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Hallucinationsoccur when a person experiences seeing, hearing, feeling, smelling, or tasting something that isn’t really there.The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies this phenomenon as one of the main symptoms of psychotic disorders.Hallucinations are commonly associated withschizophrenia.Around 60% to 70% of people with this condition experience these, with auditory hallucinations being the most common.Hallucinations may also occur in conditions such aspost-traumatic stress disorder,personality disorders, or medical illnesses like eye disease andneurodegenerative conditions.This break from reality may result for a number of reasons.This guide will examine the different causes of hallucinations in people and will cover the types, symptoms, and possible treatment methods for hallucinations.Types of HallucinationsA hallucination can involve any of the five senses. That means that perceptions can be felt through the ears, eyes, skin, nose, or tongue.Auditory HallucinationsThese hallucinations occur when a person perceives sounds that are not actually present. In some studies, auditory hallucinations are observed in between 5% and 28% of the population.Highly prevalent in schizophrenia, auditory hallucinations are also seen in 20% to 50% of people living with bipolar disorder. By some estimates, 10% of the population with major depression, and 40% managing PTSD also experience auditory perceptual disturbances.Auditory hallucinations may come in a variety of sounds. But when the non-apparent sounds are comprised of voices, they are referred to as auditory verbal hallucinations.Around 9% of children experience auditory hallucinations, with numbers that move between 5% and 16% in adolescence.When hallucinations are verbal, the voices may be degrading, commanding, or haunting enough to affect daily functioning.Visual HallucinationsPeople who experience visual hallucinations will often see anon-existent image, believing it to be real. These incidents are more commonly observed in older people.Visual hallucinations are commonly seen in degenerative diseases of the brain and eye.Patients withParkinson’s diseasemay experience visual hallucinations, depending on how long the condition has lasted. The dopamine medication used to manage the disease also raises hallucination risk.Visual illusions may occur in up to 80% of Parkinson’s patients over the course of their illness.Dementiasand eye/visual pathway diseases are also linked to visual hallucinations in patients.Tactile HallucinationsTactile hallucinations are also known as haptic hallucinations ortactile phantasmata.When a person goes through this experience, they usually feel touches to or under the skin in the absence of any real stimulation.Tactile hallucinations can feel like pinpricks, the feeling of liquid or wind on the skin, a hand on the shoulder, etc.Somatichallucinations are a variation of this condition. Here, sensations are felt inside the body without any corresponding stimuli.Tactile hallucinations are generally rare in neurological and psychiatric conditions. However, one study found that these types of sensations make up the second-most common type of hallucination in the general population.Olfactory and Taste HallucinationsHallucinations of smell are observed in a significant minor of patients withschizophrenia. Around 4% and 25% of individuals with the disorder experience these illusions.However, limited research exists on this phenomenon.Olfactory hallucinations have been reported to occur in about 5% of the older population generally associated with an impaired sense of smell.These hallucinations are otherwise known asphantosmia.They occur where odors are perceived without a source present.In addition to psychotic illnesses, phantosmia has been reported in the context of epileptic seizures,depression,migraines, and ear, nose, and throat diseases.The most commonly reported auditory hallucinations are burnt/smoky smells. Patients also report foul, unpleasant, spoiled, or rotten odors.Phantom smells can reduce the quality of life in patients. This condition has been described asintrusiveand distressing.Olfactory hallucinations typically occur with taste or gustatory hallucinations. However, it is possible to experience these conditions independently.What Causes Hallucinations?Hallucinations are often the result of a psychotic disorder or a related condition. However, the exact mechanism behind these symptoms is less clear. There are a few possible explanations that have been proposed.Auditory HallucinationsFunctional magnetic resonance imaging (fMRI) examinations have demonstrated how the spontaneous activation of the auditory network can contribute to hallucinations.Likewise, a neurocognitive model called the VOICE model has proposed that an unbalancedlimbic systemmismatched against a hypoactive prefrontal inhibitory system is at play.The limbic system is a part of the brain responsible for processing emotions, memory, fear, pleasure, hunger, etc. When this system becomes hyperactive, and the brain’s prefrontal region which is involved in cognitive control is unable to properly modulate this, hallucinations may occur.Visual HallucinationsThere are different mechanisms intended to explain visual hallucinations in eye and brain conditions:Perception Attentional Dysfunction:In this case, the body’s perception and attention networks are impaired, affecting visual processing. This visual dysfunction is associated with dementia or Parkinson’s disease.Hyperexcitability:This model is tied to Charles Bonnet syndrome—a condition where visual hallucinations occur as the brain adjusts to vision loss. This can lead to increased spontaneous activity in parts of the brain associated with vision. In such cases, incidents of visual hallucination may be observed.Poor