Overview

Hallucinations involve having sensory experiences that occur in the absence of an external stimulus. They are not under voluntary control and are often vivid and clear, appearing to possess the full force and impact of normal perceptions.1 

Hallucinations may affect any senses, including vision, hearing, touch, taste, and/or smell. It’s generally not helpful to dismiss them as figments of the imagination, as hallucinations often seem real to the person undergoing them and may have profound psychological implications that potentially limit their ability to lead a healthy lifestyle. When an individual experiences auditory hallucinations, visual hallucinations, tactile hallucinations, or any other type of hallucination, it can be crucial for them to receive comfort and support from loved ones. Invalidation or aggression from others may worsen hallucinations and cause distrust, which may lead to an individual not seeking medical or mental health treatment. 

Hallucinations may be caused by various factors, such as mental health conditions2 like schizophrenia,3 bipolar disorder, or severe depression. Certain neurological disorders like Parkinson's disease, Alzheimer's disease, and Lewy body dementia may also increase the likelihood of experiencing hallucinations. Other risk factors may include high levels of stress, a lack of sleep, or having experienced a traumatic event. Treatment for hallucinations may consist of professional support, cognitive behavioral therapy, and medication.

Signs

Understanding the signs of a hallucination can be crucial for early intervention and effective treatment. Individuals experiencing hallucinations might report seeing, hearing, smelling, tasting, or feeling what others cannot perceive. They may also seem to be interacting with a person or a situation that's not present. They might appear suspicious, or display distress without an apparent cause. 

If you notice these signs, it may be helpful to approach the person with compassion and understanding and offer support in seeking professional help. If you notice hallucinations in yourself (e.g., a mismatch between what you’re experiencing and what others report), seeking professional support may also be crucial for addressing symptoms.

Signs of hallucinations may include the following:

  • Hearing voices when no one is present
  • Seeing objects, people, or events that are not present or actually happening
  • Being told by people around you that you are hallucinating 
  • Smelling odors that others don't perceive
  • Feeling sensations on the skin that aren’t connected to real stimuli 
  • Tasting a flavor when you haven't eaten anything
  • Behavior that’s unusual for your regular habits or personality traits
  • Withdrawal from usual hobbies or social activities 

Risk factors for hallucinations may include:

  • Mental health disorders like schizophrenia, bipolar disorder, and depression
  • Neurological conditions like dementia or a stroke
  • Certain types of migraines or epilepsy
  • Substance use or withdrawal
  • Severe stress or trauma
  • Certain medications

For those struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

Types

Hallucinations can indicate potentially serious underlying health concerns in some cases, so learning to recognize them can be vital. They may come in various forms, including the following types of hallucinations:

  • Visual hallucinations. Visual hallucinations involve seeing what is not present, such as patterns, people, or lights. 
  • Auditory hallucinations. Auditory hallucinations are characterized by hearing voices or sounds that do not exist. 
  • Tactile hallucinations. These hallucinations often involve a physical sensation that is not present, such as the sense of bugs crawling on the skin. 
  • Olfactory hallucinations. These hallucinations involve smelling odors that others cannot perceive and are not truly present. 
  • Gustatory hallucinations. These hallucinations refer to tastes without a stimulus, often reported as metallic or bitter.

Individuals can experience different hallucinations concurrently. These experiences may be distressing and disorientating, which can make understanding, compassion, and professional support crucial. Not everyone who hallucinates believes that their hallucination is real, as hallucinations and delusions do not always present together. Some people may become distressed by their hallucinations due to their knowledge that they’re not reality, which may lead them to seek support.

Related conditions

Schizophrenia is a mental illness often linked with hallucinations. People with specific subtypes of schizophrenia may experience various hallucinations that prevent them from establishing a stable connection with reality. These hallucinations may be vivid and seem entirely real to the person experiencing them, often leading to distress and confusion. 

