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Living With The Voices Inside Your Head

Ms. Snigdha Samantray

5 Min Read

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Delusion vs Hallucination: What is the difference? Often, we hear the terms ‘Hallucination’ and ‘Delusion’, when we talk or read about mental health. Many people commonly use these words to express their own or someone else’s experience. However, clinically both are a part of a serious mental health condition called ‘Psychosis’ and may not be as simple as used by lay people in day-to-day interactions. In Psychosis a person lacks connection with reality, has marked disturbance in personality, is not able to function adequately in social, interpersonal, or occupational life, has poor judgment and absence of understanding about their own symptoms and abnormal behavior.

Also, since symptoms of Hallucinations and Delusions often co-occur in several mental health disorders, they can often be confused. But there are major differences between both— while one is sensory, the other is cognitive. Let’s have a look at the differences in order to have a better understanding.

What Are Hallucinations?

Hallucination is primarily a disorder of perception in which the person having it, hears, sees, smells, or even feels things in the absence of real stimuli. It involves the five sensory organs, namely the eyes, nose, ears, taste, and sense of touch. An example of hallucination would be a person who hears the voices of people speaking where in reality no one has spoken or is present around.

Hallucinations occur frequently in people with psychiatric conditions like schizophrenia and bipolar disorder, however sometimes people may experience hallucinations even in the absence of a mental health disorder such as in substance abuse, certain medications, or even physical injuries to the head.

Types of Hallucinations.

Broadly there are five categories of Hallucinations based on the modality they are experienced. They are:

(1) Auditory:

It is the most common type of hallucination which involves hearing voices or sounds that no one else can hear. People presenting with auditory hallucinations often complain about hearing external voices that are unpleasant, repetitive, commanding, or interactive. But this may not always be the case. They may also hear other kinds of things such as music or even meaningless noise.

(2) Visual:

It involves seeing shapes, colors, objects, or people that aren’t physically present or real. It is the second most common type of hallucination.

(3) Tactile:

It involves a false sense of touch in absence of a real source. For example, People having it may feel as if bugs are crawling over their body or are trapped inside their body without a real source. Certain medications, mental health disorders, substance use disorders, neurological conditions have been known to trigger these hallucinations.

(4) Olfactory:

Also called Phantosmia, this type of hallucination is less common than auditory and visual hallucination. It involves perception of smell that isn’t present in the environment or has a real physical source. For example, people having it may smell unpleasant things such as blood or smelly socks whereas others present may not be able to smell it. Usually, patients with head injuries, brain tumors, Parkinson’s, or schizophrenia present with these symptoms.

(5) Gustatory:

This type of hallucination is the rarest of all types of Hallucination. It involves the perception of some usually strange or unpleasant taste, such as the taste of metals or raw meat. People having epilepsy sometimes present with this type of hallucination.

What Are Delusions?

Delusion is primarily a disorder of thought in which a person having it usually has one or more false unshakable beliefs that conflict with reality, however, he is completely convinced that it’s absolutely true. Delusions often result from the misinterpretation of events and have some level of paranoia involved. For example, someone might contend that a family member is trying to poison them. While this may not be true, there is a continued belief in the delusion despite contrary evidence. Not all delusions are the same. While most delusions involve non-bizarre beliefs that have a possibility of occurring in real life, other kinds may be bizarre, magical, or impossible. Let’s have a look at some common types of Delusion.

(1) Persecutory

People with this type of delusion strongly believe that somebody is trying to harm, poison or mistreat them. For example, a person having this delusion may believe that someone in their family is plotting against them and this could result in a very negative outcome or behavior towards that family member.

(2) Reference

People with this type of delusion have a strong belief that everything occurring around them is somehow related to them when in fact it isn’t. These people tend to believe that others think or discuss more about them than others actually do. For example, a person having this delusion walks across a street and notices two strangers talking and laughing and believes that they are laughing at him or her when in reality the strangers did not even notice them.

(2) Erotomaniac

People with this type of delusion have a strong belief that someone, usually very famous or beautiful, is in love with them. For example, a person having this delusion may be very much convinced that a famous actor or actress wants to marry them and they communicate to them via secret gestures.

(3) Grandiose

People with this type of delusion have an overinflated sense of self. They strongly believe that they have extraordinary powers, talent, influence, or connections. For example, a person having this delusion may believe that they have extraordinary intelligence or the power to end a war or a special ability to speak with god.

(4) Jealous

People with this type of delusion have a strong belief that their partner is unfaithful or is cheating on them. For example, they might firmly believe that their partner is traveling to meet their lover than for work without any concrete evidence

(5) Somatic

People having this delusion believe that they are sick or physically disabled, despite medical evidence that states normalcy. Examples include the belief that someone is infected with worms, pregnant, or has a serious health condition.

Diagnosis & Treatment

Hallucinations & Delusions are clinically complex symptoms of Psychosis which can only be diagnosed by trained mental health professionals. Often normal perceptual phenomenon, sensory distortions and sensory deceptions like illusions may be mistaken as Hallucination without proper medical training. Likewise perceived threat that has connection to reality may be mistaken as delusion. Hence it’s advisable to avoid self-diagnosis.

Treatment for psychosis involves medication and therapy. While medication is more effective in treatment of hallucinations, therapy such as CBT are more effective treatment options for delusions. This does not necessarily rule out the fact that often a combination of medication & therapy gives the best result. Non-judgmental acceptance & family support have also been proven to be helpful and effective in the treatment of hallucinations and delusions.

Do you or a loved one have psychosis? There is help!

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Alternatively, you could also consult one of our psychotherapists available online through audio or video calls to address your concerns.

Additionally, using our MFine mobile app, you could also book a lab test and order medicines online.

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Read a complete guide on Depression in Indians.

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Written by

Ms. Snigdha Samantray

Ms Snigdha Samantray is a Certified Clinical Psychologist and Digital Mental Health Specialist, currently working as a Program Manager and Clinical Psychologist at MFine. She played a key role in the establishment of the Psychotherapy specialty at MFine.

Living With The Voices Inside Your Head

What Are Hallucinations?

Types of Hallucinations.

(1) Auditory:

(2) Visual:

(3) Tactile:

(4) Olfactory:

(5) Gustatory:

What Are Delusions?

(1) Persecutory

(2) Reference

(2) Erotomaniac

(3) Grandiose

(4) Jealous

(5) Somatic

Diagnosis & Treatment

Request a Call Back

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