Auditory hallucinations are considered one of the most common symptoms of various mental and physical diseases. The patient clearly hears sounds, noises or voices that do not actually exist. Despite the seeming harmlessness of this phenomenon, auditory illusions can cause a lot of problems for the patient, causing many unpleasant situations and even aggressive behavior.

Pay attention! Auditory hallucinations can be classified as subjective sounds. They are audible only to the patient, which makes diagnosing and treating this disease very difficult.

Types of auditory hallucinations

There are several types of extraneous sounds that spontaneously manifest themselves in the patient’s consciousness:

• Tinnitus. Standard noise effects resembling buzzing, clicking, whistling, ringing, etc.
• Acoasma. More specific sounds: creaking, drops, music, etc.
• Phonemes. The most dangerous hallucinations that can carry a certain meaning and directly influence human behavior. These can be individual words, phrases or voices, which clearly indicates mental problems.

In addition, any illusions (including acoustic ones) are usually divided into true and false:

True hallucinations occur when a person hears all kinds of non-existent sounds in the surrounding space and tries to organically fit them into his worldview. The patient is completely confident in the reality of these sounds and never questions them.

Hallucinations false most often for the patient it comes from within. Moreover, sounds are not always heard in a person’s head. Intrusive and commanding voices can come from the stomach, chest, and any other place on the body. Such illusions are considered to be the most dangerous for the life of the patient and the people around him.

Reasons for appearance

In order to correctly diagnose the type of anomaly and determine approaches to its elimination, it is necessary to understand as clearly as possible the causes of auditory illusions. Various factors can provoke this phenomenon:

• Strong overwork, nervous or physical exhaustion. Overvoltage can cause disruptions in the normal functioning of the brain and changes in a person’s consciousness.
• Feverish conditions, high temperature. They can cause disturbances in certain body systems. In some cases, this manifests itself in the form of auditory or visual illusions.
• Tumors in the area of ​​the brain. The tumor can put pressure on certain areas of the auditory system or brain.
• Mental disorders: schizophrenia, psychopathy, all kinds of syndromes.
• Ear diseases, inflammatory processes and even sulfur plugs may well disrupt the functioning of sound-conducting channels and cause extraneous noise.
• Malfunctions of electronic hearing aids. The most harmless reason that can be eliminated by replacing or repairing the device.
• Use of psychotropic substances. Drug addiction or treatment with certain drugs can affect a person's brain activity in a similar way.
• Alcohol abuse. Attacks of delirium tremens often result in visual or auditory hallucinations.

Photo 2. It was the appearance of hallucinations that gave rise to the phrase “getting drunk as hell.” Source: Flickr (bluevinas).

When falling asleep

Oddly enough, but exactly When falling asleep, auditory hallucinations most often disturb patients. It would seem that the body, tired during the day, is as relaxed as possible and is preparing to get a long-awaited rest, but that was not the case. A person begins to hear non-existent sounds or voices.

In medicine, such hallucinations have a separate name - hypnagogic. Their main danger is that at the time of their appearance the patient, as a rule, is alone and in complete silence. The lack of distractions makes a person more vulnerable and unable to resist the voices giving him orders.

Symptoms and signs of hearing hallucinations

The volume of acoustic illusions depends on their type and the patient’s character traits. Sometimes the patient hears a barely audible whisper, in other cases - loud orders that are almost impossible to resist. In the latter case, the patient most likely develops one of the varieties of schizophrenia.

Sometimes the patient hears voices, but is not the subject of their discussion. It is as if he hears from the outside a conversation between two or more non-existent people on abstract topics. Such hallucinations are considered completely harmless, although they cause a lot of inconvenience both to the patient himself and to those around him.

Disturbances are considered more dangerous when the patient hears voices repeating his own thoughts and beliefs. At the same time, it seems to the patient that these thoughts (often very intimate and impartial) are heard by everyone around him. This can become a reason for aggression.

Pay attention! In some cases, auditory hallucinations can be confused with manifestations of an “inner voice” or actual tinnitus resulting from various diseases.

Diagnostics

Auditory hallucinations are not an independent disease, but only a symptom of another disease. The doctor will necessarily begin the diagnosis by collecting an anamnesis. This can be quite difficult to do, since the patient may have an extremely negative and skeptical attitude towards his pathological condition. If the patient does not want to contact the doctor, you can try interviewing the closest relatives.

To exclude the organic nature of the pathology, laboratory tests of urine, blood, spinal cord. Older patients using hearing amplification devices should additionally check the correct operation of the electronic device.

The presence of acoustic hallucinations can also be guessed from the specific behavior of a person. The patient may hesitate to answer, clearly listening to something. When talking with such a patient, the doctor needs to try to win him over as much as possible and establish a trusting relationship.

Treatment of auditory hallucinations with homeopathy

Along with traditional medicine, modern homeopathy can offer a number of drugs that can help eliminate such an unpleasant and sometimes dangerous disease for the life and health of the patient:

• Elapse(Elaps). Indicated for extraneous noise, clicking, unbearable itching in the ears. It will help eliminate attacks of deafness at night, accompanied by crackling and roaring in the ears.
• Curare(Curare). Helps eliminate whistling or ringing noises, sounds reminiscent of animal cries.
• Valerian(Valeriana). The drug is recommended for patients who have ringing in the ears, acoustic illusions, hyperesthesia (increased sensitivity of the senses).
• Eupatorium purpureum(Eupatorium purpureum). Effective for various types of auditory hallucinations, sensations of constant ear congestion, crackling when swallowing.
• Galvanism(Galvanism). Suitable for patients who hear the sounds of gunshots, explosions, the playing of a brass band, or the sound of bells.
• Anacardium(Anacardium). The drug helps patients who experience voices imposing strange orders or whispering blasphemies.
• Carboneum sulfuratum(Carboneum sulphuratum). Helps eliminate burning ears, singing voices or harp sounds.

Contact qualified specialists who can select the most suitable drug for your clinical case and prescribe the correct dosage and course of administration.

A fairly common problem caused by hallucinations is tinnitus, the occurrence of sounds of unknown origin that do not exist in reality. It should be noted that such phenomena are not as harmless as is sometimes believed. Constant or periodic sounds can represent symptoms of disorders, and sometimes quite serious ones. In patients with auditory hallucinations, noise manifests itself in different ways. In the mild form of the disease, the phenomenon is especially pronounced in silence; in other situations, the sounds present in the environment cover up the hallucinations. Patients often complain that strange sounds arise at the moment when a person changes body position or makes certain movements.

Sometimes, upon additional examination, it turns out that this condition is associated with changes in pressure in the blood vessels, muscles, and nerves. As a rule, patients usually say that sound hallucinations can be compared to a low-frequency whistle, or a person hears hissing, buzzing, creaking, and other sounds. Moreover, low-frequency noises are observed less frequently during auditory hallucinations. Such noise is often mistaken for the sounds produced by operating ventilation or other household electrical appliances. If you hear noise, but are not sure that it comes from an external source, you should clarify this circumstance with those around you.

Another type of sound hallucinations are various sounds that can be classified as musical. Such phenomena are typical for people with partial hearing loss; in patients with normal hearing they are quite rare, and if they are observed, they quickly pass. Sound hallucinations called pulsating are also known. Their peculiarity is that the patient hears rhythmic sounds that sound in time with the heart. In most cases, they are caused by changes in blood flow in the vessels that are located near the ears. Such hallucinations are very annoying for the patient, and can lead to an extremely agitated state when immediate medical attention is required.

Causes of auditory hallucinations

When auditory hallucinations occur, one of the common causes of the disease is a damaged inner ear. In this case, the sounds that a person hears fall into it, then, using the auditory nerves, information about the existing sounds is transmitted to the brain. If there is any damage to the inner ear, information access to certain parts of the brain may be impaired. Thus, these areas begin to persistently “demand” the missing information from parts of the inner ear that continue to function normally. But under such conditions, their signals are distorted, creating auditory hallucinations.

If such a disorder occurs in elderly patients, then sound hallucinations may accompany the aging process, during which hearing becomes worse. Young people often suffer from inner ear damage caused by regular exposure to excessive noise. Also, many diseases can be among the causes that damage the inner ear and lead to sound hallucinations. For example, middle ear infections, otosclerosis, Meniere's disease, anemia, Paget's disease. It happens that sound hallucinations are caused by the accumulation of earwax, which has a blocking effect on the ears.

Rarer causes of tinnitus and nonexistent sounds include traumatic brain injury, a consequence of exposure to unexpected and excessively loud noise, such as an explosion or gunshot. In some cases, auditory hallucinations are caused by an acoustic neuroma, a rare benign tumor that affects the auditory nerve. In clinical practice, there are cases where auditory hallucinations are side effects caused by an overdose of certain medications. People who abuse drugs or suffer from alcoholism are also at risk and often experience various types of auditory hallucinations.

Treatment of auditory hallucinations

Auditory hallucinations are a very good reason to seek help from a specialist. Do not forget that this condition is a clear danger, since it may turn out that these are symptoms of diseases that require immediate treatment. To identify the cause of noise and strange sounds in the ears, a special hearing test is used, the functioning of the vestibular apparatus is assessed, and an x-ray of the ears and a blood test are also performed. Sometimes the doctor prescribes magnetic resonance imaging or computed tomography.

When treating sound hallucinations, the therapeutic effect is on the immediate disease that needs to be cured to get rid of tinnitus and eliminate sounds that do not exist in reality. Sometimes the treatment is simple and the patient only needs special drops. In some cases, your doctor will prescribe procedures to remove earwax. But, of course, such simple cases, unfortunately, are rare, and sound hallucinations cannot be easily cured. In addition, there are no drugs that can quickly eliminate the symptom.

Hallucinations are a person’s perception of an object that is not present in reality, occurring against the background of various mental disorders or problems with the senses. In this case, a person can see, hear, or even feel and touch an object that is not only not next to him at the moment, but may not even exist in nature at all.

A little background

It is no secret that only 20% has been studied, and the remaining area remains a mystery to modern scientists. Therefore, it is not surprising that everything mysterious and unexplainable is attributed to this area. This criterion also includes hallucinations, which were a common occurrence back in ancient times, when shamans or priests used various mushrooms or plants both to induce “prophetic” visions and to communicate with long-dead ancestors. It is worth noting that some peoples believed that hallucinations were a kind of panacea for certain diseases. There have also been recorded cases of their use in art, science or culture. As an example, we can cite the works of such famous masters as Edgar Allan Poe, Gogol, Chopin, Vincent Van Gogh. The only sad thing is that the price for such masterpieces was gradual degradation and, as a result, absolute devastation.

Today, the types of hallucinations are quite diverse and include auditory, visual, olfactory, and tactile. But the first thing that is worth considering in more detail is, of course, the reason for the occurrence of such a phenomenon.

Hallucinations: causes, symptoms

Some of the reasons for the appearance of hallucinations may be the use of various narcotic substances (hashish, opium) and drugs that stimulate the psychological state of a person (antidepressants, phenothiazines). Do not forget that the prerequisites for such conditions can also be poisoning caused by both excessive consumption of alcohol and certain mushrooms or spices. An example is nutmeg, which causes hallucinations when consumed in large quantities.

Lesions in the temporal part of the brain can cause olfactory hallucinations, which are quite common in patients with schizophrenia. And if you add something else to it, it also adds flavor.

Manifestations of visual hallucinations are associated primarily with exacerbations of diseases of the visual organs. Such states are usually characterized by a variety of visions and images in which a person can take part.

Species

In addition to being divided according to the original source of appearance, hallucinations are also divided into false and true. For example, in the second type of state, a person is not a direct participant in the action, but rather, like an outside observer. A false phenomenon, on the contrary, completely captures being projected only in it.