interpretation:This model proposes that the brain may be confused in its ability to attribute the source of internally generated sensations as internal.Tactile HallucinationsWhile tactile hallucinations can present as part of psychiatric illness, neurodegenerative diseases (such as Parkinson’s), illicit drug use, and medication may also cause hallucinations that feel like insects crawling on the skin, and other tactile sensations.Olfactory and Taste (Gustatory) HallucinationsPhantom smells may result from trauma or nasal conditions like sinusitis.Certain degenerative neurological conditions such as Parkinson’s disease and Alzheimer’s have links to olfactory hallucinations.Viral infections can also cause damage to the olfactory receptor neurons (ORNs). The direct mechanism behind this remains unclear.When experiencing phantom tastes—trauma, or infections of the upper respiratory tract may be responsible.Likewise, toxic substances and medicines can play a role in taste hallucinations.Treatment of HallucinationsHallucinations may be managed using different approaches. There are treatments to manage hallucinations and their impact.MedicationMedication is the main approach to treat hallucinations in psychotic and other illnesses.Antipsychoticscontrol many symptoms of psychosis such asanxiety,agitation,delusions, and hallucinations.It’s important to note, however, that 25% to 30% of auditory hallucinations may offer resistance toantipsychotics.Transcranial Magnetic Stimulation (TMS)RepetitiveTMSis a relatively new treatment option, and there is some data that it might be helpful in the management of hallucinations.PsychoeducationEducation on the nature of hallucinations and mental illness can help individuals and their loved ones better manage these symptoms.Psychoeducation also helps people learn about factors that influence the condition and how to better manage it.Psychoeducation is also a useful tool in managing the stigma around this disorder.Cognitive Behavioral TherapyFor anyone managing hallucinations, cognitive behavioral therapy is another useful tool. This type of psychotherapy can help one challenge and change the way they think about and respond to these experiences.A Word From VerywellWhen reality is different from what your senses experience in real time, it can be incredibly challenging. Hallucinations may be the result of mental or physical conditions, and will often require active treatment. If you experience hallucinations in any form, it’s important to receive an accurate diagnosis from a healthcare provider. This diagnosis can form the basis of the appropriate management methods for the condition.
Hallucinationsoccur when a person experiences seeing, hearing, feeling, smelling, or tasting something that isn’t really there.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies this phenomenon as one of the main symptoms of psychotic disorders.Hallucinations are commonly associated withschizophrenia.Around 60% to 70% of people with this condition experience these, with auditory hallucinations being the most common.
Hallucinations may also occur in conditions such aspost-traumatic stress disorder,personality disorders, or medical illnesses like eye disease andneurodegenerative conditions.This break from reality may result for a number of reasons.
This guide will examine the different causes of hallucinations in people and will cover the types, symptoms, and possible treatment methods for hallucinations.
Types of Hallucinations
A hallucination can involve any of the five senses. That means that perceptions can be felt through the ears, eyes, skin, nose, or tongue.
Auditory Hallucinations
These hallucinations occur when a person perceives sounds that are not actually present. In some studies, auditory hallucinations are observed in between 5% and 28% of the population.
Highly prevalent in schizophrenia, auditory hallucinations are also seen in 20% to 50% of people living with bipolar disorder. By some estimates, 10% of the population with major depression, and 40% managing PTSD also experience auditory perceptual disturbances.
Auditory hallucinations may come in a variety of sounds. But when the non-apparent sounds are comprised of voices, they are referred to as auditory verbal hallucinations.
Around 9% of children experience auditory hallucinations, with numbers that move between 5% and 16% in adolescence.When hallucinations are verbal, the voices may be degrading, commanding, or haunting enough to affect daily functioning.
Visual Hallucinations
People who experience visual hallucinations will often see anon-existent image, believing it to be real. These incidents are more commonly observed in older people.
Visual hallucinations are commonly seen in degenerative diseases of the brain and eye.Patients withParkinson’s diseasemay experience visual hallucinations, depending on how long the condition has lasted. The dopamine medication used to manage the disease also raises hallucination risk.Visual illusions may occur in up to 80% of Parkinson’s patients over the course of their illness.
Dementiasand eye/visual pathway diseases are also linked to visual hallucinations in patients.
Tactile Hallucinations
Tactile hallucinations are also known as haptic hallucinations ortactile phantasmata.When a person goes through this experience, they usually feel touches to or under the skin in the absence of any real stimulation.
Tactile hallucinations can feel like pinpricks, the feeling of liquid or wind on the skin, a hand on the shoulder, etc.
Somatichallucinations are a variation of this condition. Here, sensations are felt inside the body without any corresponding stimuli.
Tactile hallucinations are generally rare in neurological and psychiatric conditions. However, one study found that these types of sensations make up the second-most common type of hallucination in the general population.
