The voices with schizophrenia are outside of the head, a voice heard often clearly as though they were physically spoken. They are consistent auditory hallucinations. These can be quite nutural; one sign of paranoid schizophrenia is the voices making a running commentary of everyday actions.
If people are having chronic hallucinations, whether positive, nutural or negative, it's something to be concerned about. Usually there are symptoms outside of these hallucinations in this case where sufferers are not able to look after themselves.
In patients with bipolar during a manic/hypomanic phase, I could except hallucinations to be very positive in nature, such as supporting delusions of grandeur.
This may be much different from talking to ourselves or physically responding to dialogue WITHIN our heads, which I imagine is the source of many imaginary friends.
EDIT: I'm not qualified to speak on these subjects but I suffered from psychosis from a number of years and was misdiagnosed with schizophrenia at one stage due to the nature of my hallucinations (though still a bit over zealous on the psychiatrists part). I naturally came to learn a lot about what it is, how it's treated and spoke to many patients with psychotic illnesses in my stay in hospital (for mental disorders, a stay of 3 - 4 months is a short amount of time, many who I was in there with had been in for a year or more)
You're right, and as I read your post I wondered if you'd suffered the voices, or at least been around it enough to know.
The running commentary was the worst. For me it was 20 years ago, first year uni. Made lectures interesting but also ridiculous as your brain interprets sounds around you.
I was lucky it only affected me for a year or so then faded away after I tackled the subject and read a lot about how the mind works and other people's experiences. I had to get objective and not take shit from myself any more. I never sought professional help, but haven't had the voices since.
Even just regular noises like a car horn in the distance... your brain's imagination is secretly working overtime in the background to connect dots that aren't there. Your own mind delivers you a frank and confident explanation about the story behind the "car horn in distance". That car horn, you learn, was actually sounded by someone you know, and they're checking in as arranged, they have connections with people in this lecture hall...etc. But you never grasp exactly the explanation, or receive real proof, but there's a conspiracy nevertheless, a rambling unflattering, disapproving conspiracy - and you're at the center. That you're sure of.
It's like you're constantly on the verge of exposing the conspiracy, if only you had one more piece of evidence. But you don't need to fish for evidence, your imagination drip-feeds it all day.
That's interesting. I had assumed coming from a RF EE kind of background that it was very much like having a gain control turned way up from a noisy input resulting in peculiar signals being demodulated, but perhaps not so.
For example last night the weather was really awful and at the limit of perception almost asleep (well, I was probably actually asleep) I thought I heard a very unhappy cat meowing outside, so I actually got up and tried to find it, perhaps let it in my dry warm garage to warm up a bit. No cat existed of course.
So under my hypothesis if I had the disease I would hear phantom cats and stuff in general all the time not just once, maybe multiple ones at the same time, and specifically in that situation hear my wife (soundly sleeping like everyone else) telling me loudly and clearly to let the stray cat in to warm up, verbally and clearly and loudly.
However the alternative model, is I'd solely hear the wife telling me to let the stray cat in to warm up, maybe not even hearing the phantom meow.
An individual spurious signal model vs a generally increased noise level model.
A side orthogonal issue might be requiring it to have substantial influence on life. While almost asleep I once thought I barely heard a stray meow outside in the freezing rain so I got up and looked out the windows for a minute has no real influence on my life as an isolated although unusual incident, in comparison, constantly hearing voices loudly tell me peculiar things would have a huge influence on my daily life. So that is interesting too.
If people are having chronic hallucinations, whether positive, nutural or negative, it's something to be concerned about. Usually there are symptoms outside of these hallucinations in this case where sufferers are not able to look after themselves.
In patients with bipolar during a manic/hypomanic phase, I could except hallucinations to be very positive in nature, such as supporting delusions of grandeur.
This may be much different from talking to ourselves or physically responding to dialogue WITHIN our heads, which I imagine is the source of many imaginary friends.
EDIT: I'm not qualified to speak on these subjects but I suffered from psychosis from a number of years and was misdiagnosed with schizophrenia at one stage due to the nature of my hallucinations (though still a bit over zealous on the psychiatrists part). I naturally came to learn a lot about what it is, how it's treated and spoke to many patients with psychotic illnesses in my stay in hospital (for mental disorders, a stay of 3 - 4 months is a short amount of time, many who I was in there with had been in for a year or more)