As mentioned above, today there are quite a lot of types of hallucinations, so we will consider only the main and most common of them.

Visual hallucinations

Such hallucinations can manifest themselves either as spots or smoke (simple), or as a variety of visions (complex), arising against the background of a clouding of consciousness. They may be:

1. Moving.
2. Motionless.
3. Changing.
4. Plain.
5. Multi-colored.

Their size can vary from small to very large. As a rule, visual hallucinations most often occur not in a person’s field of vision, but somewhat behind or to the side. They appear mainly in the evening and at night.

Auditory hallucinations

Today, auditory hallucinations include acoasms, phonemes and verbal ones.

1. Acoasm is the name given to hallucinations that manifest themselves in the form of a variety of bells, ringing, crackling and grinding noises.
2. Phonemes include hallucinations that appear in individual words or phrases that are heard by the patient.
3. Verbal hallucinations are characterized by various voices familiar to a person that address him. They can manifest themselves both in the form of a whisper and in the form of a scream. It is worth noting that the nature of the voices can be benevolent and calming, arising against the background of euphoria, or, conversely, threatening and condemning (depression).

As a rule, auditory hallucinations are perceived by both ears, but there are exceptions when sounds are heard only on one side. Most often they occur at night or in complete silence.

Hallucinations of olfactory, tactile and gustatory nature

Olfactory hallucinations include not very clear and faintly distinguishable odors that cause unpleasant sensations.

Taste hallucinations are the sensations of the taste of food and moisture in the mouth. It is worth noting that when eating food, most patients noted an unpleasant and unusual taste.

Important! Treatment of hallucinations of this origin is quite troublesome if not started in the early stages.

Tactile sensations include tickling sensations and goosebumps. Cases of such hallucinations have been recorded both on the body and inside it.

Diagnostics

The first thing you need to understand is that a person is having a hallucination, and not a manifestation of an illusion, when it may seem to him that the object standing in front of him will change its shape and turn into some kind of animal. Hallucinations are when a person can point, for example, to the corner of a room and quite seriously claim that someone is there. The difference between this condition is that it is quite difficult to convince the patient that he was mistaken.

It is also very important to observe a person’s behavior, since it is by this behavior that it often becomes possible to determine what type of hallucination is taking place. There are common cases of such an episodic phenomenon; in this case, it is very important not to miss this period. There is no need to panic and think: “Oh God, these are hallucinations, what should I do?” The first step is to pay special attention to a person’s facial expressions, since in most cases they reflect facial expressions that are uncharacteristic for a given situation (fear, horror, anger, joy, surprise, etc.). More pronounced hallucinations are manifested in spitting out food, sharply closing the eyes, pinching the nose and plugging the ears. Cases have been recorded of people in such states throwing themselves under cars or jumping out of windows to escape imaginary monsters. As a rule, this phenomenon is most often combined with various states of delirium, and its manifestations in an isolated state are very rare.

Diseases that cause hallucinations

The cause of this condition can be a variety of diseases, the main ones being schizophrenia and alcoholism.

Thus, people suffering from alcoholism are primarily susceptible to auditory hallucinations. As a rule, this manifests itself in various voices arguing with each other, which causes the patient to panic, leading to the most unpleasant consequences.

Syphilis of the brain can also cause hallucinations, expressed in negative visions and screams.

We should not forget that taking narcotic substances not only leads to the appearance of malignant tumors, but is also expressed in strong hallucinations of an imperative nature.

Particularly worth noting is the disease amentia, which is characterized by a severe form of impaired consciousness. Its symptoms are manifested in a violation of the synthesis of perception, thinking, speech and the inability to navigate in the surrounding space. The danger is that the types of hallucinations caused by the disease can be fatal.

Hallucinogens

Despite all the negative consequences, a sufficient number of people still try to consciously induce hallucinations in themselves. For this purpose, both hallucinogens (marijuana, beta-carbolines, LSD) and various plants or mushrooms are used, for example, nutmeg, which causes hallucinations in the form of short-term euphoria and various visions.

Reasons for taking hallucinogens include:

1. Long-term depression and disappointment in life.
2. Expectation of acute and unusual sensations and emotions.
3. Desire to evoke vivid visions.

But it is worth remembering that hallucinations are not only short-term minutes filled with new bright colors, but also moments for which you may have to pay with your health or even life.

Manifestation of hallucinations in older people

According to the latest statistics, the greatest number of manifestations of hallucinations is recorded in older people, which is not surprising, given the possible age-related changes in their health. As a rule, older people are most often susceptible to attacks of depression, complicated by a variety of anxiety sensations and fear of the unknown. This condition, in turn, is fertile ground for the appearance of hallucinations in older people, manifested in the form of various voices, color spots or unpleasant tactile sensations.

Hallucinations in children

This phenomenon does not escape the younger generation either. So, according to the latest data, more than 15% of children are susceptible to this phenomenon.

It manifests itself regardless of the gender or location of the child. Reasons that cause hallucinations in a child include intense fever. This happens because high body temperature not only leads to weakness and aches throughout the body, but also causes clouding of consciousness, which, in turn, means that the brain is not able to control it at the proper level. It is especially worth noting that it is strictly forbidden to leave a child in this state, since this phenomenon is temporary and can develop into panic.

The most dangerous hallucinations in children include those that occur at night. And in this case, for parents whose children are not only terrified of being left alone at night, but may also scream and wet the bed during sleep, it is very important to find out the reason for this condition. It is important not to judge or reproach anyone for showing fear. Remember that you need to listen to your child with full attention and, most importantly, understanding, since if left unattended, such a condition in the future can develop into a phobia and lead to serious changes in the child’s psychological state.

According to some experts, treatment of hallucinations in children does not cause such an urgent need as in adults, since they tend to outgrow it. But there is an opinion that it is unlikely to completely get rid of them, and under certain circumstances they may arise again.

First aid for hallucinations

The first thing to do when symptoms of this phenomenon appear is to take into account that for the patient everything that happens is reality. Therefore, you need to follow the following recommendations that can minimize possible conditions:

• Under no circumstances should you even try to somehow dissuade the patient that everything that happens to him is unreal.
• It is necessary to find a way to help the person cope with the feelings or sensations that have gripped him. For example, if he has a strong impression that vampires can come to him at night and drink his blood, then together with him he needs to come up with means of “saving” him from them.
• It is necessary to create conditions under which the hallucination would not be terrible either for the person who came under its influence or for the people around him.

1. Make fun of his feelings.
2. Show irritation in response to groundless fears.
3. Convince the patient that everything that happens to him is a figment of his imagination.
4. Focus attention on what is happening to him. For example, to find out the source of “suspicious” sounds.
5. It is especially important during this period not to raise your voice unnecessarily towards the patient. In this case, it is recommended to create in him the feeling that you will do everything possible to “save” him.
6. In special cases, when the patient is overly excited, you can try to calm him down with the help of various sedatives, walk around the guests or play soothing music for him. In some cases, you may need to call a doctor.

Treatment methods

Today there are several methods for treating hallucinations. But it should be borne in mind that if their cause is a mental disorder, then therapy should be started only after consulting a psychiatrist. Treatment is mainly aimed at stopping the attack and eliminating the delusional state. For this purpose, the patient is given an injection of the drug “Aminazine” or “Tizercin”, combining it with the drug “Trisedil” or “Haloperidol”. The treatment regimen may also include the use of antipsychotic and atypical antipsychotic drugs.

But, as practice shows, a healthy lifestyle, reducing the amount of stress and refusing to use hallucinogens will reduce the manifestation of hallucination in a person several times, or even allow one to forget about its existence altogether.

Miss Stewart, 70, lived in the suburbs of California. Over the past few years, nothing special has happened in her measured life. And, perhaps, Miss Stewart’s earthly life would have ended so calmly if one night she had not woken up from a small earthquake, as common as rain in these parts.

Finally, the ground stopped shaking and Stewart tried to sleep. But that was not the case: suddenly she heard a melody - the sad song of her youth began to sound quite loudly, but not deafeningly, in her head.

When Stewart was a girl, her father played this song on the piano. And now the elderly woman sits in bed and listens, unable to sleep. Because the song did not stop, but was repeated over and over again, and for many hours. Finally, the woman managed to pass out. But only after waking up, she again heard a familiar melody in her head.

Gradually, over the course of several months, the repertoire was enriched and other melodies were heard. The music often started playing when Stewart went to bed or while driving. In any case, the “concert” lasted for several hours. Moreover, the sound was always so bright, as if an orchestra was playing nearby.

Of course, the woman began to get tired of these odd concerts, and after some time she found out that the only way to get rid of the music in her head was to turn on the radio.

At the same time, the melodies in the head had another ominous quality: even the most favorite pieces of music, once heard “inside”, could not be perceived from ordinary sources, since they were wildly annoying.

After several months of “musical” torture, Stewart finally decided to see a doctor about her problem. Oddly enough, the doctor was not surprised by the patient’s story. He told the woman that she was suffering from a little-known and rare disorder - musical hallucinations- and refers to a small but significant number of people who hear music that simply isn't there.

Most of these sufferers are elderly. Songs often come to them from the deepest “archives” of memory. Some play Italian opera, which their parents loved to listen to in time immemorial. Others have hymns blaring, jazz playing or popular tunes blaring.

Some people get used to it and even enjoy it, but there are only a few of them. The majority of people try to stop the music: they close windows and doors, put cotton wool in their ears, or sleep with a pillow on their head. But, of course, all these techniques do not help.

Meanwhile, musical hallucinations are far from a new phenomenon: they have invaded people’s heads before. For example, the famous composer Robert Schumann hallucinated music at the end of his life and recorded this fact - he told his descendants that he wrote under the dictation of Schubert's ghost.

However, “musical” hallucinations have long been unrecognized by medical professionals as a disorder in their own right and have therefore been largely associated with a range of human conditions, including old age, deafness, brain tumors, drug overdoses and even organ transplants.

The first large-scale study of musical hallucinations was conducted in a Japanese psychiatric hospital in 1998. There it was discovered that 6 out of 3 thousand 678 patients heard music in their heads. This ratio, however, did not reflect the real state of affairs, since all patients had serious mental disorders.

So, Japanese psychiatrists and their few followers have discovered that our brains process music through a unique network of neurons. First, sounds entering the brain activate an area near the ears called the primary auditory cortex, which begins to process sounds at their most basic level.

The auditory cortex then transmits its own signals to other areas that can recognize more complex features of the music, such as rhythm and melody.

It turned out that this network of neurons in the auditory cortex can begin to work incorrectly, without affecting any other areas of the brain with its “failure.”

The English scientist Timothy Griffiths continued work in this direction. He studied six elderly patients who developed musical hallucinations along with deafness. Using tomography, the scientist discovered several areas in the brain that became more active during musical hallucinations. The doctor was puzzled by the result: he saw almost the same as in normal people who listen to music.

True, musical hallucinations do not activate the primary auditory cortex, but use only the parts of the brain responsible for turning simple sounds into complex music.

According to Griffiths' hypothesis, music-processing areas of the brain continually look for patterns in signals coming from the ears. Because these areas require melody, they enhance certain sounds that match the music and minimize extraneous noise.

When there are no sounds coming into the ears, parts of the brain can try to grab onto something, random impulses and signals, try to create some kind of structure out of them, delving into memories. So a few notes can suddenly turn into a familiar melody.

For most of us, this can end up producing a song that barely gets out of our heads because the constant stream of information entering our ears overwhelms the music. Deaf people, of course, do not have this flow, so they can hear music all the time.

Let's say Griffiths figured out musical hallucinations in the deaf. But what about hearing people like Miss Stewart?

Aziz and Warner tried to solve this problem. To do this, they analyzed 30 cases of musical hallucination. The average age of the patients studied was 78 years, and a third of them were deaf. Research has shown that women have music playing in their heads more often than men. In two thirds of cases, older people hear religious music.

