I Thought It Was Just Stress, Until the Voices Stayed
For years I was told hearing voices was a symptom of the mania I experienced with Bipolar I disorder. I accepted that. But the voices I heard during calm moments did not fit. They whispered in between episodes, in the quiet. Eventually, someone listened long enough to give it a name: Schizoaffective disorder.
Schizoaffective disorder is a complex mental illness that blends Schizophrenia symptoms with a mood disorder, in my case Bipolar I disorder. Since childhood, I can remember hearing voices in my head that made little sense. At times they were muffled, more like noise in the recesses of my brain than clear speech. During stressful periods, they grew louder and sharper, delivering messages that questioned my self-worth and chipped away at my confidence.
Hearing voices can feel terrifying, isolating, or strangely familiar. It becomes even more confusing when your diagnosis does not fully account for it. When I was first diagnosed with Bipolar I disorder, I believed the voices were simply a symptom my medication was not strong enough to quiet. To be fair, I had lived with them so long they felt woven into my mental landscape. I trained myself not to question them and, for the most part, not to acknowledge them.
At their worst, the voices guided impulsive and disruptive behaviour, sometimes through religious ideation. At best, they were static in the background, white noise I could ignore. This blog explores what it is like to live with auditory hallucinations through the new lens of Schizoaffective disorder after years of living under a Bipolar I diagnosis.
The Voices That Didn’t Wait for Mania or Depression
Auditory Hallucinations: Bipolar Disorder vs. Schizoaffective Disorder
Auditory hallucinations in Bipolar disorder with psychotic features usually occur only during severe manic or depressive episodes and tend to resolve once the mood episode ends. In Schizoaffective disorder, hallucinations can persist for at least two weeks outside of a mood episode, which reflects a more chronic psychotic profile.
In Bipolar disorder, hallucinations often match the mood state. During depression, they may attack your self-worth. During mania, they may feed grandiosity or urgency. In Schizoaffective disorder, hallucinations are more independent of mood and can continue even during relatively stable periods. They may also feel more chronic, more intrusive, and less tied to a specific emotional state.
I learned early in my mental health journey that hallucinations, whether auditory or visual, were only supposed to happen during psychotic episodes. My reality, however, has always been different. I hear voices during periods of stability as well as during stress and crisis. They are not always constant, but they are familiar. Until recently, that left me feeling disconnected from my original Bipolar I diagnosis because the criteria did not fully reflect what I had been living with for most of my life.
Though I had grown used to hearing voices and learned to block them out, I could not explain where the symptom was coming from or how to gain the right tools to cope with auditory hallucinations that seemed to follow me regardless of mood.
The Moment It Made Sense, And Still Hurt
Everything changed for me when I discovered the Schizoaffective disorder diagnosis. I knew very little about the condition except for a few patients I had met during past psychiatric residencies. I remember one young man explaining that he constantly heard voices or noise in his head, sometimes giving him instructions, and that he had learned not to obey them. He said, “Just because they’re there doesn’t mean I have to listen.” That stayed with me.
My own voices often attack my self-worth and amplify everyday fears during periods of stability. When I am unwell, they shift and become darker, leaning toward suicidal or religious ideation.
During my residency at Ontario Shores Centre for Mental Health Sciences, I underwent a psychiatric re-evaluation and my diagnosis changed. While I did exhibit symptoms of Bipolar I disorder, deeper observation brought to light symptoms that had previously been overlooked, especially the continuous and intrusive auditory hallucinations. When I stumbled upon my new diagnosis of Schizoaffective disorder, bipolar type, I felt many things at once. I felt grief, confusion, and anger. But I also felt relief. At last, I had a diagnosis that included all of me, all the symptoms that had gone unexplained and untreated for years.
Still, I mourned the loss of my old diagnosis. For more than twenty years, Bipolar I disorder had framed my experiences, my advocacy, and the way I understood myself.
The question I kept asking was simple and painful: How am I supposed to move forward on my journey to wellness if I do not even know my diagnosis? How am I supposed to navigate this world if I do not know what I have?
It was my support team that reminded me that a diagnosis is a label, not my identity. They let me grieve, but they also reminded me that new information is not a punishment. It is a tool.
Living with Voices, Not Just Silencing Them
The most valuable lesson I have learned while managing auditory hallucinations, long before Schizoaffective disorder was formally added to my mental health profile, is that I am still in the driver’s seat. Not all voices are commands. In my experience, they are often commentary, echoes, or emotional mirrors that feed fear and anxiety into my mind.
Instead of feeding the noise, I have learned to interrupt it. A few things help me:
Practice grounding techniques.
Breathing exercises, meditation, and hikes in nature help regulate my body and redirect my focus. Nature’s sounds can be louder and clearer than the noise inside my head.Listen to music, often.
I have found that I cannot fully absorb two things at once. When I listen to artists like CeCe Winans, Drake, Ne-Yo, Ella Fitzgerald, or my gospel and 90s alternative playlists, my mind fills with memories, comfort, and emotional safety instead of fear.Adjust medication when needed.
Once my psychiatrist and I began openly discussing the voices, we were able to adjust my medication in a way that improved my external focus rather than leaving me trapped in my inner dialogue.Talk about the experience.
I speak with at least one member of my support team every day. Whether I am sharing anxiety, receiving prayer, or hearing encouragement, that connection helps me cope with voices that can feel loud, negative, and overpowering.Coping with voices when you live with Schizoaffective disorder is not easy, but it is possible. Talking about them instead of pretending they are not there was one of the first steps in taking away their power. The more honestly you share your lived experience, the less likely shame and stigma are to define it. This is your journey, and you get to choose who you share it with. But there is support in families, communities, peer spaces, and professional care if you are willing to reach for it.
Final Thoughts
Reclaiming Power Through Understanding
People say knowledge is power. I believe knowledge also brings understanding. When it comes to auditory hallucinations, no two experiences are exactly the same. That is why safe spaces matter. Whether in peer support, therapy, or a hearing voices group, being able to speak honestly about what you hear can shift the experience from fear to understanding.
Voices may be part of your condition, but they are not your identity.
The more I understand what I experience, the less power those voices have over me. And that, in itself, is a form of healing.
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