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Try one of these related symptoms.
Hallucinations
Tactile hallucination
Hearing sounds that aren’t real
Seeing things and feeling restless after cutting down on alcohol less than 2 days ago
See things don't exist
Visual hallucinations from alcohol withdrawal less than 2 days ago
Imaginary insects
Daydreaming
Delirium
Hallucinating
Most commonly, a hallucination can be seeing or hearing something that does not exist, but it could also include one of the other senses such as smell or touch. It can be caused by many different physical or psychiatric conditions.
Seek professional care if you experience any of the following symptoms
Generally, Hallucinating can be related to:
A psychotic disorder characterized by disturbances in thinking (cognition), emotional responsiveness, and behavior, with an age of onset typically between the late teens and mid-30s. Hearing voices and/or believing things that aren't consistent with reality are common symptoms. The exact cause is unknown, but a mix of genetic, psychological, and environmental factors are likely responsible.
Dissociative disorder is a mental disorder that involves experiencing a disconnection and lack of continuity between thoughts, memories, surroundings, actions, and identity. People with dissociative disorder escape reality in ways that are involuntary and unhealthy, causing problems with functioning in everyday life.
Herpes Simplex Encephalitis (HSE)
Herpes encephalitis is inflammation of the brain caused by the herpes simplex virus, resulting in neurological symptoms.
Sometimes, Hallucinating may be related to these serious diseases:
Posterior Reversible Encephalopathy Syndrome (PRES)
Posterior reversible encephalopathy syndrome (PRES) is a brain dysfunction characterized by reversible changes in white matter, often associated with hypertension.
Your doctor may ask these questions to check for this symptom:
Reviewed By:
Charles Carlson, DO, MS (Psychiatry)
Dr. Carlson graduated from Touro University in Nevada with a degree in osteopathic medicine. He then trained as a resident in Psychiatry at Case Western Reserve University/University Hospitals where he was also a chief resident and completed a fellowship in Public and Community Psychiatry. After training, he started practicing in | Addiction Psychiatry at the U.S. Department of Veterans Affairs where he also teaches Psychiatry residents.
Yu Shirai, MD (Psychiatry)
Dr. Shirai works at the Yotsuya Yui Clinic for mental health treatment for English and Portuguese-speaking patients. He treats a wide range of patients from neurodevelopmental disorders to dementia in children and participates in knowledge sharing through the Diversity Clinic.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 6, 2025
Following the Medical Content Editorial Policy
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Q.
Seeing Things? Why Your Brain Hallucinates & Medical Next Steps
A.
Hallucinations are a symptom that can arise from many causes, including sleep loss, fever, medications, substances, psychiatric conditions, neurological disease, and delirium; some situations are emergencies, especially with sudden confusion, fever with stiff neck, severe headache, seizure, chest pain, trouble breathing, one-sided weakness, suicidal thoughts, or alcohol withdrawal. For nonurgent cases, see a doctor if symptoms are new, worsening, or affect daily life; expect a review of sleep, substances, and medications, possible labs and brain imaging, and treatment that targets the cause, while you prioritize sleep, hydration, avoiding alcohol or drugs, reviewing meds, and tracking episodes. There are several factors to consider. See the complete guidance below for important details that can shape your next steps.
References:
* de Lavalle V, et al. From Perception to Hallucination: Insights into the Neurobiology of Perceptual Errors. Neurosci Biobehav Rev. 2023 Feb;145:105021. doi: 10.1016/j.neubiorev.2022.105021. Epub 2022 Dec 31. PMID: 36608935.
* Modarres T, et al. Hallucinations: A Review of Pathophysiology and Treatment. Curr Treat Options Neurol. 2021 Jan;23(1):1-16. doi: 10.1007/s11940-020-00657-4. Epub 2021 Jan 9. PMID: 33420542.
