Auditory hallucinations, or hearing voices, are relatively common. They can happen because of a mental health condition or during times of stress, grief, or lack of sleep.

Ever heard a voice inside your head that wasn’t your own? You may have experienced an auditory hallucination.

The voice might have sounded like someone you knew, making you do a double-take to check they hadn’t come up behind you. Or maybe it sounded like a stranger striking up a conversation or commenting on your choice of clothing.

However the voice sounded, you might have felt a little confused, possibly even concerned about your mental well-being.

You might have kept it to yourself, knowing that people often associate seeing or hearing things that aren’t there with schizophrenia and other serious mental health conditions.

Yet research from 2020 notes that up to 15% of the general population experiences auditory hallucinations.

Auditory hallucinations don’t sound the same for everyone.

For instance, they may:

  • sound like a friend
  • speak kindly or compliment you
  • talk about private things you’ve never told anyone
  • say unkind things or criticize you
  • comment on your activities
  • offer guidance, including spiritual guidance
  • urge you to do potentially dangerous things
  • sound like music or other sounds rather than voices

These auditory hallucinations can happen with or without other mental health symptoms.

In fact, research from 2017 explains that auditory hallucinations have various causes and can also occur without any underlying condition.

The authors of that report urge mental health professionals to avoid diagnosing schizophrenia or any psychotic disorder when someone reports hearing voices without other symptoms.

Voices that occur with mental health conditions tend to:

  • start slowly and intensify, then end gradually rather than all at once
  • last longer
  • seem to come from an external source
  • accompany or contribute to delusions
  • get in the way of everyday life

Still, voices that happen with schizophrenia and other conditions can vary quite a bit.

Research from 2023 suggests cultural background could play a part in the type of voice you hear.

In a sample of around 6,000 people who reported hearing voices and met the criteria for schizophrenia, the researchers found:

  • people in Europe (the United Kingdom) tended to say the voices were more abusive, commanding, and scary compared to people in West Africa
  • people in the Middle East (Suadi Arabi) were most likely to hear voices related to religious and supernatural themes

Do intrusive thoughts count as auditory hallucinations?

Typically, no. Intrusive thoughts tend to show up as distinct thoughts, so you “hear” them in your own mental voice just as you would any other thought.

With auditory hallucinations, you hear the voice of someone else or a distinct sound.

While it’s absolutely possible to hear voices without any underlying condition, auditory hallucinations sometimes have a specific cause.

You could hear voices:

Auditory hallucinations can also show up as a symptom of some medical and mental health concerns.

Schizophrenia spectrum disorders

Symptoms of schizophrenia and related conditions typically appear in early adulthood. They’re characterized by a disconnect from reality, which usually includes auditory or visual hallucinations as well as delusions.

Other common symptoms include:

Sleep disorders

A sleep disorder is any condition that regularly prevents you from getting the amount of sleep you need.

Your brain and body need sleep to function properly, and regular sleep deprivation can have serious health consequences.

You’ll want to talk with a healthcare professional if you:

  • have trouble falling asleep or wake up often
  • feel fatigued during the day or need naps to function
  • have trouble breathing while sleeping
  • notice difficulty concentrating on daily tasks
  • notice daytime anxiety, irritability, or depression
  • can’t maintain your desired sleep and wake schedule
  • frequently talk or move in your sleep

Post-traumatic stress disorder (PTSD)

Some people hear voices after experiencing a traumatic event. PTSD often causes extreme physical and emotional distress, so it can have a big impact on daily life.

Along with hallucinations, you might experience:

  • flashbacks or nightmares
  • difficulty focusing
  • anger and irritability
  • feelings of guilt, blame or self-blame, or depression
  • disinterest in your usual activities
  • anxiety, uneasiness, or panic

Other mental health conditions

It’s possible to have auditory hallucinations with many different mental health conditions, though not everyone with these conditions will ever hear voices.

  • Depression involves a persistent low mood, along with feelings of sadness, hopelessness, or emotional numbness.
  • Bipolar disorder is characterized by episodes of extreme mood. Along with hallucinations, you can experience episodes of mania (highs), episodes of depression (lows), or a combination.
  • Borderline personality disorder involves instability in emotions, sense of self, and relationships. You might also have fears of abandonment or feelings of emptiness.
  • Dissociative identity disorder is characterized by a person’s identity being split into two or more separate identities. You could hear people talking in your head or notice significant memory gaps.

