Is it normal to hear a voice in your head?  I hear a voice in my head that doesn’t sound like my voice.  I can have a conversation with the voice and the voice replies.  Sometimes I hear another voice and I think it is female.  I am not sure and that voice is mean.  I don’t know if this could be an indication of a mental illness? Karen

Thank you for your question Karen.  Voice hearing is often called auditory verbal hallucinations in the research literature.  Hearing a voice or voices is not an uncommon occurrence with between 0.6% and 84% of the population hearing voices that other people don’t. The content and tone of the voices people hear is often different with some people finding the voices comforting while others find them distressing.  A persons cultural or spiritual context can also impact their understanding of the voices and the level of distress they feel from hearing the voices.

Research has suggested that hearing voices does not necessarily indicate that someone is going to develop a psychosis or schizophrenia.  Generally, an indication that someone may benefit from help or treatment for their voices is that you have negative experiences or beliefs from the voices.  This can include negative content, frequency or emotional tone.  In your message you say that the voice you hear is “mean”.  As this voice is negative it indicates that you would benefit from discussing your voices with a health professional (i.e. your GP or a psychologist).   I would suggest you make an appointment with a psychologist so they can further assess your situation.

There have been many advances in treatment and there are psychological treatments which can assist with the symptoms you describe.  Cognitive Behaviour Therapy (CBT) has been found to be effective in the treatment of voices, delusions, or other psychotic symptoms.  This treatment is based on the idea that some people are genetically predisposed to these types of experiences and that if they have stressful experiences their vulnerability to psychosis may be expressed.  Treatment for voices focuses on helping you learn techniques for coping with stress and decreasing the distress and disturbance from these experiences.  You and your therapist would work together to find ways to distract you from the voices and decrease the problems that can be associated with hearing voices.  Alongside CBT some people also find medications helpful and a Psychiatrist or your GP would be able to discuss these with you.

Without further assessment I can’t tell you whether the voices you hear are an indication of a mental illness, however if you are distressed by your voices it is important to know there are effective treatments which can help you to manage these experiences.