Auditory hallucinations

Auditory hallucinations are experiences in which a person hears sounds, speech, or noises that do not actually exist in the environment. These sounds and speech may be perceived as real and may include various sounds such as voices, whispers, music, ringing, and many other sound phenomena.

Auditory hallucinations can be auditory, that is, hearing-related, and they can be one of the symptoms of various psychiatric and neurological conditions. It is important to note that auditory hallucinations are not a normal experience and can be disruptive and confusing for those who experience them.

Examples of psychiatric and neurological conditions that may be associated with auditory hallucinations include:

1. Schizophrenia: This is a serious mental disorder that is often accompanied by auditory hallucinations, especially auditory voices.
2. Bipolar Disorder: In some cases, people with bipolar disorder may experience auditory hallucinations during manic or depressive episodes.
3. Auditory hallucinosis: This is a rare psychiatric disorder in which auditory hallucinations may be the dominant symptom.
4. Epilepsy: Some forms of epilepsy may be accompanied by auditory hallucinations during epileptic seizures.
5. Other Conditions: Auditory hallucinations can also occur with other medical conditions including acute stress, sleep disorders, drug or alcohol intoxication, and others.

People experiencing auditory hallucinations may be frightened and distressed. Treatment includes psychotherapy, medication and, in some cases, correction of an underlying medical condition. It is important to see a doctor or psychiatrist if you or someone close to you is experiencing similar symptoms.

Causes of the auditory hallucinations

Here are some of the most common causes of auditory hallucinations:

1. Schizophrenia: Schizophrenia is a serious mental disorder characterized by a variety of symptoms, including auditory hallucinations (auditory hallucinations). Patients with schizophrenia may hear voices or conversations that do not exist in reality.
2. Bipolar Disorder: People with bipolar disorder may experience auditory hallucinations during manic or depressive episodes.
3. Auditory hallucinosis: This is a rare psychiatric disorder characterized by chronic auditory hallucinations without other psychotic symptoms.
4. Epilepsy: Some forms of epilepsy can cause auditory hallucinations during epileptic seizures.
5. Stenson-Barnes syndrome: This is a medical condition characterized by auditory hallucinations and other psychotic symptoms.
6. Psychotropic substances: The use of drugs or alcohol, or withdrawal or reduction of psychotropic medications, can cause auditory hallucinations.
7. Stress and anxiety: Intense stress and anxiety can cause temporary auditory hallucinations.
8. Medical Conditions: Some medical conditions, such as fever, medication side effects, infections, or sleep disorders, may cause temporary auditory hallucinations.
9. Traumatic Brain Injury: Severe brain injuries may be associated with auditory hallucinations and other neurologic symptoms.
10. Neurological disorders: Some neurological disorders, such as Parkinson's disease and Alzheimer's disease, may be associated with auditory hallucinations.

It is important to note that auditory hallucinations are the perception of sounds that are not actually there, and they can have different natures and origins. Below are a few situations in which auditory hallucinations may occur:

1. When falling asleep:

   • Auditory hallucinations upon falling asleep or upon waking are called hypnagogic or hypnopompic hallucinations. They may manifest as unusual sounds, noises, or conversations and may be associated with the transition processes between sleep and wakefulness. These hallucinations are usually normal and are not a sign of a mental disorder.

2. In my dreams:

   • Auditory hallucinations that occur in dreams are called somnambulic auditory hallucinations. They can be part of vivid dreams or nightmares. These hallucinations can also be normal and are not necessarily related to mental disorders.

3. After an alcoholic binge:

   • Alcohol use can cause hallucinations, including auditory hallucinations. This can be associated with alcohol intoxication and even alcohol delirium (Delirium tremens), which is a serious condition that requires medical attention.

4. With schizophrenia:

   • Schizophrenia is a mental disorder that can be accompanied by auditory hallucinations. People with schizophrenia may hear voices or sounds that others cannot hear. These hallucinations are generally considered one of the symptoms of schizophrenia and require professional medical intervention and treatment.

5. When there's a fever:

   • High fever (hyperthermia) can in some cases cause hallucinations, including auditory hallucinations. This can occur with infectious diseases such as influenza or other conditions that cause body temperature to rise. Hyperthermia can be a serious condition and medical attention is needed in such cases.

6. With neurosis:

   • Neuroses, such as insomnia neuroses or hysterical neuroses, may be accompanied by a variety of psychotic symptoms, including hallucinations, including auditory hallucinations. Hallucinations in neurosis may be associated with increased anxiety and stress.

7. For depression:

   • Auditory hallucinations can sometimes occur in people suffering from depression, especially in severe or psychotic forms of depression. These hallucinations may be associated with impaired processing of sound information in the brain.

8. In dementia:

   • Dementia, such as Alzheimer's disease or frontotemporal dementia, can cause a variety of mental symptoms, including hallucinations, including auditory hallucinations. These hallucinations may be associated with changes in the brain characteristic of dementia.

