Depressed After Losing My Sight, Now Hearing a Voice

Reader’s Question

I am a 50-year-old male. I lost most of my vision about 11 years ago from a virus and am now legally blind. I was also diagnosed with depression 2 years ago by my doctor, and he put me on 20 mg of paroxetine per day. I have always been an “antisocial” person, but I’ve become even more socially isolated since losing my vision.

For the last several months, I have been experiencing a voice talking to me. It just carries on normal conversations and warns me of various things, remarks about the news, people, daily activities (e.g., “Don’t eat that;” “Stay away from this or that person because they don’t like you;” “Your neighbors are watching you;” etc.). What is happening to me? Can you give me some suggestions about what what might be causing this or on how to make the voice stop? I would greatly appreciate any suggestions you can give me.

Our Clinical Psychologist’s Reply

It goes without saying that because you are under a physician’s care and being actively treated for a mental condition, you should inform your doctor about what’s been happening.

Sometimes, depression can be accompanied by symptoms more frequently associated with other mental illnesses. These symptoms can be thematically congruent with a person’s depressed mood (e.g., someone who’s already feeling guilty hearing a voice that says they’re “no good”), but sometimes they can be thematically unrelated or counter-related. There are also various psychological factors that can influence both the type and severity of a depression a person might experience.

So, it’s very important to discuss all these things with your treatment provider. In some cases, adjustments in your medication regimen could be indicated. Adjunctive psychotherapy or other psychological intervention might also be indicated. It is interesting that you describe your personality as “antisocial” even before the onset of your blindness. The term “antisocial” is often used inaccurately to describe socially withdrawn behavior, and I’m assuming that what you’re really trying to convey is some tendency toward social isolation. Losing your vision is likely to have compounded your difficulty engaging socially.

It’s quite likely that in addition to whatever chemical imbalances you’re being treated for, you might indeed benefit from adjunctive psychological counseling, especially in view of the fact that your loss of vision is bound to have engendered significant stress for you and because you have a history of difficulty accessing and engaging with sources of social support.

So, inform your doctor, abide by any changes in your medication regimen, and discuss the potential benefits of other psychological intervention.