Hallucination

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 who has hallucinated 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 hallucination symptoms.

Hallucination 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.

Hallucinations can indicate potentially serious underlying health concerns in some cases, so learning to recognize them can be vital. Hallucinations 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.

Concurrent hallucinations

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.

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 hallucinations, 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 hallucinations and lead fulfilling lives.

Conditions causing hallucinations

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 or brain 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.

Hallucination factors

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 for the hallucinations.

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

Antipsychotic medication for hallucinations

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 hallucination 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 or hallucinations. 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, including hallucinations. The information in this article is not a replacement for medical advice or diagnosis.