When a person’s schizophrenia is active, they may experience symptoms of psychosis such as hallucinations, delusions, paranoia, and distorted thinking. Hallucinations are very real to the person experiencing them, but no one else can see, hear, or experience them, says Dr. Daramus. Hallucinations are non-specific and can be normal or caused by many different underlying reasons. This article explores the types and causes of schizophrenic hallucinations, as well as some treatment options and coping strategies that may be helpful.

Types of Schizophrenic Hallucinations

There are five types of hallucinations, based on the five senses, says Dr. Daramus. These are the five types of schizophrenic hallucinations:

Auditory hallucinations, which involve hearing sounds no one else can hear or hearing voices when no one is in the room. The voices may be friendly, hostile, abusive, or annoying. They may originate from a single source, such as a television, or multiple sources. They may talk directly to the person, have discussions with them, give them instructions, or describe events taking place. Visual hallucinations, which involve seeing things no one else can see. For instance, the person may see spiders crawling all over the room, says Dr. Daramus. Or, they may see objects move in ways that they normally don’t. Olfactory hallucinations, which involve smelling things no one else can detect. The person may believe the odor is coming from them or from something around them. Gustatory hallucinations, which involve tasting things no one else can taste. The person may feel that what they’re eating tastes extremely odd. Somatic or tactile hallucinations, which involve feeling sensations no one else can feel. The person may feel like spiders are crawling all over their skin, or someone is tickling them, or there’s a draft of cold air blowing on their face.

Auditory hallucinations are the most common types of hallucinations. However, many people with schizophrenia tend to experience multimodal hallucinations that involve multiple sensory modalities. For instance, the person may simultaneously be able to see visuals, hear voices, and smell something, making the experience very real for them.

Causes of Schizophrenic Hallucinations

The exact causes of schizophrenia are unknown. Anyone can develop this condition. However, these are some factors that may contribute to the development of schizophrenia and cause someone to experience hallucinations:

Genetic factors: Variations in multiple genes can contribute to the risk of developing schizophrenia. A person has a 10% to 15% chance of developing schizophrenia if one of their parents has it, and a 7% to 8% chance of developing it if one of their siblings has it.Brain chemistry: People with schizophrenia may have an imbalance of certain brain chemicals, which may be inherited.Stressors: Environmental stressors can contribute to the development of schizophrenia.

People who have schizophrenia may experience acute episodes, also known as psychotic episodes, where their symptoms are particularly active and they experience hallucinations and other symptoms. These episodes may occur once or twice in the person’s lifetime, or they may come and go in phases. 

Experiencing Schizophrenic Symptoms

When a person has an acute schizophrenic episode, they may have multiple symptoms of psychosis, such as hallucinations, paranoia, and delusions, simultaneously.  For instance, they may have a paranoid delusion that someone is trying to harm them. As a result, they may experience hallucinations that someone is threatening them, watching them, or following them, even though that is not the case. If they’re eating a meal, this sense of danger may take the form of an olfactory and gustatory hallucination that causes them to believe the food is poisoned, says Dr. Daramus.  These symptoms can cause the person to lose touch with reality. They may believe friends or family members are trying to harm them, or space aliens are trying to control them. These beliefs can affect their behavior and cause them to behave in strange and unpredictable ways.  These symptoms can also make it difficult for the person to function at work or school and in social settings.

Treating Schizophrenic Hallucinations

Although schizophrenia cannot be cured, it can be treated with a combination of medication and therapy. Below, Dr. Daramus outlines some treatment modalities and coping mechanisms for schizophrenia.

Medication

Additionally, medication can help people recognize what’s real and what isn’t. It can also reduce feelings of confusion and promote clear thinking.

Therapy

Therapy can also involve social skills training to help people with schizophrenia fit in and develop supportive relationships.

Reality Testing

People can learn to use cues in their environment to tell what’s real. For instance, if they can see big spiders all over the room but no one else seems bothered, it’s probably a hallucination.  Reality testing can also help them remember that voices may threaten, or they might see terrifying things, but a hallucination can’t really hurt them.  Friends and family can also learn how to help the person reality-test hallucinations and delusions. It can be useful to have people who can help the person figure out when they’re hallucinating and help them feel safe if the hallucinations are threatening.

A Word From Verywell

If you live with someone with schizophrenia, the most helpful things you can do are to be supportive and help them feel calm and safe, says Dr. Daramus. She adds that you can also help them get to healthcare appointments and remind them to take their medication.