Hi @RichardRichard ,
I too have started hearing voices in a recent psychotic episode and can identify with what you are saying. I wanted to respond to let you know you are not alone.
To tell you my story, I had a diagnosis of 'drug induced psychosis' in my early 20s. I had a lot of paranoid thinking, disorganised thoughts and some aggression in interpersonal relationships. No voices. I had been medicated and went through therapy.
I originally never understood what people meant by "hearing voices". I didn't understand how that was possible or part of my condition. I had always explained my own condition as being that I had an internal monologue that sometimes was overstimulated but that I was always able to distinguish that a 'thought' is distinctly different to a 'sound'.
For most of my adult life I had been a "high functioning" schizophrenic. I took my medication I was prescribed. I was able to get a job, performing well and working my way through up promotions. My family life was good. For the most part, I continued to recreationally use drugs (moderate use) with only isolated periods of abuse (high use), but no real escalation of symptoms. I have always struggled with romantic relationships, but otherwise, I was mostly able to conceal my condition. I had long periods of well with only some small periods of turbulence.
Fast forward 20 years. I'm now 40, started hearing voices and a confirmed schizophrenia diagnosis. I had a deterioration in my mental health and some challenges on multiple fronts (work stress & issues, family stress & issues, and changes in friendship circles leading to social isolation). Initially, I was able to challenge it as a hallucination and that it wasn't real.
At the time I started to become unwell, I was using medicinal cannabis under the guidance of a doctor for sleep issues, depression and anxiety, as I deteriorated I ceased the cannabis, but continued to go downhill even after stopping and when I took my regular medication.
The voices were specific people. People I knew from all across my life. Most were alive. There was 2 who were people who had deceased.
As I deteriorated, I too formed a delusion that they were real and clandestine, and that I couldn't talk about it with mental health care professionals for a fear of some consequence.
Due to observations by family members, I was involuntarily hospitalised which was an absolute nightmare of an experience. The circumstances by which I was admitted (ie. no one explained why I was going into hospital) exacerbated my symptoms (the voices became more frequent) and created further distrust with the doctors (I was even more scared of telling them what was going on) which complicated treatment.
My best advice (as scary as it is) you should talk to someone about the voices you are experiencing, whether it's a healthcare professional (I feel safer talking to psychologists than doctors myself), a trusted friend or an anonymous forum (as you are doing here).
My result of not talking about it was that it escalated, I was hospitalised, and when I commenced treatment I was unresponsive to medication for a long time because of how far gone I'd become (the idea in my head that I couldn't talk about it only continued to escalate even when I commenced medication).
Acting on voices also caused issues in interpersonal relationships. For example, I heard voices telling me that I couldn't hug my family members when they came to visit me in hospital.
My recovery only started after I left hospital, I recommenced old medications that have worked for most of my life and had the least unfavourable side effects (all antipsychotics seem to have pretty bad side effects - the lesser of all evils), and once I started talking to family members and telling them I was hearing voices it created understanding that started to heal the rifts in relationships which had occurred when I was unwell.
Hope this helps and know you are not alone. It is a scary experience, but there is help and I found although it's very scary to talk about, commencing talking about it has been critical to my recovery.