What Are Auditory Hallucinations? Causes, Symptoms, and Treatment

A comprehensive guide to understanding auditory hallucinations, including their causes, symptoms, and treatment options, with a focus on mental health conditions and available therapies.

An auditory hallucination is the perception of sound in the absence of an external auditory stimulus. These hallucinations may manifest as simple sounds, such as ringing or buzzing, or as complex perceptions, such as hearing voices or music. While commonly associated with psychiatric and neurological conditions, auditory hallucinations can arise from a variety of medical, environmental, and psychological factors. Understanding the causes, symptoms, and treatment options is crucial to supporting hallucination patients and reducing the stigma surrounding this phenomenon.

Types of auditory hallucinations

Auditory hallucinations can be classified into several categories and the nature of these hallucinations varies widely depending on the underlying cause. Here are common types of auditory hallucinations:

• Simple auditory hallucinations include non-verbal noises such as clicking, humming, or hissing, often linked to conditions like hearing loss or hearing impairment. 
• Complex auditory hallucinations involve more intricate sounds, including music, conversations, or distinct voices. 
• Auditory verbal hallucination, where individuals hear voices instructing them to perform actions, sometimes dangerous or harmful. 

Causes of auditory hallucinations

There are multiple causes of auditory hallucinations, ranging from psychiatric disorders to neurological conditions and substance use.

Psychiatric conditions

Experts say that auditory hallucinations are most frequently associated with schizophrenia symptoms and other psychotic disorders, where hearing voices may be persistent and emotionally charged. Schizoaffective disorder combines features of mood disorders and psychosis, often leading to auditory verbal hallucinations. Bipolar disorder can also involve hallucinations, particularly during manic or depressive episodes with psychotic symptoms. In severe cases of major depressive disorder, individuals may hear critical or distressing voices, exacerbating their emotional struggles.

Neurological and medical causes

Several neurological disorders can contribute to auditory hallucinations. Epilepsy, particularly temporal lobe epilepsy, can produce auditory disturbances before or during seizures. A brain tumor affecting auditory processing areas may lead to hallucinations. Neurodegenerative disorders like Parkinson’s disease and Alzheimer’s disease can also cause auditory misperceptions, often as part of broader cognitive decline. Hearing loss or hearing impairment can sometimes lead to auditory hallucinations as the brain compensates for the lack of external sound input.

Substance use and withdrawal

Alcohol and drug use can significantly impact auditory perception. Alcohol withdrawal, particularly in cases of delirium tremens, may cause auditory hallucinations. Recreational drugs such as LSD, methamphetamine, and cocaine can induce temporary hallucinations. Certain prescription medications, particularly those affecting dopamine or serotonin levels, may also contribute to auditory hallucinations as a side effect.

Other contributing factors

Beyond medical and psychiatric causes, extreme stress and trauma (as seen in PTSD) can trigger auditory hallucinations, often in the form of intrusive voices. Sensory deprivation, such as prolonged isolation, may lead to hallucinations due to the brain’s attempt to fill in missing sensory input. Hypnagogic hallucinations, occurring between wakefulness and sleep, can create realistic auditory or visual hallucinations, sometimes accompanied by a sense of fear or paralysis. Panic attacks can also trigger auditory disturbances, making them more distressing.

How are auditory hallucinations diagnosed? 

Proper assessment of auditory hallucinations requires a comprehensive approach. Medical professionals conduct psychiatric evaluations to determine if hallucinations are linked to a mental health condition. Neurological tests and imaging may be necessary to rule out brain tumors or degenerative disorders. Differentiating between normal inner thoughts and true hallucinations is crucial, as some individuals may mistake intrusive thoughts for external voices. Early intervention can significantly improve outcomes, making prompt diagnosis essential.

Treatment approaches for auditory hallucinations

Treating auditory hallucinations depends on the underlying cause. A combination of medication, therapy, and lifestyle changes can help manage symptoms effectively.

Psychiatric treatment

For those with psychotic disorders, antipsychotic medication such as risperidone or olanzapine can help reduce hallucinations by altering dopamine activity in the brain. Mood stabilizers and antidepressants may be prescribed for individuals with schizoaffective disorder, bipolar disorder, or major depression with psychotic symptoms.

Therapeutic approaches

Cognitive behavioral therapy (CBT) is a valuable tool for helping individuals challenge and reframe distressing hallucinations. Therapy can provide coping strategies to reduce the emotional impact of hallucinations. Mindfulness techniques and grounding exercises can help individuals regain a sense of control over their experiences. Additionally, support groups and psychoeducation offer a sense of community and shared understanding.

Lifestyle and alternative strategies

Beyond clinical treatments, lifestyle modifications can help manage auditory hallucinations. Reducing stress, improving sleep, and avoiding known triggers (such as alcohol and stimulant use) can decrease symptom severity. Some individuals find relief through sensory interventions, such as listening to music or engaging in relaxation exercises.

When to seek help for auditory hallucinations

It is crucial to seek professional support if auditory hallucinations cause significant distress, interfere with daily life, or lead to unsafe behaviors. Warning signs that require urgent attention include command hallucinations urging self-harm or violence, severe paranoia, or a rapid decline in functioning. Resources such as mental health hotlines, therapy, and psychiatric care can provide much-needed support for those struggling with auditory hallucinations.

How Charlie Health can help

If hallucinations or psychosis are affecting your mental health, Charlie Health is here to help. Charlie Health’s virtual Intensive Outpatient Program (IOP) provides mental health treatment for people dealing with serious mental health conditions, including psychosis, anxiety, depression, trauma, and more. Our expert clinicians incorporate evidence-based therapies into individual counseling, family therapy, and group sessions. With this kind of holistic online therapy, managing your mental health is possible. Fill out the form below or give us a call to start healing today.