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Hallucinations are surprisingly common. Many people see, hear, smell, taste, and feel things that aren't objectively there. That does mean something is notably wrong with their brains, but that doesn't mean they are crazy.

Hallucinations take many forms:
  • The zigzag shapes people see just before and during migraine headaches are a hallucination.
  • Fleeting images you see out of the corner of your eye when you are extremely fatigued or upset are a hallucination.
  • The sound of a droning jet engine you continue to hear about a long flight is a hallucination.
  • The boogie man under a child's bed is a hallucination.

No one is committed to a psychiatric ward because he or she sees a kaleidoscopic images during a migraine headache. No one packs up a child for a visit to the child psychiatrist because there is a monster under the bed. No one sees a psychologist because he or she continues to hear airline noises after a flight from New York to Tokyo.

The great psychologist William James considered the images he saw after taking nitrous oxide (laughing gas) to be signs that all consciousness does not have to rational, and "irrational" or mystical consciouness can be explained in many different ways. The late neurologist Oliver Sacks, who wrote an entire book on hallucinations just two years before his death in 2015, himself suffered hallucinations (and migraines). The experience of St. Paul (of the Bible) on the road to Damascus, where he met Jesus in a flashing light, could be explained as a hallucination, although it was not necessarily just a hallucination.

Generally speaking, if you have a hallucination, and you know it's a hallucination, the problem is in a localized area of your brain. 

Maybe you have an extremely active imagination, and your brain is just presenting possibilities to you in a different way. Maybe there is something wrong with the connections in your brain's occipital lobe, so you see things. However, when you have a hallucination and you know you are having it, you don't suffer a more serious psychiatric disturbance called a delusion.

Delusions are beliefs about the world that aren't supported by evidence in the physical world. A hallucination, for example, might be to look into the mirror and see yourself as a zombie. A delusion would be to look into the mirror, see yourself as a zombie, and decide "Brain, me need brain." Hallucinations don't have to be accepted as reality. Delusion occurs when they are.

There are certain recurring themes in hallucinations.

  • Our brains generate hallucinations to fill in the gaps of our experience. If you lose your hearing, you might hallucinate that you are hearing music. If you lose your sight, you might hallucinate bright colors and strange shapes. If you lose a hand or a foot, your brain may continue to tell you that you have feeling in the limb you know longer have. If you feel you are trapped in a personal situation, you might hallucinate an image of Prince Charming come on a white horse to rescue you. If you lose your husband or your wife or your parent or your child, you may hallucinate that they have come to visit you.
  • Hallucinations usually aren't menacing, unless they are part of a more comprehensive psychiatric disturbance, such as schizophrenia or bipolar disorder. Even in these severe psychiatric conditions, however, it can be as the great English physician William Osler suggested, "Ask not which disease the patient has, ask which patient the disease has." Some paranoid schizophrenics, for instance, are happy and well adjusted when they are not presented with life challenges they cannot handle. Some are angry and defensive and even dangerous, even though they have the same disease as someone who appears calm.
Generally speaking, if you have hallucinations, and you know it, you may or may not want treatment. If the hallucination doesn't interfere with your life, you may not want to deal with the side effects of the medications needed to make the hallucination stop. 

It's important to get a medical diagnosis, because hallucinations can be a sign of a brain disease (a tumor, for example, or a stroke) that can be treated. Hallucinations can also be a symptom of:

  • Inappropriate medication.
  • High blood pressure.
  • Parkinson's disease.
  • Lewy body disease.
  • Sepsis.
  • Chronic sleep disturbance.
  • Altitude sickness.
  • Extreme fatigue.
  • Dehydration.
All of these conditions can and should be treated. However, treatment is a matter of discussion between you and your doctor as long as your hallucination has not become a delusion.

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