Hallucinations are sensory experiences 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 isn’t real.
Hallucinations are typically a symptom of a psychosis-related disorder, particularly schizophrenia, but they can also result from substance use, neurological conditions and some temporary situations.
There are several different types of hallucinations, including –
• Auditory (sound) hallucinations
These are the most common type. They involve hearing sounds that aren’t real, like music, footsteps or doors banging. Some people hear voices when no one has spoken. The voices may be positive, negative or neutral. They may command you to do something that may cause harm to yourself or others.
• Visual (sight) hallucinations
These hallucinations involve seeing things that aren’t real, like objects, shapes, people, animals or lights.
• Tactile (touch) hallucinations
These hallucinations cause you to feel touch on your body or movement in your body that’s not real. They may involve feeling like bugs are crawling on your skin or your internal organs are moving around.
• Olfactory (smell) hallucinations
These hallucinations involve experiencing smells that don’t exist or that no one else can smell.
• Gustatory (taste) hallucinations
These hallucinations cause tastes that are often strange or unpleasant. Gustatory hallucinations (often with a metallic taste) are a relatively common symptom for people with epilepsy.
• Presence hallucinations
These hallucinations make you feel that someone is in the room with you or standing behind you.
• Proprioceptive hallucinations
These hallucinations make you think that your body is moving, such as flying or floating, when it’s not.
There are also types that are sleep-related, including –
• Hypnopompic hallucinations: These are hallucinations that occur as you’re waking up from sleep. For most people, hypnopompic hallucinations are considered normal and aren’t cause for concern. They may be more common in people with certain sleep disorders.
• Hypnagogic hallucinations: These are hallucinations that happen as you’re falling asleep. They’re usually short-lasting and about 86% of them are visual. People commonly see moving patterns and shapes or vivid images of faces, animals or scenes. These aren’t usually a cause for concern.
Hallucinations vs. Delusions
A hallucination is when your senses are perceiving something that isn’t happening in reality (i.e., you see and hear a person in the room who’s not really there). A delusion, on the other hand, is the belief that something is happening, for which there is no evidence (i.e., you believe that the government is controlling you through your TV).
Hallucinations often signal an underlying problem with how the brain is processing information, such as when a person with dementia develops hallucinations or depression triggers psychosis.
Some other symptoms a person might experience includes –
• changes in brain function as a person ages
• unusual beliefs
• depression or anxiety
• visual or hearing problems
• paranoid or aggressive behavior
• belief in conspiracies
• Mental health conditions
Mental illnesses are among the most common causes. Schizophrenia, dementia, and delirium are a few examples.
• Substance use
Substance use is another fairly common cause of hallucinations. Some people see or hear things that aren’t there after drinking too much alcohol or taking drugs like cocaine. Hallucinogenic drugs like LSD and PCP can also cause you to hallucinate.
• Lack of sleep
Not getting enough sleep can also lead to hallucinations. You may be more prone if you haven’t slept in multiple days or don’t get enough sleep over long periods of time.
Certain medications taken for mental and physical health conditions can also cause hallucinations. Parkinson’s disease, depression, psychosis, and epilepsy medications may sometimes trigger such symptoms.
• Other conditions
Other conditions can also cause this condition.These can include:
▪︎ high fevers, especially in children and the elderly
▪︎ social isolation, particularly in older adults
▪︎ deafness, blindness, or vision problems
▪︎ terminal illnesses, such as stage 3 HIV (AIDS), brain cancer, or kidney and liver failure
After asking about your symptoms, medical history, and lifestyle habits, your health provider will likely do a physical exam and order a few tests to try and rule out medical or neurological causes of your problem. Diagnostic tests may include:
• Blood tests to check for metabolic or toxic causes
• Electroencephalogram (EEG) to check for abnormal electrical activity in your brain and to check for seizures
• Magnetic resonance imaging (MRI) to look for structural brain issues such as a brain tumor or stroke.
The treatment will depend on the type of hallucination, the underlying cause, and your overall health. In general, however, your doctor will likely recommend a multidisciplinary approach that includes –
Psychotherapy involves engaging the patient to be curious around the details of the symptoms, providing psycho-education, exploring “plausible reasons” for the hallucinations and normalizing the experience.
The following self-help strategies can help patients cope with such frightening auditory experience –
• Humming or singing a song several times (like “Happy Birthday”)
• Ignoring the voices
• Listening to music
• Reading (forward and backward)
• Talking with others
Antipsychotic medications often are effective for treatment, either by eliminating or reducing the frequency with which they occur or by having a calming effect that makes them less distressing.
Nuplazid (pimavanserin)is the first drug approved for treatment associated with psychosis experienced with Parkinson’s disease.
An important aspect of helping a loved one who is experiencing hallucinations is reassuring them that treatment is available. Here are a few more practical steps for helping your loved one cope with hallucinations.
▪︎ Pay Attention the Environment
The environment can play an important role in misperceptions and worsening of situation; for example, a poorly lit room and loud, chaotic setting may increase the likelihood of such frightening experience.
▪︎ Stay Calm
Although it can be frightening and uncomfortable when a loved one experiences these episodes, it’s important to do your best to respond in a calm, supportive manner. For example, you might say “I know this is scary for you” or “Don’t worry; I’m here.”
▪︎ Use Distraction
Depending on the severity, gently touching or patting your loved one may help serve as a distraction and reduce the hallucination. Other possible distractions include conversation, music, or a move to another room.
▪︎ Be Honest
While you don’t want to upset your loved one or engage in an argument, you do want to be honest and assure them that you’re not dismissing their concerns. If they ask: “Did you hear that?” Consider saying: “I know you heard something, but I didn’t hear it.”
▪︎ Maintain Routines
Keeping normal and reliable day-to-day routines can make it less likely that your loved one will stray from reality and experience hallucinations. Consider keeping a record of when such condition occur and under what circumstances.
While not all hallucinations can be prevented, there are some strategies you can use at home that might help reduce the frequency of them for certain people with neurological conditions that may cause this condition, including:
• Having good lighting and participating in stimulating activities in the evening.
• Checking for sounds that might be misinterpreted, like noise from a television or an appliance.
• Looking for and correcting lighting that casts shadows, reflections or distortions.
• Covering mirrors with a cloth or removing them if the person thinks they’re looking at a stranger.
If you’re taking medication to help treat hallucinations, it’s important to continue taking the medication unless your healthcare provider tells you otherwise. Stopping the medication suddenly can cause more intense hallucinations.
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