Olfactory and Taste Hallucinations
Hallucinations of smell are observed in a significant minor of patients withschizophrenia. Around 4% and 25% of individuals with the disorder experience these illusions.However, limited research exists on this phenomenon.
Olfactory hallucinations have been reported to occur in about 5% of the older population generally associated with an impaired sense of smell.
These hallucinations are otherwise known asphantosmia.They occur where odors are perceived without a source present.
In addition to psychotic illnesses, phantosmia has been reported in the context of epileptic seizures,depression,migraines, and ear, nose, and throat diseases.
The most commonly reported auditory hallucinations are burnt/smoky smells. Patients also report foul, unpleasant, spoiled, or rotten odors.
Phantom smells can reduce the quality of life in patients. This condition has been described asintrusiveand distressing.
Olfactory hallucinations typically occur with taste or gustatory hallucinations. However, it is possible to experience these conditions independently.
What Causes Hallucinations?
Hallucinations are often the result of a psychotic disorder or a related condition. However, the exact mechanism behind these symptoms is less clear. There are a few possible explanations that have been proposed.
Functional magnetic resonance imaging (fMRI) examinations have demonstrated how the spontaneous activation of the auditory network can contribute to hallucinations.
Likewise, a neurocognitive model called the VOICE model has proposed that an unbalancedlimbic systemmismatched against a hypoactive prefrontal inhibitory system is at play.
The limbic system is a part of the brain responsible for processing emotions, memory, fear, pleasure, hunger, etc. When this system becomes hyperactive, and the brain’s prefrontal region which is involved in cognitive control is unable to properly modulate this, hallucinations may occur.
There are different mechanisms intended to explain visual hallucinations in eye and brain conditions:
While tactile hallucinations can present as part of psychiatric illness, neurodegenerative diseases (such as Parkinson’s), illicit drug use, and medication may also cause hallucinations that feel like insects crawling on the skin, and other tactile sensations.
Olfactory and Taste (Gustatory) Hallucinations
Phantom smells may result from trauma or nasal conditions like sinusitis.Certain degenerative neurological conditions such as Parkinson’s disease and Alzheimer’s have links to olfactory hallucinations.
Viral infections can also cause damage to the olfactory receptor neurons (ORNs). The direct mechanism behind this remains unclear.
When experiencing phantom tastes—trauma, or infections of the upper respiratory tract may be responsible.Likewise, toxic substances and medicines can play a role in taste hallucinations.
Treatment of Hallucinations
Hallucinations may be managed using different approaches. There are treatments to manage hallucinations and their impact.
Medication
Medication is the main approach to treat hallucinations in psychotic and other illnesses.Antipsychoticscontrol many symptoms of psychosis such asanxiety,agitation,delusions, and hallucinations.
It’s important to note, however, that 25% to 30% of auditory hallucinations may offer resistance toantipsychotics.
Transcranial Magnetic Stimulation (TMS)
RepetitiveTMSis a relatively new treatment option, and there is some data that it might be helpful in the management of hallucinations.
Psychoeducation
Education on the nature of hallucinations and mental illness can help individuals and their loved ones better manage these symptoms.
Psychoeducation also helps people learn about factors that influence the condition and how to better manage it.Psychoeducation is also a useful tool in managing the stigma around this disorder.
Cognitive Behavioral Therapy
For anyone managing hallucinations, cognitive behavioral therapy is another useful tool. This type of psychotherapy can help one challenge and change the way they think about and respond to these experiences.
A Word From Verywell
When reality is different from what your senses experience in real time, it can be incredibly challenging. Hallucinations may be the result of mental or physical conditions, and will often require active treatment. If you experience hallucinations in any form, it’s important to receive an accurate diagnosis from a healthcare provider. This diagnosis can form the basis of the appropriate management methods for the condition.
