Auditory hallucinations happen when you hear voices or noises that don’t exist in reality. In some cases, they’re temporary and harmless, while in others, they may be a sign of a more serious mental health or neurological condition. Auditory hallucinations have many possible causes.
Auditory hallucinations happen when you hear voices or noises that aren’t there. The sounds you hear may seem real, but they’re not.
A person may perceive auditory hallucinations as coming through their ears, on the surface of their body, in their mind or from anywhere in the space around them. They can occur as frequently as daily or as an isolated episode.
Auditory hallucinations are often associated with schizophrenia and other mental health conditions, but they can happen for several other reasons, such as hearing loss, and aren’t always a sign of a mental health condition.
Researchers estimate that 5% to 28% of people in the United States experience auditory hallucinations. They’re the most common type of hallucination.
Some people experience auditory hypnogogic hallucinations that specifically take place as they’re falling asleep. These types of hallucinations are common and usually not a cause for concern.
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The two main types of auditory hallucinations are verbal (hearing voices) and hearing sounds or noises.
An auditory verbal hallucination is the phenomenon of hearing voices in the absence of any speaker.
The experience of hearing voices can vary greatly from person to person and even for the same person. They can vary in how often you hear them, what they sound like, what they say and whether they’re familiar or unfamiliar.
The voices may come from a single source, such as a television, or multiple sources. It may be a singular voice or multiple voices. They may talk directly to the person, have discussions with them or describe events taking place.
The voices may be positive, negative or neutral. Sometimes, hearing voices can be upsetting or distressing. They may command you to do something that may cause harm to yourself or others.
Auditory verbal hallucinations most commonly affect people with schizophrenia and/or post-traumatic stress disorder (PTSD), but they can happen to people who don’t have any health conditions.
Auditory hallucinations can take the form of hearing sounds or noises, such as music, animal calls, nature sounds or background noises. They may seem like they’re coming from anywhere in the space around you or in your mind. The noise volume can vary from very quiet to very loud.
If you experience auditory hallucinations just as you’re falling asleep (hypnogogic hallucinations) or waking up (hypnopompic hallucinations), it’s considered normal and usually not a cause for concern. Up to 70% of people experience these types of hallucinations at least once.
If you experience auditory hallucinations while you’re wide awake, it may be — but isn’t always— a symptom of a mental health or neurological condition. Talk to your healthcare provider about the hallucinations and any other symptoms you have.
Several situations and conditions — both temporary and chronic — can cause auditory hallucinations.
Scientists don’t yet know the exact mechanisms in your brain that cause auditory hallucinations, but they have a few theories, including:
Approximately 75% of people with schizophrenia experience auditory hallucinations — usually hearing voices.
Schizophrenia refers to both a single condition and a spectrum of conditions that fall under the category of psychotic disorders. These are conditions where a person experiences some form of disconnection from reality. Those disconnections can take several different forms, including experiencing hallucinations.
Schizophrenia is characterized by:
Schizophrenia is a chronic condition that may progress through several phases, although the length and patterns of the phases can vary. People with schizophrenia are more likely to experience hallucinations during the active phase.
People with other mental health conditions can experience auditory hallucinations. They affect:
Auditory hallucinations occur in 16% of adults with hearing impairment, which can take two forms: simple hallucinations (tinnitus) and complex hallucinations (speech and music).
According to studies, the more severe the hearing impairment, the more likely it is that you’ll experience auditory hallucinations.
Several neurological conditions can cause auditory hallucinations, including:
Several other — usually temporary — conditions and situations can cause auditory hallucinations, including:
The treatment for auditory hallucinations depends on the cause. Hallucinations caused by temporary conditions, such as extreme hunger or lack of sleep, will stop once the underlying condition has been treated or resolved.
Healthcare providers only prescribe medication to manage auditory hallucinations if they’re part of an underlying chronic condition. Medications include:
For people with mental health conditions who experience auditory hallucinations, psychotherapy (talk therapy) can help in conjunction with medication.
Psychotherapy is a term for a variety of treatment techniques that aim to help you identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to you and your family.
Types of psychotherapy that can help with auditory hallucinations include:
If you’re experiencing auditory hallucinations only as you’re falling asleep (hypnogogic hallucinations), they may decrease in frequency if you do the following:
If you experience auditory verbal hallucinations (hearing voices) due to a mental health or neurological condition, it’s important to talk to your healthcare provider about them. Aside from medication and talk therapy, other techniques may help you manage and cope with them, including:
Auditory hallucinations have several causes — some of which are normal and harmless. But if you’re experiencing auditory hallucinations that are causing you distress, talk to your healthcare provider.
If you or someone you know is experiencing auditory hallucinations and is detached from reality, you or they should get checked by a healthcare provider as soon as possible.
A note from Cleveland Clinic
It’s important for people experiencing auditory hallucinations to talk about them with their family and healthcare team, especially if they’re causing distress. Auditory hallucinations caused by a mental health condition are usually manageable with treatment and can become disturbing or dangerous if they’re not treated. Discuss all possible symptoms with your healthcare provider, no matter how minor or bizarre you may think they are. Hallucinations can make you feel nervous, paranoid and frightened, so it's important to be with and talk with someone you can trust.
Last reviewed by a Cleveland Clinic medical professional on 06/10/2022.
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