Brain and nervous system disorders

You could hear voices with health conditions that affect the brain or nervous system, including:

Symptoms of these conditions may include:

  • sudden, persistent head pain
  • numbness and tingling
  • vision changes
  • trouble with memory or concentration
  • weak or rigid muscles or muscle tremors
  • seizures
  • slurred speech or difficulty speaking clearly

Vitamin deficiency

You could experience hallucinations when you don’t get enough of certain vitamins, including vitamins D and B12.

Research from 2021 has associated lower levels of vitamin D to more severe schizophrenia symptoms.

Symptoms of vitamin D or B12 deficiency might include:

Hearing voices isn’t always a cause for concern. You probably don’t need to worry if:

  • you don’t feel disconnected from reality
  • the auditory hallucinations don’t affect your everyday life
  • you don’t have other symptoms
  • the voices don’t bother you or encourage you to hurt anyone
  • you hear voices very rarely

Hearing voices that say cruel or unkind things, however, can affect your sense of self-worth and emotional well-being.

Even if you don’t have other symptoms, a trained therapist can offer nonjudgmental guidance and support.

Hearing voices can be confusing, distracting, or even upsetting, especially if they say critical or unkind things or make you feel bad about yourself.

Not knowing why the voices happen might add to your distress.

These strategies may not always make the voices go away, but they can help you cope with them:

Keep a journal

Some people find it helpful to keep a log of auditory hallucinations they experience.

Recording what the voices say, when you hear them, and how they make you feel can offer insight into potential causes or triggers of the voices and common themes you notice.

For example, you might only hear them at a specific time of day or when you feel a certain way, such as tired or angry.

If you decide you want to talk with a therapist about the voices, this recorded information could be key to identifying what’s going on.

Talk about them

You might hesitate to tell loved ones that you’re hearing voices, but opening up to someone you trust can help.

Try talking with someone who has a history of offering nonjudgmental support, such as a best friend or close sibling.

Simply telling someone about your experience can help ease distress, and knowing you have support can help you feel less alone.

If you’re hearing voices while under a lot of stress or after a loss or traumatic event, talking about those underlying triggers may help you get the support you need to cope. In time, this could help the voices go away entirely.

Not ready to talk about hearing voices to anyone you know? That’s absolutely OK.

You can also try peer support groups for people who hear voices, such as:

Accept them

It often helps to acknowledge that hearing voices is common — plenty of people hear voices from time to time.

Accepting these voices as part of your experience can help you feel less distressed, and over time, you might notice them less and less.

While some people find it most helpful to ignore the voices, talking back could help you accept them and regain some control.

Some tips:

  • Speak calmly and compassionately, even if the voices say negative things.
  • Try a “Thanks, but no thanks” approach. Acknowledge the voice by letting it know, “I hear what you’re saying, but I’m not going to focus on it right now.” Then return your attention to what you were doing.

Becoming more mindful in your day-to-day life can also help. When you’re focused on the present moment, voices and unwanted thoughts might not distract you so easily.

Even if you hear a voice or sound occasionally, increased mindfulness can make it easier to acknowledge it and let it go.

Relax and practice self-care

Taking care of yourself and making time for relaxation can help boost your well-being. This can, in turn, ease the effects of stress and mental health symptoms.

Self-care might include:

Hobbies and other enjoyable activities can also offer a distraction from voices and other sources of stress.

Music, another great relaxation strategy, can do more than help ease stress. Some people also find it helps tune voices out.

Along with your favorite playlists, you can also try:

  • relaxing sounds, such as rain, waterfalls, and ocean waves
  • instrumental or ambient music
  • audiobooks

Get professional support

When voices do occur alongside other symptoms, cause distress, or happen frequently enough to affect your daily life, you can talk with a healthcare professional to discuss diagnosis and treatment options.

If you hear voices that encourage you to hurt yourself or anyone else, get support as soon as possible to stay safe.

A therapist or other health professional won’t call you “crazy” or immediately diagnose a specific condition.

They will:

  • ask questions about other symptoms to help rule out medical concerns
  • help you explore the voices and any potential triggers or underlying causes
  • offer guidance on treatments and coping skills

A healthcare professional like a primary doctor can offer more guidance when you experience physical symptoms rather than mental ones.

Experiencing auditory hallucinations may not automatically mean you have a mental health condition, but it can still feel unsettling and frightening.

If you can’t seem to turn the voices down or tune them out, a therapist can offer compassionate guidance and support.

Crystal Raypole has previously worked as a writer and editor for GoodTherapy. Her fields of interest include Asian languages and literature, Japanese translation, cooking, natural sciences, sex positivity, and mental health. In particular, she’s committed to helping decrease stigma around mental health issues.