Clinical Psychiatry Open Access

Introduction

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. These symptoms may be caused by mental illnesses, the side effects of medications, or physical illnesses like epilepsy or alcohol use disorder. You may need to visit a psychiatrist, a neurologist, or a general practitioner depending on the cause of your hallucinations. Treatment may include taking medication to treat a health condition. Your doctor may also recommend adopting different behaviours like drinking less alcohol and getting more sleep to improve your hallucinations.

Types of Hallucinations

Visual hallucinations

Visual hallucinations involve seeing things that aren’t there. The hallucinations may be of objects, visual patterns, people, or lights. For example, you might see a person who’s not in the room or flashing lights that no one else can see.

Olfactory hallucinations

Olfactory hallucinations involve your sense of smell. You might smell an unpleasant odour 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.

Gustatory hallucinations

Gustatory hallucinations are similar to olfactory hallucinations, but they involve your sense of taste instead of smell. These tastes are often strange or unpleasant. Gustatory hallucinations (often with a metallic taste) are a relatively common symptom for people with epilepsy.

Auditory hallucinations

Auditory hallucinations are among the most common type of hallucination. 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

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.

Causes

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 to hallucinations if you haven’t slept in multiple days or don’t get enough sleep over long periods of time. It’s also possible to experience hallucinations right before falling asleep, known as hypnagogic hallucinations, or right before waking up from sleep, known as hypnopompic hallucinations.

Medications

Certain medications taken for mental and physical health conditions can also cause hallucinations. Parkinson’s disease, depression, psychosis, and epilepsy medications may sometimes trigger hallucination symptoms. Antipsychotic meds frequently are compelling for treating visualizations, either by killing or decreasing the recurrence with which they happen or by having a quieting impact that makes them less troubling. Nuplazid (pimavanserin) is the primary medication affirmed to treat mental trips related with psychosis experienced with Parkinson's infection.

Diagnosis

The best thing to do is call your doctor right away if you suspect that your perceptions aren’t 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’s hallucinating, don’t leave them alone. In some severe cases, fear and paranoia triggered by hallucinations can lead to dangerous actions or behaviours. Stay with the person at all times and go with them to the doctor for emotional support. You may also be able to help answer questions about their symptoms and how often they occur.

Treatment

Your doctor will be able to recommend the best form of treatment for you once they figure out what’s causing your hallucinations. Treatment for your hallucinations will depend entirely on their underlying cause. For example, if you’re hallucinating due to severe alcohol withdrawal, your doctor might prescribe medication that helps calm down your nervous system. However, if hallucinations are caused by Parkinson’s disease in a person with dementia, this same type of medication may not be beneficial, and other medications may be used. An accurate diagnosis is very important for treating the condition effectively. Counselling might also be part of your treatment plan. This is particularly true if the underlying cause of your hallucinations is a mental health condition. Speaking with a counsellor can help you get a better understanding of what’s happening to you. A counsellor can also help you develop coping strategies, particularly for when you’re feeling scared or paranoid.