Auditory hallucinations

A doorbell ringing, but no one is at the door; music, even though the radio is off; voices or noises, even though there is no one else in the house. Auditory hallucinations can take many different forms. And many people have experienced them in one way or another at some point. They are often harmless, but can sometimes be a symptom of a mental health condition. Below, you can find out more about auditory hallucinations, including their causes, examples and treatment.

What are auditory hallucinations?

Hallucinations are sensory illusions, meaning that those affected perceive stimuli that are not actually real. These stimuli can affect all the senses, such as sight, hearing or touch. A distinction is therefore made between, amongst other things, visual, auditory and tactile hallucinations.

Auditory hallucinations relate to hearing. People who suffer from auditory hallucinations therefore hear things that cannot be attributed to a real sound source, but which appear real to them. These can include voices, noises or even music. Acoustic hallucinations should not be confused with ringing in the ears or tinnitus, which are caused by physical factors such as noise pollution, hearing loss or circulatory disorders.

Examples of auditory hallucinations

People with auditory hallucinations can perceive them in very different ways. Some report hearing whispers or voices in their head, others hear specific sounds such as hissing or crackling, whilst others hear music, specific songs or melodies.

The intensity or frequency of auditory hallucinations also varies depending on the individual or the cause. They can occur continuously or intermittently.

It is essential to have the causes investigated by a doctor so that the correct treatment can be identified based on the diagnosis.

Causes of auditory hallucinations

Normally, we perceive external stimuli through our sensory organs - that is, our skin, mouth, nose, ears and eyes. These stimuli are then sent to our brain, where they are processed.

In the case of auditory hallucinations, however, misperceptions occur in the brain that trigger these stimuli. The reasons for this can vary greatly, ranging from mental health conditions and neurological disorders to stress.

Mental health conditions

Mental health conditions are among the most common triggers of auditory hallucinations, as well as hallucinations in general. Examples include depression, borderline personality disorder, schizophrenia, anxiety disorders and psychoses, which can be triggered, for example, by loneliness, lack of sleep or high levels of stress.

Stress

Stress does not automatically lead to a mental illness, but it can contribute to the occurrence of auditory hallucinations. People under a lot of stress often sleep poorly. Stressed individuals are also more likely to resort to unhealthy coping mechanisms, such as high consumption of coffee, alcohol or drugs.

Physical causes

There are various physical causes of auditory hallucinations, ranging from dehydration to conditions such as brain tumours, epilepsy, dementia, injuries and traumatic brain injuries, right through to strokes. Various ear conditions such as tinnitus and hearing disorders can also trigger auditory hallucinations.

Alcohol and drug use

The consumption of drugs and alcohol is also one of the most common causes of auditory hallucinations. Furthermore, certain medications can produce a similar effect. Even excessive coffee consumption has been identified as a cause in connection with the occurrence of auditory hallucinations.

Altered states of consciousness

In addition to drug use, there are other mind-altering practices that can trigger hallucinations. These include, for example, various forms of meditation. Therefore, one should also be particularly careful in this regard.

Auditory hallucinations in hearing impairment

A particularly interesting phenomenon is auditory hallucinations in cases of hearing loss.

They actually occur very frequently in mentally healthy but hard-of-hearing or deaf people and often increase as hearing loss worsens. Those affected also hear noises, voices or music that are not real or that, due to their hearing impairment or loss, could not possibly be heard at all. They are therefore aware that these are not real noises or sounds, which is why this is also referred to as ‘pseudohallucinations’.

Acoustic hallucinations at night

Acoustic hallucinations occur particularly frequently at night or whilst half-asleep. People suddenly hear voices or noises, think the telephone has rung, their mobile has vibrated, and so on. They do not know whether they are dreaming or awake; the situation feels very real.

Unlike in a dream, however, one is still awake, albeit only “half-awake”. And often, it is only when fully awake that those affected realise that what they heard was not real.

In medicine, these sleep-related hallucinations are classified as either ‘hypnagogic’ or ‘hypnopompic’ hallucinations. The former occur when falling asleep, the latter when waking up.

Auditory hallucinations in children

Auditory hallucinations are relatively common, particularly in children and adolescents. In such cases, it is especially important to recognise early on whether this is merely temporary or an initial sign of a mental health condition.

In any case, auditory hallucinations in children are very distressing, particularly for the children themselves. If you notice hallucinations in your child, it is therefore important to seek professional help, for example from a doctor or a psychotherapist.

What can be done about auditory hallucinations?

Auditory hallucinations can have a wide variety of causes. It is therefore important to investigate these in order to find the right treatment.

You should therefore seek medical help in any case if

• you hear, see, feel or perceive things that do not actually exist or cannot exist
• you hear, see, feel or perceive things that others do not hear, see, feel or perceive
• you are unsure whether the things you hear, see, feel or perceive are real
• hallucinations occur frequently
• hallucinations make you feel uneasy or anxious
• You notice hallucinations caused by medication
• You notice hallucinations caused by alcohol or drugs

Treatment of auditory hallucinations

The treatment of hallucinations is always tailored to the individual and depends on the doctor’s diagnosis and the underlying causes.

If the cause is psychological, psychotherapy - such as cognitive behavioural therapy - may be appropriate, possibly in combination with medication.

If stress is the trigger for hallucinations, relaxation and mindfulness are particularly important. Getting enough sleep, meditation or yoga exercises can be helpful.

There are also various treatment methods and aids available for auditory hallucinations associated with hearing loss, including hearing aids and hearing assistance devices, as well as specialised audio therapies.

Regardless of the cause, you should always discuss treatment with a doctor.