Hallucinations and delusions are among the most common symptoms of schizophrenia. Both are considered positive symptoms, meaning they are not seen in healthy people.

Hallucinations


Hallucinations are defined as experiences and sensations that are not comprehensible to others. To the person experiencing them, however, they may seem real, urgent, and vivid. Roughly 70% of people with schizophrenia will experience hallucinations.

Auditory hallucinations are most commonly experienced by people with schizophrenia and may include hearing voices—sometimes multiple voices — or other sounds like whispering or murmuring. Voices may seem angry or urgent and often make demands on the hallucinating person.

Visual hallucinations involve seeing objects, people, lights, or patterns that are not actually present. Visualizing dead loved ones, friends or other people they knew can be particularly distressing. Perception may be altered as well resulting in difficulty judging distance

Olfactory hallucinations involve the sense of smell or taste, both good or bad, that are not actually present. This can be particularly dangerous if a person believes he is being poisoned and refrains from eating.

Tactile hallucinations are feelings of movement or sensation on your body that are not actually present such as hands on your body or insects crawling around or inside you.

Hallucinations don’t necessarily indicate schizophrenia. People with mood disorders, schizoaffective disorders, and other physical and mental health conditions may also hallucinate. Hallucination may also occur when under the influence of drugs or alcohol.

Delusions


Delusions are defined as beliefs that conflict with reality. Delusions are one of the most common symptoms of schizophrenia. These beliefs might include:

Persecutory delusions:  When a person believes a person, group, or organization is mistreating or harming them despite contradictory evidence.

Erotomanic delusions: When a person believes another is in love with them, despite no evidence. This other person is often a celebrity or person in power.

Somatic delusions: When a person believes they have an illness or their body is affected by a strange condition, despite contradictory evidence. 

Grandiose delusions: When a person believes they have superior abilities or qualities (i.e. talent, fame, wealth) despite no evidence.

Sometimes a person will experience a recurring theme in their delusions over a period, which makes them seem more convincing to the individual experiencing them. Hallucinations are sometimes categorized as secondary delusions if they involve having a false belief in the voice they are hearing or other sensation they are experiencing.

How to Help a Loved One


Try to stay calm and avoid feeling overwhelmed, confused, or fearful of someone experiencing hallucinations or delusions. A tranquil disposition can help the individual connect to reality. Here are some additional tips:

Encourage openness

Hallucinations and delusions often come from a place of shame and fear so having a productive conversation can be challenging. Try gently explaining that you cannot see or hear what they are experiencing and need help understanding it.

Be patient

Try to be sympathetic. Hallucinating is a very consuming experience. Speak slowly and clearly and frequently use the person’s name. Managing your own anxiety will encourage the hallucinating person to be more responsive.

Reinforce reality

Don’t argue with the hallucinations or deluded observations. It isn’t useful to challenge the person who is struggling. Instead, focus on reality and work to stay engaged with that content.

Ask for help

If you feel ill-equipped to help someone experiencing psychosis, get help. Find out if there is a trusted friend, family member, or community resource you can reach out to. Never make threats and let them know it’s okay if they’d rather contact that person themselves first.

Hallucination and delusion can be scary to witness but the good news is that medication, therapy, psychoeducation, and family support can make a difference. The symptoms may never disappear completely, but people plagued by these problems can learn to manage them. If you know someone with schizophrenia, seek out more education and training to help your loved one cope and even thrive with schizophrenia.

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Last Updated: Nov 28, 2017