Hallucinations

1) What it is

Hallucinations are when someone sees, hears, smells, tastes, or feels something that isn’t there. They can occur in mental health and physical health conditions and are not always a sign of severe illness — but they should always be assessed.

NHS explains hallucinations are one of the main symptoms of psychosis.

Hallucinations can include:

• hearing voices (most common in mental health settings)
• seeing figures or shadows
• tactile hallucinations (feeling touched or crawling sensations)
• smelling things that are not there

2) What it feels like (real-life examples)

• “I hear someone calling my name.”
• “I hear voices commenting on me.”
• “I see shadows in my peripheral vision.”
• “It feels real and I can’t ignore it.”
• “It scares me and I don’t know what’s happening.”

People may feel frightened, unsafe, confused, ashamed, hyper-alert, or exhausted.

3) Common signs & symptoms

• hearing voices, whispers, or commands
• seeing people or shapes others don’t
• paranoia and fear linked to experiences
• poor sleep and heightened stress
• difficulty concentrating
• withdrawing from others

Hallucinations may occur alongside delusions, confused thinking, and disorganised speech.

4) What causes it / risk factors

• psychosis (including schizophrenia)
• severe depression or bipolar disorder (sometimes)
• trauma or PTSD
• sleep deprivation
• substances or withdrawal
• grief (brief hallucinations can occur)
• neurological or medical causes

Risk increases with stress, drugs/alcohol, trauma triggers, and lack of sleep.

5) Triggers

• sleep deprivation
• stress and overwhelm
• substance use
• isolation
• panic or high anxiety
• overstimulation
• conflict or feeling unsafe

6) What helps right now

• reduce stimulation (quiet, low light)
• grounding to the present
• calm reassurance
• don’t aggressively fight the experience
• seek urgent assessment if new, escalating, or commanding harm

7) Longer-term strategies

• protect sleep
• reduce substances
• track triggers
• build safe routines and support
• therapy for trauma/anxiety
• relapse prevention plan

8) Treatment options

Treatment may include antipsychotic medication, CBT, early intervention services, and community mental health support.

9) Medication overview

Medication can reduce voice intensity, paranoia, and distress. Clinician-guided.

10) Daily life tips

• reduce stress during flare-ups
• tell trusted people what helps
• avoid arguing about “reality”
• keep routines stable

11) When to seek urgent help

• new or sudden hallucinations
• voices commanding harm
• severe fear or distress
• risk to self or others
• severe insomnia

12) Trusted help & resources

• NHS: Psychosis overview
• Rethink Mental Illness
• Samaritans: 116 123
• Shout: text SHOUT to 85258

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