Hearing Voices – Bad and Good

Janet Coburn

Aug 7

There are many different occasions when you may find yourself hearing voices. Usually, you only hear the voices of people who are physically in the room or on the phone or chat speaking to you. But sometimes the voices aren't real, and that can be a cause for worry.

One thing that bipolar people fear is developing – or having – psychosis. And one of the major symptoms of psychosis is hearing voices that seem to come from outside you when no one is actually speaking to you. Psychosis is not a disorder, but a symptom. Most often associated with schizophrenia, psychosis involves detachment from reality and delusions of things that are not real. Among the possible delusions is that other voices are speaking to you from another realm.

This can be the television or satellites sending secret messages to you. It can involve demons that are trying to take over your brain and even your body. Often, voices of angels or demons are signs of psychosis. (Sometimes, some people experience a voice that comes from a higher power and ascribe it to a supernatural cause. Is this psychosis? Some people think so, and others perceive it as a different form of reality. If the voice instructs you to do harm to yourself or others, it's probably psychosis.)

If people with bipolar disorder have the experience of hearing voices, it usually comes during manic episodes, though it can also occur during depressive ones. The initial symptoms of bipolar psychosis are often indistinguishable from other symptoms of the disorder – anxiety, difficulty communicating or concentrating, or flat affect (the blunting of emotional expression). Unwarranted suspicion of others is another sign that something may be amiss. Support groups or "accountability partners" can help a person recognize and cope when they believe they are about to experience psychosis.

Psychosis can be frightening to the person experiencing it and to the people around them, or it can be something that the psychotic person doesn't even notice (anosognosia). It should be noted that hallucinations and/or delusions can be caused by other problems, such as a brain tumor, dementia, or a bad reaction to medication. My mother experienced the latter when taking a new pain medication, though it was a case of seeing things that weren't there rather than hearing them.

Psychosis can be treated, but not cured, by a variety of psychotropic medications that reduce the experience of hearing voices. These include mood stabilizers, antidepressants, or anti-psychotic medications. (A person with bipolar disorder may already be taking some of these.) They should be monitored closely by a psychiatrist.

Another example of hearing voices, though, is the inner voice that most of us – especially those with mood disorders – experience regularly. Most of the time it is an "inner critic," bringing us down with negative self-talk, telling us that we're worthless or can't do anything right. This is not a form of psychosis, but can definitely be associated with stress, depression, and anxiety. It might say anything from "You're fat and you'll never lose weight" to "You can't do math" to "The people at work aren't really your friends. They treat you nicely because they have to."

These inner voices and negative self-talk can be reinforced by the real voices of other people as well. A family member might say, "You're really not good at picking boyfriends" or "You're never on time for anything" or "You just can't drive in traffic." If you start to believe these messages and those of your inner critic, they can be self-fulfilling prophecies. If you believe that you don't deserve respect and friendship, those thoughts will influence your actions, leading to other people perceiving you that way as well.

But if you have an inner critic, you also have – or at least can cultivate – an inner champion. There are ways to empower yourself through positive self-talk. It's not quick or easy. Daily affirmations can help. You can try them whenever you "hear" your inner critic dissing you. First, say, "Stop!" Derail that negative thought right away. Then replace the thought with a more accurate one – "I'm not worthless. I got out of bed and out of the house today," if that's your small triumph.

Daily affirmations are good too. You can try looking in the mirror in the morning and saying something positive about yourself. It's better if it's really specific, but it's okay if it's just "I am a good person." Some experts recommend personalizing the positive feedback using the second person – "You made it to work on time yesterday" – or even using your name as you think or say, "Janet, you took a shower today."

Affirmations that stifle your inner critic and build up your inner champion may not be a cure for psychosis or bipolar disorder, but they can help with the problems of anxiety and depression that so many people with mood disorders face on a daily basis. For that reason alone, it's worth a try.