I’ve Started Hearing Voices…

Reader’s Question

Some time ago I was diagnosed with Paranoid Personality Disorder (the primary characteristic being a psychotic sense of thought projection). I’ve had thoughts of a certain person poisoning the food, etc. (because I feel I perceive their true motive). On occasion, I’ve felt as Jim Carrey would on ‘The Truman Show’ — that my thoughts or experiences are being broadcast to a wide range of the population. In fact, 24/7. I also experience a mixture between delusions of reference and delusions of grandeur (kind of) — in the sense that certain media broadcasts will reflect my own life experience… It is as if they were aired solely for my perception — and that I’m some kind of divine entity having had this capability. But I am inquiring as to whether or not this can be seen as some kind of gradual development into schizophrenic domains. I’m just curious because last night, I perceived exteriorized vocalization not attached to any physical being… There was a voice coming from a certain area of the room. First of all, I’m not sure if it was simply a false awakening (that I dreamed I heard a voice while laying in my bed). Secondly, the voice was well audible — but incomprehensible. I could hear it, but I could not understand it. Since then, the voice has subsided and this has never occurred previously. Should I wait it out and see if it will happen again? I don’t want to get too involved if it was simply a false awakening, but just as a false awakening, it seemed realistic.

Psychologist’s Reply

There is a big difference between a Paranoid Personality Disorder (PPD), Delusional Disorder, and Paranoid Schizophrenia. You are describing a Delusional Disorder which is more severe. Delusional Disorders not only include paranoid symptoms, but the gradual development of delusions (false beliefs and interpretations) of both persecution and grandeur. One develops the feeling that the entire environment is somehow involved in an organized effort or conspiracy for some mysterious purpose. Ideas of Reference (attaching personal significance to common experiences in the environment) are severe — feeling that people on cell phones are talking about you, receiving messages from the TV and radio, and experiencing that Jim Carrey or “Matrix” sense that the entire environment has been created for you — and only for you. This is a Delusional Disorder.

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The surfacing of external vocalizations is very serious and moves more in the direction of Schizophrenia. In this condition, you will experience “voices” that are external. As you describe, they are initially mumbling or difficult to understand. As they increase in number, they also increase in clarity. These are auditory hallucinations and are soon accompanied by hallucinations involving other senses such as tactile (touch/sensation), gustatory (taste), and olfactory (smell) hallucinations. Visual hallucinations are rare but you’ll have illusions — seeing patterns/pictures in smoke, clouds, carpet patterns, etc.

I highly recommend that you seek psychiatric consultation. Suspiciousness, paranoia, ideas of reference, delusions, and hallucinations are on a scale of increasing Dopamine in the brain. The neurotransmitter Dopamine determines our perception of personal relevancy in our environment. Too little Dopamine and we have ADHD — nothing is related to us so we don’t pay attention to anything. Average Dopamine and we can tell who we know and who we don’t know in a crowd. Too much Dopamine and suddenly everything in the environment is personally related to us. This is a highly serious psychiatric issue and will not resolve on its own. We have medications that lower and stabilize Dopamine levels. They can be of great help in your situation.

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