What are visual hallucinations. visual hallucinations. Types of hallucinations according to the way they are perceived

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Hallucinations are an image that appears in the mind of an individual without the presence of an external stimulus. They can arise as a result of severe fatigue, when using a number of medicines psychotropic effects and with certain neurological ailments and some mental illnesses. In other words, hallucinations are false perceptions, an image without an object, sensations that arise without stimuli. Images that are not supported by really existing stimuli can be presented as an error in the processes of perception of the sense organs, when the patient feels, sees or hears something that does not really exist.

There are hallucinations that have a sensually bright color, persuasiveness. They can be projected outside, do not differ from true perceptions and are called true. In addition, there are hallucinations perceived by the internal auditory analyzer or visual, localized in the inner sphere of consciousness and felt as a result of the influence of some external force that provokes visions, for example, voices. They are called pseudo-hallucinations.

Causes of hallucinations

Imaginary images, not supported by really present stimuli and associated with the visual system, are characterized by the contemplation by patients of various objects or events that do not really exist in reality, in which they can take part.

These hallucinations in humans arise as a result of poisoning with alcohol-containing substances (that is, it is one of the manifestations of alcohol), with the use of narcotic drugs, as well as psychostimulants such as LSD, cocaine, etc., medicines with an M-anticholinergic effect (for example, antidepressants), some organic structures of tin. In addition, visual imaginary images, as well as auditory hallucinations, characteristic of some ailments (peduncular hallucinosis).

Visual hallucinations, therefore, are the so-called visual illusion, a disturbed perception of reality. With this ailment, the patient cannot separate real objects from imaginary images.

Orders given by a "voice from above", words of praise from invisible friends, shouts - refer to hallucinations from the auditory system. They are often observed in schizophrenic disorders, simple partial seizures, occur with alcoholic hallucinosis, are the result of various poisonings.

The sensation of imaginary odors is characteristic of olfactory erroneous perceptions, which also occur when patients often feel extremely unpleasant "aromas" of rot, rancidity, etc. In addition, olfactory hallucinations can provoke brain defects, namely, lesions of the temporal lobe. Partial seizures and encephalitis caused by the herpes virus, along with olfactory imaginary perceptions, also cause gustatory hallucinations, characterized by patients feeling a pleasant or disgusting taste in the mouth.

Tactile hallucinations in individuals are expressed in the feeling of objects that do not really exist. The cause of their occurrence is alcohol withdrawal syndrome, which can also be accompanied by auditory erroneous perceptions and visual visions.

Body hallucinations are characterized by the sensation of a variety of unpleasant sensations by the patient, for example, the passage of an electric current through the body. In addition, it can be sensations of grabbing limbs, touching the body, exploding bubbles in the intestines. These hallucinations can give rise to schizophrenia or encephalitis.

Regardless of the factors that provoke the occurrence of erroneous perceptions, hallucinations are characterized by different specifics and affect patients in different ways.

Some may have a neutral color or be devoid of emotionality. Patients suffering from such hallucinations treat them calmly, often even indifferently. However, there are exceptions in which imaginary images are emotionally manifested quite clearly.

Scientists, discussing the factors that provoke the appearance of hallucinations of various types, always emphasize that today this phenomenon is poorly understood, and the disorders that occur with erroneous perceptions are not clear enough. Separately, experts single out imaginary perceptions characteristic of healthy individuals. For example, mass hallucinations. In the course of their origin, the phenomenon of mass suggestion is observed, in which people seem to “infect” or “turn on” each other, and the crowd at the same time represents a single organism. It has long been established that human individuals in the mass are quite easily suggestible, and when alone, they are able to behave like a critically thinking person.

Often age becomes the cause of this condition. Old age is an inevitable process in the life of every person and it is accompanied by ongoing serious changes in the body. However, this does not mean at all that all elderly individuals will become feeble-minded or incapable of independent existence. But still, subjects who have crossed the sixty-year age limit often have mental disorders inherent in old age. The first position among such disorders is occupied by paranoia, which is the cause of the modification of the behavioral response of the elderly and causes various imaginary perceptions.

Also, a constantly lowered mood background, stable pessimism, high anxiety do not contribute to improving the current situation. In addition, sometimes hallucinations in the elderly are perceived by them as entertainment, an opportunity to hide from the unpleasant reality.

