Hallucinations: Types, Causes, Symptoms, & Treatment

What Are Hallucinations?

Hallucinations are experiences that directly affect a person’s senses, such as their sight, hearing, and vision. For example, hearing the voice of another person even though no one is around, or seeing a dead loved one coming down the stairs for dinner. Hallucinations come in many different forms, and vary by person and culture. They may even include something meaningful within one’s culture and/or religion.¹

Hallucinations are much more common than most people think. In the general population, about 10% of people experience auditory hallucinations during their lifetime.² Many studies find that children and teenagers are more likely to experience hallucinations than adults.

Although hallucinations are usually considered a mental health symptom, often indicating a psychotic disorder like schizophrenia, these experiences can occur in many different situations. For instance, some cultures and religions include historical traditions and modern day beliefs about prophets receiving visions from gods or experiencing the spiritual on earth.³. These kinds of situations are not signs of mental illness.

Hallucinations vs. Delusions & Illusions

Hallucinations and delusions are sometimes confused with each other. These are both common symptoms of psychotic disorders, but hallucinations are sensory based. Conversely, delusions are beliefs that one strongly believes to be true, despite objective evidence suggesting the contrary. In both cases, the person who experiences a hallucination or delusion may or may not think what they are experiencing is “real.” Regardless, these symptoms can cause a lot of distress.

Hallucinations and illusions are similar in that they are both sensory-based. However, illusions are usually a sensory “trick,” such as an optical illusion due to relative lighting. One key difference between illusions and hallucinations is that illusions are commonly shared across people, while hallucinations are typically individually experienced. Hallucinations may also be recurring and have some kind of personal meaning.

Types of Hallucinations

There are many different types of hallucinations and a person may experience only one or a number of them. These can occur at the same time or at different times. How a hallucination is experienced greatly varies depending on the individual.

The types of hallucinations include:⁴

Auditory Hallucinations

Auditory hallucinations are hallucinations a person hears and are the most common type. They usually involve a human voice, but could include any other sound like animal noises or alarms, among others. These may sound like they are coming from inside or outside of a person’s head. The sounds can be clear, vague, or hard to understand.

Hearing voices can be a positive, neutral, or negative experience. Some people hear voices that provide comfort or increase confidence. People are most likely to be diagnosed with a mental health condition when their voices are critical or scary, and they don’t feel like they can control them. Sometimes these more negative voices can tell people lies about themselves (“you are worthless” or “no one loves you”) or try to command them to hurt themselves or others.

Visual Hallucinations

Visual hallucinations are ones that are seen. They could include people, animals, and objects or be more abstract, such as colors, lights, or shapes. Similar to auditory hallucinations, visual hallucinations impact a person in a variety of ways. They may be scary, distressing, confusing, or overwhelming, making it hard to go about one’s day-to-day life. However, they may also remain neutral or positive.

Tactile Hallucinations

Tactile hallucinations occur when a person can physically feel something without the existence of a tangible cause. For example, sometimes people feel insects crawling on them or mud on their hands. Tactile hallucinations are less common than auditory or visual hallucinations.

Olfactory Hallucinations

Olfactory hallucinations are unexplainable smells. A person may smell smoke or eat a fresh meal that smells rotten.

Gustatory Hallucinations:

Gustatory hallucinations are unexplainable tastes. For instance, the taste of dirt or rancid meat. These hallucinations are also less common than auditory and visual hallucinations.

Hypnopompic & Hypnagogic Hallucinations

Hypnopompic and hypnagogic hallucinations are sleep-related. A hypnopompic hallucination occurs when a person is in the process of waking up, while a hypnagogic hallucination happens when going to sleep. Both can impact any sense, but are most commonly visual. A person might see something very distinct or much more abstract, like shapes or colors.

People who only experience hypnopompic and hypnagogic hallucinations will not meet criteria for a psychotic disorder or another mental health condition. These disorders require at least some hallucinations to occur while fully awake. Some may have hypnopompic and hypnagogic hallucinations due to sleep impairments, medications, or other substances.

What Causes Hallucinations?

Although hallucinations are most frequently associated with mental health conditions, specifically psychotic disorders, it is possible to experience them without a diagnosis. It is essential to consider medical and substance related reasons for hallucinations, especially when they occur suddenly and intensely. The specific features of one’s hallucinations can help a person identify what is causing them and if treatment is needed.

Possible reasons for hallucinations include:⁵

Mental Health Condition

Hallucinations can be a symptom of a number of mental health conditions and are often a part of psychosis. However, sometimes people with other mental health concerns can experience hallucinations, such as PTSD.⁵

Mental health conditions that may frequently include hallucinations include:

• Schizophrenia
• Schizoaffective disorder
• Brief psychotic disorder
• Major depressive disorder with psychotic features
• Post-traumatic stress disorder (PTSD)
• Bipolar disorder

Emotional Distress, Stress, & Grief

A person may experience hallucinations for emotional or mental health related reasons that are not associated with a diagnosable disorder. For example, it is not unusual for a person who has suddenly lost a loved one to see that person or even speak to them after death. When the brain is under immense stress, it may process and experience the world differently than usual. This is normal and not necessarily a sign of concern. If it lasts or becomes concerning, then seeking professional help is wise.

Sleep Disturbances

Poor sleep and some sleep disorders may lead to hallucinations. When people experience severe sleep impairment, brain function may be negatively impacted, resulting in sensory issues such as hallucinations. Moreover, in certain sleep disorders, many report hypnopompic and/or hypnagogic hallucinations as they are falling asleep or waking up. Common sleep disorders that can cause hallucinations include insomnia, narcolepsy, and sleep paralysis.