These experiences, while often profoundly unsettling, are a symptom of the condition and not a reflection of an individual's character or strength. With appropriate treatment and support, people with schizophrenia may learn to manage these symptoms and lead fulfilling lives.

Hallucinations, while often associated with conditions like schizophrenia, may also be a symptom of other medical or mental health conditions. For instance, hallucinations may sometimes occur in the context of post-traumatic stress disorder (PTSD), severe depression, and anxiety disorders. People experiencing manic episodes due to bipolar I disorder may also have hallucinations, though this is typically only seen in severe cases of bipolar disorder.

Individuals diagnosed with Parkinson's disease or Alzheimer's could also experience hallucinations as a result of the neurological changes that Parkinson’s disease and Alzheimer’s cause. Migraines and certain types of epilepsy, such as temporal lobe epilepsy, have been known to potentially cause hallucinations as well.

However, experiencing hallucinations doesn't automatically imply a serious medical or mental health disorder. Various factors, including high levels of stress, lack of sleep, or certain medications, may contribute to temporary hallucinations. It’s also worth noting that one particular type—hypnagogic hallucinations, which may happen briefly when falling asleep—are considered normal and do not typically require treatment. Otherwise, if you or a loved one is experiencing hallucinations, it’s generally recommended that you consult a healthcare provider to determine the underlying cause and appropriate treatment.

Treatments

Research suggests that various evidence-based treatments can be effective in managing hallucinations, including but not limited to the following:

Medication 

Medication prescribed by a healthcare professional may sometimes play a role in the treatment of hallucinations, especially when they’re associated with mental health disorders and psychosis.

Antipsychotic medications, for instance, are frequently prescribed for psychotic symptoms like hallucinations, as these medications may reduce the frequency and intensity of hallucinatory episodes and help treat the underlying condition in the case of some psychotic disorders like schizophrenia. However, note that their efficacy and potential side effects may vary significantly depending on the individual and the specific medication.

Note also that one study suggests that cognitive behavioral therapy combined with antipsychotic medications may be more effective than CBT or medication alone in treating symptoms of psychosis. That said, each individual is unique, and treatment is typically most effective when it involves a combination of different methods tailored to the individual’s co-occurring conditions (if any), preferences, and context.

Each individual is unique, and treatment can be personalized, involving a combination of different methods tailored to the individual’s co-occurring conditions, preferences, and context. 

Consult a medical doctor before starting, changing, or stopping a medication for any condition. The information in this article is not a replacement for medical advice or diagnosis. 

The BetterHelp platform is not intended for any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content is providing generalized information, not specific for one individual. You should not take any action without consulting with a qualified medical professional.

Therapy

Cognitive behavioral therapy (CBT) is a widely used method for managing various mental health symptoms, including hallucinations. This therapeutic modality is based on the premise that thoughts influence feelings and behaviors. The fundamental notion is that, by changing their thought patterns, clients may be able to alter their responses and improve emotions and actions. 

CBT may benefit clients who experience hallucinations by guiding them to understand the nature of their hallucinations, identify events that incite hallucinations, and develop coping strategies. This approach is not designed to eliminate the hallucinations but to reduce the distress they cause and their impact on the person's life. CBT sessions for hallucinations often involve techniques like reality testing, coping-strategy enhancement, and anxiety management, all aimed at promoting better understanding, acceptance, and control over the hallucination experience.

Other modalities that may benefit individuals experiencing hallucinations include but are not limited to the following: 

  • Social recovery therapy. Social recovery therapy is a modality designed to support individuals experiencing first-episode psychosis, which can involve hallucinations. This modality works by supporting individuals through social systems and social skills training. It may be helpful for those with conditions like schizophrenia or schizoaffective disorder. 
  • Cognitive therapy. Cognitive therapy may be another helpful support option for those experiencing psychosis and/or hallucinations. This modality is the foundation of CBT and focuses primarily on identifying and changing harmful thought patterns. Studies suggest that this modality can be effective, especially in supporting individuals with auditory hallucinations.

Associated terms

Updated on June 27, 2024.
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