* Benjamins L, et al. Visual hallucinations: A clinical review. J Neuroophthalmol. 2022 Mar 1;42(1):e1-e12. doi: 10.1097/WNO.0000000000001449. Epub 2021 Sep 1. PMID: 34547287.
* Ffytche D, et al. Hallucinations: A Symptom-Based Approach. Curr Top Behav Neurosci. 2019;42:127-148. doi: 10.1007/7858_2018_17. PMID: 30535091.
* Waters F, et al. Neural Mechanisms of Hallucinations. Curr Psychiatry Rep. 2018 Jan 29;20(2):9. doi: 10.1007/s11920-018-0875-1. PMID: 29379895.
Q.
Bugs in the Corner? Why Peripheral Hallucinations Happen
A.
There are several factors to consider: fleeting bugs or shadows in your peripheral vision are often benign from floaters, fatigue, stress, or the brain misreading low-detail motion, but they can also signal retinal problems, migraine aura, medication effects, substance use or withdrawal, or neurological conditions. Know the red flags that need urgent care, like sudden flashes, a dark curtain over vision, severe headache, confusion, weakness, or speech trouble; if episodes persist or worsen, get an eye exam and a medical review of your medications and health. See more details below to choose the right next steps.
References:
* Ffytche DH, Williams MT. Visual Hallucinations: A Review of Pathophysiology and Treatment. J Neuroophthalmol. 2021 Dec 1;41(4):e582-e593. doi: 10.1097/WNO.0000000000001389. PMID: 34812836.
* Menon SP, Nair P, Shah S. Charles Bonnet syndrome: a review of the current evidence. J Clin Neurosci. 2020 Jul;77:33-38. doi: 10.1016/j.jocn.2020.04.053. Epub 2020 May 2. PMID: 32362534.
* Kaplan SM, Rumbaugh EJM. Peduncular Hallucinosis: A Review of the Literature. Curr Treat Options Neurol. 2021 Oct;23(10):24. doi: 10.1007/s11940-021-00693-7. PMID: 34505105.
* Diederichs AA, Williams DR, Pavese N. Visual hallucinations in Parkinson's disease: Mechanisms and management. Pract Neurol. 2021 Oct;21(5):384-393. doi: 10.1136/practneurol-2020-002772. Epub 2021 Jun 25. PMID: 34172421.
* Kienle FT, Ffytche AC. Elementary visual hallucinations. Pract Neurol. 2015 Apr;15(2):121-7. doi: 10.1136/practneurol-2014-001042. Epub 2015 Jan 19. PMID: 25599026.
Q.
Waking Up to Crawling Skin? The Truth About Tactile Hallucinations
A.
The crawling-on-the-skin feeling at night is a recognized tactile hallucination called formication, often linked to sleep-wake hallucinations, stress or anxiety, medication effects, substance use or withdrawal, hormonal shifts, or neurological and mental health conditions. There are several factors to consider; see below to understand common triggers and how they differ. Occasional episodes are usually benign, but persistent or daytime symptoms, or any episode with confusion, high fever, severe headache, seizures, chest pain, or sudden weakness or numbness, warrant prompt medical care; the complete guidance below covers urgent red flags, what doctors check, and practical steps you can start now.
References:
* Stone, J. M., Roiser, J. P., & Fusar-Poli, P. (2021). Tactile hallucinations: a review of the literature. *Current Psychiatry Reports*, *23*(7), 47.
* Freedman, R., Adler, L. E., & Leonard, S. (2012). Formication: A review of the literature. *International Journal of Dermatology*, *51*(8), 911-915.
* Hasan, S., & Abid, K. F. (2022). Delusional parasitosis: a comprehensive review. *Clinical Dermatology*, *40*(5), 793-801.
* Leppert, A., Pirkola, S., & Isometsä, E. T. (2023). Psychosis and tactile hallucinations associated with drug use: a systematic review of the literature. *Journal of Substance Abuse Treatment*, *154*, 109033.
