Hallucinations

Hallucinations are medically defined as apparent perception of an external object while the fact is that no such object is present. They are false or distorted sensory experiences that appear to be real perceptions to the person which is hallucinating. What is important about these sensory impressio...

Hallucinations are medically defined as apparent perception of an external object while the fact is that no such object is present. They are false or distorted sensory experiences that appear to be real perceptions to the person which is hallucinating. What is important about these sensory impressions? It is important to know that they are generated by the mind rather than by any external stimuli. Hallucinations could be seen, heard, felt, and even smelled or tasted by the person who is hallucinating. People may experience hallucinations as part of their normal developmental stages, especially during the preschool years, in the 2-5 year old range.

Possible causes of hallucinations

It is proven that the hallucinatory experience has a wide range of etiologies like:

%26middot; neurological insult,

%26middot; seizure and sleep disorders,

%26middot; substance abuse,

%26middot; grief,

%26middot; stress- It is proven that prolonged or extreme stress can impede thought processes and trigger hallucinations

%26middot; metabolic, endocrine and infectious diseases

%26middot; Electrical or neuro-chemical activity in the brain- It is proven that a hallucinatory sensation, often appears before, and gives warning of, a migraine. They are also reported as hallucinations!

%26middot; Mental illness- several researches done in the past have came to the conclusion that there is up to 75% of schizophrenic patients admitted for treatment which reported hallucinations.

%26middot; Brain damage or disease. Lesions or injuries to the brain may alter brain function and produce hallucinations.

The fact is that patients suffering from dementia and psychotic disorders such as schizophrenia frequently mostly experience hallucinations, but there is no rule because, hallucinations can also occur in patients who are not mentally.





In most cases we are talking about a result of stress overload, hypertension or exhaustion. It is also proven that sleep deprivation for a longer period can also lead to hallucinations.

Drug reactions %26ndash; Several researches done in the past have came to the conclusion that the use of psychotomimetics and many medication's side-effects could trigger hallucinations: ecstasy, LSD, mescaline, and psilocybin trigger hallucinations.

Top 10 drugs or classes associated with hallucinations.

• SSRIs



• tramadol



• bupropion



• venlafaxine



• quinolones



• proton pump inhibitors



• clarithromycin



• zopliclone



• ropinirole



• %26beta;-adrenoreceptor antagonists

Other drugs such as marijuana and PCP have hallucinatory effects. Hallucinogens can be classified by:

%26middot; quality of action,

%26middot; mechanisms of action,

%26middot; by chemical structure

Almost all hallucinogens contain nitrogen and are classified as alkaloids. THC and Salvinorin A are exceptions. Many hallucinogens often have chemical structures similar to those of human neurotransmitters, such as serotonin, and temporarily interfere with the action of neurotransmitters and/or receptor sites.

Beside these pathological causes- there are also some medical and psychiatric causes of hallucinations. Common causes include:

• Fever, which can occur with almost any infection,



• Intoxication or withdrawal from drugs



• Delirium or dementia



• Sensory deprivation such as blindness or deafness



• Severe medical illness including liver failure, kidney failure, and brain cancer



• Some psychiatric disorders, particularly schizophrenia, psychotic depression, and post-traumatic stress disorder

The mechanism of hallucination

Various theories have tried to explain the occurrence of hallucinations. Hallucinations were first seen as a projection of unconscious wishes and desires, but biological theories have claimed that hallucinations are more often thought of as being caused by functional deficits in the brain. Important thing to know is that the function of the neurotransmitter dopamine is thought to be particularly important. Hallucinations may result from biases in meta-cognitive abilities. These are abilities that allow us to monitor or draw inferences from our own internal psychological states.

Types of hallucinations

Hallucinations occur while a person is awake and conscious and some of the common hallucinations include:

• Hearing voices when no one has spoken (auditory-hallucinations)



• Seeing patterns, lights, beings or objects that aren't there (visual-hallucinations)



• Feeling a crawling sensation on the skin (tactile-hallucinations)



• Hallucinations related to smell or taste are rare, but possible

Visual Hallucination

• Hypnagogic Hallucination

These hallucinations occur just before falling asleep and can last from seconds to minutes; all the while the subject usually remains aware of the true nature of the images.