9. After COVID-19:

   • Some patients who have COVID-19, report hallucinations, including auditory hallucinations. This may be due to the effects of the virus on the nervous system, inflammation or stress associated with the disease.

Symptoms of the auditory hallucinations

To distinguish auditory hallucinations from other auditory perceptions, the following signs and symptoms should be noted:

1. No external sources of sounds: One of the main signs of auditory hallucinations is that the person hears sounds or voices that cannot be heard by other people around them. For example, he or she may hear voices when no one else is around.
2. Realistic sounds: Auditory hallucinations can be very realistic and similar to real sounds or voices. This can make them difficult to distinguish from real sounds.
3. The subject and content of hallucinations: Hallucinations can have a variety of content, including voices commenting on a person's actions, ordering something to be done, talking, or sounds such as noises or music. The content of hallucinations can vary from person to person.
4. Frequency and duration: If a person periodically hears sounds or voices that others cannot hear, this may be a sign of auditory hallucinations. They can be brief or last for a long time.
5. Emotional Response: People who experience auditory hallucinations may react to them emotionally, such as experiencing fear, anxiety, or even attempts to interact with the voices.
6. Related Events: Sometimes auditory hallucinations can be linked to specific events, stress or trauma in a person's life.

The most dangerous auditory hallucinations

The dangers of auditory hallucinations can range from low to high, and they can affect the patient and those around them. Here are some of the possible dangerous aspects of auditory hallucinations:

1. Suicidal hallucinations: In some cases, auditory hallucinations may contain commands or calls for suicide. This is one of the most dangerous aspects as it can increase the risk of suicide attempts.
2. Aggressive or threatening hallucinations: Auditory hallucinations that contain threats or commands for violence may pose a threat to the patient or others.
3. Loss of touch with reality: A profound loss of touch with reality caused by auditory hallucinations can leave the patient vulnerable and unable to make rational decisions, which can lead to dangerous situations.
4. Decreased social function: Persistent auditory hallucinations can make it difficult to communicate and interact with others, which can lead to social isolation and poor quality of life.
5. Stress and Anxiety: Persistent hallucinations can cause severe stress and anxiety, which can negatively affect a patient's mental and physical health.
6. Inappropriate behavior: In some cases, patients may respond to auditory hallucinations in inappropriate or unpredictable ways that may pose risks to their own safety or the safety of others.

Forms

Auditory hallucinations can be categorized into several types depending on their characteristics and nature. Here are some of the types of auditory hallucinations:

1. True auditory hallucinations: True auditory hallucinations are characterized by the person hearing voices or sounds as if they were real and perceived as external sounds. The voices may have their own personality, character and may talk to the person.
2. False auditoryhallucinations: False auditory hallucinations, also known as pseudohallucinations, are characterized by the fact that the person hears sounds or voices, but they realize they are not real or external. These hallucinations may be more like internal sounds or conversations in the mind.
3. Imperative auditory hallucinations: Imperative auditory hallucinations involve voices or sounds that order a person to do something specific. These hallucinations may be commands or instructions that affect the person's behavior.
4. Simple auditory hallucinations: Simple auditory hallucinations are characterized by listening to simple sounds or noises without various details. These can be, for example, noises, knocks, rustles, etc.
5. Complex auditory hallucinations: Complex auditory hallucinations include more detailed and varied sounds or voices. These can be conversations, music, dialog, or even the sounds of specific events.

Treatment of the auditory hallucinations

Treatment includes antipsychotic medication and therapy. It is important to emphasize that the choice of medication and its regimen should be prescribed by a physician based on the individual needs of the patient and the characteristics of his or her condition. Below are some antipsychotic medications that may be used for auditory hallucinations, as well as their general characteristics:

1. Risperidone (Risperidone):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Dosage varies from case to case and may vary.
   • Indications: Schizophrenia, bipolar disorder, autism, etc.
   • Contraindications: Allergy to the drug, serious cardiovascular disorders.
   • Side effects: Drowsiness, headache, weight gain, etc.

2. Olanzapine (Olanzapine):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Dosage is individualized, often starting with a low dose and gradually increasing.
   • Indications: Schizophrenia, bipolar disorder, other psychiatric disorders.
   • Contraindications: Allergy to the drug, diabetes mellitus, hypertension.
   • Side effects: Weight gain, drowsiness, changes in appetite, etc.

3. Clozapine (Clozapine):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Dosage is individualized, requires strict medical supervision.
   • Indications: Schizophrenia when other drugs are ineffective.
   • Contraindications: Agranulocytosis (decrease in the number of white blood cells), allergy to the drug.
   • Side effects: Risk of agranulocytosis, somnolence, salivation and others.

4. Quetiapine (Quetiapine):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Usually start with a low dose and gradually increase.
   • Indications: Schizophrenia, bipolar disorder, depression.
   • Contraindications: Allergy to the drug, diabetes mellitus.
   • Side effects: Drowsiness, weight gain, headache, etc.

