What are Auditory Hallucinations?
Auditory hallucination, also known as paracusia, is a type of hallucinations where the patient perceives sounds like voices, music etc. without any actual auditory stimulus, i.e. the patient hears sounds which do not exist and are imaginary. Auditory hallucinations are commonly experienced by people suffering from brain tumors, epilepsy, migraines, Alzheimer's disease, dementia, Lewy body dementia, post-traumatic stress disorder, bipolar disorder, and Parkinson's disease. Auditory hallucinations can also be induced by certain drugs, such as amphetamines and cocaine. Schizophrenia is the most common cause for auditory hallucinations. Also is the surprising fact that in about 15% of people, who have absolutely no physical or mental issues, also may have auditory hallucinations.
Types of Auditory Hallucinations
Auditory Hallucinations Is Divided Into 3 Major Groups:
- The patient hears a voice which is speaking his/her thoughts.
- The patient hears only one voice or multiple voices that are fighting and arguing with each other.
- The patient hears voices which narrates the patient's actions.
However, these 3 categories don't include all the types of auditory hallucinations.
Other types of Auditory Hallucinations include:
- Musical Ear Syndrome. In musical ear syndrome, the patient hears one or many musical songs and musical tones playing in his/her mind. According to studies, listening to music for prolonged period of time can cause musical ear syndrome. This condition can also develop due to lesions in the brain stem, abscesses, tumors, hearing loss, encephalitis, epileptic activity and sleep disorders like narcolepsy.
- Exploding Head Syndrome. The patient hears loud imaginary explosive noises, such as a gunshot, bomb exploding etc.
What are the Causes of Auditory Hallucination?
Some of the common causes of auditory hallucinations include the following:
Brain-Related Causes of Auditory Hallucinations
Brain damage occurring from injury, accident or any medical problem can cause auditory hallucinations. Many patients who have been involved in severe accidents report hearing holy and spiritual voices. There are also many patients who hear different voices immediately after they go to sleep or after they just wake up from a dream. This has relation to different parts of the brain. When a person is sleeping, the brain waves change to a slower range of theta which causes occurrence of random dreams. Most of the people who hear voices in their dreams often hear people calling out their name.
Auditory Hallucinations Caused by Bully or Abuse
People who are abused or bullied in their childhood tend to develop mental health issues like insecurities, anxiety, and depression, which eventually cause auditory hallucinations. Children who have grown up alone without any siblings and who have suffered bullying are at increased risk for auditory hallucinations. Other than this, physical and sexual abuse in children can also cause Auditory Hallucinations which may include the abuser's voice and the patient is not able to control it.
Auditory Hallucinations Induced by Drugs
There are some drugs which affect the neurotransmitters of the brain, resulting in auditory hallucinations. A person after taking a certain drug or after stopping a certain medicine can suffer from auditory hallucinations. Auditory hallucinations can occur in people suffering from Adderall-induced psychosis.
Auditory Hallucinations Caused by Mental Stress
Stress can also cause auditory hallucinations. A person suffering from increased amounts of stress over a long time period of time may hear voices in his/her head. Other than this, death of a loved one can also trigger anxiety and auditory hallucinations. Auditory hallucinations act as a coping mechanism in some people during their initial bereavement days. Isolation also triggers Auditory Hallucinations. A person who is living an isolated life for a long time tends to hear different voices. People in such type of occupations like sailors and castaways experience auditory hallucinations which act as compensation for their lack of social interaction.
Auditory Hallucinations Caused by Starvation
Starvation or lack of food causes malnourishment of the brain due to which the function of the brain is impaired and the patient can experience strange behaviors including auditory hallucinations.
Auditory Hallucinations Caused by Lack of Sleep
Chronic sleep deprivation or insufficient sleep can also induce auditory hallucinations. According to studies, severe sleep deprivation is related with neurons that form the "I-function" of the brain, which pressurizes the neurons and causes symptoms of psychosis including auditory hallucinations.
Auditory Hallucinations Caused Medical Illness
Mental disorders such as psychosis, schizophrenia, dissociative identity, bipolar disorder and major depression disorder can cause auditory hallucinations where the patient hears threatening voices. Post-traumatic stress disorder can also trigger auditory hallucinations which can be seen in victims of crimes, soldiers and victims of natural disasters. Other than mental issues, physical illnesses can also produce delirium in the patient which makes the patient disassociate from his/her surroundings and experience auditory hallucinations.
Treatment for Auditory Hallucinations
If the patient is hearing voices which are positive in nature, then patient need not necessarily silence them and can learn to live with them. However, if the patient hears voices which threaten, pressurize, swear or control him/her, then treatment is needed through a professional psychologist/psychiatrist. Treatment of Auditory Hallucinations consists of:
Antipsychotic medications are the commonly used medications for treating auditory hallucinations. These medicines affect the dopamine metabolism to resolve the problem. If the patient is suffering from mood disorders, then adjunctive medicines, such as antidepressants and mood stabilizers, are also prescribed along with antipsychotic medications.
Cognitive behavioral therapy (CBT) is quite an effective treatment which helps in reducing the frequency and intensity of auditory hallucinations. Supportive psychotherapy also helps in reducing auditory hallucinations. Other behavioral therapies can be used in combination with cognitive behavioral therapy for treating auditory hallucinations.
Electroconvulsive therapy (ECT) is also used for treating symptoms of depression, schizophrenia; symptoms which also include auditory hallucinations. Repetitive Transcranial Magnetic Stimulation (RTMS) is type of brain stimulation treatment which can help in resolving auditory hallucinations. RTMS changes the neural activity of the brain and can be used in conjunction with antipsychotic medications for treating auditory hallucinations.
Cognitive Restructuring or Cognitive Reframing
This is a psychological technique where the irrational or disruptive voices in auditory hallucinations are identified and changed towards positive ones. Reframing the voices heard in auditory hallucinations is a good method of managing them. In Cognitive Reframing, the voices heard in auditory hallucinations are identified and patient is told to bring them to his/her conscious awareness and recognize that these voices are not real and do not exist. Once the patient becomes comfortable with these voices, he/she is able to manage them and decrease their frequency and intensity.