Neurological Conditions

Given that hallucinations originate in the brain, medical conditions that impact brain functioning can sometimes result in hallucinations. This is particularly true of disorders that impact sensory processing, motor functioning, memory, and other key areas of the brain.

Neurological disorders that sometimes include hallucinations include:

• Parkinson’s disease
• Alzheimer’s disease
• Other forms of dementia
• Migraines
• Seizure disorders

Substance Use

Many substances alter how the brain processes information. Psychoactive substances, such as marijuana and alcohol can sometimes induce hallucinations. Typically, these effects last only until the substance wears off. However, in some cases symptoms may continue to last and become chronic.

When to Seek Professional Help

A person with hallucinations may or may not need professional help. However, it is important to seek help sooner rather than later so you receive the care you need, regardless of what is causing your experiences. When hallucinations begin suddenly, are intense, are distressing, include commands to do something dangerous, and/or make it hard to function, locating treatment is essential.

How Are Hallucinations Diagnosed?

Most commonly, a licensed mental health provider diagnoses what is causing your hallucinations. They will be able to determine if your symptoms are a part of a mental health condition or potentially related to something else. If needed, you might also see a medical provider, such as a neurologist or a sleep specialist, to see if there is a medical explanation for your hallucinations. Receiving an accurate diagnosis is imperative in developing an appropriate treatment plan.

How Are Hallucinations Treated?

A tailored treatment for addressing hallucinations is the best course of action. For those with mental health conditions who want to eliminate, reduce, and/or manage their hallucinations, a combined approach with both medication and therapy often works best. It may take some time to find the option that is right for you.

Medications

Antipsychotic medications are most commonly used to treat hallucinations. However, the best fit for you will depend on other related symptoms and tolerance for potential side effects. These medications are available in a pill form or sometimes as a long acting injectable (LAI). It’s important to rule out neurological causes of hallucinations before consulting with your doctor about these medications, as they may make symptoms worse. Additionally, some find that antidepressants or antianxiety medications help with hallucinations.⁶

Therapy

Certain therapeutic approaches can help people manage and reduce the distress caused by hallucinations and live a happy life, even if symptoms continue. Therapy may also help individuals identify ways to test whether or not a hallucination is real. This can be beneficial for those who feel controlled by their symptoms, or are scared and distressed by them. It’s important to find the right therapist with expertise in hallucinations.

Therapy options for hallucinations may include:⁶

• Cognitive behavioral therapy for psychosis (CBTp)
• Acceptance and commitment therapy (ACT)
• Recovery-oriented cognitive therapy (CT-R)

Alternative Treatments

There are a number of alternative approaches to dealing with hallucinations. For example, certified peer support specialists use their personal shared experience to help you figure out the best way to navigate your own life and recovery process. Peer groups provide a space for people with similar experiences to support each other and identify helpful strategies in and outside of formal treatment.

Additionally, some individuals who experience hallucinations may elect to try medical treatments like transmagnetic stimulation (TMS).⁷ This is a non-surgical approach that stimulates the brain with magnets and is typically conducted in an outpatient clinic. TMS is safe, but the data on its effectiveness is still preliminary. Talk to your doctor about whether it may be a viable option for you.

Can Hallucinations Be Prevented?

In general, hallucinations cannot typically be prevented, unless they are related to sleep disturbances or substance use. If you have difficulties sleeping, seeing a specialist can help improve your overall physical and mental health. If you currently experience hallucinations or believe you are at risk for experiencing them, this is a good reason to reduce or eliminate unnecessary substance use, as they may cause or make hallucinations worse.

People who experience hallucination sometimes reduce how frequent and intense their hallucinations are through adjustments to their environment, including:

• Adjusting lighting to reduce shadows, reflections, etc. that may contribute to visual hallucinations
• Removing objects from your home that tend to cause visual hallucinations
• Using noise canceling headphones
• Playing white noise
• Having one or more “reality testing” buddies

How to Help Someone Experiencing Hallucinations

If someone you love is having hallucinations, please remember that this is likely a scary and uncomfortable experience for them. It can be very isolating to be in their position. You can help provide support by offering a safe and nonjudgmental place for them to feel accepted and respected, regardless of their symptoms.

You may want to help your loved one with their mental health or medical treatment, which can be a wonderful thing–if it is what the person with hallucinations wants. It can be beneficial to discuss with your loved one about what they need from you moving forward.

Here are some ways to help someone who is experiencing hallucinations:

• Offer reality checks: Some people like to reality test their hallucinations with another person. By talking to your loved one, you can understand what they need.
• Continue to connect with your loved one in other ways: Support your loved one by continuing to develop a strong relationship that’s not just about their symptoms– make time to have dinner together, go to the beach, or engage in shared hobbies.
• Avoid telling them the hallucinations are wrong/false: It can be frustrating, invalidating, and isolating to constantly hear from others that your ongoing life experience is “fake.”
• Provide a safe space to talk: Hallucinations are stigmatized, so people often don’t feel comfortable discussing them openly with others, even those they love. This can make experiencing hallucinations harder, leading to isolation, depression, and anxiety. Being willing to listen to your loved one’s experiences can be validating.
• Encourage treatment: If your loved one is open to it, you can discuss why you think it might be helpful to talk to a professional. For example, if you think there could be a medical cause, you could encourage your loved one to get neurological and other causes ruled out.
• Help your loved one live in a safe and non-stigmatizing community: Work to decrease stigmatizing messages and behavior around your loved one’s symptoms. When you hear others refer to your loved one or other people as “psycho,” “crazy,” or “deranged,” correct them.

Final Thoughts

If you are experiencing hallucinations, you are not alone. If your hallucinations cause you distress or make it hard for you to live the life you deserve, please seek help. There are a number of therapy approaches that can help reduce or eliminate these experiences.