* Lim, K. T., Ong, Y. K., Ch'ng, C. W., Chew, K. S., Ng, S. B., Lim, Y. C., ... & Tan, H. J. (2023). Tactile hallucinations and their neurological correlates: a review. *Parkinsonism & Related Disorders*, *112*, 102766.
Q.
Wall Patterns in the Dark? Why Your Eyes Play Tricks on You
A.
There are several factors to consider: seeing colors, shapes, or moving patterns in the dark is often a normal low-light brain response near sleep, but it can also stem from migraine aura, sleep deprivation, medication or substance effects, or, less commonly, eye or neurological conditions; see below to understand more. Seek urgent care for persistent or sudden flashes, one-eye changes, a curtain over vision, vision loss, severe headache, confusion, or other neurological symptoms, and review practical next steps like sleep habits and medication checks in the complete details below.
References:
* Ohayon MM, Ohayon MA. Hypnagogic Hallucinations. Semin Neurol. 2022 Feb;42(1):33-40. doi: 10.1055/s-0041-1740921. Epub 2022 Feb 21. PMID: 35189569.
* Storm L, Tressoldi P, Di Risio L. The Ganzfeld Effect: A Systematic Review. Front Hum Neurosci. 2017 Aug 16;11:426. doi: 10.3389/fnhum.2017.00426. PMID: 28860956; PMCID: PMC5563385.
* Wardle SG, Wallis TS, Birznieks I, Clifford CW. Seeing faces in everyday objects: The neural basis of visual pareidolia. Cortex. 2019 Aug;117:155-165. doi: 10.1016/j.cortex.2019.04.018. Epub 2019 May 1. PMID: 31103756.
* Parr T, Friston KJ. Predictive coding, precision and the perception of visual scenes. Prog Neurobiol. 2018 Jan;160:62-75. doi: 10.1016/j.pneurobio.2017.08.001. Epub 2017 Aug 10. PMID: 28803975; PMCID: PMC5759755.
* Hebert C, Routhieau L, O'Toole L, Simard M. Visual perception in low light conditions: a systematic review. Ophthalmic Physiol Opt. 2021 Jan;41(1):154-169. doi: 10.1111/opo.12767. Epub 2020 Dec 21. PMID: 33346927.
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Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1Jardri R, Larøi F, Waters F; International Consortium on Hallucination Research. Hallucination Research: Into the Future, and Beyond. Schizophr Bull. 2019 Feb 1;45(45 Suppl 1):S1-S4. doi: 10.1093/schbul/sby170. PMID: 30715538; PMCID: PMC6357977.
https://academic.oup.com/schizophreniabulletin/article/45/Supplement_1/S1/5305654Zepf J, Zepf S. Hallucination in Adolescence-Or, Nora in Nowhereland Between Neurosis and Psychosis. Psychoanal Rev. 2018 Oct;105(5):463-480. doi: 10.1521/prev.2018.105.5.463. PMID: 30300083.
https://guilfordjournals.com/doi/10.1521/prev.2018.105.5.463Graux J, Lemoine M, El Hage W, Camus V. From depersonalization to hallucination. Psychopathology. 2012;45(1):42-52. doi: 10.1159/000325911. Epub 2011 Nov 28. PMID: 22123515.
https://www.karger.com/Article/Abstract/325911Blom JD. Auditory hallucinations. Handb Clin Neurol. 2015;129:433-55. doi: 10.1016/B978-0-444-62630-1.00024-X. PMID: 25726283.
https://www.sciencedirect.com/science/article/abs/pii/B978044462630100024X?via%3DihubWu F, Cheng J, Wang X, Wang L, Tao D. Image Hallucination From Attribute Pairs. IEEE Trans Cybern. 2022 Jan;52(1):568-581. doi: 10.1109/TCYB.2020.2979258. Epub 2022 Jan 11. PMID: 32275630.
https://ieeexplore.ieee.org/document/9059026