Hallucinations and sensory illusions are perceptual disorders. An affected person feels or sees impressions in the process, although no real triggers can be found for this. The contents of hallucinations and their manifestations vary – therapies usually treat the causative factors.
What are hallucinations?
Hallucinations or sensory illusions are classified in medicine as part of the group of perceptual disorders. Hallucinations can also be referred to as delusions. Among other things, things are perceived that are not objectively real. There are different forms of sensory illusions. For example, a distinction is made between acoustic hallucinations (e.g., hearing voices), optical hallucinations (a perception of images), gustatory hallucinations (sensory illusions involving taste), or tactile hallucinations (touch or tactile hallucinations, among others). In medicine and psychology hallucinations are further considered under aspects such as their clarity (i.e. the clarity or distinctness in which sensory illusions appear to a person affected) or their intensity. Also, the fact whether an affected person knows that the contents of his hallucinations do not correspond to reality plays a role.
Causes
Hallucinations can be caused by various factors. Here, depending on the form of the sensory illusions, the possible causes differ. Auditory hallucinations can be triggered by psychiatric disorders such as schizophrenia or even various forms of depression. Optical hallucinations can also be caused by psychiatric diseases; for example, optical hallucinations are observed in delirium as a result of alcohol dependence. Likewise, optical hallucinations can also be caused by organic diseases or the use of mind-expanding drugs (such as cocaine) or medication. Smell and taste hallucinations can be triggered, among other things, by tumorous changes in the brain or by an impending epileptic seizure – as well as by various psychiatric syndromes.
Symptoms, complaints, and signs
The difficult thing about hallucinations is that the sufferer perceives them to be real. He or she cannot tell the difference between the sensory illusion and what is really there. These sensory illusions can be auditory, visual, or olfactory in nature and can cause discomfort in the area in question. An initial symptom of hallucinations is that the person affected suddenly perceives things in familiar places that have never been there before. This is especially common in the visual field. For example, one sees colored areas on the wall, perceives the colors of the traffic lights changed or similar. Strongly pronounced hallucinations can cause the experience of entire situations. In the case of auditory hallucinations, the affected person usually hears voices, even if he is alone. These are clearly talking about him or giving advice. Hearing music is also typical. In olfactory hallucinations, the sufferer smells or tastes certain non-existent substances. Here it is particularly difficult to distinguish between delusion and reality. There are also sensory illusions that relate to the perception of one’s own body. Here, for example, affected persons feel how a certain organ moves or grows. Also, the feeling may arise that a body part is not part of the body, in which case this is perceived as disturbing or painful.
Diagnosis and progression
A diagnosis of hallucinations is usually based on the narratives of affected individuals. Based on the patient’s descriptions, it is possible for the diagnostician (a medical doctor, psychiatrist, or psychologist) to determine various characteristics of sensory hallucinations present. For questioning a patient, the diagnostician usually has various questionnaires at his disposal, which can help to perform a detailed assessment of existing hallucinations. The course of hallucinations depends, among other things, on the causes underlying the sensory illusions. If these are causes that can be treated or cured, there is usually also a favorable prognosis for combating the associated hallucinations.
Complications
With hallucinations, it is not possible to universally predict the symptoms or complications. In most cases, these always depend on what the hallucinations are about or what drug caused them. In most cases, the hallucinations disappear again after a certain period of time, so that the complaints do not last permanently. It is not uncommon for patients to lose consciousness and faint. In the process, injuries can occur in the event of a fall. Furthermore, those affected are usually no longer able to assess their thoughts and actions correctly, so that there is an increased risk of accidents. Coordination and cognitive abilities are also extremely limited by the hallucinations. The affected person may also experience delirium and develop severe psychological symptoms or depression. Furthermore, the hallucinations may cause sweating or panic attacks. There is no direct treatment for the hallucinations. However, the affected person must abstain from the respective substances that are responsible for the hallucinations. Withdrawal may be necessary if the patient is addicted to drugs. In many cases, psychological treatment of the patient is also necessary.
When should one go to the doctor?
Whether a doctor should be consulted for hallucinations usually depends very much on the cause of the hallucinations. Should the affected person have taken alcohol or other drugs, hallucinations represent a common symptom that does not need to be treated. The symptoms will disappear on their own within a short time. However, if the hallucinations last longer, a doctor should be consulted. If the symptoms are caused by medication, a doctor should also be consulted. The patient should not stop or change medications without first consulting a physician. However, if the hallucinations occur without taking medication or using drugs, a medical doctor must be consulted, as this is usually a mental disorder that must be treated in any case. First and foremost, a general practitioner can be consulted, who can usually refer the affected person to a psychologist or psychiatrist. In the case of drug addiction, withdrawal can also be carried out to combat the hallucinations.
