How can we “hear” auditory hallucinations?

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What causes auditory hallucinations in the brain? For example, when you are sleep deprived, it is possible to hear things very clearly as if they were real. For example, voices of people talking, which some people with schizophrenia experience commonly in their daily lives. But of course there is no input from the ears. So what exactly is happening and how is that possible?

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Normally, when you hear something, the soundwaves travel through your ear and eventually creates signals in your nerves. That signal travels to the brain, gets processed, and you hear it. So, while the ears are how you sense sounds, your brain is doing the actual hearing.

In any hallucination (auditory or otherwise), it’s the brain perceiving something despite no actual signal of the thing from your senses.

The process by which we hear something starts with a sound. This sound is a bunch of tiny changes in pressure. These changes in pressure physically move hairs in your ear. These movements trigger neurons in the ear, which send signals to the brain. Your brain interprets these signals and responds to them.

The important piece of this is that how you respond to the sound is directly related to the neurons in your brain. If I disconnected your ear neurons from your brain, no amount of sound would elicit a reaction from you. You’d just be deaf.

Hallucinations are what happens when something triggers the neurons in your brain that are usually triggered by sound. Your brain can’t differentiate between “signals from changes in pressure that move ear hairs” and “a 9 volt battery that I hooked up to the neurons connected to those hairs.” It just interprets the signals that it gets.

Auditory input is processed in parts of the thalamus, so you can hallucinate a sound when there is a signal sent to that brain centre responsible for processing sounds even there is no stimulus (such as in hallucination). High levels of serotonin (a neurotransmitter in the brain) can sometimes cause auditory hallucination (as seen with some drug use and in cases of schizophrenia). Source: my own neurology studies.

You various causes.
The first is when you hear a sound as normal, your brain then processes this sound. Now at times what you actually hear isn’t that great in terms of volume and quality, so your brain has to process it and guess what sound it is. So this part can be broken, typically it might be that you hear people chatting and you think they are talking about you.

Second might be when your internal voices and thoughts get disassociated from you, so it sounds like you are hearing voices.

Then you might have some kind of misfiring in your auditory system so it sounds like you are hearing something when there is no input. The.

That feeling like you’ve been hit by a ball in a game (or something) while you’re dozing off, making you jump out of your skin (myoclonic jerk?) – is so random. But these days (getting old) I have the auditory version. Huge noises that cause me to jump up, trying to figure out what catastrophe just occurred?! The brain is crazy 😝