Hallucinations are sensations that appear real but are created by your mind. They can affect all five of your senses. For example, you might hear a voice that no one else in the room can hear or see an image that is not real. These symptoms may be caused by mental illness, the side effects of medications, or physical illnesses like epilepsy or alcoholism. Depending on the cause, you may need to visit a psychiatrist, a neurologist, or a general practitioner. Treatment may include taking medication to cure a physical or mental illness or adopting healthier behaviors like drinking less alcohol and getting more sleep.
Hallucinations may affect your vision, sense of smell, hearing, or bodily sensations.
Visual hallucinations involve seeing things that aren’t there. The hallucinations may be of objects, visual patterns, people, and/or lights. For example, you might see a person who is not in the room or flashing lights that no one else can see.
Olfactory hallucinations involve your sense of smell. You might smell an unpleasant odor when waking up in the middle of the night or feel that your body smells bad when it doesn’t. This type of hallucination can also include scents you find enjoyable, like the smell of flowers.
Auditory hallucinations are among the most common. You might hear someone speaking to you or telling you to do certain things. The voice may be angry, neutral, or warm. Other examples of this type of hallucination include hearing sounds, like someone walking in the attic, or repeated clicking or tapping noises.
Tactile hallucinations involve the feeling of touch or movement in your body. For example, you might feel that bugs are crawling on your skin or that your internal organs are moving around. You might also feel the imagined touch of someone’s hands on your body.
As the name implies, temporary hallucinations are not chronic. They may occur, for example, if a relationship has just ended or if someone dear to you has just passed away. You might hear the person’s voice for a moment or briefly see his or her image. Typically, this type of hallucination disappears as the pain of your loss diminishes.
Mental illnesses are among the most common causes of hallucinations. Schizophrenia, dementia, and delirium are a few examples.
Substance abuse is another fairly common cause. Some people see or hear things that aren’t there after drinking too much alcohol or taking drugs like cocaine or PCP.
Lack of sleep can lead to hallucinations. If you have not slept in days or do not get enough sleep over long periods of time, you may be more prone to hallucinations.
Medications taken for certain mental and physical conditions can also cause hallucinations. Parkinson’s disease, depression, psychosis, and epilepsy medications may trigger hallucination symptoms.
Other conditions that can cause hallucinations include:
- terminal illnesses, such as AIDS, brain cancer, or kidney and liver failure
- high fevers, especially in children and the elderly
- social isolation, particularly in older adults
- deafness, blindness, or vision problems
- epilepsy (in some cases, epileptic seizures can cause you to see flashing shapes or bright spots)
Because many factors can trigger hallucinations, the best thing to do is to call your doctor right away if you suspect that your perceptions are not real. Your doctor will ask about your symptoms and perform a physical exam. Additional tests might include a blood or urine test and perhaps a brain scan.
If you know someone who is hallucinating, avoid leaving them alone. Fear and paranoia triggered by hallucinations can lead to dangerous actions or behaviors. Stay with the person at all times and go with them to the doctor for emotional support. You may also be able to help in answering questions about their symptoms and how often they occur.
Treatment for your hallucinations will depend entirely on their underlying cause. For example, if you are hallucinating because of delirium due to severe alcohol withdrawal, your doctor might prescribe medication that slows down your nervous system. For psychosis, the treatment may be a different kind of medication like dopamine antagonists. However, if hallucinations are caused by Parkinson’s disease in a patient with dementia, this same type of medication would be detrimental. An accurate diagnosis is, therefore, very important for treating the condition effectively.
Counseling might also be part of your treatment plan, particularly if the underlying cause of your hallucinations is a mental health condition. Speaking with a counselor can help you get a better understanding of what is happening to you. A counselor can also help you develop coping strategies, particularly for when you are feeling scared or paranoid.
Recovery from hallucinations depends on the cause of the condition. If you are not sleeping enough or are drinking too much, these behaviors can be adjusted. If your condition is caused by a mental illness, such as schizophrenia, taking the right medications can improve your hallucinations significantly. By seeing a doctor immediately and following a treatment plan, you are more likely to have a positive long-term outcome.
Written by: Chitra Badii
Medically reviewed by George Krucik, MD