• Peduncular Hallucinosis

These hallucinations occur most often in the evenings but unlike the previous type-the subject is usually fully conscious.

• Delerium Tremens

The subject which suffers from delirium tremens is usually agitated and confused, especially in the later stages of this disease. It is also accompanied with sleep disorders!

• Parkinson's Disease and Lewy body Dementia

Parkinson disease is associated with Lewy body dementia because they produce similar hallucinatory symptoms. These hallucinations start with illusions and they typically last for several minutes. What is the cause? Well, it is a known fact that Parkinson's disease is usually associated with a degraded substantia nigra pars compacta.

• Migraine Coma

This type of hallucination is usually experienced during the recovery from a comatose state. Some researches have proven that these hallucinations occur during states of full consciousness.

• Charles Bonnet Syndrome

Symptoms characteristic to this syndrome are being felt by blind patients who experience visual hallucinations. The hallucinations usually occur during the morning or evening, but are not dependent on low light conditions.

• Focal Epilepsy

It is well known that some focal epilepsy could produce hallucinations which are characterized by being brief, and stereotyped.

Auditory Hallucinations

The definition is simple- they occur when people hear voices or other noises although nothing is there. It is also very important to rule out possible causes such as physical illness and the side-effects of medication. How to recognize? One sign that the person may be having hallucinations involving voices is when they talk to themselves although there are no rules!

Several researches has been conducted and the results are:

• 38% percent of subjects described the sound as stereophonic,



• 6% said it came from the right side,



• 4% said left.



• 10% ascribed the origin of sound as coming from behind them



• 9% percent said from the front



• 52% percent of subjects could not ascribe a gender to the voice, and considered it to be a mix,



• 24% considered the voice to be male and 5% female.

Auditory hallucinations are more common in psychotic conditions such as schizophrenia, although they may sometimes be associated with high doses of cocaine, amphetamine or other stimulants.

Hallucinations- a symptom of dementia

It is a proven fact that people with dementia often have hallucinations. It's still not clear if this is an indication that the dementia is getting worse, but the fact is that most dementia does worsen over time. When a person with dementia has hallucinations, it's important to rule out delirium as a cause.

Causes of delirium include:

• heart or lung disease,



• infections,



• poor nutrition,



• drug interactions



• hormone disorders

Hallucinations due to delirium usually go away with treatment of the underlying cause. When hallucinations occur as a symptom of dementia, treatment may include several medications.

Diagnosis

There is no doubt that every person should seek evaluation, if experienced hallucinations more then once and in unusual occasion!

Differential diagnosis

A general physician, psychologist, or psychiatrist will try to rule out possible organic, environmental, or psychological causes through a detailed medical examination and social history. If a psychological cause such as schizophrenia is suspected, a psychologist will typically conduct an interview with the patient and his family and administer one of several clinical inventories, or tests, to evaluate the mental status of the patient.

Occasionally, people who are in good mental health will experience a hallucination. If hallucinations are infrequent and transitory, and can be accounted for by short-term environmental factors such as sleep deprivation or meditation, no treatment may be necessary. However, if hallucinations are hampering an individual's ability to function, a general physician, psychologist, or psychiatrist should be consulted to pinpoint their source and recommend a treatment plan.

Treatment and prognosis

Every patient should know that hallucinations which are symptoms of a mental illness such as schizophrenia should be treated by a psychologist or psychiatrist.

• Medications

Antipsychotic medication such as thioridazine (Mellaril), haloperidol (Haldol), chlorpromazine (Thorazine), clozapine (Clozaril), or risperidone (Risperdal) may be prescribed.

• Psychosocial therapy

If hallucinations persist, psychosocial therapy can be helpful in teaching the patient the coping skills to deal with them. Hallucinations due to sleep deprivation or extreme stress generally stop after the cause is removed.