In addition to the above reasons, there are also drugs, hallucinations are often provoked precisely by the intake of narcotic drugs. Therefore, before making a diagnosis, the possibility of perceptual delusions due to excessive use of drugs or side effects of other drugs should be excluded.

Symptoms of hallucinations

Since illusory perceptions are subdivided according to the analyzer systems, their symptoms will also correspond to the analyzer system in which there is a violation of perception. In practical terms, the most important are the following hallucinations.

Hypnagogic imaginary images - visual or auditory erroneous perceptions that occur when falling asleep, that is, with eyes closed, often portends the development of alcoholic delirium.

In addition, imaginary perceptions are true and false (pseudohallucinations). A patient who has true hallucinations is confident in their reality. For him, they are displayed in the space that surrounds him, and are identical to everyday sounds, voices and visual images. And pseudohallucinations are limited to the limits of the patient's body, they are accompanied by a feeling of alienation (for example, they can hear voices from outer space in their own head, they are sure of an outside influence on their thought-sensitive processes). As a rule, pseudohallucinations are observed in combination with delusions of exposure. True illusory perceptions are more characteristic of psychoses of an alcoholic, traumatic and organic nature. Pseudohallucinations are unique to schizophrenia.

Psychopathological syndrome, consisting in pronounced, abundant ( different kind) hallucinations that prevail in clinical picture disease is called hallucinosis. This syndrome is often accompanied by delirium.

Acute hallucinosis develops due to an infectious or intoxicant nature. Acute hallucinosis can turn into a chronic course against the background of organic disorders of the brain or vascular diseases with insufficient treatment. In the chronic course of the described syndrome, the symptoms are dominated by auditory illusory perceptions and less often tactile imaginary sensations. At the same time, the behavior of patients is characterized by orderliness, perhaps even a critical attitude towards non-existent "voices" in the head. Often, patients can remain functional.

Verbal hallucinations of a threatening nature are expressed in the patients' persistent perception of verbal threats against themselves, for example, it seems to them that they are going to be hacked to death, castrated, or forced to drink poison.

Contrasting imaginary perceptions have the character of a collective dialogue - one set of voices furiously condemns the patient, demands that he be subjected to sophisticated torture or put him to death, and the other group uncertainly defends him, timidly asks for a delay in torture, assures that the patient will improve, stop drinking alcoholic drinks will become better. Characteristic of this type of disorder is that the group of voices does not address the patient directly, but communicate with each other. Often they give the patient exactly the opposite orders (to fall asleep and dance at the same time).

Speech-motor hallucinations are characterized by the patient's conviction that someone takes possession of his own speech apparatus, by influencing the muscles of the tongue and mouth. Sometimes the articulatory apparatus pronounces voices that are not heard by others. Many researchers attribute the described imaginary perceptions to variations of pseudohallucinatory disorders.

Visual hallucinations in individuals in terms of their prevalence occupy the second position in psychopathology after auditory ones. They can also be elementary (for example, a person sees smoke, fog, flashes of light), that is, with incomplete objectivity and with the presence of subject content, namely zoopsy (visions of animals), polyopic (multiple images of illusory objects), demonomaniac (visions of mythological characters , devils, aliens), diplopic (visions of doubled illusory images), panoramic (visions of colorful landscapes), endoscopic (visions of objects inside one's body), scene-like (visions of plot-related imaginary scenes), autovisceroscopic (contemplation of one's own internal organs).

Autoscopic imaginary perceptions consist in the observation by the patient of one or more of his doubles, completely copying his behavioral movements and mannerisms. There are negative autoscopic misperceptions where the patient is unable to see their own reflection in a mirror surface.

Autoscopies are observed with organic disorders in the temporal lobe and parietal brain, with alcoholism, with postoperative hypoxia, due to the presence of pronounced psychotraumatic events.

Microscopic hallucinations are expressed in perceptual delusions, representing an illusory decrease in the size of people. Such hallucinations are most often found in psychoses of infectious origin, alcoholism, chloroform poisoning, and ether intoxication.

Macroscopic illusions of perception - the patient sees enlarged living beings. Polyopic imaginary perceptions consist in the patient's vision of many identical imaginary images, as if created as a carbon copy.

Adelomorphic hallucinations are visual distortions, devoid of distinctness of forms, brightness of colors and volumetric configuration. Many scientists attribute this type of disorder to a special type of pseudohallucination, which is characteristic of schizophrenia.

