Bipolar Disorder Symptoms What Are Hallucinations? By Marcia Purse Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. Learn about our editorial process Updated on September 10, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Tim Robberts Collection / Stone / Getty Images Table of Contents View All Table of Contents What Are Hallucinations? Types Symptoms Diagnosis Causes Treatment Coping What Are Hallucinations? Hallucinations are the "perception of a nonexistent object or event" and "sensory experiences that are not caused by stimulation of the relevant sensory organs." The word "hallucination" comes from Latin and means "to wander mentally." In layman's terms, hallucinations involve hearing, seeing, feeling, smelling, or even tasting things that are not real. Auditory hallucinations, which involve hearing voices or other sounds that have no physical source, are the most common type. Hallucinations occur frequently in people with psychiatric conditions, including schizophrenia and bipolar disorder, however, you don’t necessarily need to have a mental illness to experience hallucinations. No matter what is causing hallucinations, they should be taken seriously. Types There are five types of hallucinations, including: Auditory hallucinations: Hearing voices or sounds that no one else can (most common type of hallucination)Visual hallucinations: Seeing people, colors, shapes, or items that aren't real (second most common type of hallucination)Tactile hallucinations: Feeling sensations (like bugs crawling under your skin) or as if you're being touched when you're notOlfactory hallucinations: Smelling something that has no physical source (less common than visual and auditory hallucinations)Gustatory hallucinations: Having a taste in your mouth that has no source (rarest type of hallucination)Presence hallucinations: A sensation that someone is nearby or in the room with you when there isn't anyone thereProprioceptive hallucinations: The feeling that your body is moving or that your limbs are separate from your body, when neither of these things are happening Some people experience hallucinations at night or in the morning. These types of hallucinations include: Hypnopompic: Hallucinations that take place as you're waking up from sleepHypnagogic: Hallucinations that take place as you're falling asleep Hallucinations vs. Delusions A hallucination is when your senses are perceiving something that isn't happening in reality (i.e., you see and hear a person in the room who's not really there). A delusion, on the other hand, is the belief that something is happening, for which there is no evidence (i.e., you believe that the government is controlling you through your TV). Hallucinations Can Affect Any of the Five Senses Symptoms Hallucinations can have a range of symptoms, depending on the type, including: Feeling sensations in the body (such as a crawling feeling on the skin or movement)Hearing sounds (such as music, footsteps, or banging of doors)Hearing voices (can include positive or negative voices, such as a voice commanding you to harm yourself or others)Seeing objects, beings, or patterns or lightsSmelling an odor (can be pleasant or foul and in one or both nostrils)Tasting something (often a metallic taste) Examples of Hallucinations You see someone in your bedroom and you hear them speaking to you (visual and auditory hallucination)You see flashing lights outside of your window, but no one else sees them (visual hallucination) Delusions vs. Hallucinations: What Are the Differences? Diagnosis After asking about your symptoms, medical history, and lifestyle habits, your health provider will likely do a physical exam and order a few tests to try and rule out medical or neurological causes of your hallucinations. Diagnostic tests may include: Blood tests to check for metabolic or toxic causesElectroencephalogram (EEG) to check for abnormal electrical activity in your brain and to check for seizuresMagnetic resonance imaging (MRI) to look for structural brain issues such as a brain tumor or stroke Unfortunately, studies show that people underreport hallucinations. When talking to a doctor, it’s important to be honest about the duration and frequency as well as the specific symptoms associated with your hallucinations. Causes Hallucinations are most often associated with schizophrenia, a mental illness characterized by disordered thoughts and behaviors. However, they are also a possible characteristic of bipolar disorder. With bipolar I disorder, hallucinations are possible both with mania and depression. In bipolar II, hallucinations may occur only during the depressive phase. Bipolar disorder that presents with hallucinations and/or delusions can also lead to a diagnosis of bipolar disorder with psychotic features. Not only do hallucinations occur with mental health conditions like schizophrenia and bipolar disorder, but they can also occur with the following physical and psychological