However, scientists believe that in the future people will begin to hallucinate both popular and classical music, that is, the music that they hear all the time today.

Psychiatrists believe that musical hallucinations occur when people are deprived of a sound-rich environment, lose their hearing, or live in isolation.

In this situation, the brain produces random impulses, which it interprets as sounds, then turns to memories of music for help, and a song arises.

When a person hears (or thinks he hears) sounds or voices that do not reflect changes in the real world, they say that he has auditory hallucinations. In the vast majority of cases, when auditory hallucinations appear, a person immediately needs medical help - the causes of these phenomena are painful changes in the psyche.

How do auditory hallucinations manifest?

Only a qualified psychiatrist who will evaluate not only this sign, but also other painful changes in the human mental sphere can answer the question unambiguously whether or not the voice that appears in the head is an auditory hallucination. In the case when a person, previously completely healthy, in the process of active reflection begins to listen to his own inner voice, then this phenomenon cannot be called a hallucination.

The patient not only hears, but also understands that there is no real object emitting this voice - he is critical of his own condition. At first glance, it is possible to say that auditory hallucinations have appeared only at a moment when there is no criticism of one’s own sensations - it seems that the voice has a real origin, but this is not confirmed in any way.

If a person experiences painful sensations or auditory hallucinations, the reasons for their appearance are hidden in severe mental disorders or neurological pathology. Such symptoms should not be taken lightly - a competent and comprehensive comprehensive examination will help make an accurate diagnosis, and after that the doctor can prescribe medications for hallucinations or prescribe treatment for the underlying disease (vascular pathology, brain tumors).

Most often, auditory hallucinations become one of the first manifestations of schizophrenia - some psychiatrists believe that these symptoms are a person’s thoughts that have acquired verbal form, and painful changes in the psyche influence not the occurrence of this phenomenon, but the critical attitude towards it. A sick person who suffers from mental illness stops critically assessing his condition - auditory and visual hallucinations seem to the patient to be completely real events.

A person with mental disorders considers it necessary to follow all the recommendations expressed by voices, without realizing their origin. For him, such voices become a reality that controls his life. It is under the influence of voices (auditory hallucinations) that a person begins to pose a danger to others and himself.

Auditory hallucinations in elderly patients most often occur against the background of vascular diseases of the brain or as a result of the effects of medications that are prescribed to them for the treatment of somatic diseases. Proof of this is the fact that with the return, the likelihood of developing auditory hallucinations in elderly patients progressively increases.

It is also worth remembering that in older patients, auditory hallucinations can develop against the background of somatogenic depression, mania, and Alzheimer's disease. It is possible to make a diagnosis for elderly patients only after the person has been examined not only by a psychiatrist, but also by an audiologist - quite often, auditory hallucinations in a person who has poor hearing occur when a hearing aid is incorrectly selected or a low-quality device is used, and in this case, about a psychiatric there is no need to talk about illness.

How to treat the disease

Only a qualified and experienced specialist who comprehensively analyzes the changes occurring in the patient can make a diagnosis and prescribe treatment. Doctors do not consider auditory hallucinations to be temporary, passing phenomena that may appear in a person before going to bed or during the development of depressive but correctable conditions.

If a person experiences auditory hallucinations, treatment is prescribed not only by psychiatrists, but also by a general practitioner who monitors the person constantly. Its task should be to analyze previously prescribed medications and identify (with subsequent replacement) those drugs that could potentially cause auditory hallucinations.

If a person uses a hearing aid, then he must be consulted by a doctor-sudrologist - often after replacing a low-quality device, auditory hallucinations disappear.

If all of the above methods are ineffective or symptoms of mental disorders are detected, the patient is treated by a psychiatrist who selects an effective combination of psychotropic drugs or antidepressants for each patient.

Ecology of health: Science currently does not have a clear answer to the question of what happens in the brain when a person hears voices...

A hallucination is a perception in the absence of an external stimulus that has the quality of a real perception.

Hallucinations can occur in all senses:

• auditory,
• visual,
• tactile,
• olfactory.

Likely, most common type hallucinations manifests itself in the fact that a person “hears voices”. They are called classroom verbal hallucinations. They are often symptoms of psychiatric illnesses such as schizophrenia. Visual hallucinations may also be associated with pathologies. Although they are less common in schizophrenia, visual hallucinations sometimes occur in neurological disorders and dementia.

Definition of the concept

Although auditory hallucinations are commonly associated with psychiatric illnesses such as bipolar disorder, they are not always signs of illness. In some cases, hallucinations may be caused by lack of sleep. Marijuana and stimulant drugs can also cause perceptual disturbances in some people. It has been experimentally proven that hallucinations can also be caused by prolonged absence of sensory stimuli.

In the 1960s, experiments were conducted (which would be impossible now for ethical reasons) in which people were kept in dark rooms without sound or any sensory stimuli. Eventually people began to see and hear things that were not there. So hallucinations can occur in both sick and mentally healthy people.

Research into hallucinations has been going on for quite some time. Psychiatrists and psychologists have been trying to understand the causes and phenomenology of auditory hallucinations for about a hundred years (maybe longer). In the last three decades, we have been able to use encephalograms to try to understand what is happening in the brain when people experience auditory hallucinations. We can now look at the areas of the brain involved in hallucinations using functional magnetic resonance imaging or positron tomography. This has helped psychologists and psychiatrists develop models of auditory hallucinations in the brain, mainly related to language and speech function.

Proposed theories of the mechanisms of auditory hallucinations

When patients experience auditory hallucinations—that is, hearing voices—an area of ​​their brain called Broca's area is said to become more active. This area is located in the small frontal lobe of the brain and is responsible for speech production - when you speak, Broca's area works!

One of the first to study this phenomenon were professors Philip McGuire and Sukhi Shergill from King's College London. They showed that their patients' Broca's area was more active during auditory hallucinations than when the voices were silent. This suggests that auditory hallucinations are produced by the speech and language centers of our brain. This led to the creation of “inner speech” models of auditory hallucinations.

When we think about something, we generate “inner speech,” that is, an inner voice that “voices” our thinking. For example, when we think “what will I have for lunch?” or “What will the weather be like tomorrow?”, we generate internal speech and, we believe, activate Broca’s area.

But how does this internal speech begin to be perceived as external, not coming from oneself? Inner speech models of auditory verbal hallucinations suggest that the voices are internally generated thoughts, or inner speech, somehow misidentified as external, foreign voices. This leads to more complex models of how we monitor our own inner speech.

Chris Frith and others have proposed that when we engage in the process of thinking and inner speech, our Broca's area sends a signal to an area of ​​our auditory cortex called Wernicke's area. This signal contains information that the speech we perceive is generated by us. This is because the signal is supposed to dampen the neural activity in the sensory cortex, so it is less activated than by external stimuli, such as someone talking to you.

This model is known as the self-monitoring model, and it suggests that people with auditory hallucinations have a deficit in this monitoring process, causing them to be unable to differentiate between internal and external speech.

Although the evidence for this theory is somewhat weak at this time, it has certainly been one of the most influential models of auditory hallucinations of the last twenty or thirty years.

Consequences of hallucinations

About 70% of people with schizophrenia hear voices to some degree. Sometimes voices “respond” to medications, sometimes they don’t. Usually, although not always, voices have a negative impact on people's lives and health.

For example, people who hear voices and do not respond to treatment have a higher risk of suicide. Sometimes voices tell them to harm themselves. One can imagine how difficult it is for them even in everyday situations, when they constantly hear humiliating and insulting words addressed to them.

However, it would be a gross oversimplification to say that only people with mental disorders experience auditory hallucinations. Moreover, these voices are not always evil. There is a very active Voice Hearing Society led by Marius Romm and Sandra Asher. This movement talks about the positive aspects of voices and fights the stigma around them.

Many people who hear voices live active and happy lives, so we can't assume that voices are always a bad thing. They are often associated with aggressive, paranoid and anxious behavior of mentally ill people, but this behavior may be a consequence of their emotional disturbance rather than the voices themselves. It is perhaps not so surprising that anxiety and paranoia, often at the core of mental illness, manifest themselves in what voices say.

It is worth noting that There is many people without a psychiatric diagnosis report hearing voices. For these people, voices can also be a positive experience, as they calm them down or even guide them in their lives. Professor Iris Sommer from the Netherlands has carefully studied this phenomenon. She discovered a group of healthy, well-functioning people hearing voices. They described their “voices” as positive, helpful, and confidence-boosting.

Treatment of hallucinations

People diagnosed with schizophrenia are usually treated with "antipsychotic" medications. These medications block postsynaptic dopamine receptors in an area of ​​the brain called the striatum. Antipsychotics are effective for many patients, and their psychotic symptoms, especially auditory hallucinations and mania, improve to some extent as a result of treatment.

However, many patients' symptoms do not seem to respond well to antipsychotics. Approximately 25-30% of patients who hear voices have little effect on medications. Antipsychotics also have serious side effects, so these medications are not suitable for all patients.

As for other treatments, There are many non-pharmacological intervention options. Their effectiveness also varies. Example - cognitive behavioral therapy (CBT). The use of CBT for the treatment of psychosis is somewhat controversial, as quite a few researchers believe that it has little effect on symptoms and overall outcome. There are types of CBT designed specifically for patients who hear voices. These therapies usually aim to change the patient's relationship with the voice so that it is perceived as less negative and unpleasant. The effectiveness of this treatment is questionable.

I'm currently leading a study at King's College London to see if we can teach patients to self-regulate neural activity in the auditory cortex.

This is achieved using “real-time fMRI neural feedback.” An MRI scanner is used to measure the signal coming from the auditory cortex. This signal is then sent back to the patient via a visual interface, which the patient must learn to control (i.e., move a lever up and down). Ultimately, it is expected that we will be able to teach voice-hearing patients to control the activity of their auditory cortex, which may allow them to more effectively control their voices. Researchers are not yet sure whether this method will be clinically effective, but some preliminary data will be available in the next few months.

Population Prevalence

About 24 million people worldwide live with a diagnosis of schizophrenia, and about 60% or 70% of them have heard voices at some point. There is evidence that throughout the population, 5% to 10% of people without a psychiatric diagnosis have also heard voices at some point in their lives. Most of us have ever thought that someone was calling our name, and then it turned out that no one was nearby. So there is evidence that hallucinations may not be accompanied by schizophrenia and other mental illnesses. Auditory hallucinations are more common than we think, although exact epidemiological statistics are difficult to come by.

The most famous of the people who heard voices was probably Joan of Arc. From modern history, you can remember Syd Barrett, the founder of Pink Floyd, who suffered from schizophrenia and heard voices. However, again, many people without a psychiatric diagnosis hear voices, but They perceive them extremely positively. They can draw inspiration for art from voices. Some, for example, experience musical hallucinations. This can be something like vivid auditory images, or maybe just a variation of them - these people hear music very clearly in their heads. Scientists are not very sure whether this can be equated to hallucinations.

Unanswered questions

Science currently does not have a clear answer to the question of what happens in the brain when a person hears voices. Another problem is that researchers don't yet know why people perceive them as foreign from an external source. It is important to try to understand the phenomenological aspect of what people experience when they hear voices.

For example, when people are tired or take stimulants, they may experience hallucinations, but do not necessarily perceive them as coming from external sources.

The question is why people lose the sense of their own agency when they hear voices. Even if we believe that the cause of auditory hallucinations is excessive activity of the auditory cortex, why do people still believe that the voice of God, or a secret agent, or aliens is speaking to them? It is also important to understand the belief systems that people build around their voices.