Extracampal hallucinations consist in the patient's vision with angular vision (that is, outside the normal field of view) of some phenomena or people. When the patient turns his head towards a non-existent object, such visions instantly disappear. Hemianopsic hallucinations are characterized by loss of one half of vision, are observed with organic disorders occurring in the central nervous system person.

Hallucinations of Charles Bonnet are true distortions of perception, observed when one of the analyzers is damaged. So, for example, with retinal detachment or glaucoma, visual hallucinations are noted, and with otitis media - auditory illusions.

Olfactory hallucinations are a deceptive perception of very unpleasant, sometimes disgusting and even suffocating odors (for example, the patient smells a decaying corpse, which in reality does not exist). Often, olfactory-type hallucinations cannot be differentiated from olfactory illusions. It happens that one patient may have both disorders, as a result of which such a patient refuses food. Deceptive perceptions of the olfactory type can arise as a result of various mental ailments, but they are predominantly characteristic of organic defects of the brain and are localized in the temporal region.

Taste hallucinations are often observed in combination with olfactory deceptive perceptions, manifested in the sensation of a taste of rot, pus, etc.

Tactile hallucinations consist in the patient feeling the appearance of some liquid on the body (hygric), touching something high or low temperature (thermal hallucinations), grasping from the back of the body (haptic), an illusory sensation of the presence of insects or under the skin (intrinsic zoopathy), crawling of insects or other small creatures on the skin (external zoopathy).

Some scientists refer to hallucinations of the tactile type as a symptom of the sensation of a foreign object in the mouth, for example, thread, hair, thin wire, observed in tetraethyl lead delirium. This symptom, in fact, is an expression of the so-called oropharyngeal imaginary perceptions. Tactile illusory representations are characteristic of cocaine psychosis, delirious clouding of consciousness of various etiologies, and schizophrenia. Often, tactile hallucinations in schizophrenia are localized in the genitourinary region.

Functional hallucinations originate against the background of a real-life stimulus and live until the end of the stimulus. For example, against the background of a piano melody, the patient can simultaneously hear the sound of the piano and the voice. At the end of the melody, the illusory voice also disappears. Simply put, the patient perceives at the same time a real stimulus (piano) and a commanding voice.

Functional hallucinations are also divided depending on the analyzer. Reflex hallucinations are similar to functional ones, they are expressed in the appearance of imaginary perceptions of one analyzer, when exposed to another, and exist exclusively during stimulation of the first analyzer. For example, the patient may feel the touch of something wet on the skin (reflex hygro hallucinations) when viewing a certain picture. As soon as the patient stops looking at the picture, the discomfort disappears.

Kinesthetic (psychomotor) erroneous perceptions are manifested in the sensation by patients of the movements of certain parts of the body, which occur against their will, but in reality there are no movements.

Ecstatic hallucinations in a person are detected when he is in a state of ecstasy. They are distinguished by their colorfulness, imagery, influence on the emotional sphere. Often characterized by religious, mystical content. There are visual and auditory, as well as complex. Many drugs provoke hallucinations, but they are not always accompanied positive emotions.

Hallucinosis is a psychopathological syndrome characterized by the presence of pronounced multiple hallucinations against the background of clear awareness.

Delusions, hallucinations form Plaut's hallucinosis, which is verbal (less often olfactory and visual) imaginary perceptions in combination with delusions of persecution with clear consciousness. This form hallucinosis occurs with a disease such as syphilis of the brain.

Atherosclerotic hallucinosis is observed more often in the female part of the population. At the same time, at first, deceptive perceptions are fenced off, as atherosclerosis develops, an exacerbation of characteristic signs is noted, such as weakening of memory, a decrease in intellectual activity,. The content of distorted perceptions is often neutral and concerns simple everyday activities. With the deepening of atherosclerosis, deceptive perceptions can become more and more fantastic.

Hallucinations in children are often confused with illusions, which are children's inadequate perception of real-life objects. In addition, for little crumbs, the vision of illusions is considered a physiological norm, since with their help fantasy develops.

Hallucinations, on the other hand, are spontaneously appearing types of various objects, characterized by brilliance, the perception of objects that do not exist in reality, actions.

Hallucinations in children are a constant subject of study by scientists. Recent studies indicate that approximately 10% of primary school students develop auditory hallucinations. The emergence of imaginary perceptions in children does not depend on their gender.