9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Waters F, Fernyhough C.Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes.Schizophr Bull. 2017;43(1):32-43. doi:10.1093/schbul/sbw132Boksa P.On the neurobiology of hallucinations.J Psychiatry Neurosci. 2009;34(4):260-262.Thakur T, Gupta V.Auditory Hallucinations.[Updated 2022 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.O’Brien J, Taylor J, Ballard C et al.Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management.Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(5):512-519. doi:10.1136/jnnp-2019-322702Lim A, Blom JD.Tactile and Somatic Hallucinations in a Muslim Population of Psychotic Patients.Front Psychiatry. 2021;12:728397. Published 2021 Oct 29. doi:10.3389/fpsyt.2021.728397Arguedas D, Langdon R, Stevenson R.Neuropsychological characteristics associated with olfactory hallucinations in schizophrenia.J Int Neuropsychol Soc. 2012;18(5):799-808. doi:10.1017/S1355617712000471Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ.Phantom Smells: Prevalence and Correlates in a Population-Based Sample of Older Adults.Chem Senses. 2017;42(4):309-318. doi:10.1093/chemse/bjx006Chaudhury S.Hallucinations: Clinical aspects and management.Ind Psychiatry J. 2010;19(1):5-12. doi:10.4103/0972-6748.77625Hummel T, Landis BN, Hüttenbrink KB.Smell and taste disorders.GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04. doi:10.3205/cto000077
9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Waters F, Fernyhough C.Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes.Schizophr Bull. 2017;43(1):32-43. doi:10.1093/schbul/sbw132Boksa P.On the neurobiology of hallucinations.J Psychiatry Neurosci. 2009;34(4):260-262.Thakur T, Gupta V.Auditory Hallucinations.[Updated 2022 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.O’Brien J, Taylor J, Ballard C et al.Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management.Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(5):512-519. doi:10.1136/jnnp-2019-322702Lim A, Blom JD.Tactile and Somatic Hallucinations in a Muslim Population of Psychotic Patients.Front Psychiatry. 2021;12:728397. Published 2021 Oct 29. doi:10.3389/fpsyt.2021.728397Arguedas D, Langdon R, Stevenson R.Neuropsychological characteristics associated with olfactory hallucinations in schizophrenia.J Int Neuropsychol Soc. 2012;18(5):799-808. doi:10.1017/S1355617712000471Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ.Phantom Smells: Prevalence and Correlates in a Population-Based Sample of Older Adults.Chem Senses. 2017;42(4):309-318. doi:10.1093/chemse/bjx006Chaudhury S.Hallucinations: Clinical aspects and management.Ind Psychiatry J. 2010;19(1):5-12. doi:10.4103/0972-6748.77625Hummel T, Landis BN, Hüttenbrink KB.Smell and taste disorders.GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04. doi:10.3205/cto000077
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Waters F, Fernyhough C.Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes.Schizophr Bull. 2017;43(1):32-43. doi:10.1093/schbul/sbw132Boksa P.On the neurobiology of hallucinations.J Psychiatry Neurosci. 2009;34(4):260-262.Thakur T, Gupta V.Auditory Hallucinations.[Updated 2022 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.O’Brien J, Taylor J, Ballard C et al.Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management.Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(5):512-519. doi:10.1136/jnnp-2019-322702Lim A, Blom JD.Tactile and Somatic Hallucinations in a Muslim Population of Psychotic Patients.Front Psychiatry. 2021;12:728397. Published 2021 Oct 29. doi:10.3389/fpsyt.2021.728397Arguedas D, Langdon R, Stevenson R.Neuropsychological characteristics associated with olfactory hallucinations in schizophrenia.J Int Neuropsychol Soc. 2012;18(5):799-808. doi:10.1017/S1355617712000471Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ.Phantom Smells: Prevalence and Correlates in a Population-Based Sample of Older Adults.Chem Senses. 2017;42(4):309-318. doi:10.1093/chemse/bjx006Chaudhury S.Hallucinations: Clinical aspects and management.Ind Psychiatry J. 2010;19(1):5-12. doi:10.4103/0972-6748.77625Hummel T, Landis BN, Hüttenbrink KB.Smell and taste disorders.GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04. doi:10.3205/cto000077
Waters F, Fernyhough C.Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes.Schizophr Bull. 2017;43(1):32-43. doi:10.1093/schbul/sbw132
Boksa P.On the neurobiology of hallucinations.J Psychiatry Neurosci. 2009;34(4):260-262.
Thakur T, Gupta V.Auditory Hallucinations.[Updated 2022 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.
O’Brien J, Taylor J, Ballard C et al.Visual hallucinations in neurological and ophthalmological disease: pathophysiology and management.Journal of Neurology, Neurosurgery & Psychiatry. 2020;91(5):512-519. doi:10.1136/jnnp-2019-322702
Lim A, Blom JD.Tactile and Somatic Hallucinations in a Muslim Population of Psychotic Patients.Front Psychiatry. 2021;12:728397. Published 2021 Oct 29. doi:10.3389/fpsyt.2021.728397
Arguedas D, Langdon R, Stevenson R.Neuropsychological characteristics associated with olfactory hallucinations in schizophrenia.J Int Neuropsychol Soc. 2012;18(5):799-808. doi:10.1017/S1355617712000471
Sjölund S, Larsson M, Olofsson JK, Seubert J, Laukka EJ.Phantom Smells: Prevalence and Correlates in a Population-Based Sample of Older Adults.Chem Senses. 2017;42(4):309-318. doi:10.1093/chemse/bjx006
Chaudhury S.Hallucinations: Clinical aspects and management.Ind Psychiatry J. 2010;19(1):5-12. doi:10.4103/0972-6748.77625
Hummel T, Landis BN, Hüttenbrink KB.Smell and taste disorders.GMS Curr Top Otorhinolaryngol Head Neck Surg. 2011;10:Doc04. doi:10.3205/cto000077
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