PTSD and Auditory Hallucinations


You know that many combat veterans are diagnosed with post-traumatic stress disorder (PTSD), but did you know that 30 to 40 percent of those individuals report having auditory hallucinations?

Auditory hallucinations (AH) are commonly described as "hearing voices." For instance, combat journalist Paul Watson has recently talked about his experience of hearing the voice of a corpse, an American soldier, that he photographed in Mogadishu in 1993.

Psychotic Symptom, Not a Psychotic Disorder

An AH is a psychotic mental health symptom, meaning that what is heard has no basis in our shared reality. People with severe depression can experience AH. Someday, PTSD with secondary psychotic features (like AH) might be recognized as a PTSD subtype for diagnosis.

For now, the AH symptom presentation slides easily under the PTSD radar for two reasons. First, people are fearful of reporting hallucinations as they are traditionally associated with psychotic illnesses such as schizophrenia. Second, emphasis has typically been placed on the PTSD symptom of intrusive images or memories.

Facts About AH Associated with PTSD

  1. Individuals with PTSD and AH symptoms show no chronic changes in affect (e.g., emotional flatness) as do most people with psychotic illnesses such as schizophrenia.
  2. Individuals with PTSD and AH symptoms do not have the delusions, or bizarre thoughts, that often accompany psychotic disorders.
  3. The symptom of AH is more common in veterans with the greatest amount of combat exposure and whose symptoms are generally intense.
  4. AH in PTSD tends to be ego-dystonic, or in conflict with the individual’s sense of self, values and goals. This causes the individual to experience guilt, shame and a sense of isolation related to the traumatic experience.

There is not yet enough evidence to make PTSD with psychotic features a diagnostic subtype. Plus, not everyone agrees that the AH should be considered a psychotic symptom. It may be better classified as a dissociative experience, a symptom owed to a person’s mental-emotional detachment from the immediate environment.

Although AH is a distressing symptom, it does not indicate an individual with PTSD is “losing it” or coming down with a severe psychotic disorder. If you have PTSD and AH, reporting it to your doctor or therapist will help you cope with the symptom and ensure this aspect of PTSD gets the attention it deserves.

June is PTSD Awareness Month. Please pass this information on to friends, co-workers and family members.

Source: The Public Library of Science (PLOS)

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