Treatment

For effective treatment disturbances of perceptions, it is necessary to find out the reason that provoked the appearance of this condition.

Hallucinations, what to do? Today, many methods have been developed to treat different types of hallucinations. But with a number of ailments, therapy is aimed at curing the disease that caused the hallucinations, and at eliminating or alleviating the symptoms. Since in an isolated form hallucinations are quite rare. Often they are an integral part of a number of psychopathic syndromes, often combined with different variations of delusions. Often the appearance of imaginary perceptions, especially at the beginning of the course of the disease, usually affects the patient and is accompanied by excitement, feeling, anxiety.

Until now, the question of effective therapy hallucinations is debatable, but almost all healers agree that treatment should be individualized.

First of all, it is necessary to exclude various diseases and intoxications, which are often factors provoking the appearance of this condition. Then you should pay attention to medicines used by the patient. Since in clinical practice there have been many cases when, for the treatment of errors in the perception of various analyzers, it was sufficient to stop taking certain drugs.

People suffering from the appearance of hallucinations may be characterized by a critical attitude towards imaginary ideas that arise in the mind, and not critical. The individual may be aware that the voices he hears or the scenes he observes do not exist in reality, or he may think that they are true. Often, patients can see quite real scenes that correspond to reality, for example, observe events involving relatives.

Some patients suffering from this condition are able to distinguish imaginary perceptions from reality, while others are not able, some may feel changes in the body, which are harbingers of imminent hallucinations. A close environment may notice the appearance of this disorder in an individual by his behavior, namely, by observing his gestures, facial expressions, actions, listening to the words uttered by him, which do not correspond to the surrounding reality. This is very important, since quite often patients, afraid of being placed in a "psychiatric hospital" or due to their delusional considerations, try to hide their symptoms, dissimulate hallucinatory experiences.

A patient suffering from hallucinations is characterized by concentration and alertness. He can peer into the surrounding space with a gaze, listen intently to something, or move his lips silently, answering his unreal interlocutors. It happens that this condition in individuals occurs periodically. In such cases, it is characterized by a short course, so it is important not to miss an episode of hallucination. The facial expressions of patients often correspond to the content of imaginary perceptions, as a result of which they reflect surprise, fear, anger, less often joy, delight.

With hallucinations, characterized by the brightness of perception, they can respond to the voices they hear aloud, plug their ears, pinch their noses with their hands, close their eyes, fight off non-existent monsters.

Hallucinations, what to do? At the pre-medical stage, the main thing is the safety of the sick individual and his environment. Therefore, possible dangerous and injurious actions must be prevented.

Responsibility for the treatment of individuals suffering from an erroneous perception of reality, in the first turn, falls on their closest environment - on relatives.

At the medical stage, an anamnesis is first collected, the nature of the visible, audible, felt is specified, a laboratory examination is carried out in order to accurately diagnose and prescribe therapy, methods of care and observation of the patient.

Treatment is focused on the relief of arousal attacks and is aimed at eliminating symptoms such as delusions, hallucinations. For this purpose, intramuscular injections of Tizercin or Aminazine can be used in combination with Haloperidol or Trisedil. The patient is hospitalized in a psychiatric clinic in the presence of a serious mental illness that provoked the appearance of hallucinations.

Failure to provide assistance to patients is dangerous because this disorder can progress and can become chronic (hallucinosis), especially in the presence of aggravating factors, such as alcoholism. The patient is unable to distinguish all his hallucinations from reality, and as time passes, he begins to think that this is the norm.

Doctor of the Medical and Psychological Center "PsychoMed"

The information provided in this article is for informational purposes only and is not a substitute for professional advice and qualified medical care. At the slightest suspicion of the presence of hallucinations, be sure to consult a doctor!

The appearance of hallucinations is a cause for concern not only for the person suffering from them, but also for his relatives. In some cases, they are considered a sign of severe mental disorders. In no case should this situation be ignored, you should consult a doctor who, with the help of medical correction, will improve the patient's condition. Our article will tell you how to get rid of hallucinations with the help of medications.

The occurrence of hallucinations requires immediate medical attention. Most often, the responsibility for treatment falls on the shoulders of the patient's relatives, since usually the latter do not understand the seriousness of the situation and are in no hurry to see a specialist. Before treating hallucinations, it is necessary to consult a doctor who, before prescribing treatment, establishes the cause that caused this problem and in accordance with it establishes adequate therapy.

