ELI5, Schizophrenic Voices. Are they “legitimate” voices in your head, or more like an extra intrusive normal voice similar to you saying to yourself in your head, “I need to buy bread today”.
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My ex-wife claims the voices and hallucinations are external. Hers are very religious in nature and horrifying. She once went a week without changing clothes or taking a shower because of the inferno in the closet.
She claimed there was a dark pit in the closet with smoke and heat rising from it and you could hear the screams of the tortured.
She has been hospitalized off and on most of her adult life.
Psychiatrist here-auditory hallucinations are by definition a true sensory experience without the presence of an external stimulus. In other words someone with schizophrenia who is hearing voices hear them just like you would hear someone who is actually present speaking to you. They are not “in their head”. True the cause of them is internal, but the actual experience that they have is that of a true voice.
There are symptoms of other illnesses which cause so called “pseudopsychosis” or “micropsychosis”. In these conditions patients will say they have auditory hallucinations, but it is really an inner dialogue. Whereas in true psychotic disorders the hallucinations are very real and the patient invariably (at least at first) has no way to tell the difference between the hallucination and someone real that is speaking to them.
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I have a friend that was diagnosed in University.
He said when he was on the bus he would hear people making remarks about him or straight up swearing at him. He though this was 100% real because he didn’t know he had a mental illness at this point.
He also said when he was at his home, he would hear people walking by talking about breaking in to kill him. This led to him duct taping blankets over all his windows and locking himself in his room at all times.
Luckily(?) he is an incredibly mild-mannered, non-confrontational person so he just tried to ignore all of this. It wasn’t until he mentioned how abusive people on the bus were being towards him that we caught on that he may need help. We hadn’t seen the windows in his room as he went to University in a different city than the rest of our friend group and none of us had been to visit him yet.
For me, it’s like someone is speaking to me. Outside of my head. Just a normal conversation. The majority of the time, it sounds like I’m in a crowd of 1000 people and they are all talking at once. Occasionally I’ll hear a word or two and it will go back to the noise. Occasionally they will pipe in when I’m talking to someone and it’s hard to focus on the conversation. During episodes though the voices take turns yelling things at me, telling me to do things. They just get louder and louder. I’ve heard voices since I was a kid, just thought it was normal. They got worse as I aged. In high school I was hospitalized 3 times in like 6 months. But I was put on meds and those helped them stay quieter. Then I turned 23. I started having even more symptoms like visual hallucinations and delusions. My life crumbled around me, I lost my job, I was hospitalized two more times. But we got a good balance of meds now and I’m doing okay! It’s been a wild ride.
Not schizophrenic. But I had a manic psychosis. I heard voices when I did what I thought was meditating. They felt external, like my loved ones whispering affirmations to me. What was so convincing was they seemed to have information I didn’t have, saying stuff like ”there’s a lot of money in that family farm” and so forth. Looking back it was obviously information I had and all in my head.
I grew up with schizophrenia. My delusions started when I was 4, and I remember hearing my first voice at around 8. It was a hill on the playground I named Tracky. I experience external voices, internal voices, intrusive thoughts, and thought insertion. Here is how I would describe each:
External voices or, more often for me, music is just like hearing someone else talking to you or a radio playing in the next room. I wish I knew music because they are original songs and I would love to write them down. Usually, it’s classical music; that time I heard country music was just torture! I do sometimes not respond to people, especially in large groups, because I don’t realize it’s a real person.
Internal voices are more common for me. Most of these voices have names and personalities attached to them, like Tracky. When I was 12 several girls my age came to live in my head. They would talk to me, respond when I spoke to them, and speak to each other. My main voice, April, is my older alien sister. When I came to Earth she found a way to talk to me through technology and brought the other girls with her. Each of these voices sound different to me even though they are in my head.
Intrusive thoughts are easily recognized as mine, just really hurtful. A lot like negative self talk or images that I can’t control.
Thought insertion is like an intrusive thought but I don’t recognize it as coming from my own head. Unlike the voices, these thoughts do not interact with me but are just dropped into my head.
Your brain is not just one large organ, it is a collection of various parts that communicate with each other.
Just like your brain takes the two separate images from your eyes, stitches it together. and filters out the unimportant stuff “e.g., nose”, it does the same with the way the different parts of your brain communicate with each other.
It’s like the parts of your brain are all members of a committee, and there is a secretary taking down notes and consolidating all points of discussion into one single memo that everyone can understand, which it then hands out to everyone to use.
Schizophrenic Voices is when that system breaks down.
Imagine that the “secretary” of the brain is not there, and neither are their notes. Now instead of one single voice, your brain is instead trying to put together what all the members are trying to say.
Problem is not all the parts of the brain speak the same way, or the same language, or even speak at the same time. Some use audios to communicate, others use images, some use a combination of both, while others don’t use any of those.
Worst of all, despite working together for years, your brain doesn’t know who these membersare. So, when one part of the brain tries to “communicate”, it seems like a foreign message like you are hearing voices. Truth is you **are** hearing voices, but it’s just your own, and your brain can’t realise that.
**Example:**
**Non-Schizophrenic**: Your parents always te;l you; you were never good enough. Sometimes it would get so bad you would have dark thoughts about them dying.
So, the secretary of your brain converts those thoughts into a psychological condition such as depression, feelings of inadequacy, and guilt.
**Schizophrenic**: Your parents always tell you; you were never good enough. Sometimes it would get so bad you would have dark thoughts about them dying.
Then one day, while studying you hear your dad saying, “Don’t bother you’re never going to pass.”, but when you look up and around, he isn’t there.
You try studying again and this time you hear your mom says, “Someone has to study this much is obviously a moron.” as clear as if she was standing next to you.
Again, you look around and no-one is there. This happens more and more frequently.
When you’re in the room with them, you start having outbursts like “What did you say?!” despite no-one saying a word.
One day, you walk into the kitchen and see your parents dead on the floor with blood pouring out of them and have a nervous breakdown, only for those same parents to walk through the door and ask you what’s happening.
Edit 1: “If people know what condition they have, why is it difficult to tell the difference between what is real?”
I have Tinnitus. Logically, I know that the ringing in my ears is not real. That it’s probably a combination of ear canal damage and neurological flippery. That doesn’t stop it from getting so bad that sometimes I want to rip my ears off.
Edit 2: No I don’t have the Schiz, but my brother does. And there is something I’ve learnt, if a bit controversial. He’s not crazy. Those voices are real. Those images are real. Those frightening patterns he sees in day-to-day life, are real. I will never try to convince him otherwise. The real issue to deal with is that he understands they only exist in his head.
Not to make light of your episodes but I kinda have a funny story about hearing commercials. I also hear voices the way you do (like people talking in another room) but medication has helped me tremendously. BUT when I moved into my house several years ago I would hear voices and sometimes music and sometimes commercials. One afternoon I plugged in a pair of speakers to connect to my computer and the voices got louder. It turned out I had moved close to a radio tower and the signals were being picked up by the wiring in my house. So I was not losing my mind just hearing 107.3 “Jamz”
After reading some of these comments from people who suffer from auditory and/or visual hallucinations, I think we should admire the courage it takes to live with mental illness. Schizophrenia must be terrifying to live with and it must be extremely frustrating to try to explain it to doctors and society in general.
I truly wish we lived in a world that was more understanding and supportive of people who suffer from an unhealthy mind. There is so much judgment, so many jokes, but in reality, it can be more crippling than physical illness and can be fatal under the wrong conditions. We need a world that offers support instead of judgment and criticism. Respect to those who are fighting a good fight every damn day.
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