Treatment and therapy
Effective therapy for hallucinations usually starts by addressing the causes that condition present sensory delusions. For example, if hallucinations are based on organic diseases or dysfunctions, early treatment of these disorders can lead to a positive impact on associated sensory delusions. If hallucinations are due to certain medications, one therapeutic step may be to identify the corresponding drug(s) and arrange for a change in medication. Often, however, various possible triggers of sensory hallucinations cannot be immediately and clearly defined; thus, it may be useful to combine different therapeutic approaches to develop an individually effective therapy:
For example, in the presence of psychiatric causes for hallucinations, medicinal and psychotherapeutic therapy steps can be combined. The same applies to organically caused sensory illusions. Within the framework of psychotherapy, a person affected can, among other things, learn to cope better with existing hallucinations. In this way, the suffering pressure associated with sensory illusions for the individual can be reduced.
Outlook and prognosis
Because hallucinations are not a disease in their own right, there is no basic prognosis for these complaints. The occurrence of hallucinations is determined by the underlying disease present and therefore must be assessed on an individual basis. If the underlying disease can be cured, there is also a reduction of the sensory delusions. A complete cure is therefore possible in some patients. In the case of a temporary acute condition initiated by drugs or alcohol, the patient normally experiences a spontaneous cure. Perceptual illusions gradually recede as the toxins are broken down and removed from the organism. In most cases, they disappear completely within a few hours or a few days.If a mental illness is present, sensory illusions may occur throughout the patient’s life. For example, they are part of the patient’s clinical picture in schizophrenia or other personality disorders. Often these disorders are not curable. By administering medication, the occurrence of hallucinations is largely mitigated or temporarily deactivated. However, as soon as the patient stops taking the medication, hallucinations recur. In some cases, patients lack insight into their illness. They therefore do not undergo therapy and accordingly do not seek treatment. These people usually do not suffer from any serious illnesses and ultimately experience hallucinations throughout their lives.
Prevention
Prevention of the development of hallucinations can also consist primarily of having psychiatric or organic problems treated at an early stage. If these possible causes of sensory delusions are controlled by specific treatments, the risk of developing hallucinations decreases. Furthermore, responsible use of medications and intoxicants can prevent various forms of hallucinations and sensory delusions.
Follow-up
In the case of hallucinations, the options or measures of aftercare usually depend very much on the cause and on the severity of these symptoms. Therefore, no general prediction can be made about the possibilities of aftercare. First and foremost, the condition must be properly treated by a physician so that the symptoms can be alleviated. If the hallucinations occur as a result of taking certain medications or drugs, these must be discontinued. In this case, regular examinations should always be carried out by a doctor in order to carry out withdrawal properly. In the case of other psychological upsets or depression, treatment by a professional psychologist is usually necessary. However, discussions with relatives or friends are also very useful and also helpful and can alleviate the discomfort of hallucinations. First and foremost, the trigger or underlying condition for the hallucinations must be identified and treated in order to permanently treat these delusions. In severe cases, the sufferer will require treatment in a closed hospital. The relatives should make the patient aware of the symptoms of the hallucinations and persuade him to seek treatment. Not infrequently, contact with other sufferers is also very helpful.
What you can do yourself
Hallucinations belong to the mental illnesses in which the affected person no longer has any influence. This leads to the fact that there are no possibilities of self-help for the ill person in everyday life. He himself is not aware that he is subject to a sensory illusion, so that it is impossible for him to react to it. Even with an existing diagnosis and information of the disease, he himself has no possibility to act. Therefore, in these cases, it is rather the relatives or persons from the close social environment of the affected person who are called upon. They are recommended to inform themselves comprehensively about the disease in order to avoid misunderstandings. They can learn more about their own options for providing help and can find out how to protect themselves or set themselves apart. Often, they need to be educated about which behavioral patterns of the ill person must be seen as part of the illness. This helps to be able to react appropriately to difficult situations. In many cases, the close relatives themselves should accept psychological help in order to be able to process the events well. In the case of hallucinations, the sufferers are often seen as a danger to themselves and others. Therefore, the options for medical care should be explored in order to make the best decisions for everyone involved.