If this condition is caused by drugs, then you should not only stop taking them, but also rid the body of intoxication. When auditory hallucinations occur simultaneously with visual hallucinations, it is necessary for the patient to be hospitalized in a hospital. To date, there are various medications that help cure different types hallucinations.

Important! Before prescribing treatment in the presence of mental illness, dementia, the doctor must be warned, because some types of pills can worsen the course of the disease.

Antipsychotics

Therapy of hallucinations is most often carried out with the help of medications belonging to the group of neuroleptics, which quite successfully cope with this problem. Antipsychotics are psychotropic drugs designed to eliminate neurological and psychological problems. However, these drugs have many side effects, although today there are neuroleptics of the modern generation, which are safer than the previous one.

New generation drugs help not only cure hallucinations, but also relieve muscle tension, have a mild hypnotic effect, and clarify the thought process. The most popular remedies that help treat hallucinatory-delusional syndrome today include:

tranquilizers

Often, the treatment of hallucinations requires the addition of tranquilizers that have a calming effect. Tranquilizers stop panic, anxiety, stress, depression, help eliminate hallucinations. These drugs will help relieve internal tension, while not affecting cognitive processes. Tranquilizers for hallucinations are prescribed if the pathology is caused by an increased anxiety state. The most prescribed drugs include:

Antidepressants

Drugs that are active in relation to depression, helping with mental disorders associated with a weakening of motor activity, autonomic disorders, decreased mood, loss of reality, are called antidepressants. The most commonly prescribed antidepressants for hallucinations include:

Important! It is impossible to independently use medicines aimed at the treatment of hallucinations, since the human psyche is a rather delicate system, incorrectly chosen medicines can unbalance it for a long time.

The occurrence of a hallucination should imply treatment only under the constant supervision of a specialist. With proper monitoring of the patient and systematic treatment, you can get rid of this unpleasant symptomatology for a long time.

Hallucinations are false, distorted sensory experiences that appear to be real perceptions. English word"hallucination" comes from the Latin verb hallucinari, which means "to wander in the mind." These are emotional experiences that are generated by the mind, and not by any external stimuli. They are olfactory, visual, auditory and tactile.

It is important to distinguish between hallucinations and illusions (delusions), terms often confused in popular journalism. Hallucination is a distortion of sensitive perception, perceived as reality. For example, the elderly often have visions of dead loved ones. An illusion is an erroneous or false interpretation of real events. For example, a traveler in the desert sees a pool of water, but in fact, this is just a mirage caused by the refraction of light as it passes through layers of air. different density. The bluish color is a real sensory stimulus, and seeing it as water is an illusion.

A delusion is a false belief that a person retains despite evidence to the contrary. For example, some claim that they have seen unidentified flying objects, although these may be ordinary aircraft, meteorological balloons, satellites.

Symptoms of hallucinations

It is difficult to describe "typical" hallucinations, as they vary in duration, quality, and patient experience. Some visions last only a few seconds. However, some patients with Charles Bonnet syndrome have experienced visual hallucinations for several days. In people taking psychotropic drugs, they lasted several hours.

There is not always a connection between cause and emotional response. Only 13% of patients rate them as pleasant, and 30% find them terrible. Most patients with narcolepsy, alcoholic hallucinosis, or post-traumatic stress disorder report unpleasant, frightening hallucinations.

They occur after emotional stress, stress, medication, severe fatigue or mental illness, during periods of consciousness. Appear as a vision, sounds, voices, tactile sensations, smells, sounds. Patients suffering from dementia, schizophrenia, experience fear of hallucinations. Visions are possible healthy people after nervous overload, fatigue or caused, deliberately, by taking drugs, meditation.

Statistics

Many researchers believe that statistics are underestimated for several reasons:

• Fear of being branded "crazy";
• Some species, mainly in the elderly, are not well understood;
• Many people are afraid to admit to taking drugs.

Based on a few studies (surveyed 13 thousand adults) in 2000, the following statistics are known:

• 6% of adults experience once a month, 2% once a week;
• 27% experience hallucinations during the day;
• 3% experience tactile hallucinations, 3% visual, 0.6% auditory. Tactile, associated with the use of drugs.