The content of auditory hallucinations and its original source is another problem: Do these voices come from inner speech, or are they stored memories? What is certain is that this sensory experience involves activation of the auditory cortex in the speech and language areas. This tells us nothing about the emotional content of these voices, which can often be negative. This, in turn, suggests that the brain may have a problem processing emotional information.

Also interesting:

Scientists about the brain: the best TED lectures with Russian voice acting

Additionally, two people may experience hallucinations very differently, meaning that the brain mechanisms involved may be quite different. published

Translation: Kirill Kozlovsky

Hallucinations- these are sensually vivid images and sensations that arise in a person in a state of wakefulness against his will, appearing without the presence of an object or event, projected outward and having the character of objective reality. Hallucinations differ from illusions (distorted perception of the existing world and phenomena) and states of altered consciousness.

Factors that cause hallucinations are:

Hallucinations can be caused by:

• dehydration of the body;
• lack of sleep;
• violation of thermoregulation - hypothermia, high temperature;
• isolation from society.

Natural aging of the body is accompanied by a complex of degenerative changes, incl. and in the central nervous system. Hallucinations in the elderly are caused by senile dementia, caused by diffuse destruction of brain structures, and the attenuation of brain activity is caused by near-death visions.

The causes of hallucination are not fully understood, but researchers suggest that the neuronal “loop” through which impulses from the analyzers pass to the brain structures and back is disrupted.

Types of hallucinations

There are several types of classifications, depending on the involvement and type of analyzer:

• simple ones are noted when using one system;
• complex, in which several analyzers are involved, and the signals from them are connected by a common meaning.

In accordance with the modality of sensory systems, the following types of hallucinations are distinguished:

• auditory;
• visual;
• taste;
• olfactory;
• tactile - sensation of touching, temperature changes, crawling under the skin, binding, suffocation, striking;
• bodily – the illusion of displacement or deformation of internal organs;
• kinesthetic – the feeling that someone is controlling individual parts of the body;
• vestibular – in which the patient “floats” or “falls”;
• hypnagogic and hypnopompic - visual or auditory images appear on the verge of sleep and wakefulness.

Each type of aberration has subtypes or varieties that describe the characteristics of hallucinatory manifestations.

Auditory or sound hallucinations

Auditory hallucinations occur against the background of a decrease in the thickness of gray matter in the temporal lobe of the brain and in the RT (planum temporale) region of speech perception. This is the most common type of phenomenon, which, in turn, is divided into:

1. Acoasms are elementary groups that manifest themselves in the form of crackling, noise, rustling, ringing, and whistling. In some cases, sounds have a connection with phenomena and objects - the creaking of floorboards, the knock of a closing door, steps, sighs, groans.
2. Phonemes - a person hears parts of words or individual words.

In addition to simple forms, there are more complex hallucinations:

• musical, during which the patient hears the singing of a choir, famous melodies, and the sound of musical instruments;
• verbal - the patient hears incoherent shouts, words, meaningless phrases or conversations, monologues that have ideological value for the patient.

Auditory hallucinations differ in their semantic load:

• imperative - voices order or prohibit something to be done. This variety is socially dangerous, because the patient may commit actions that are contrary to conscious intentions (urges to commit suicide or murder, self-harm, refusal to take medications or food);
• threatening - the patient hears threats, accusations against him, which are supported by delusions of persecution;
• evaluative - voices comment and evaluate a person’s past, present and future actions, thoughts or intentions.

Imperative and threatening varieties are most often observed in patients who have experienced sexual or physical abuse at an early age. The patient hears voices nearby - from the next room, from the closet, from the roof or in the corridor. Very rarely they sound at a considerable distance. With false hallucinations, sounds do not go beyond the person and sound “in the head.”

Visual hallucinations

Visual hallucinations are no less varied:

• photopsia - threads, cobwebs, wires, spots, flashes, fog;
• completed - figures of people, animals, objects, scenes.

Often images have intense colors or can be completely monochrome, change, “flow” from one form to another. Depending on the subjective perception of size, the following are distinguished:

• normoptic - dimensions correspond to real ones;
• microptic - less than normal;
• macroptic - figures and objects of enormous size.

With the extracampal variety, the patient sees images outside the field of vision. They are located on the side or back. If the patient sees his double, then they speak of an autoscopic form of pathology. The person behaves in accordance with what he sees - he runs away and hides from his pursuers, monsters, and shakes insects off his body. Most often, episodes occur at night.

A migraine attack is accompanied by photopsia, this effect is called a migraine “aura”. In healthy people, photopsia occurs when the eyes are tired or due to a stroke. Hallucinations from lack of sleep can be of different types, but they disappear after normalization of sleep.

Olfactory and gustatory hallucinations

Often they are closely related - the patient feels not only non-existent smells, but also taste. Patients describe them as unpleasant, strong, intrusive. In healthy people

similar effects occur during pregnancy, after dental surgeries and dental prosthetics, removal of adenoids and polyps.

In addition to true hallucinations, there are also false or pseudohallucinations. The patient perceives reality in an illusory, distorted form - functional, Bonnet. High variability, subjective perception, and individuality complicate diagnosis.

Diagnosis of hallucinations

Since hallucination is a condition or symptom of certain diseases, the cause of the phenomenon is identified. Relevant laboratory tests and instrumental studies are prescribed.

How to get rid of hallucinations (Treatment)

The therapeutic algorithm depends on the underlying cause that caused the abnormal condition. If the cause of the pathology is exposure to natural and synthetic toxins, then detoxification and normalization of electrolyte and fluid homeostasis are carried out. If necessary, relief from withdrawal symptoms and treatment of addiction.

The drugs are selected individually; their dose and course of treatment depend on the type of pathology. To eliminate obsessive, prolonged hallucinations, tablets are used: Aminazine, Trisedil, Haloperidol, Tizercin. The help of a psychotherapist or psychiatrist helps to get rid of the disease faster.

May occur in the context of many disorders and syndromes. Therefore, the choice of treatment depends not only on the type of perceptual deceptions and the impact on daily functioning, but also on the underlying disorder. At times, it can be very difficult to determine the underlying disorder, since hallucinations, for example, in borderline personality disorder, psychotic depression or temporal lobe epilepsy, may be indistinguishable from hallucinations in schizophrenia at the phenomenological level.

Associated symptoms such as paroxysmal activity, parkinsonian motor symptoms, and loss of vision or hearing are the most reliable signs used in the differential diagnosis. Some people who hallucinate may simply be concerned that their experience is a sign of a mental disorder, without being concerned about the hallucinations themselves. For others, the burden of hallucinations may not outweigh the side effects of their treatment. As a result, treatment may not be applicable in all cases. This article will look at some of the errors that are often associated with hallucinations, as well as specific treatment options for them.

Hallucinations in schizophrenia

Schizophrenia can be accompanied by hallucinations in any sensory modality. In 70% of cases they are auditory in nature, and in 50% of cases visual hallucinations are observed. Other types of hallucinations are less common.

The only type of medications known to be successfully used to treat hallucinations in schizophrenia are antipsychotics. Only 8% of first-episode psychotic patients still experience hallucinations after 1 year of treatment. However, to date, no clinical studies have been published that compare the effectiveness of different antipsychotic drugs for a single and specific indication: hallucinations. Therefore, the analysis used data from the European First Episode Psychotic Study, which assessed the effectiveness of 5 antipsychotic drugs in the treatment of hallucinations. Olanzapine, amisulpride, ziprasidone, and quetiapine have been found to be equally effective against hallucinations; haloperidol, according to the study authors, cannot be the drug of first choice.

If the first choice drug does not provide improvement, it is best to switch to another drug after 2-4 weeks of treatment. Clozapine is the drug of choice for patients who are refractory to two adequate courses of antipsychotic medications. To prevent relapse, treatment should be continued with the same antipsychotic and, preferably, at the same dose. Long-acting formulations should be considered for all patients because the risk of non-compliance is very high.

Cognitive behavioral therapy (CBT) may be used in addition to antipsychotic therapy. CBT is aimed at reducing the emotional distress associated with auditory hallucinations, it teaches the patient to ignore the “voices” and focus on future plans and goals, which is reflected in the quality of life of the patients. However, CBT had no effect on the frequency of hallucinations.

On the other hand, transcranial magnetic stimulation (TMS) can reduce the frequency and severity of auditory hallucinations. Several meta-analyses have demonstrated efficacy for low-frequency repetitive TMS of the left temporoparietal region compared with placebo. As a consequence, TMS now has the status of a potentially useful treatment for auditory hallucinations, but only in combination with modern antipsychotic therapy.

Several guidelines mention electroconvulsive therapy (ECT) as the final step in the treatment of treatment-resistant psychoses within schizophrenia. Although several studies have shown clinical improvement following the use of ECT, specific reductions in hallucination severity have never been assessed at the group level.

Treatment of delirium

Delirium is an acute neuropsychiatric syndrome characterized by psychotic symptoms such as hallucinations and delusions in the presence of decreased attention, fluctuations in consciousness and other cognitive functions. This condition is very common in patients admitted to intensive care units, with an incidence of 32%, and is notably associated with a poor prognosis and increased mortality.

The only etiological treatment for delirium is to improve the patient's physical condition. Symptomatic treatment of hallucinations and other symptoms of delirium should begin with measures aimed at normalizing the patient's circadian rhythm and orientation. Pharmacological treatment should preferably consist of haloperidol or olanzapine, as recommended in the latest NICE guidelines. Although benzodiazepines are widely used to treat delirium, their use is recommended only for alcoholic delirium. Cholinesterase inhibitors are not recommended, as evidenced by a randomized clinical trial of rivastigmine in patients with delirium admitted to the intensive care unit. This study was stopped early due to a significant increase in mortality and duration of delirium compared with the control group.

Hallucinations in Parkinson's disease (PD)

The prevalence of hallucinations and other psychotic symptoms among patients with PD is 80%. In the case of dementia with Lewy bodies, which is pathogenetically closely related to PD, these numbers are even higher, especially for visual hallucinations. Auditory hallucinations are present in 20% of cases.

The pathophysiology of psychosis in PD and dementia with Lewy bodies involves a complex interaction of environmental and disease-related factors, including central dopaminergic activity, imbalances of the dopaminergic and cholinergic neurotransmitter systems, dysfunction of the visual pathways, changes in the regulation of the sleep-wake cycle, and impaired attentional focus. However, the most important external factor in the development of hallucinations within PD is drug treatment.

Treatment strategies: decrease antiparkinsonian medications, increase low-dose “atypical” antipsychotics, and possibly cholinesterase inhibitors. Eng and Welty reviewed 13 studies of antipsychotic treatment in patients with PD and concluded that long-term therapy with clozapine is indeed effective, while results from studies using quetiapine are inconsistent. Only one double-blind, placebo-controlled trial involving 188 patients with PD and hallucinations supports the effectiveness of the cholinesterase inhibitor rivastigmine. Thus, although the use of cholinesterase inhibitors, especially rivastigmine, appears to be a promising treatment for hallucinations in PD, these studies support the use of clozapine alone.

Hallucinations in Alzheimer's disease (AD)

In AD, the occurrence of psychosis in 30–50% of cases has serious consequences for both patients and caregivers. Cholinesterase inhibitors such as donepezil may have a beneficial effect on hallucinations with a relatively mild side effect profile. Another study on the treatment of psychosis in AD examined the effectiveness of olanzapine, quetiapine, risperidone and placebo over 36 weeks. The results showed that risperidone was more effective than the other two drugs and placebo. However, these drugs should be taken with caution due to the increased risk of complications in elderly patients.

As a consequence, it is strongly recommended not to consider antipsychotic drugs as a first choice for the treatment of psychotic symptoms in AD. Extrapyramidal symptoms and arrhythmias due to QT prolongation are common complications of “typical” antipsychotic drugs, while various cerebrovascular pathologies occur more often with the use of “atypical” antipsychotics. However, these medications should be used when the severity of symptoms is extreme or when symptoms do not respond to other types of medications or nonpharmacologic interventions.

