Q:  Bipolar Disorder & Hearing Voices/Internal Dialogue

Dear Dr. Phelps

     I have a question regarding bipolar II and internal voices.  Do people with bipolar disorder hear voices? I do not mean external voices, or voices not their own, but an internal dialogue? 

For example.  I have finally been relatively controlled with medications.  Basically down to more a cyclothymic state, with my body trying its best to defeat the meds and become hypomanic. I had just come off a slight "up" and was feeling neither depressed nor manic, but rather emotionless.

My internal voice kept telling me , take all your medication , you can do it. Like a dare almost.  So I took 3000mg of my Lamictal.  Needless to say, I am still here.  I dont remember 24 hours of my life, but do remember the after effects for days.  I am confused, bcause I have not been suicidal, I dont feel suicidal now , and yet I impulsively acted on my thoughts.

Any ideas why this would come about, because I am confused.  Is this something that can happen with bpd ?  Or is there something else seriously wrong with me?

Thanks for listening.  
 

Dear Hearing -- 
Hearing voices, like one's own internal dialog as a voice speaking to you -- which we would call "auditory hallucinations", officially speaking -- is a very common part of manic symptoms.  This is often forgotten by medical personnel who come to equate "voices" with schizophrenia, but there is no controversy about it whatsoever.  In one review by Drs. Goodwin and Jacobson, patients with manic symptoms who had some form of psychosis (loss of contact with reality) had auditory hallucinations half the time. So, having voices does not mean you have "something else" besides bipolar disorder to deal with.  You could have an average form of bipolar disorder. 

Dr. Phelps

 

Published August, 2005