There is no evidence that hallucinations are more common in certain ethnic groups, not related to gender. The demographic characteristics are as follows:

• The child has. Hallucinations occur in children under eight years of age. About 40% have schizophrenia (all its types), the child is dominated by visual or auditory;
• Eye disease - 14% of patients receiving drugs for glaucoma or age-related macular degeneration experienced distinct visual visions;
• Alzheimer's disease - in 40% in the later stages;
• Addiction. Among schoolchildren and students, hallucinogens are the third most consumed drug (after marijuana and alcohol). The highest level is in the Caucasus, in men aged 18-25;
• In healthy people, they occur during the transition from wakefulness to sleep, or vice versa. This condition is not considered pathological;
• Migraine. 10% of patients experience visual visions before the onset of an attack;
• Epilepsy. 80% of those suffering before an attack feel visual, olfactory, auditory disturbances;
• Post-traumatic - after cranial injuries, 60% experience auditory.

Auditory disorders are in the form of separate sounds or verbal - commenting, threatening, ordering. The patient listens, unable to resist. Sometimes they end in criminal acts or suicide.

Visual - the second most frequent, after speech. There are elementary (flashes, smoke) or objective: visions of animals, imaginary characters, devils, landscapes, internal organs. Vision of plot scenes, duality of objects. Allocate:

• Microscopic - objects and people of reduced size;
• Macroscopic - gigantic visions;
• Autoscopic - observation of your double;
• Adelomorphic - distortion of the shape and color of objects;
• Charles Bonnet - true distortions in case of damage to the auditory or visual analyzer.

Olfactory - the sensation of unpleasant odors (the smell of a corpse), which do not exist. Accompanied by organic brain damage. Often appear together with taste.

Tactile - sensation on the body of insects, liquid, internal crawling of animals or insects. Happen with lead poisoning, delirium, schizophrenia. These include the symptom of a "foreign body" - the feeling of a thread, wire in the mouth or other organs.

Kinesthetic - movement, in addition to the will, of individual parts of the body.

With infectious, inflammatory lesions of the brain, hallucinosis occurs - olfactory, visual visions, combined with delirium against the background of a clear consciousness.

Distinguish atherosclerotic hallucinosis in the elderly, which is accompanied by dementia, memory loss, apathy. Perceptions relate to everyday problems and objects. More common in women.

Visions in a child are associated with knowledge of the world around them. For young children, this process of getting to know reality is considered normal. Such conditions are still being studied.

Causes of hallucinations

For explanations, various reasons are offered, but there are no common ones, for all groups of patients. Common causes:

1. Drugs. Hallucinogens - ecstasy, mushrooms, LSD. Other drugs, like marijuana, have a hallucinatory effect. Cancellation of these drugs can cause visual and tactile visions, as in alcoholics - delirium tremens. Some teenagers know how to induce hallucinations by inhaling solvents, acetone, or certain types of glue.
2. Stress. Severe and prolonged stress leads to impaired consciousness.
3. Insomnia and/or exhaustion. Physical and emotional exhaustion blurs the line between sleep and wakefulness.
4. Meditation and/or sensory deprivation. The brain compensates for the lack of external stimulation with memories of the subject. This species is found in blind and deaf people.
5. Electrical or neurochemical brain activity. Sensory sensations, an aura, appear before a migraine attack. Olfactory and tactile auras warn of the onset of an epileptic seizure.
6. Various types of mental illness, of which 70% of patients with schizophrenia.
7. Trauma and inflammation of the brain due to impaired brain function.

Diagnostics

The differential diagnosis can be difficult, but the history helps the doctor narrow down the list of possible diagnoses. If the patient is brought to the hospital unconscious, the attendants may report necessary information. Before a psychiatric examination, it is necessary to perform a medical examination, which includes:

• Lab tests;
• X-ray examination;
• Neurological examination.

If there is a suspicion that the person is suffering from dementia, mental disorders, or is delusional, the doctor will perform a standard mental health assessment. It is based on the following features:

• Appearance of the patient;
• Cognitive, speech skills;
• Content thinking;

The scale assesses the condition: delirium, dementia, schizophrenia, severe depression. In older patients, the medical evaluation includes specialized psychiatric counseling as well as standard vision and hearing screening.

Treatment of hallucinations

Hallucinations are a manifestation of the underlying disease. Depending on this, treatment consists of anticonvulsants, antidepressants, psychotropic drugs, neurosurgical and otolaryngological methods, as well as drug dependence therapy. Visions associated with normal sleep and wakefulness are not subject to specialized treatment.

