Hearing voices with bipolar disorder

Not everyone realises that some sufferers of Bipolar disorder also have psychotic symptoms. These could include delusions, auditory and visual hallucinations. For me, I hear voices. This happens during periods of extreme moods, so when I’m manic or severely depressed. 
 
During mania, the voices can be comforting. I have many ideas racing through my head during a manic phase, and the voices I hear add to the jumble. They give me ideas and fill me with confidence that then elevates my mood further. I often speak out loud to them and they reply very audibly, as if they were in the room with me. I remember instances when I’d been in my bedroom alone and I would run downstairs extremely excited, like I had just spoken to a friend on the telephone who I hadn’t seen for a while. I’ve had conversations with people where I’ve become distracted or ‘zoned out’ because there is a voice speaking to me. Sometimes I might make a joke that no one understands but me and the voices, or laughed out loud for seemingly no reason. The voices have become my friends and I think I would miss them if they were gone. If my mood becomes very elevated  I know they will be there and I look forward to hearing them.
 
When I’m severely depressed I have heard screaming and shouting in my head. It’s often incoherent with a few words and sentences scattered about and all of it incredibly loud. The loudness of it all makes it an extremely intense experience, like being at the cinema with the sound booming all around you. Sometimes if feels directed at me and at other times the shouting feels intrusive, like somebody is ranting and raving at nothing or no one in particular.

The worst part of this is not knowing how long it will go on for, and knowing I can’t escape it. It often happens when I’m in bed and can’t sleep, but it has happened during the day too. I’m sat or lying in the dark when the screaming starts. The screaming is constant and then there is a voice shouting “Everyone hates you,” “You’re worthless” and “Why don’t you kill yourself.” It frightens me immensely. I’ve found myself covering my ears to escape the noise. I’ve curled into a ball and cried on the floor or in bed as the screaming continues. Very occasionally, I hear tapping. It usually happens when I’m extremely irritable, which can happen when I’m depressed or manic. 
 
When I was younger I thought having someone who talked to me in my head was normal. I know people have conversations out loud to think through a problem, but the difference is they know exactly what the next sentence is going to be. As I’ve got older I’ve realised that my experiences are not the same. Now I find it embarrassing and I don’t like discussing it with anyone.

I have been caught out a couple of times; I was on a train with my partner when I answered a question out loud. He said to me looking confused “Who are you talking to?” I remember turning red and saying “Oh sorry, I thought you asked me a question.” and left it at that. I also felt that if I told anyone about the screaming and shouting they would think I was disturbed and crazy.

I’ve tried a few times to reach out to people but I can never seem to articulate exactly how it feels, or even to admit to the problem. I find writing and blogging to be therapeutic and it’s an easier way to explain how I feel. 
 
At the moment I am taking lamotrigine, an anticonvulsant, and aripiprazole, an antipsychotic. They have helped balance my moods, giving me stability. It’s not perfect, and I still have manic and depressed phases where I sometimes hear voices. I’m learning more about how to deal with these episodes, such as trying to rationalise what is happening and ignoring it when I feel able to.