Hearing voices. Auditory hallucinations. That means I am crazy, right? That I have finally lost it, gone over to the land of no return, no more reality for me?
That’s what I thought the first time it happened. I was terrified. I was scared to tell anyone. I wasn’t sure what really happened. Maybe it didn’t really happen. Maybe I was just thinking something, I didn’t really hear something.
But then it happened again. And again. And umm okay I thought about telling my husband and psychiatrist. This was about 15 years, before I was diagnosed with PTSD. With my brother’s history of schizophrenia, we were all sure that I was starting some psychosis. I was put on anti-psychotics. The meds did not make the voices stop, they made me sick, anxious, and caused visual hallucinations. The doctor said that was impossible and was simply my psychosis advancing. I was given more meds to try. I played along for a while, until some combination of the meds and my situation made me give in to suicidal urges. My suicidal ideation became a concrete plan and I made the first of several attempts that year. The only times I have ever attempted suicide I have been heavily medicated. Otherwise, I only have this ideation, this distant aching thought that I wish to be nonexistent, which is VERY different from looking up lethal dosages.
Anyway, back on topic, I realized I have not talked here about AH – Auditory Hallucinations and that they can be part of PTSD. I wanted to share my experience and some of the research I found. Here are some links to read more about AH with PTSD.
“In the past, when someone uttered the phrase ‘I hear voices in my head’ the immediate assumption was that they had a mental illness such as schizophrenia or psychosis. These days however, we are more attuned to the nature of auditory hallucinations and understand that it is a complex subject that has many different causes. There is also far more support and understanding for those who experience voices, hopefully showing that they are not alone.
The experience of hearing voices differs from person to person. Some people hear the sound through their ears, just as if someone is speaking. Others hear the voice from inside their head. There may be one voice or several. The voices can be encouraging and supportive or malevolent and intimidating. You may recognise the voice as someone in your life – or it may be an entirely new voice.
Some people believe they can hear other people’s thoughts, while others may feel threatened by their voices. In some cases, the voices try to tell people what to do which can be incredibly frightening for the listener.
The important thing to remember is that admitting that you hear voices in your head is not an admission of insanity – it is an important starting point to help you regain control.”
“Among combat veterans with PTSD, 30-40% report auditory hallucinations (AH). AH are more frequent in combat veterans with chronic PTSD and it has been suggested that this may reflect a distinct subtype of PTSD that may be under recognized for two reasons: first, patients are reluctant to report AH and, second, more emphasis has, traditionally, been placed on the intrusive images associated with PTSD and less on intrusive auditory hallucinations.
It is important to recognize that such patients do not have the overt changes in affect or bizarre delusions characteristic of other psychoses e.g. schizophrenia. AH in PTSD appears to be seen more in veterans with higher combat exposure and more intense PTSD symptoms and who report more severe symptoms of hyperarousal. The AH are typically: ego-dystonic; contribute to an increases sense of isolation and shame; associated with feelings of lack of controllability; consist of combat-related themes and guilt; non bizarre; not associated with thought disorders and, overall, more refractory to treatment interventions.“
“Auditory hallucinations are present in several nonpsychotic disorders, as well as a proportion of the ‘normal’ population. Auditory hallucinations in PTSD may be chance occurrences, which are perceived as threatening, secondary to the heightened arousal state of PTSD. Misdiagnosis is likely to persist without a longitudinal approach and understanding of the underlying biological basis for the illness and its later course, as the clinical presentation is difficult to differentiate on a cross-sectional basis. Symptoms such as hallucinations have been shown to be clinically indistinguishable in adolescents with PTSD or a psychotic disorder.”
“Rare cases of PTSD may involve auditory hallucinations and paranoid ideation. Individuals who experience auditory hallucinations may experience tinnitus, a constant ringing in one’s ears, or they may hear a voice or set of voices that are not physically present. Individuals who are experiencing paranoid ideation are highly guarded and constantly suspicious of being harmed and harassed by those around them. When the trauma involves violent death, symptoms of both complicated grief and PTSD may be present.”
As for my own experiences, mainly I have a deep man’s voice that I hear. It is loud and startling. I usually hear it to my left, causing me to turn my head and look for the person who might have said something, but of course no one is there. It is so loud that I am startled, often I jump or gasp in reaction. The voice says horrible things to me. I don’t think the voice is my father’s voice, it sounds much deeper and raspier to me-like a demon radio announcer. It does however say things to me similar to what my father would have said – similar – but not exactly. So this voice is not exactly a flashback. I do have those too, reliving experiences, and this is different. This voice I hear I don’t leave reality, I am still in the current time, there is no visual component either. I will doing ANYTHING and this voice can intrude.
Like yesterday I was walking down the hallway and noticed my dog sleeping sweetly in my son’s room. I felt warm and smiled as I walked by on my way to the bathroom. Then I heard this deep voice, booming, almost like through a PA announcing “She is going to die”. Instantly I am filled with sadness and fear for my dog, dreading her death. She is in good health. No one is going to hurt her. I know this. So is this voice a remnant of my father hurting my past pets? I don’t think he ever actually said those exact words to me. I generated that, not remembered that.
Other times I will be talking to Hubby, about nothing in particular, and I will hear the voice say “You are a fool, stupid slut, no one loves you” or “He hates you, its a trick” or “why do you keep trying?”
Again, these voices I hear are similar to messages I received as a child, but not exact memories. So I think it is related to PTSD. Is it psychosis? Well…I do hear voices from nonexistent people. Is it a form of schizo-blahblah whatever disorder? No one knows. But it seems related.
All I know, is it sucks big time. It is getting more difficult to manage, not easier. Meds do not help, and I have tried them all. This is seriously debilitating, and makes it impossible to have relationships and be around people since I am in constant battle with the voices in my head. It is exhausting to keep saying “shut up, they do love me, I am worth it, I am safe, no one is tricking me here, go away”. I used to shut off the voices instantly – like talk to the hand. But this new therapy program wanted me to listen to them, to sit with the feelings, to explore the thoughts. Okay, great, so I have done that, and now I hear them more than ever and feel everything the voices want me to feel. Is this supposed to be better? I am not sure how long this stage is supposed to last. No one has an answer for me on this. I am supposed to keep using my cpt tools and working through it without losing my mind completely, which I actually do fear will happen one day. The mental exhaustion of sorting through all of this is too much sometimes. That’s when I choose to zone out and mindlessly watch TV for hours on end.
So I have been paying more attention and I think I hear other sounds too, not just the voice – like squeals, cries, wind, footsteps, scrapes, other creepy there might be someone in your house horror movie kind of sounds. That might be the hypervigilance producing something for me, since I am always on guard, once in a while it gives me something to hear. Research thinks these sounds and AH are related to dissociating and flashbacks somehow but the mechanisms are not entirely understood in our amazingly complex brains. I think I used to listen so carefully for signs of danger, and now I generate sounds of danger similar to memories.
I am resisting a slew of snarky comments, about how fun this condition is for me. You get it. But I am curious if anyone else hears stuff too. Don’t worry, you can tell me, I won’t tell anyone, and I won’t think you are crazy, or at least not any crazier than I am. I would like to know how anyone copes, manages, handles it, other than simply waiting for it to go away.