Hallucinations in epilepsy

The reported incidence of hallucinations and other psychotic symptoms in epilepsy is 3.3%, and in temporal lobe epilepsy it is as high as 14%. Hallucinations may occur shortly before (aura), during, or after an epileptic seizure, but often occur independently of any motor seizures. Hallucinations often resemble those found in patients diagnosed with schizophrenia and are referred to as “schizophrenic psychoses of epilepsy.”

Treatment of hallucinations should primarily involve minimizing any drug that may mediate these symptoms. Various antiepileptic drugs, such as phenobarbital, zonisamide, levetiracetam and gabapentin, are known to induce hallucinations. In such cases, reducing the dose or switching to another antiepileptic drug can lead to relatively rapid relief of hallucinations.

When antiepileptic drugs cannot be reduced or discontinued, antipsychotics are the drugs of choice. Clozapine and chlorpromazine should be avoided due to their epileptogenic properties, while quetiapine, risperidone and haloperidol are generally well tolerated.

Hallucinations due to sensory deafferentation

Patients with low vision may experience complex visual hallucinations, a condition known as Charles Bonnet syndrome. Likewise, people with progressive hearing loss may develop auditory hallucinations of music, voices, or other sounds.

It is believed that such hallucinations are actually phenomena due to deafferentation of areas of the visual or auditory association cortex of the brain, which can lead to so-called “phantom perceptions.” Cognitive defects and social isolation may act as additional risk factors.

Patients who understand their unrealistic nature tend to suffer less from them, although they may still be distressed by the fear of "inevitable madness." Reassurance and explanation that visual or auditory deceptions do not imply any mental disorder can have a powerful therapeutic effect.

According to the authors, psychotropic treatment is not always necessary, since relief of hallucinations may cease either spontaneously or after the cessation of social isolation. The first choice of treatment is restoration of vision or hearing, for example through cataract surgery, external hearing treatment or hearing aids.

When such interventions are unsuccessful, pharmacological treatment may be considered, although the benefits of treatment do not always outweigh the disadvantages of side effects. Although antipsychotics, antiepileptic drugs, and cholinesterase inhibitors have previously been reported to be effective in these settings, there are currently no randomized studies of the effectiveness of these types of medications in patients with hallucinations as part of sensory deafferentation. If pharmacological treatment is considered necessary, quetiapine or lamotrigine may be the drugs of choice. TMS has also been used for this type of hallucination, but the results remain inconclusive.

The material was prepared as part of the ProSchizophrenia project - a specialized section of the official website of the Russian Society of Psychiatrists dedicated to schizophrenia, modern approaches to its diagnosis and treatment.

Prepared by: Kasyanov E.D.

Psychiatric and neurological patients sometimes complain of auditory hallucinations. This is a distorted perception of reality. A person hears sounds that do not exist in reality. There are many types of this symptom. Therapy will consist of timely treatment of the underlying disease.

Diseases characterized by symptoms:

• schizophrenia;
• malignant neoplasms of the brain;
• hallucinatory-delusional syndromes;
• depressive states;
• bipolar affective disorder;
• dementia;
• Alzheimer's disease;
• various vascular diseases (atherosclerosis, circulatory insufficiency of some parts of the brain);
• chronic alcoholism.

What are auditory hallucinations

Auditory or acoustic hallucinations are a perception disorder when a person hears sounds without the stimulus affecting the hearing aid. This means that reality is perceived distorted and incorrect.

Psychiatrists classify auditory hallucinations as productive symptoms, that is, they are a new phenomenon that appears as a result of illness and is absent in healthy people. Such hallucinations can be in the form of:

• sound;
• whistling;
• the sound of a vehicle braking;
• birds singing;
• words;
• a whole sentence.

Why does this disease appear?

The causes of auditory hallucinations are diseases of various etiologies. Psychiatric diseases come to the fore:

• schizophrenia;
• depression;
• bipolar affective disorder, etc.

Other reasons:

• malignant tumors and brain metastases;
• inflammatory processes of the brain;
• cerebrovascular accident.

People suffering from chronic alcoholism may hear “voices” during delirium (popularly called “delirium tremens”).

How do “voices” arise?

The exact mechanism of auditory hallucinations is unknown.

In the course of numerous experiments and studies, it was found that while the patient hears “voices,” Broca’s area is active in the cerebral hemispheres - the center of speech responsible for its reproduction; located in the cortex of the left frontal lobe (in right-handed people).

When a person simply thinks, he also activates Broca's center. This can be called inner speech. To understand that speech comes from the inside, there is a special department in the brain - the Wernicke center. It is located in the temporal and parietal lobes.

It is believed that the patient cannot recognize internal speech, but perceives it as external. That is, there is a dysfunction of the Wernicke center.

What can increase the likelihood of developing this symptom?

Relative risk factors for the development of auditory hallucinations:

• refusal to take prescribed medications;
• independent adjustment of doses of medications taken;
• simultaneous use of medications that inhibit each other’s effects.

There are no absolute risk factors for auditory hallucinations.

What types is it divided into?

Auditory hallucinations, like all others, are divided into elementary, simple and complex.

Elementary hallucinations are of two types: acoasms and phonemes.

Acoasms - noise, tapping, rumble, hissing, shooting, ringing - this is a separate sound. The symptom is found in the practice of psychiatrists and neurologists. An otolaryngologist or an ENT doctor can also come across this (with Meniere's disease - this is a disease of the inner ear, of a non-inflammatory nature, leading to deafness).

Phoneme - individual words, shouts, pronouns, syllables - speech deception. Phonemes do not form speech; they are just individual elements that do not carry a semantic load.

Both acoasms and phonemes are periodic and constant.

Simple auditory hallucinations are a deception of perception that does not affect another analyzer. That is, the patient hears only the sound, but does not see the source.

There are several types of simple ones:

• musical (the patient hears the playing of a guitar, violin or piano, singing, popular or unknown melodies, excerpts of works or entire compositions);
• verbal or verbal (the patient hears conversations, whole phrases or just individual words).

Verbal hallucinations, in turn, are divided into three types:

• commenting or evaluative (patients with such hallucinations listen to voices that judge their actions, assign an assessment to actions, intentions or the past; such “voices” can be either friendly and encouraging, or judgmental and accusatory in nature);
• threatening (quite unpleasant for the patient; the patient hears threats at his own expense, promises of violence, etc.);
• imperative (hallucinations of this type can pose a threat not only to the patient, but also to the people around him).

Imperative hallucinations interfere with the treatment process: “voices” can simply prohibit the patient from listening to the doctor and following his instructions, or taking medications.

There are very rarely cases in the practice of psychiatrists when patients turn to them for treatment on the orders of “voices”. Such a person may not even realize that he is mentally ill.

Complex hallucinations are hallucinations that simultaneously affect the function of several analyzers. For example, a person not only hears the speech of his pursuer, but also sees him in his room.

What are the special types of auditory hallucinations?

Alenshtil's auditory hallucinations are hallucinations in the form of a knock on the door or a bell. Occurs in a mentally healthy person at a moment of intense anticipation of the corresponding sound.

Antagonistic (contrasting) hallucinations - a person hears several “voices” that express opposing intentions. For example, one “voice” suggests killing someone, and the second dissuades them.

Important! Auditory hallucinations are a symptom of a mental or neurological disease. They can occur in diseases such as schizophrenia, dementia, bipolar affective disorder, and brain tumors. A person hears sounds that are real only to him without the influence of an irritant on the hearing aid. In themselves, such perception disorders are not dangerous, but their content can cause the patient to harm himself or others. Any hallucinations should be a reason to consult a psychiatrist

Auditory hallucinations in older people

Elderly people may experience auditory hallucinations due to deterioration of blood supply, organic brain damage, mental disorders, or taking medications with side effects - hallucinations.

The most common reasons for older people are:

• isolated auditory hallucinosis of Charles Bonnet - develops after 70 years of age against the background of decreased hearing. At the beginning they appear as acoasms, which over time turn into phrases and sentences with a semantic load. It is extremely rare that “voices” are imperative in nature. Most often, a person “hears” condemnation, threats and insults addressed to him;
• hallucinations as a symptom of mental illness (for example, schizophrenia);
• hallucinations in Parkinson's disease (a disease characterized by the destruction of motor cells in the brain that produce dopamine, a neurotransmitter);
• side effects of medications (drugs that lower blood pressure - antihypertensives, some antibiotics, psychostimulants, tranquilizers, anti-tuberculosis drugs).

Treatment consists of prescribing antipsychotics. In case of hallucinations from medications, the attending physician should discontinue or replace the drug that causes such an unpleasant syndrome.

It is noteworthy that with Charles Bonnet hallucinosis, the symptoms lose their intensity over time, and attacks become increasingly rare. Problems with the cognitive function of the brain (memory, attention, etc.) begin to pose a big problem.

Auditory hallucinations in children

It is not uncommon for children to experience the first years of school. During this period, the child is under significant pressure. The student experiences overwork and stress, often anxiety about grades. This condition leads to the child beginning to hear unreal “voices.”

Other causes of auditory hallucinations in older children include:

• fever;
• food and drug poisoning;
• neurological disease;
• puberty (time of hormonal changes in the body);
• use of alcohol and drugs (relevant for high school students);
• depressive disorder;
• insomnia;
• severe physical and psychological injuries.

Hallucinations in a child should alert the parent. You should immediately consult a doctor to rule out mental retardation and neurological diseases.

When and which doctor to contact

If a person is bothered by auditory hallucinations, then this is a cause for concern. You must make an appointment with or.

What first aid can be given to a person?

The sequence of actions during an attack should be as follows:

• call an ambulance;
• protect the patient from himself and others;
• try to calm down.

It is impossible to independently provide medical first aid to a person with hallucinations. This can only be done by doctors using specific medications.

How is diagnosis made?

An experienced specialist will only be able to suspect that a patient has auditory hallucinations based on behavior.

Such patients are always on guard, they are constantly listening to something, staring into the empty space of the room. They can whisper something, answer an invisible interlocutor. Under the influence of imperative hallucinations, a person may try to jump out of a window and harm himself or others.

It will be very important for the doctor to understand what kind of hallucinations he sees: true or false. With false hallucinations, the source of the “voices” will be directly in the human body. The patient will claim that they are speaking in his head, his spine. There is no projection on appearance. False hallucinations or pseudohallucinations have a more unfavorable prognosis and are included in the Kandinsky-Clerambault syndrome (a combination of hallucinations, delusions and phenomena of automatism, when patients are haunted by a feeling of “made” movements or thoughts).

Treatment tactics

Disease or condition	Type of therapy	Preparation	Drug group	Directions for use
Alcohol intoxication	Detoxification
	gastric lavage	Activated carbon	Adsorbent	2-3 spoons once
		4% sodium bicarbonate solution	Electrolyte solution	50 ml IV (single dose)
	infusion therapy	40% glucose solution	Solution for intravenous administration	20-40-50 ml IV slowly (single dose)
	symptomatic therapy	10% solution of Sulphocamphocaine	Analeptics (have a stimulating effect on the respiratory center)	2 ml IV (single dose)
		Korglykol	Cardiac glycosides	0.5-1 ml IV slowly over 5-6 minutes (once)
		Clopixol	Neuroleptic	10-50 mg orally (single dose)
		Diazepam	Tranquilizer	5 mg orally (single dose)
Mental disorders	Drug therapy (drug of choice)	Aminazine	Neuroleptics	1-5 ml of a 2.5% solution is administered intramuscularly no more than 3 times a day (take from 2-3 weeks to 2-3 months)
		Triftazin		2-5 mg 2 times a day orally (take 2-3 weeks)
		Haloperidol		10 mg IM 2-3 times a day (take 2-3 months)

For Alzheimer's disease, dementia and others, it is necessary to use specific drugs that improve the course of the underlying disease, while eliminating attacks.

