Symptoms | Hallucinations

Symptoms

The symptoms of hallucinations depend on the type of false sensation. Depending on which sensory perception is deceived or clouded, the patient may experience completely different experiences. As a rule, one only speaks of hallucinations when the patient actually believes that everything he or she perceives is reality.

If the affected person recognizes the hallucination, this is called a pseudo-hallucination. Below are examples of different types of hallucinations. Acoustic hallucinations (hearing): The patient hears sounds, melodies or voices that do not exist.

The form in which the voices communicate with the patient may vary.A dialogue between the voices and the patient is possible, an accompanying or commenting voice and a commanding form. With the latter, the patient often feels compelled to give in to the “will” of the voices. Optical hallucinations (seeing): The patient sees phenomena (e.g. light phenomena, which can, however, also occur with eye diseases), things (living beings, objects) or scenes that do not really exist.

Olfactory/gustatory hallucinations (smell/taste): The patient smells or tastes something that he/she cannot actually perceive. For example, a severely depressed patient may perceive a foul odor coming from himself. Tactile hallucinations (feeling): The patient has false sensations on the skin, in the form of tingling, pricking, pressure or caressing.

A special form of this is the so-called dermatozoan delusion (literally “skin-animal delusion”), in which the patient thinks bugs or worms live and move under his skin. Body hallucinations: The patient has a complex sensation that affects his entire body. For example, he feels weightless or moved, hollowed out inside or filled with stones, inflamed, dried out or rotten.

Corresponding hallucinations rarely occur and give an indication of a complex psychiatric clinical picture. Hallucinations that occur in the transition from sleep to awakening or when waking up are called hypnopompe hallucinations and are associated with disorders such as narcolepsy, sleep apnea, migraine and anxiety disorders. It is the widespread phenomenon of experienced sleep paralysis.

The patient is awake, but has no control over his body. At the appropriate time, the body is still subject to the inhibition of REM or dream sleep. The benefit of this inhibition of arbitrary movement is that actions and movements experienced in dreams are not really carried out.

Normally, sleep paralysis ends when the patient wakes up. If there is a delay, the affected person is in an intermediate state between sleep and wakefulness. During this period hallucinations can occur.

Optical hallucinations in particular are called “nightmares that come true” by those affected. Often the hallucinations are fearful and put the affected person in a terrible situation, as he/she feels helplessly exposed due to the paralytic state. It does not necessarily have to come to an optical misperception – all other senses or a combination of several may be affected.

Schizophrenia is a group of psychiatric diseases that are similar in their symptoms and often represent a severe impairment for the patient. Schizophrenic patients have numerous deficits in the areas of thinking, will, perception, emotionality, drive and psychomotor performance (psychomotorics = relationship between mental health and movement). Hallucinations are an important symptom of a schizophrenic disorder and most often manifest themselves as acoustic misperceptions.

The hearing of voices plays the most important role and can be perceived in different forms. The voices talk to the patient (dialogically), accompany his actions in a commentary manner or command the patient what he should do (imperatively). In many cases, the acoustic hallucinations are associated with delusional experiences.

For example, the patient thinks that the television or radio program is related to him or her and perceives acoustic hallucinations in the form of altered texts directed at him or her. Such a disorder is called pranoidal hallucinatory schizophrenia. Another form of hallucination that can occur frequently in connection with schizophrenia is hallucination of the body.

The patient feels electrified, irradiated or otherwise influenced or directed from the outside. After an operation under general anesthesia, a so-called postoperative cognitive deficit can occur. Old and very sick people are particularly affected.

Inflammation levels probably play a role, causing reactions in the brain and impairing its function. If the patient is already cognitively (thinking) impaired before the operation, for example because he or she suffers from dementia, the probability of a postoperative cognitive deficit is increased. After awakening from anesthesia, patients suffer from impaired thinking and states of confusion.

These can range from short-term disorientation to thinking disorders lasting for days or weeks.Hyperactive delirium is particularly dangerous in contrast to the classic delirium, in which the patients are heavily dazed and inactive. The affected persons are completely disoriented but very active, develop delusions and can also have hallucinations. In the context of this postoperative confusion, they often harm themselves by moving too much, removing catheters or accesses and having an aggressive mood.

When sleeping, the body and mind of every person recovers. Without enough sleep, one feels exhausted, cannot concentrate and stands beside oneself. However, extreme sleep deprivation can also lead to hallucinations.

If the brain cannot rest, various substances produced by the body accumulate. These usually cause you to become tired and fall asleep. If you resist the urge to sleep, the substances continue to accumulate in the brain without being broken down during the restful sleep phase.

Above a certain amount, these substances can cause hallucinations without the presence of psychiatric illness or drug use. The hallucinations can be many and varied, but are mainly concentrated on acoustic and visual misperceptions. If the sleep deprivation lasts too long, it can lead to serious consequential damage. For example, an epileptic seizure can be provoked, brain haemorrhages or a stroke can occur. From a medical point of view, a prolonged lack of sleep is therefore to be advised against.