People with hallucinations experience appearances and illusions. They see or hear things that are not really there. What types of hallucinations are and how they are treated.
What are hallucinations?
Hallucinations are hallucinations that make people believe things are unreal. The brain lets the hallucinating person experience scenes with characters that do not exist in reality. He feels transported to places and situations that have no relation to the present. The senses perceive something, although the external stimulus is missing. The person concerned considers the sensory impressions to be extremely realistic and is firmly convinced that what they see or hear actually exists.
Hallucinations are differentiated from illusions in which a person perceives a real role model "wrongly" or reinterprets the content. A typical illusion is, for example, when a person sees a tree trunk as a dangerous, gigantic figure at night and develops fear of it. By contrast, people with hallucinations would see a tree trunk that is not there at all. Doctors also differentiate between real hallucinations and pseudo-hallucinations, in which the patient is aware of the deception.
At a glance:
What types of hallucinations are there?
Hallucinations can affect any sense of the body. However, the most common hallucinations are visual, acoustic, and tactile – that is, vision, hearing, and touch.
optical (visual) hallucinations (Facial hallucinations): seeing non-existent images, patterns, films, flickering scotoma (out of focus, followed by increasingly clear zigzag lines); Visions
acoustic hallucinations: Akoasmas (hearing sounds or noise), phonemes (hearing voices, sounds, words, sentences, indistinct whispers), music
tactile hallucinations: Perception of touch; Heat / cold hallucinations; Perception of vermin crawling on the skin (dermatozoal delusion)
Olfactory hallucinations: Perception of non-existent odors, which usually have an unpleasant character (e.g. disgusting, stinking smell such as putrefaction, putrefaction)
Taste hallucinations: mostly unpleasant kind, for example bitter, salty, putrid
Hallucinations of the sense of balance: For example, those affected have the sensation of flying, falling, swaying, floating or being lifted
Causes of hallucinations
How hallucinations develop in detail is not known. One explanatory model assumes that in some cases an impaired sense, such as the sense of sight or hearing, leads to the hallucinations. In the case of hearing impairment or visual impairment, the brain releases the hearing or visual impressions stored in the memory.
Another explanation is that regions in the brain that are linked to the memory of the respective sense (e.g. visual memory, acoustic memory) are excessively activated and release their contents.
The following causes, among others, are possible in hallucinations:
Schizophrenia and other psychoses: in the most common form of schizophrenia, paranoid schizophrenia, acoustic as well as optical hallucinations are typical; Those affected hear voices talking about him, entering into dialogue with him or giving him orders.
high fever
more extreme lack of sleep, great exhaustion
more extreme Dehydration, Dehydration
longer Irritation deprivation and social isolation
delirium from alcohol (alcoholism)
hallucinogenic drugs, such as LSD, cocaine, mescaline or cannabinoids
migraine with aura: optical illusions, for example flashes of light that announce the migraine attack
Illnesses and injuries of the brain: Examples are epilepsy (seizures), Brain tumors, stroke, dementia, Encephalitis, traumatic brain dream
Drugs for Parkinson's disease: Up to a third of all treated people with Parkinson's disease suffer from hallucinations, mostly visual hallucinations.
Hearing loss: Induction of acoustic hallucinations
Eye diseases, for example, damage to the optic nerve or retinal detachment
Charles Bonnet Syndrome: Induction of visual hallucinations in old age in the visually impaired; the cause is unclear.
peduncular hallucinations: The suppression of dream activity in the waking state is disturbed.
postoperative delirium: Especially in older people, a continuity syndrome can occur after an operation with general anesthesia. This is a brief state of confusion that is associated with disorientation, hallucinations and fear.
Lewy body dementia: Similar to Alzheimer's disease and associated with optical hallucinations. Hallucinations can also occur with other types of dementia in old age.
In the case of hallucinations of any kind, a doctor should always be consulted to clarify the cause of the hallucinations.
How is the diagnosis made?
In an anamnesis interview, the doctor asks the person concerned or their relatives about the current symptoms and the medical history.
For example, the following questions are important:
- What kind are the sensory impressions? For example visual, acoustic, tactile?
- What is the preferred time of day for hallucinations to occur?
- How often do you experience such illusions? Several times a day, daily, weekly?
- How strong and impressive do you find the hallucinations?
- Are there any situations that encourage or lessen the occurrence of hallucinations?
- How badly do you feel affected by the sensations?
- Are there any other symptoms besides the hallucinations, for example anxiety, sweating?
- Do you currently suffer from a physical (Parkinson's, epilepsy) or mental illness (schizophrenia) or have you previously been diagnosed with one?
- Do you take any medicine? Which?
- Do you consume alcohol regularly and in what amounts?
- Do you use hallucinogenic drugs? Since when, how often and in what quantities?
- Are there any known physical and mental illnesses in your family?
These tests are common for hallucinations
The doctor then does a thorough physical examination, during which, among other things, he tests the function of the various senses. A blood test provides clues as to whether the hallucinations are due to alcohol abuse, drug use, or a metabolic disorder. Depending on the suspected cause, further examinations will follow. These include:
- neurological examination: Test of the condition of the brain and nervous system, examination of reflexes, strength, sensitivity, coordination or flexibility
- Eye exam at the ophthalmologist: for example damage to the optic nerve, retinal detachment
- Ear examination at the ENT doctor: for example, hearing loss, tinnitus
- psychiatric examination: Indications of schizophrenia, depression
- Examination of the brain with imaging procedures, such as computed tomography (CT) or magnetic resonance imaging (MRI, magnetic resonance imaging): indications of tumors, stroke, encephalitis
- Electroencephalography (EEG): Measurement of brain waves
Treatment of hallucinations
Which therapy is used to treat the hallucinations depends on the cause. In the case of Charles Bonnet syndrome, for example, in older, visually impaired people, it is often sufficient to educate the elderly about the harmlessness of the visual hallucinations and to provide them with simple coping strategies. Examples are closing your eyes, approaching the apparition, looking away, or looking back and forth. These tricks soften the hallucinations and take away the fear that they might have gone "crazy".
If there is a physical cause, doctors treat it accordingly. Suitable therapies include:
Hearing loss: Regular wearing of a hearing aid makes the acoustic hallucinations disappear.
Tumors: An operation is recommended here, through which the hallucinations should also subside.
epilepsy: Use of anti-spasmodic drugs called anticonvulsants
mental illness, for example in paranoid schizophrenia or another form of psychosis: antipsychotic drugs (neuroleptics) and, if necessary, psychotherapy
Hallucinations as Side effect of a drug: If possible, switch to an alternative preparation or discontinue the medication
If the hallucinations are due to a significant lack of sleep, dehydration and dehydration as well as alcohol and drug consumption, those affected can take appropriate countermeasures.
Can hallucinations be prevented?
Most types of hallucinations cannot be prevented directly. With schizophrenia, for example, symptoms can only be taken seriously at an early stage. Overall, a healthy lifestyle with sufficient sleep, exercise and mental exertion and without alcohol abuse and drug consumption is recommended. Existing illnesses should be adequately treated and medicated.
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