Doctor's advice! Don't be afraid to use antipsychotics. Despite the fact that they have side effects, these drugs do an excellent job of improving the patient’s condition and quality of life.

What could be the consequences?

Auditory hallucinations are not an independent disease, so they have no direct complications. However, if you do not resort to treatment for this condition, as well as the disease that causes the appearance of such a symptom, the consequences can be depressing.

The progression of the disease leads to social maladjustment and loss of self-care skills.

We must not forget that in some cases, auditory hallucinations can prompt a person to attempt suicide.

How to prevent the occurrence

There is no specific prevention. Prevention of such conditions comes down to the need for timely treatment of specific diseases.

What to Expect After an Episode of Auditory Hallucinations

The prognosis depends on the root cause of the appearance, since they are just a symptom and do not act as an independent disease.

In situations resulting from taking medications or fatigue, the prognosis is quite favorable, since you just need to stop taking medications, rest and reduce the impact of stress on the body.

However, for mental disorders, it is necessary to take medications that eliminate the productive symptoms of the disease. Such medications have significant side effects and are used exclusively under the prescription of a psychiatrist.

Auditory hallucinations are considered one of the most common symptoms of various mental and physical diseases. The patient clearly hears sounds, noises or voices that do not actually exist. Despite the seeming harmlessness of this phenomenon, auditory illusions can cause a lot of problems for the patient, causing many unpleasant situations and even aggressive behavior.

Pay attention! Auditory hallucinations can be classified as subjective sounds. They are audible only to the patient, which makes diagnosing and treating this disease very difficult.

Types of auditory hallucinations

There are several types of extraneous sounds that spontaneously manifest themselves in the patient’s consciousness:

• Tinnitus. Standard noise effects resembling buzzing, clicking, whistling, ringing, etc.
• Acoasma. More specific sounds: creaking, drops, music, etc.
• Phonemes. The most dangerous hallucinations that can carry a certain meaning and directly influence human behavior. These can be individual words, phrases or voices, which clearly indicates mental problems.

In addition, any illusions (including acoustic ones) are usually divided into true and false:

True hallucinations occur when a person hears all kinds of non-existent sounds in the surrounding space and tries to organically fit them into his worldview. The patient is completely confident in the reality of these sounds and never questions them.

Hallucinations false most often for the patient it comes from within. Moreover, sounds are not always heard in a person’s head. Intrusive and commanding voices can come from the stomach, chest, and any other place on the body. Such illusions are considered to be the most dangerous for the life of the patient and the people around him.

Reasons for appearance

In order to correctly diagnose the type of anomaly and determine approaches to its elimination, it is necessary to understand as clearly as possible the causes of auditory illusions. Various factors can provoke this phenomenon:

• Strong overwork, nervous or physical exhaustion. Overvoltage can cause disruptions in the normal functioning of the brain and changes in a person’s consciousness.
• Feverish conditions, high temperature. They can cause disturbances in certain body systems. In some cases, this manifests itself in the form of auditory or visual illusions.
• Tumors in the area of ​​the brain. The tumor can put pressure on certain areas of the auditory system or brain.
• Mental disorders: schizophrenia, psychopathy, all kinds of syndromes.
• Ear diseases, inflammatory processes and even sulfur plugs may well disrupt the functioning of sound-conducting channels and cause extraneous noise.
• Malfunctions of electronic hearing aids. The most harmless reason that can be eliminated by replacing or repairing the device.
• Use of psychotropic substances. Drug addiction or treatment with certain drugs can affect a person's brain activity in a similar way.
• Alcohol abuse. Attacks of delirium tremens often result in visual or auditory hallucinations.

Photo 2. It was the appearance of hallucinations that gave rise to the phrase “getting drunk as hell.” Source: Flickr (bluevinas).

When falling asleep

Oddly enough, but exactly When falling asleep, auditory hallucinations most often disturb patients. It would seem that the body, tired during the day, is as relaxed as possible and is preparing to get a long-awaited rest, but that was not the case. A person begins to hear non-existent sounds or voices.

In medicine, such hallucinations have a separate name - hypnagogic. Their main danger is that at the time of their appearance the patient, as a rule, is alone and in complete silence. The lack of distractions makes a person more vulnerable and unable to resist the voices giving him orders.

Symptoms and signs of hearing hallucinations

The volume of acoustic illusions depends on their type and the patient’s character traits. Sometimes the patient hears a barely audible whisper, in other cases - loud orders that are almost impossible to resist. In the latter case, the patient most likely develops one of the varieties of schizophrenia.

Sometimes the patient hears voices, but is not the subject of their discussion. It is as if he hears from the outside a conversation between two or more non-existent people on abstract topics. Such hallucinations are considered completely harmless, although they cause a lot of inconvenience both to the patient himself and to those around him.

Disturbances are considered more dangerous when the patient hears voices repeating his own thoughts and beliefs. At the same time, it seems to the patient that these thoughts (often very intimate and impartial) are heard by everyone around him. This can become a reason for aggression.

Pay attention! In some cases, auditory hallucinations can be confused with manifestations of an “inner voice” or actual tinnitus resulting from various diseases.

Diagnostics

Auditory hallucinations are not an independent disease, but only a symptom of another disease. The doctor will necessarily begin the diagnosis by collecting an anamnesis. This can be quite difficult to do, since the patient may have an extremely negative and skeptical attitude towards his pathological condition. If the patient does not want to contact the doctor, you can try interviewing the closest relatives.

To exclude the organic nature of the pathology, laboratory tests of urine, blood, spinal cord. Older patients using hearing amplification devices should additionally check the correct operation of the electronic device.

The presence of acoustic hallucinations can also be guessed from the specific behavior of a person. The patient may hesitate to answer, clearly listening to something. When talking with such a patient, the doctor needs to try to win him over as much as possible and establish a trusting relationship.

Treatment of auditory hallucinations with homeopathy

Along with traditional medicine, modern homeopathy can offer a number of drugs that can help eliminate such an unpleasant and sometimes dangerous disease for the life and health of the patient:

• Elapse(Elaps). Indicated for extraneous noise, clicking, unbearable itching in the ears. It will help eliminate attacks of deafness at night, accompanied by crackling and roaring in the ears.
• Curare(Curare). Helps eliminate whistling or ringing noises, sounds reminiscent of animal cries.
• Valerian(Valeriana). The drug is recommended for patients who have ringing in the ears, acoustic illusions, hyperesthesia (increased sensitivity of the senses).
• Eupatorium purpureum(Eupatorium purpureum). Effective for various types of auditory hallucinations, sensations of constant ear congestion, crackling when swallowing.
• Galvanism(Galvanism). Suitable for patients who hear the sounds of gunshots, explosions, the playing of a brass band, or the sound of bells.
• Anacardium(Anacardium). The drug helps patients who experience voices imposing strange orders or whispering blasphemies.
• Carboneum sulfuratum(Carboneum sulphuratum). Helps eliminate burning ears, singing voices or harp sounds.

Contact qualified specialists who can select the most suitable drug for your clinical case and prescribe the correct dosage and course of administration.

Hallucinations are a cause for concern, whether you experience them yourself or observe them in another person. Mild cases of hallucinations can be successfully treated at home, but severe or chronic cases require mandatory medical intervention.

Steps

Home treatment (self-help)

Understand the nature of hallucinations. Hallucinations can affect any of the five senses - sight, hearing, taste, smell or touch - and can have a variety of underlying causes. However, in any case, the person experiences them while conscious, and they seem absolutely real.

• Most hallucinations are disorienting and unpleasant, but some seem interesting or enjoyable.
• If you hear voices, such hallucinations are called auditory; if you see non-existent people, objects, light - these are visual hallucinations. The feeling of insects or something else crawling on the skin is a common tactile hallucination.

Take your temperature. High body temperature can cause hallucinations of varying severity, especially in children and the elderly. Even if you're not in one of these age categories, it can cause hallucinations, so it's best to check if you have a fever.

Get enough sleep. Mild to moderate hallucinations can be caused by severe lack of sleep. Severe cases of hallucinations usually have other causes, but lack of sleep can make them worse.

• An adult needs an average of seven to nine hours of sleep a night. If you are currently suffering from severe sleep deprivation, you may even need to increase this amount by a few hours until your body recovers.
• Daytime naps can disrupt the normal sleep cycle and lead to insomnia and, as a result, hallucinations. If your sleep pattern is off, try to establish a normal routine.

Manage stress more effectively. Anxiety is another common cause of mild hallucinations, but can also intensify severe hallucinations caused by other causes. Learning to minimize psychological and physical stress can help reduce the frequency and severity of hallucinations.

• To reduce physical stress, you need to stay hydrated and get enough rest. Regular light to moderate exercise will also improve your overall health and relieve stress-related symptoms, including mild forms of hallucinations.

Recognize when it's time to ask for help. If you are unable to distinguish reality from a hallucination, you should seek emergency medical help immediately.

• If you are experiencing mild hallucinations but they keep happening over and over again, you should also make an appointment with your doctor as there is likely a medical reason behind them. This is especially likely if general measures to improve well-being have had no effect.
• If you are experiencing hallucinations accompanied by other severe symptoms, you also need emergency medical attention. Such symptoms include discoloration of the lips or nails, chest pain, clammy skin, confusion, loss of consciousness, fever, vomiting, fast or slow heart rate, difficulty breathing, injury, seizures, severe abdominal pain, or behavioral disturbances.

Home treatment (helping others)

1. Learn to recognize the symptoms. People who experience hallucinations may not talk about it openly. In such cases, you need to know how to spot the less obvious signs of hallucinations.

   • A person experiencing auditory hallucinations may not notice others and actively talk to themselves. He may seek solitude or listen to music obsessively in an attempt to drown out the voices.
   • A person whose eyes are focused on something you cannot see may experience visual hallucinations.
   • If a person scratches or shakes off something invisible to the eye, this may be a sign of tactile (tactile) hallucinations, if he pinches his nose for no reason - hallucinations associated with the sense of smell. Spitting out food may be a symptom of taste hallucinations.

2. Stay calm. If you need to help someone who is hallucinating, it is important to remain calm throughout.

   • Hallucinations can become a source of increased anxiety, so that the patient may be in a state of panic. If stress or panic increases because of you, it will only make the situation worse.
   • If someone you know is hallucinating, you should also discuss this with them when they are not hallucinating. Ask what the likely cause might be and what kind of support you can offer.

3. Explain what is really happening. Calmly explain to the patient that you do not see, hear, touch, taste or smell what he is describing.

   • Speak directly and without accusing anything, so as not to upset the patient.
   • If the hallucinations are mild or moderate and the person has experienced hallucinations before, you can also try to explain to them that what they are experiencing is not real.
   • Those who are experiencing hallucinations for the first time, as well as those who suffer from severe hallucinations, may not be able to recognize that they are hallucinating and act aggressively in response to your doubts.

4. Distract the patient. Depending on the circumstances, it can be useful to distract the person by changing the topic of conversation or moving to another location.

   • This advice is suitable for cases of mild to moderate hallucinations, but you may not be able to influence someone who is experiencing severe hallucinations.

5. Encourage the person to seek professional help. If someone you know suffers from recurring hallucinations, be persistent in encouraging them to seek medical or psychological help.

   • Talk to the person when they are not hallucinating. Discuss the severity of the situation and share any knowledge you have regarding possible causes and solutions to the problem. Your approach should be one of love and support. Never take an accusatory position.

6. Continue to monitor the situation. When hallucinations worsen, they can become a threat to the safety of the patient himself or others.

