Q: I am a 16 years old girl and hear many voices, some speaking very fast, some very slow when I try to go to sleep for the last 4-5 years. When I put my head on the pillow, I feel very heavy. When I walk, there is a big thud in my head, then the voices continue. In the day time sometimes when I look at people, particularly in college, they either seem a lot further away or very close, this triggers the problem off. I also experience very fast sounds / images (in a fast tempo). What is this? Do I need any medical help?

A:The symptoms you are describing may indicate severe anxiety, which can sometimes present in this way with things around you seeming unreal, or feeling unreal yourself. Sometimes people can have an aggravation of these symptoms in situations that they find stressful, like being in crowded places or uncomfortable situations. However, the voices you describe are concerning - while in some people they can occur occasionally in the brief period of transition from wakefulness to sleep, their occurrence at other times can indicate a psychotic illness, and it is very important that you consult a Psychiatrist to ascertain this more clearly. Most hospitals have a department of Psychiatry, or you could search the internet or yellow pages to find Psychiatrists practicing in your area. You should describe exactly what you are experiencing, and the doctor should be able to ask you further questions to clarify the diagnosis. Both anxiety and other illnesses can be well managed with medication, but can also worsen with time and stress if not treated well. So I would advise you to consult a Psychiatrist directly, or at least a physician who can then refer you on to a Psychiatrist.