5. Aripiprazole (Aripiprazole):

   • Mechanism of action: Dopamine and serotonin agonist-antagonist.
   • Dosage: Individualized, usually starting with a low dose.
   • Indications: Schizophrenia, bipolar disorder, other psychiatric disorders.
   • Contraindications: Allergy to the drug, Parkinsonism.
   • Side effects: Nervousness, insomnia, headache, etc.

6. Lulesperidone (Lurasidone):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Dosage may vary.
   • Indications: Schizophrenia, bipolar disorder.
   • Contraindications: Allergy to the drug, serious cardiovascular disorders.
   • Side effects: Drowsiness, dizziness, anxiety, etc.

7. Paliperidone (Paliperidone):

   • Mechanism of action: Dopamine antagonist.
   • Dosage: Individualized, a gradual increase in dose may be required.
   • Indications: Schizophrenia, bipolar disorder.
   • Contraindications: Allergy to the drug, Parkinsonism.
   • Side effects: Drowsiness, insomnia, anxiety, etc.

8. Ziprasidone (Ziprasidone):

   • Mechanism of action: Dopamine and serotonin antagonist.
   • Dosage: Dosage may vary.
   • Indications: Schizophrenia, bipolar disorder.
   • Contraindications: Allergy to the drug, prolonged QT interval, serious cardiac problems.
   • Side effects: Drowsiness, dizziness, changes in cardiac activity, etc.

9. Cariprazine (Cariprazine):

   • Mechanism of action: Dopamine and serotonin antagonist-agonist.
   • Dosage: Individualized, a gradual increase in dose may be required.
   • Indications: Schizophrenia, bipolar disorder.
   • Contraindications: Allergy to the drug, Parkinsonism.
   • Side effects: Drowsiness, insomnia, anxiety, etc.

10. Prolinperidin (Prolintane):

    • Mechanism of action: Excitatory action on norepinephrine and dopamine systems.
    • Dosage: Dosage and safety have not been established for the treatment of auditory hallucinations. This medication may be used in some cases, but with caution and only when prescribed by a doctor.
    • Indications: Auditory hallucinations within bipolar disorder or other conditions (used experimentally).
    • Contraindications: Allergy to the drug, heart rhythm disorders, arterial hypertension.
    • Side effects: Agitation, insomnia, nervousness, etc.

Please note that this list of medicines is provided for information only and should only be used under the supervision and prescription of a doctor. Each drug has its own peculiarities based on the patient's specific case, so it is important to get a consultation with a specialist before starting treatment.

Forecast

Auditory hallucinations do not always go away on their own. Depending on the cause and the underlying illness that caused them, they may be temporary or persistent.

1. Temporary auditory hallucinations: Some auditory hallucinations may be caused by stress, lack of sleep, mental imbalance or substance use. In such cases, the auditory hallucinations may disappear when the cause is removed or after rest.
2. Persistent auditory hallucinations: If auditory hallucinations are caused by serious mental disorders such as schizophrenia, bipolar disorder or paranoid personality disorder, they may be more persistent and require professional treatment. In such cases, the hallucinations may be controlled but rarely disappear completely without treatment.

Treatment for auditory hallucinations may include psychotherapy, psychopharmacotherapy (the use of medication), and other methods depending on the diagnosis and condition of the patient. It is important to contact a health care professional for an evaluation and treatment plan if you or someone you love has auditory hallucinations.

List of authoritative books and studies related to the study of auditory hallucinations

1. Book: "Hallucinations" Author: Oliver Sacks Year: 2012
2. Book: "Auditory Hallucinations: Causes, Coping Strategies, and Impacts on Daily Living" Author: Frank Larøi Year: 2012
3. Book: Hallucinations in Clinical Psychiatry: A Guide for Mental Health Professionals Author: Giovanni Stanghellini et al Year: 2007
4. Book: The Neuroscience of Hallucinations Author: Renaud Jardri, John-Paul Cauquil et al Year: 2012
5. Study: "Neural Basis of Auditory Hallucinations in Schizophrenia" Authors: Ralph E. Hoffman, Jean A. Boutros et al Year: 1999
6. Study: "The Cognitive and Neural Basis of Auditory Hallucinations" Authors: David S. Knopman et al Year: 1999
7. Study: "Functional Neuroanatomy of Auditory Hallucinations in Schizophrenia" Authors: Anissa Abi-Dargham, John H. Krystal et al Year: 1999
8. Book: The Oxford Handbook of Hallucinations Author: Jan Dirk Blom (Editor) Year: 2013

Literature

Alexandrovsky, Y. A. Psychiatry : national guide / ed. By Y. A. Alexandrovsky, N. G. Neznanov. Y. A. Alexandrovsky, N. G. Neznanov. - 2nd ed. Moscow : GEOTAR-Media, 2018.