conditions as well: Alcohol or drug use and/or withdrawalAuditory nerve diseaseDissociative identity disorder (DID)EpilepsyGlaucomaHallucinogen useMetabolic conditionsMiddle or inner ear diseasesMigraineNarcolepsyNeurologic disordersOphthalmic diseasesPost-traumatic stress disorder (PTSD)Schizoaffective disorderSleep deprivationStroke Treatment The treatment of hallucinations will depend on the type of hallucination, the underlying cause, and your overall health. In general, however, your doctor will likely recommend a multidisciplinary approach that includes medication, therapy, and social support. Psychotherapy Psychotherapy for hallucinations involves engaging the patient to be curious around the details of the symptoms, providing psycho-education, exploring "plausible reasons" for the hallucinations and normalizing the experience. Self-Help The following self-help strategies can help patients cope with auditory hallucinations: ExerciseHumming or singing a song several times (like "Happy Birthday")Ignoring the voicesListening to musicReading (forward and backward)Talking with others Medication Antipsychotic medications often are effective for treating hallucinations, either by eliminating or reducing the frequency with which they occur or by having a calming effect that makes them less distressing. Nuplazid (pimavanserin) is the first drug approved to treat hallucinations associated with psychosis experienced with Parkinson’s disease. Other Treatments Repetitive transcranial magnetic stimulation (rTMS), a relatively non-invasive procedure that involves placing a small magnetic device directly on the skull, has some preliminary evidence that it may be able to reduce the frequency and severity of auditory hallucinations in some people with schizophrenia. Coping An important aspect of helping a loved one who is experiencing hallucinations is reassuring them that treatment is available. Here are a few more practical steps for helping your loved one cope with hallucinations. Pay Attention the Environment The environment can play an important role in misperceptions and worsening of hallucinations; for example, a poorly lit room and loud, chaotic setting may increase the likelihood of a hallucination. Stay Calm Although it can be frightening and uncomfortable when a loved one experiences a hallucination, it’s important to do your best to respond in a calm, supportive manner. For example, you might say “I know this is scary for you” or “Don’t worry; I’m here.” Use Distraction Depending on the severity of the hallucination, gently touching or patting your loved one may help serve as a distraction and reduce the hallucination. Other possible distractions include conversation, music, or a move to another room. Be Honest While you don’t want to upset your loved one or engage in an argument, you do want to be honest and assure them that you're not dismissing their concerns. If they ask: "Did you hear that?" Consider saying: "I know you heard something, but I didn’t hear it." Maintain Routines Keeping normal and reliable day-to-day routines can make it less likely that your loved one will stray from reality and experience hallucinations. Consider keeping a record of when hallucinations occur and under what circumstances. If you or a loved one are struggling with hallucinations, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Chaudhury S. Hallucinations: Clinical aspects and management. Ind Psychiatry J. 2010;19(1):5-12. doi:10.4103/0972-6748.77625 Cleveland Clinic. Hallucinations. Rodríguez-Testal JF, Senín-Calderón C, Moreno R. Hallucinations and delusions as low-quality attributions: Influencing factors and proposal for their analysis. Front Psychol. 2021;12:533795. doi:10.3389/fpsyg.2021.533795 National Institutes of Health. Hallucinations. Badcock JC, Dehon H, Larøi F. Hallucinations in healthy older adults: An overview of the literature and perspectives for future research. Front Psychol. 2017;8:1134. doi:10.3389/fpsyg.2017.01134 National Institute of Mental Health (NIMH). Bipolar Disorder. U.S. Department of Health and Human Services. National Institutes of Health. Ali S. Hallucinations: Common features and causes. Current Psychiatry. November 2011;10(11):22-29. Sosland M, Pinninti N. 5 ways to quiet auditory hallucinations. Current Psychiatry. 2005; 4(4):110-110. U.S. Food & Drug Administration. FDA approves first drug to treat hallucinations and delusions associated with Parkinson’s disease. Cole JC, Green Bernacki C, Helmer A, Pinninti N, O'reardon JP. Efficacy of transcranial magnetic stimulation (TMS) in the treatment of schizophrenia: A review of the literature to date. Innov Clin Neurosci. 2015;12(7-8):12-9. PMID:26351619 By Marcia Purse Marcia Purse is a mental health writer and bipolar disorder advocate who brings strong research skills and personal experiences to her writing. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist Online Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.