[21F] Experiencing auditory hallucinations and paranoia

Patient Description

A 21-year-old female reports hearing noises such as things moving around, knocking above her bed, and growling or low rumbling sounds. She rates the severity of these noises as 9 out of 10. Additionally, she experiences a high-pitched ringing in her ears that worsens at certain times. The patient also feels paranoid, describing sensations of someone constantly hovering behind her, feeling watched, and someone sitting on her bed. These symptoms have been present for a few weeks. Listening to music helps alleviate some of her paranoia. She has difficulty sleeping and tends to overeat. The patient has a history of Severe Depression Disorder and Anxiety, diagnosed in January. She is not currently taking any medications and has an allergy to Lamictal, which she took for ADHD as a child.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

  • Auditory Hallucinations: Hearing noises, such as things moving around, knocking, growling, or low rumbling, can be a sign of auditory hallucinations. These can be associated with severe depression, anxiety, or other mental health conditions.

    • Treatment: Treatment typically involves a combination of medication and therapy. Antipsychotic medications may be prescribed, and cognitive-behavioral therapy (CBT) can help manage symptoms.
  • Paranoia: Feeling paranoid, scared, and like someone is constantly watching or hovering behind you can be a symptom of anxiety disorders, severe depression, or other psychiatric conditions.

    • Treatment: Similar to auditory hallucinations, treatment usually involves medication (such as antidepressants or antipsychotics) and therapy (such as CBT).
  • Tinnitus: The high-pitched ringing in your ears could be tinnitus, which is a common condition that can be caused by stress, anxiety, or exposure to loud noises.

    • Treatment: Tinnitus is often managed with sound therapy, hearing aids, or cognitive-behavioral therapy. Reducing stress and avoiding loud noises can also help.

What you can do

  1. Seek Professional Help: It's important to consult a mental health professional, such as a psychiatrist or psychologist, who can provide a formal diagnosis and recommend appropriate treatment. They may suggest medication, therapy, or a combination of both.
  2. Practice Relaxation Techniques: Techniques such as deep breathing, meditation, and mindfulness can help reduce anxiety and improve sleep.
  3. Maintain a Healthy Lifestyle: Regular exercise, a balanced diet, and good sleep hygiene can have a positive impact on your mental health.
  4. Avoid Triggers: If you notice certain situations or activities worsen your symptoms, try to avoid them or find ways to manage them.

What you should look out for

  • Worsening Symptoms: If your symptoms worsen or you experience new symptoms, seek medical attention promptly.
  • Thoughts of Harm: If you ever have thoughts of harming yourself or others, seek immediate help by calling a crisis hotline or going to the nearest emergency room.
  • Changes in Behavior: Significant changes in behavior, such as increased isolation or difficulty functioning in daily life, should be addressed with a healthcare professional.

Remember, while I can provide information based on your symptoms, it's crucial to seek care from real health professionals to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are auditory hallucinations and how are they treated?

Auditory hallucinations involve hearing sounds that are not present, such as voices or noises. They can be associated with mental health conditions like severe depression or anxiety. Treatment often includes antipsychotic medications and cognitive-behavioral therapy (CBT) to help manage symptoms.


How can paranoia be managed in individuals with anxiety or depression?

Paranoia, characterized by feelings of being watched or followed, can be managed with a combination of medication, such as antidepressants or antipsychotics, and therapy, particularly CBT. Relaxation techniques and lifestyle changes can also help reduce anxiety-related paranoia.


What causes tinnitus and what are the treatment options?

Tinnitus is a condition where a person hears ringing or other noises in the ears without an external source. It can be caused by stress, anxiety, or exposure to loud noises. Treatment options include sound therapy, hearing aids, and CBT. Reducing stress and avoiding loud environments can also help manage symptoms.


What steps can be taken to improve sleep and reduce overeating in someone with anxiety and depression?

Improving sleep and reducing overeating can be achieved through relaxation techniques like deep breathing and meditation, maintaining a regular sleep schedule, and engaging in regular physical activity. A balanced diet and avoiding triggers that worsen anxiety or depression are also beneficial.


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