Am I Experiencing Auditory Hallucinations or Schizophrenia? - Psychiatry

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Do I have hallucinations? Or am I experiencing schizophrenia?


Hello, doctor.
I have always been an outgoing person since childhood, considered an invincible source of happiness by my family and friends.
I am always the life of the party during celebrations, farewells, and April Fool's Day.
I had a passion for role-playing from a young age, often acting in soap operas and historical dramas.
My academic performance has been good, and I have a talent for the arts and languages.
Throughout my life, everything has gone smoothly; I was a recipient of special admissions in middle school, high school, and even college.
Many younger siblings around me have always looked up to me as a role model for learning, which makes me happy but also puts a lot of pressure on me.
After high school, I chose to study alone in the United States, pursuing my lifelong love—performing arts.
Suddenly, my family was no longer nearby, and I had little contact with friends.
With a 16-hour time difference, academic pressure, and the need to stay in touch with family, I found myself staying up all night.
However, I still love this profession and enjoy life in the U.S., feeling no hardship at all.

But the situation has become increasingly severe...
I went from being sensitive to sounds to being unable to read books without vocalizing the text.
Now, I start hearing people constantly interviewing me, and I usually respond.
However, the number of interviewers has increased, and some even appear when others are present.
On the other hand, due to long nights, my liver enzymes have exceeded normal levels, and I have gained at least 20 kilograms compared to my weight before going abroad.
I am losing confidence, eating alone, watching movies alone, and shopping alone.
Additionally, I have a severe fear of birds, especially pigeons and sparrows.
Just seeing, thinking about, or hearing birds makes my heart race and causes me to break out in a cold sweat.
Once, I was startled by a bird suddenly flapping its wings and got hit by a passing car.
This has made me avoid stepping out of my dormitory unless I have classes.

I used to be very outgoing, sociable, and talkative as a Leo, but now I feel extremely anxious in crowded places, keeping my head down and hiding, fearing encounters with people I know.
Recently, it has worsened; not only do interviewers appear from time to time, but I also receive calls from people I know.
We have deep conversations, and I can indeed hear them talking to me.
However, upon inquiry, I find out that those people never actually called.
In the past couple of days, voices claiming to be my friends have appeared, but those voices seem to come directly from my mind rather than from a distance.
I don't know if I am simply too immersed in drama, constantly embodying a role, or if I am truly experiencing auditory hallucinations or symptoms of schizophrenia...

Skye, 10~19 year old female. Ask Date: 2016/06/22

Dr. Zhang Zhehong reply Psychiatry


Hello: Your psychiatric symptoms may include auditory hallucinations, depression, and anxiety.
1.
First, there are physiological issues; elevated liver enzymes and weight loss require prompt medical attention.
Please consult an internist for evaluation and treatment of internal medicine conditions.
2.
Mental health issues should be addressed urgently; please see a psychiatrist for assessment.
Differential diagnoses may include major depressive disorder, bipolar disorder, and schizophrenia, and a medication and psychotherapy plan should be developed.
3.
Avoid staying up late; regarding sleep and anxiety, you can practice anxiety relaxation techniques and incorporate diverse leisure activities and exercise into your routine.

Reply Date: 2016/06/22

More Info


It sounds like you are experiencing a range of distressing symptoms that could be indicative of auditory hallucinations, and possibly a more complex mental health condition such as schizophrenia or another psychotic disorder. Your description of hearing voices, including those of people you know who are not actually calling you, suggests that you may be experiencing auditory hallucinations. This phenomenon can occur in various mental health conditions, including schizophrenia, but it can also be present in other disorders such as severe depression or bipolar disorder.

To clarify, auditory hallucinations are perceptions of sound that occur without an external stimulus. They can manifest as hearing voices, music, or other sounds that are not present in the environment. In your case, the voices you hear seem to be interacting with you, which is a common characteristic of auditory hallucinations. The fact that you also feel a heightened sensitivity to sounds and have developed significant anxiety, especially in crowded places, adds another layer of complexity to your situation.

The symptoms you describe, such as increased anxiety, fear of birds, and significant changes in your social behavior, may also indicate underlying anxiety disorders or stress-related issues. The pressure you felt as a high-achieving student, combined with the stress of moving to a new country and adapting to a different culture, could have contributed to your current mental state. It's important to recognize that mental health conditions can be exacerbated by stress, lack of sleep, and significant life changes.

Given the severity of your symptoms, it is crucial to seek professional help from a mental health provider, such as a psychiatrist or psychologist. They can conduct a thorough assessment to determine the nature of your symptoms and provide an accurate diagnosis. This may involve discussing your medical history, current symptoms, and any relevant life events that may have contributed to your condition.

Treatment options may include psychotherapy, medication, or a combination of both. Cognitive-behavioral therapy (CBT) is often effective for managing anxiety and psychotic symptoms, as it helps individuals develop coping strategies and challenge distorted thinking patterns. Medications, such as antipsychotics, may be prescribed to help manage hallucinations and stabilize mood.

Additionally, lifestyle changes can play a significant role in improving your mental health. Establishing a regular sleep schedule, engaging in physical activity, and practicing relaxation techniques can help reduce anxiety and improve overall well-being. It may also be beneficial to connect with supportive friends or family members, even if it feels challenging at times.

In summary, while your experiences may suggest auditory hallucinations and possibly a more complex mental health condition, a professional evaluation is essential for an accurate diagnosis and appropriate treatment. Don't hesitate to reach out for help; mental health is just as important as physical health, and there are effective treatments available to help you navigate this challenging time.

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