Is it normal to hear sounds (like people having a conversation away from you but unable to make out what’s being said) when laying in bed but still wide awake?

Everything I read online states it’s bc your brain is in an in between stage but for me it’s as soon as I lay down and things get quiet-I’m wide awake and it’s usually at a decent bedtime 10pish. It doesn’t scare me, per se, but as someone who works in mental health I may be a bit more aware of what could come of it. It started about 3-4 years ago when I was 30 which is old for onset. Idk what my brain is up to.

Is this normal or should I be worried about symptoms?

This is a great question! I bet there are a few people out there that also have this experience, so I hope that I can provide a little more info and potentially reassure a few of you. The technical term for this is non-clinical auditory hallucination. In other words, hearing something that isn’t actually there (probably) but without other concerning clinical symptoms that would qualify you for a diagnosis like a schizophrenia spectrum disorder. Most of us have non-clinical auditory hallucinations every once in a while. Like I always hear someone calling me from the other room when that’s not the case. It seems that there is a subset of the population that has these experiences much more commonly.

As you mention in the question, there are people that have this experience as their brain is shifting from wakefulness to sleep. There are a lot of interesting things that can happen as you make that transition. Sometimes people have full auditory or visual hallucinations. You can also have sleep paralysis, extremely vivid dreams, and lots of other fun stuff. But for you, you are saying that it doesn’t seem to happen when you are really falling asleep. Instead, it happens when you lie down and things are quiet, but you are still fully awake. It could be that you are one of these people that are more sensitive to hearing voices.

There is actually a fascinating article that suggests people who have more frequently non-clinical auditory hallucinations are actually more keyed into perceiving speech and tend to over-interpret auditory patterns. In the study called Distinct processing of ambiguous speech in people with non-clinical auditory verbal hallucinations (https://academic.oup.com/brain/article/140/9/2475/4085330), Alderson-Day and colleagues had voice hearers and non-voice hearers listen to sine wave speech, which is basically just distorted speech that takes a while to realize that there are actually intelligible words being said.

The voice hearers were able to recognize more language more quickly than the controls, suggesting that their brain was more primed to recognize speech. They were also scanned during this experiment using a functional MRI and the parts of the brain that were more active were not necessarily speech centers, but the areas that influence our attention control. Super fascinating stuff. Very similar to when you see faces in the clouds or in the trees.

One thing to clarify is whether you can tell that the voices are essentially in your head or are you convinced that there are real conversations happening? If you understand that they are most likely in your mind, then you are probably in good shape and not experiencing clinical psychosis. Honestly, you also need to make sure that there aren’t actually voices that you ARE hearing. Like if you live in an apartment, it’s totally reasonable that there would be muffled speech that you can hear. You might also be hearing the TV from another room, etc. Some interesting experiments you can try – sleeping at a different time, sleeping in a different location, and seeing if the same thing happens when you are not at home. If you are concerned, you could do a sleep study to see if there might actually be something happening with your brain waves as you approach sleep. I know you said that you feel that you are fully awake when they happen, but an EEG might tell a different story.

I think it’s good that you’re paying attention to it, but if they aren’t increasing in severity, becoming more well-formed, referencing you directly, or becoming otherwise disturbing, I think you are probably okay. Keep your doctors aware of it, for sure, but don’t stress about it.

Hello,

I’ve struggled with depression and anxiety for as long as I can remember (I just turned 25 so for at least 20 years). I struggle so hard with controlling my anger. I’m angry and I hate that I feel anxious and sad all the time. I have the most amazing partner who has such a huge heart but I snap at him and make him feel as though he’s beneath me but he isn’t. I’m lost on what to do with myself. I am on medication, citalopram 20mg 1x daily. I loathe myself entirely due to my anxiety/depression.

If there’s any advice you can give me, I’d greatly appreciate it.

Thank you for writing in. Sorry that you are struggling with this. It sounds like you’ve been dealing with this for quite some time. The amount of time that you’ve been experiencing depression probably makes it even more frustrating. You also seem to have made some efforts to improve, which can cause hopelessness when it feels like nothing is working.

A few questions for you. First, are you in therapy? Have you ever been in therapy? With such a chronic and impactful issue, I think it makes a lot of sense to be in therapy. If you feel like therapy isn’t for you or you’ve had a bad experience with it, I’d definitely suggest giving it another thought. There are a variety of ways that therapy can be helpful. CBT or DBT can help you identify coping skills to reduce the impact of the strong emotions that you feel. They can also help you better catch yourself when your thoughts are spiraling out of control. Overall, CBT and DBT can give you actionable tools to use in everyday life. You might also be interested in more depth-based therapies such as psychoanalytic therapy, as those will dive deeper into the origins of this depression and explore some of those underlying issues.

I also wonder about medications. Are you getting your meds from your primary care physician or a psychiatrist? Citalopram is an SSRI, which can be helpful for depression and anxiety, but if it’s not doing the trick, it’s not doing the trick. Maybe you need a medication adjustment or a different medication entirely. There are medications that can be added on such as Seroquel or other mood stabilizers that might help to reduce the agitation and intense emotional swells that you are getting. I think that a psychiatrist would be your best bet because there is definitely some nuance to prescribing medications like this. There are also several options for treatment resistant depression, which I talk about in episode 107.

Regarding your relationship, I think there are some things that you can do to help the situation out. First off, always have follow-up conversations. When you explode or things go sour in some sort of way, come back to what happened later on when things are more calm. Explain what you were feeling, apologize if you need to, and provide any feedback that you need to. This can help both of you not take things as personally. You can also work together to collaboratively develop boundaries for yourselves. You can decide on what sort of behaviors are and are not okay in interactions with one another and what your options are for dealing with the situation when those boundaries are crossed.

Couples counseling can definitely be helpful here – to identify each other’s boundaries and hot-button topics so that you can be more sensitive and considerate when deciding when to address your partner or confront them about something. You also need to realize that your partner is there for a reason. You should definitely still try to be as sensitive as possible and treat him with the care that you think he deserves, but also don’t get yourself convinced that the relationship is all bad. There is clearly an upside for both of you, otherwise you wouldn’t be there.

Lastly, I’d encourage you to work on your own personal coping skills to manage your body’s excitation. Perhaps start keeping track of explosive events in a journal to identify patterns and recognize that cascade of changes your body goes through when you feel the rage building. You can also practice deep breathing exercises to bring your physiological elevation down a few notches. Journaling can also help you keep track of language that you use that might be meaner than you intend so that you can work on identifying the real issue and using more accurate words instead of words intended to cause harm.

Again, I’m sorry that you’ve been struggling for so long, but I do think that you have a lot of options here. Hopefully, something that I’ve suggested pushes you in a helpful direction. You got this.