Why Am I Hearing Things That Aren’t Real?

Nothing throws you for a loop like when you swear you can hear something that doesn’t seem to have an explanation. If what you heard really doesn’t have a source, it might be an “auditory hallucination.” It can range from a simple sound to hearing music so clearly, it’s hard to believe there’s no band or radio nearby.

Often, what people hear is voices. Sometimes, they’re mean, critical voices. But others might be neutral or even pleasant.

No matter what the sound is, it’s a clear sign to go talk to your doctor. The sooner you do, the quicker you can find out what’s going on and get treated.

Why It Can Happen

Mental illness is one of the more common causes. But there are a lot of other reasons you might be hearing things, too.

Alcohol and illegal drugs . Heavy drinking and certain street drugs, like ecstasy and LSD, more often cause you to see things that aren’t there. But they can make you hear things, too, both as you use them and when you quit after you’ve used them a long time.

Alzheimer’s disease and other types of dementia . It’s the later stages of Alzheimer’s when you’re more likely to hear things. A similar condition called Lewy body dementia can cause it, too (but it’s more common to see things -- visual hallucinations -- than hear them with this type of dementia.) For some people, the voices seem so real, they talk back to them.

Brain tumors. Hearing things doesn’t mean you have a brain tumor. But it could happen when a tumor is in the part of the brain that deals with hearing. You might hear anything from random sounds to actual voices.

Epilepsy. When seizures from epilepsy affect the brain area that processes hearing, you might get a buzzing sound or voices. In some cases, it warps how you hear things, so they’re not as loud or clear.

Hearing loss. People with hearing loss in one or both ears may hear anything from odd sounds to music and voices, none of which are really there.

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High fevers and infections. Some infections, like encephalitis and meningitis, can make you hear things, along with the other symptoms. The same is true for high fevers.

Intense stress. Serious stress, as you might have after going through something traumatic, can cause hallucinations. It’s especially common to hear the voice of a loved one after their recent death.

Mental illness. Hearing voices is very common with schizophrenia. The voices may come from inside your head or outside, like from the TV. And they could argue with you, tell you what to do, or just describe what’s happening.

It can sometimes happen with other mental illnesses as well, including:

Migraines. Often, if you get migraines with auras, you see things. But some people hear things instead. Usually, it’s voices. And that may be more likely if you also have depression.

Parkinson’s disease. It’s more likely that you would see things that aren’t there when you have Parkinson’s. But in some cases, you hear things from the scenes you’re seeing.

Side effects from medicine. If you begin to hear things once you start a new medicine or your doctor puts you on a higher dose of something you already take, that change could be the reason. It most often affects older adults and gets more likely the more medicines you take.

Sleep issues. It’s pretty common to hear a sound just as you fall asleep or wake up. And it’s usually not something to see your doctor about. But if you fall asleep randomly (narcolepsy) or have a hard time falling asleep (insomnia), it’s much more likely to happen.

Thyroid disease. Myxedema is a rare condition where your thyroid is not making enough hormone and your levels get dangerously low. It’s a life-threatening condition that can also make you hear things.

Tinnitus. Doctors don’t think of the usual ringing or hissing of tinnitus as a hallucination. But this condition can raise your risk. It may be more likely if you also have depression.

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Diagnosis

Your doctor will start with your health history and symptoms. You may answer questions like:

  • What are you hearing? Voices? Buzzing? Other sounds?
  • When did it start?
  • Does it tend to happen at certain times, like as you’re falling asleep?
  • Do you have any other symptoms when it happens?
  • If it’s voices, are they threatening, rude, pleasant, or normal?
  • What medicines are you taking?
  • Are you using any other drugs?

After that, you’ll get some tests based on what your doctor thinks might be the cause. For example, you might need to see a psychiatrist to check for a mental illness. Or you might get an electroencephalogram (EEG), which measures electrical signals in your brain, to look for epilepsy. Or a hearing exam to check for hearing loss or tinnitus. The goal of all these questions is to help your doctor narrow down what might be happening.

Treatment

This depends on what’s causing you to hear things. Sometimes, once you and your doctor solve that problem, the hallucinations go away or at least may not happen as much.

In some cases, there’s an easy solution. Your doctor may lower the dose of a medicine you take. In others, treatment is more complex and you may need to try several things to see what works. For example, with an illness like schizophrenia, you might need a mix of medications, therapy, and other care.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on August 04, 2017

Sources

SOURCES:

U.S. National Library of Medicine: “Visual Hallucinations: Differential Diagnosis and Treatment,” “Hallucinations as a trauma-based memory: implications for psychological interventions,” “Hallucinations: Clinical aspects and management,” “Hypothyroidism Presenting as Psychosis: Myxedema Madness Revisited,” “Auditory hallucinations in tinnitus patients: Emotional relationships and depression.”

American Journal of Psychiatry: “The Clinical Value of Hallucinations in Localizing Brain Tumors.”

British Tinnitus Association: “Musical Hallucination (Musical Tinnitus).”

NHS: “Hallucinations and hearing voices,” “Schizophrenia.”

Alzheimer’s Association: “Hallucinations and Alzheimer’s.”

Alzheimer’s Society: “Perception and Hallucinations.”

NCBI Bookshelf, Holland-Frei Cancer Medicine, 6th Edition: “Clinical Presentation.”

Medscape: “Temporal Lobe Epilepsy Clinical Presentation,” “Myxedema Coma or Crisis,” “Childhood Migraine Variants Clinical Presentation.”

American Academy of Child and Adolescent Psychiatry: “Hearing Voices and Seeing Things.”

New Zealand Ministry of Health: “Fever in Children.”

American Hearing Research Foundation: “Tinnitus.”

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