   • When it comes to safety, immediately call an ambulance.
   • If hallucinations are accompanied by other severe physical symptoms, or if the patient is no longer able to distinguish hallucinations from reality, emergency medical attention is also required.

Medical assistance

1. Diagnose and treat the root cause. Hallucinations are a typical symptom of certain mental disorders, but can also be caused by a number of physiological reasons. The only way to rid a person of hallucinations in the long term is to treat the underlying cause.

   • Psychiatric causes include schizophrenia, schizoid and schizotypal personality disorder, psychotic depression, post-traumatic disorder and bipolar disorder.
   • Physiological factors affecting the central nervous system can also cause hallucinations. These include brain tumors, delirium, dementia, epilepsy, stroke and Parkinson's disease.
   • Some infectious diseases, such as bladder infections or lung infections, can also cause hallucinations. Some people experience hallucinations during migraines.
   • Using drugs or alcohol can also cause hallucinations, especially when taking large doses or when stopping use (withdrawal syndrome).

2. Take antipsychotic medications. Antipsychotics, also known as antipsychotics, are most often used to help control hallucinations. These medications may be prescribed to treat hallucinations caused by both mental and physiological causes, especially when other treatments are unavailable or insufficient.

   • Clozapine, an atypical antipsychotic, is usually prescribed in dosages of 6 to 50 mg per day, depending on the severity of the hallucinations. The dose should be increased gradually to prevent complications. Your blood counts should be monitored regularly while being treated with this drug, as it can lower your white blood cell count to dangerous levels.
   • Quetiapine is another atypical antipsychotic used to treat hallucinations. It is generally less effective than clozapine in most cases, but is also safer.
   • Cocaine, LSD, amphetamines, marijuana, heroin, ketamine, phencyclidine, ecstasy are all hallucinogens.
   • Hallucinations can appear not only during drug use, but also when it is abruptly stopped. However, hallucinations caused by withdrawal symptoms can usually be treated with antipsychotic medications.

3. See a therapist regularly. Cognitive behavioral therapy, in particular, may help some patients who suffer from recurring hallucinations, especially those caused by psychological disorders.

   • This therapy examines and evaluates a person's feelings and thoughts. By identifying the likely psychological causes of the problem, a professional psychotherapist can develop strategies to help the patient cope with it and reduce symptoms.

4. Find group therapy opportunities. Classes in help and self-help groups can help reduce the severity and frequency of hallucinations, especially auditory hallucinations caused by psychological reasons.

   • Help groups teach patients to stay in touch with reality and help them separate hallucinations from real life.
   • Self-help groups motivate people to take responsibility for their hallucinations, thereby helping them control and cope with them.

Probably every person has talked to himself at least once in his life, and experts do not see anything terrible in this. But when a person begins to think that in response to asking himself the question “Well, when will I start thinking about what I’m saying,” he hears a real voice, and not his own thoughts, they are already talking about the presence of auditory hallucinations. The reasons for them can be very different, but most immediately begin to suspect serious mental illness, and this is wrong.

Causes of auditory hallucinations

As mentioned above, most people associate auditory hallucinations with serious mental illness, for example, or mania. And this may indeed be the case, but only a specialist can make a diagnosis, so if such phenomena are observed for a long time, it is simply necessary to contact him.

But auditory hallucinations can be caused by a number of other reasons, most often this is a prolonged lack of sleep or taking any psychotropic drugs. Also, this phenomenon can be caused by medications; in particular, anti-spasm medications often have this side effect. In addition, sound hallucinations can appear during severe nervous excitement - an attack of jealousy, rage, severe sadness, falling in love, etc. Depression can also be accompanied by hearing disorders. Some diseases (Alzheimer's disease) may also be accompanied by auditory hallucinations. Ear diseases or poor quality hearing aids can also cause a person to hear voices that do not exist in reality.

Sounds that cause hallucinations

It is curious that a person himself can cause hallucinations of this kind; we are not talking about taking alcohol and other psychotropic substances, but about using sounds that cause hallucinations. There is the so-called Ganzfeld method (from German “empty field”), a technique based on the formation of a dreamlike state of consciousness against the background of deep relaxation of the body. The person is asked to lie down, close their eyes (it's best to wear a sleep mask to avoid distractions from light) and relax while listening to white noise - the sound that a radio makes on an empty frequency. Another example of white noise is the sound of a waterfall. After some time, the person relaxes and plunges into a state similar to the deep sleep phase. But since he is not actually sleeping and continues to be aware of what is happening, he begins to experience auditory or visual hallucinations; we can say that in this state a person dreams in reality.

Auditory hallucinations are a type of productive pathology in psychiatry, in which the patient hears various sounds in the absence of their real source. An important characteristic of what is heard precisely as hallucinations is that the patient is convinced of their truth. He will never describe imaginary sounds with the word “seemed.”

Types of auditory hallucinations

What is directly audible can be different - the sound of the wind, the sound of a car, the singing of birds, and most characteristically - voices. The characteristics of the voices are also different:

• Voices commenting on the patient's behavior. In most cases, those commenting on hallucinations have a sarcastic tone, which causes dissatisfaction and aggression. If the circumstances are unfortunate, this aggression can spill out on the patient’s relatives.
• Voices talking to each other on topics unrelated to the patient. This is a relatively safe type of auditory hallucination, in most cases perceived by the patient as a kind of radio.
• Voices repeating the patient's thoughts or confirming his ideas. This is a rather dangerous type of hallucination and can provoke aggressive behavior. In the case of repetition of thoughts, it seems to the patient that all his thoughts, even impartial or intimate ones, are being disclosed publicly. He may have a desire to eliminate the “witnesses” of mind reading. And if thoughts are confirmed by voices, any, even the most incredible, ideas, when repeated for a long time, seem like reality to the patient. The fleeting thought that his wife might cheat on him, under the influence of hallucinations, turns into a fait accompli. And the fact may be followed by retribution, also invented under the influence of hallucinations.
• Commanding (imperative) voices. The most dangerous type of auditory hallucinations, since the patient lacks criticality. He believes everything he hears in hallucinations, which means he carries out all their orders. And orders can be very different - from cleaning the apartment to going and killing grandma. The combination of delusions and imperative hallucinations is most often a symptom of a severe mental illness, such as schizophrenia.

When deciding how to treat hallucinations, it is extremely important to find out their cause in each case. It is she who plays a decisive role in choosing treatment tactics. The causes of hallucinations can be divided into several main groups:

Hearing aid malfunction. This is a fairly common cause in older people. If an elderly person using a hearing aid complains about voices, first of all you need to check the quality of its work.

Side effects of drugs. Some psychotropic drugs, in overdose or as side effects, can cause hallucinations. Hallucinations are also possible with an illiterate combination of drugs. This happens especially often when self-medicating. When contacting a doctor about symptoms of hallucinations, be sure to present a complete list of medications the patient is taking.

Alcohol intoxication and delirium. In this case, recognizing the cause is not difficult. It is necessary to distinguish between hallucinations during alcohol intoxication and delirium. During intoxication, they develop at the height of intoxication, especially when consuming surrogate alcohol, and are neutral in nature. In delirium, hallucinations of a threatening nature occur when alcohol is withdrawn after prolonged use. How to treat auditory hallucinations in this case is quite clear.

Auditory hallucinations as a symptom of mental illness. The most common and most difficult option to treat. It is in this case that all the variety of auditory hallucinations arises. They can be a manifestation of schizophrenia, manic-depressive psychosis, Alzheimer's disease and other diseases.

Treatment of auditory hallucinations

Treatment approaches may vary significantly depending on the cause of the hallucinations. Let's consider how to treat auditory hallucinations according to the reasons listed above.

1. Hallucinations due to a malfunction of the hearing aid. The most favorable variant of diagnostic results. It is treated by replacing or repairing the device. Depending on the type of hearing aid, they can independently imitate noise or reproduce voices due to the fact that the device tunes to a radio wave and transmits it to the patient.
2. Only a specialized specialist can recognize hallucinations that are a side effect of drugs or their combinations. This specialist is not always your local therapist. It may be necessary to contact a psychiatrist, cardiologist, narcologist or other doctor related to the profile of diseases and medications taken. Be sure to keep a record of all medications you take - names, doses and frequency of administration per day. This is especially important in the case of elderly patients who may confuse the medicine or take it again. It is convenient to make a special “prescription calendar” in which to mark the medications taken. When you visit your doctor, be sure to show him this “calendar” or just a list of medications.
   The occurrence of hallucinations as a result of taking medications indicates a severe overdose or long-term use of incompatible drugs. This condition cannot always be eliminated only by stopping medications or changing combinations. Intoxication may be required to speed up the elimination of substances that cause hallucinations. Treatment in this case occurs in a hospital setting. Subsequently, the patient is discharged for further treatment at home and a suitable regimen and combination of medications is recommended to continue treatment.
3. Auditory hallucinations during alcohol intoxication or delirium occur acutely and are combined with delusions, visual hallucinations, and persecution mania. In this case, treatment must be immediate and very active. The patient must be hospitalized. Active detoxification therapy, infusions of nutritional and saline solutions are prescribed to quickly remove toxic substances from the patient’s body. With severe aggressiveness, motor agitation, and obsessions with persecution, tranquilizers and antipsychotics may be prescribed. In the future, full psychosocial rehabilitation of the patient, his involvement in work, and preventive work with the family are necessary.
4. Auditory hallucinations in mental illness are part of a broad symptom complex called productive symptoms. In addition to auditory hallucinations, it includes other types (visual, tactile, pseudohallucinations), delusional ideas of various kinds, and obsessive states. Hallucinations in combination with these symptoms are an alarming signal indicating the presence of severe mental pathology. In young people, they may primarily indicate schizophrenia. In the elderly, it may be a manifestation of Alzheimer's disease or senile dementia. The specific nosology can be clarified only with a thorough examination. The choice of treatment tactics also depends on the final diagnosis. In most cases, treatment for such severe symptoms occurs in a hospital. To relieve hallucinatory phenomena, antipsychotics are used, in particular new generation atypical antipsychotics. In case of severe psychomotor agitation, it is necessary to prescribe tranquilizers. In the case of pathology in the elderly, treatment to relieve acute hallucinosis is the same as in young people. Further therapy depends on the nosology - there are specific drugs for the treatment of Alzheimer's disease, nootropics for dementia, etc.

The goal of primary treatment is to reduce the severity or completely eliminate hallucinations. At home, follow-up treatment is carried out with planned medication intake. In most cases, such patients require lifelong treatment. It is very important to train relatives to recognize the symptoms of exacerbation and monitor the patient’s condition.

"Voices in the head": 81% of people experience auditory hallucinations



The phenomenon of people hearing other people's voices in their heads is actually more complex than previously thought. Researchers from Stanford University and Durham University (both UK) published a report in the journal The Lancet Psychiatry. Scientists have discovered that voices are heard not only by people with psychiatric diagnoses, but also by healthy people. Most hear multiple voices, and some experience physical reactions to voices. For example, trembling, tingling, fever.

The researchers say this finding could help change the treatment used for auditory hallucinations. Conventional treatment includes medication, voice therapy, and other techniques. The new proposal is to focus on cognitive behavioral therapy.

Auditory hallucinations are characteristic of many mental disorders - psychosis, schizophrenia, bipolar disorder, but from 5% to 15% of healthy adults also experience auditory hallucinations.

The researchers interviewed 153 respondents. Most of them had a psychiatric diagnosis; 26 people had no history of such illnesses. The vast majority of respondents said that they hear multiple voices - 81%. 66% of respondents noted that voices were accompanied by specific bodily sensations, such as heat or tingling in the arms and legs, 31% of them experienced fear, anxiety and depression, and stress is often associated with voices, another 31% of participants said they felt positive emotions .

