucinations, including:

  • cerebral tumors, growths of atypical cells in the cerebral part of the brain
  • epilepsy, a condition involving seizures
  • tinnitus, ringing in the ears
  • delirium, an acutely atypical state of mind that manifests in incoherent thoughts or speech
  • traumatic brain injury, damage to the brain resulting from sudden trauma, such as a blow to the head
  • viral encephalitis, inflammation to the brain due to a viral infection
  • cardiovascular events that affect certain regions of the brain, such as stroke

Miscellaneous conditions

These include:

  • acquired deafness, hearing loss that occurs after birth
  • nutritional deficiencies, inadequate intake of vitamins, minerals, or other nutrients
  • thyroid dysfunction, a condition where the thyroid does not make the typical, healthy amount of hormones
  • an autoimmune disorder, a condition where the immune system attacks healthy cells in the body
  • chromosomal abnormalities, conditions that stem from a change in the number or structure of chromosomes
  • temporary extreme physical or psychological stress, which refers to a serious stressor, such as bereavement or tiredness

Substance misuse

Research from 2017 notes that auditory hallucinations may also occur with alcohol or drug misuse.

Treating and managing auditory hallucinations vary according to the underlying condition.

Treatment of psychosis

If auditory hallucinations have associations with psychosis, treatment involves an antipsychotic medication. This treatment should alleviate the hallucinations within 1 week.

The antipsychotic medication clozapine (Clozaril) is the most effective option for treating symptoms of schizophrenia, such as hallucinations. It is a dopamine antagonist, which means it binds to and blocks dopamine receptors, a neurotransmitter that may play a role in schizophrenia.

Despite this benefit, clozapine may cause severe side effects, such as blood disorders. If a person takes this drug, a doctor should monitor them with regular blood testing.

Treatment of other underlying conditions

Researchers recommend treating any underlying cause of auditory hallucinations. This could entail measures, such as:

  • taking thyroid medication to correct a thyroid hormone deficiency
  • changing the diet to reverse nutritional deficiencies
  • taking anti-seizure medication, such as phenytoin (Dilantin), to treat epilepsy

Additionally, an older 2011 study reports that using a hearing aid can correct hearing loss and ease the associated music hallucinations the condition can cause.

Treatment of hallucinations that are resistant to drug treatment

A 2018 case study states that not everyone with auditory verbal hallucinations responds to drug treatment. Limited options are available for these people, but one is cognitive behavioral therapy (CBT), which teaches someone to change how they experience the hallucinations. CBT is the psychological intervention that doctors most commonly use for auditory hallucinations, but it frequently leads to only modest effects.

The study relates a case involving the use of avatar therapy for auditory hallucinations. In this intervention, the therapist created a digital representation, or avatar, of the presumed “persecutor,” from whom the auditory hallucinations originated. Then, the therapist encouraged the person to enter into a dialog with the persecutor. The results indicated that avatar therapy may help people with auditory hallucinations that do not respond to other treatments.

Health experts advise seeking medical help for any hallucinations.

Some auditory hallucinations can have dangerous complications. They can command an individual to hurt others or result in death by suicide. With this in mind, it is important to get help before such complications occur.

A person with auditory hallucinations hears voices, sounds, cries, or music that do not come from an external source. The kind involving voices is common in schizophrenia. However, auditory hallucinations may also stem from various other psychiatric and nonpsychiatric conditions.

Treatment for auditory hallucinations depends on the cause. To illustrate, doctors treat the cause of schizophrenia with antipsychotic medication, the cause of nutritional deficiencies with dietary intervention, and the cause of hearing loss with a hearing aid.

Generally, anyone who experiences any kind of hallucination should seek medical help, as these symptoms can be dangerous.