“As long as we believe that voices are signs of pathology and disease, it hardly makes sense to study this phenomenon. Instead, we try to suppress or eliminate voices. This study is a step forward. If we want to understand more about auditory hallucinations, we must be willing to change our perception of the phenomenon, said independent consultant Rachel Waddingham. - I would like to live in a world where we are interested in understanding each other and sharing experiences, and not pathologizing. Everyone has their own story, and the world would be a much kinder place if we started listening.”

scientificrussia.ru

Auditory hallucinations

Auditory hallucinations are the most common type of hallucination. As a rule, the patient hears various sounds, conversations and noises.

Sounds can be quiet or loud, and very often cause discomfort. Often auditory hallucinations are of a commanding nature. Many researchers have repeatedly associated the presence of auditory hallucinations with structural and functional disorders in the superior temporal gyrus, especially emphasizing the damage to the anterior section of the superior gyrus of the left temporal lobe.

Only a highly qualified psychiatrist can clearly determine whether the sounds and voices arising in the head are an auditory hallucination. The psychiatrist will also identify other disorders in the person’s mental activity. It happens that a completely healthy person, actively thinking, listens to his inner voice. It is a mistake to call this phenomenon a hallucination.

The occurrence of painful sensations and auditory hallucinations may indicate severe mental disorders or neurological pathology. Such symptoms cannot be ignored. It is necessary to seek help from a qualified psychiatrist as soon as possible.

An accurate diagnosis can only be determined through a competent and comprehensive examination, after which the doctor prescribes medications for hallucinations or determines treatment for the underlying disease, such as a vascular disease or a brain tumor.

Auditory hallucinations in older people

In older people, the occurrence of sound hallucinations is usually associated with pre-existing vascular diseases of the brain, or with the side effects of drugs prescribed for the treatment of somatic diseases. In older people, the risk of developing auditory hallucinations increases with age. Also, in elderly patients, the development of auditory hallucinations can occur against the background of somatogenic depression, various types of mania, and Alzheimer's disease.

Auditory hallucinations in schizophrenia

Sound hallucinations are most characteristic of schizophrenia, and are one of its first manifestations. With schizophrenia, hallucinations of other senses may also occur (“not only steps and threatening voices are heard, directed glances, smells and even the taste of poison are felt”).

In the presence of sound hallucinations, which occur in 75% of patients with schizophrenia, the latter can hear various sounds: noise, ringing, knocking, whistling, thunder, footsteps, “voices.” “Voices” often “voice thoughts”, whisper something, comment, “advise”, conduct a dialogue with each other, threaten, scold, order, call, argue with each other, etc.

Auditory hallucinations in schizophrenia most likely represent the patient's internal or own speech. The words he pronounces in a whisper correspond to their “voices”; we can say that this is the “inaudible speech” of a sick person.

It is possible that hallucinations may be accompanied by hidden inner speech, even if there is no obvious sign that the person with schizophrenia is talking while they are hallucinating.

psyclinic-center.ru

Causes of auditory hallucinations

When auditory hallucinations occur, a person begins to hear various sounds, including voices and conversations, which do not exist in reality. In this case, you should take this violation seriously and seek help from a qualified specialist. As medical practice shows, almost every person has had to talk to himself at least once. For example, having forgotten his phone at home, he may think: “Well, when will I learn to be more collected”! Now imagine that after the phrase has been said, a voice is heard inside the person’s head that says: “Yes, indeed, you are too forgetful.” If something like this happens to a person, then it’s time to suspect that mental health is not in order.

In a situation where an individual hears non-existent voices, they say that he has auditory hallucinations, the occurrence of which can be a number of reasons, so without an appropriate examination it is difficult to name the exact cause. First of all, experts suggest that in this case there is a mental disorder of varying severity, as well as a neurological disease. The biggest mistake is that some people take such disorders lightly and put off visiting a doctor until better times.


There is currently a debate among many scientists about the causes of auditory hallucinations. Some experts argue that the auditory hallucinations that sometimes sound in the head are one’s own voiced thoughts, that is, expressed in verbal form. In this regard, the individual begins to perceive this phenomenon as the voice of an unfamiliar and extraneous subject, and sometimes even several. If the cause of an auditory hallucination is a nervous or mental illness, then the patient believes that the voices sounding in his head exist in reality.

What diseases cause auditory hallucinations?


The peculiarity of auditory hallucinations is that a sick person can quite seriously declare that an inner voice ordered him to commit suicide, or gave the order to take the lives of loved ones and acquaintances. The most dangerous thing in this case is that the patient does not consider such orders to be a hallucination, and has no doubt at all that he

obliged to comply with these inadequate instructions. Among the causes of such disorders, schizophrenia is often cited. This is a disease that causes very serious mental disorders. Young patients are most susceptible to schizophrenia. At the same time, auditory hallucinations occur in people suffering from Alzheimer's disease, various manias and depressive states.

Among the reasons that cause auditory hallucinations, a factor such as alcohol abuse is named. This condition may be caused by taking certain medications, especially in case of overdose. Sometimes similar side effects are observed when taking antispasmodics. In this case, when going to see a doctor, it is necessary to make a list of all medications taken in advance in order to show it to the attending physician. But we should not forget about such a banal reason as the poor quality of the hearing aid. Therefore, if a patient using a hearing aid begins to hear strange sounds, strange voices, noise, then first of all, you should find out whether the hearing aid is in order.

It is known that auditory hallucinations occur not only in mentally ill people who need serious and immediate help from a psychiatrist. Very often, completely healthy people who do not have mental disorders, but are in a state of severe depression, may experience auditory hallucinations. Basically, they are expressed in the fact that when falling asleep they hear voices, supposedly calling them by name. Doctors say that this factor is not a manifestation of mental illness. In this case, the cause may be ordinary nervous tension, overwork, stressful situations at work or in the family.

How to identify the cause of auditory hallucinations


In order to determine what is the real cause of this disorder, the doctor must carry out a detailed examination, talk with the patient, and ask a number of questions necessary in this case. Only after this does the specialist make a conclusion whether there is a need to send the patient for treatment to a psychiatrist. Sometimes, in order to establish the cause, it is enough for a person to visit a therapist. At present, the mechanism of the occurrence of hallucinations has not been sufficiently studied, and some reasons that are selective in nature are not entirely clear.

There is an assumption that in some cases, auditory hallucinations that occur in a healthy person are caused by a special attitude, a peculiar distortion of perception, which is influenced by previous events. Numerous scientific studies have established that the cause of auditory hallucinations is also the excessive excitability of certain areas in the brain. The simplest causes of this pathology include intoxication with substances of medicinal origin, for example, levodopa, ephedrine, and meridil. Drugs used are often to blame

patient. Therefore, when the appropriate irritants are eliminated, the problem can disappear quite quickly, even without special treatment. But in most cases, the patient needs to make efforts to get rid of hallucinations.

In searching for the cause of auditory hallucinations, doctors emphasize the special significance of many diseases. For example, attention should be paid if a patient with complaints of hallucinations has cardiovascular disease, a tumor of the temporal lobe, various abscesses, temporal arteritis, or migraine. Sometimes auditory hallucinations are associated with diseases of the sensory organs and brain damage.

www.psyportal.net

As varied as visual illusions.

Acoasma- elementary and simple auditory hallucinations of non-speech content. Elementary deceptions are felt as noise in the head or coming from the side, whistling, hissing, gurgling, creaking, crackling and other sounds, as if unrelated to certain objects and often unfamiliar to patients.

Simple auditory hallucinations are usually recognizable, have some clear meaning and are attributed to specific objects. These are, for example, slurping, gnashing of teeth, the sound of breaking dishes, the sound of waves, car horns, knocking on the door, sounds of footsteps, rustling of paper, kisses, coughing, squeaking mice, sighs, barking dogs, phone calls, door calls, etc. Thus, the patient reported that in her childhood, in a dream, she heard a doorbell ring. She woke up. The call was repeated. She went to the door and asked who was there. In response I heard: “It’s me, your death.” There were further calls. At home it seemed like it was her call, at her mother’s house it was different.

Often, up to four times a night, she wakes up to the sound of a bell. Some authors believe that such auditory deceptions can arise psychogenically (Alenstiel, 1960). In some cases, the predominance of sounds made by animals becomes so obvious that one can probably talk about such a type of deception as auditory zoological hallucinations, or zooacusis.

Phonemes- elementary and simple speech deceptions of hearing. These are shouts, groans, screams, exclamations, individual words. Some patients hear an inarticulate stream of sounds of low and incomprehensible speech, reminiscent of muttering - persistent hallucinations. Calls by first and last name are especially common, when patients hear that someone is either calling them or letting them know about their presence. In this case, one voice sounds or over time changes to some other one; the voice may be familiar or belong to an unknown person.

There are “silent” calls or calls that patients attribute to some other person. Calls occur rarely and with long intervals. Often during the entire period of occurrence they occur only 2-3 times. Patients often self-identify hearing deception. Sometimes the call is immediately repeated several times in the same way. The first reaction of patients to the appearance of calls is usually alertness and fear of a possible mental disorder. Then the patients calm down, as if they get used to them, try not to notice them, some think that this happens to everyone and there is nothing special about it.

Thus, in childhood, the patient clearly heard someone “calling” her in an unfamiliar male voice several times in a row. She was “scared”, but still went to see who could be hiding behind the tree. As an adult, a year after her father’s death, she clearly heard his voice from the street, he was calling her. “I was scared and pleased.” Another patient, also in childhood, once heard a call in the voice of his deceased father. “I was scared, I thought that a dead man had come to life.” After that, for a year, it sometimes seemed to him that his father was alive. Once he even recognized his father in an unfamiliar passerby.

Some patients say that when they hear a call or a knock on the door, they “mechanically” approach it and open it even in the middle of the night, as if forgetting that it is unsafe. Apparently, calls are one of the symptoms of the long-lasting prodromal period of the disease. During the same period of time, in addition to phonemes, disorders such as a feeling of an alien presence, a feeling of someone else's gaze, and sometimes nightmares and other abnormal dreams may occur.

Musical hallucinations- deceptions of hearing with the sound of different music and in different “performances”. It can be sublime, spiritual or “heavenly” music, some popular pop melodies, something simple, primitive, associated with something vulgar, cynical, and unworthy. You can hear choirs, solo singing, the sounds of a violin, the ringing of bells, etc. Musical things known to patients sound, long-forgotten ones emerge, and sometimes these are completely unfamiliar melodies in an equally unfamiliar performance. There are patients who are musically literate and who manage to record hallucinatory melodies. We know of a case where one of these patients managed to publish a collection of songs, the words to which she composed to such melodies.

Some patients report that they can “order” musical hallucinations. To do this, they only need to remember the desired melody or words of the song, and it immediately begins to be broadcast from beginning to end. One of the patients heard such “retro-style concerts” for more than six months. It is not at all necessary that such patients be professional musicians. Musical hallucinations are observed in various diseases, mainly, apparently, in schizophrenia, epilepsy, alcoholic psychosis, and also in drug addiction. Drug addicts seem to have a particularly high frequency of listening to psychedelic music, which they willingly listen to in order to modify the picture of intoxication in a desired way.

Verbal hallucinations- deceptions of hearing in the form of speech. Patients hear phrases, monologues, dialogues, incoherent series of words in their own, foreign or unknown languages. Rarely, there are hallucinations in conventional languages ​​known in cryptography. Many patients call verbal deceptions of hearing “voices,” initially surprised by the fact that they hear someone speaking, but do not see anyone. This contradiction does not confuse patients at all, so they do not doubt that someone is really talking, coming up with their own theories about this. It does not bother them that other people do not hear the same “voices” as they do. Usually patients, no matter what the “voices” say, address them to themselves. There are many variations of such hallucinations.