Psychiatric patients should be treated by a psychiatrist. Assign psychotropic drugs: tizercin, haloperidol, Relanium. Single, transient episodes can be attributed to short-term factors: sleep disturbance, overwork, meditation. You can do without treatment.

However, if the general condition cannot recover on its own, consultation with a therapist or psychologist is needed. It is necessary to determine the cause and draw up a treatment plan.

Forecast

Usually, chronic visions caused by schizophrenia or other mental illnesses can be controlled with medication. If the visions do not disappear, the patient should be taught the right attitude towards them. Disorders associated with sleep deprivation or severe stress stop after the cause is removed.

Last update: 06/09/2015

The word "hallucination" has its roots in Latin and means "to wander mentally". Hallucinations are defined as "the perception of a non-existent object or event" or "sensory experience that occurs without stimulation of the relevant sense organs."

In simple words, hallucinations are called auditory, visual, tactile, olfactory and even taste sensations that are not real. However, auditory hallucinations (voices or other sounds that have no physical source) are the most common type of hallucinations.

Most often, hallucinations are associated with a mental illness - schizophrenia. However, hallucinations can also occur in people with bipolar disorder, both during depression and during mania.

Hallucinations are one of the possible symptoms of bipolar I disorder, both for episodes of mania and for episodes of depression (in bipolar II disorder, they can only occur during depression).

Examples of hallucinations

“I don’t see pink bunnies like they do in cartoons, but sometimes during mania I see movement around the periphery – where there is no one or something moving in the reflection of the mirror. It seems to me that I hear my name or a strange incomprehensible noise. It makes me paranoid - after that I start to notice even more, but in fact I don’t see anything. ”

“I experienced hallucinations during depression in which I saw dead, decaying flesh on people's faces. In addition, I had auditory hallucinations. Some buzzing, thousands of buzzing voices... They were talking about me, but I couldn't make out what they were saying. And sometimes, when I was very excited, it seemed to me that I heard someone's voice whispering my name.

Imagine the following.

You walk from the kitchen into the bedroom, perhaps through the living room. The windows are open, so only the rustling of the curtains in the light breeze breaks the silence. Curtains, chandeliers, the leaves of your houseplants, and maybe even your hair all move in unison. Suddenly, as you are about to enter the hallway, a shadow enters your field of vision and you turn around.

The wind has stopped; everything that moved because of him is now motionless. And on the other side of the room, where a minute ago there was nothing and no one, now a girl in a green sweater is playing with a red ball. Unexpectedly, but for some reason this does not surprise you. She even smiles at you before returning to her game. You smile back at her and walk into the bedroom. Three dogs, a cat and two hummingbirds pass you on the way to the room. Whereas just a minute ago you didn't have pets.

If you are under seventy and have been diagnosed with dementia with Lewy bodies, this picture is quite common for you. Hallucination refers to sensations in the absence of a stimulus. As we have already said, it can be visual, auditory, tactile, olfactory or gustatory sensations. For example, in tactile hallucinations, a person feels that something is crawling over their skin, when in fact there is nothing there. A hallucination should not be confused with an illusion - a distorted or incorrect interpretation of real sensations. In the case of the illusion, the girl in the green sweater, for example, would actually be a houseplant; in the case of a hallucination, there is actually nothing green in this place.

Hallucinations are usually very vivid and seem real - it's almost like a dream, with the only difference being that it occurs while you are awake. Some hallucinations can be pleasant, while others turn out to be scary and destructive.

Causes of hallucinations

Hallucinations appear in three cases:

• visual impairment;
• disorders of the brain;
• side effects of drugs;

visual impairment

In 1760, Charles Bonnet, a Swiss naturalist and philosopher, first described the interesting case of his 87-year-old grandfather who suffered from cataracts. He still retained his mental abilities, however, being almost blind in both eyes, he claimed to see people, birds, animals and buildings.

This syndrome is called Charles Bonnet syndrome, which is characterized by the presence of visual hallucinations in older people with various diseases eye: retinal detachment, macular degeneration, cataracts and damage to the optic nerve. However, the mechanism of its development is still not fully understood.

Some scientists suggest that in this case there is no "blockage" in the areas of the brain that normally process the image. The visual stimulus that is transmitted from our retina to the brain tends to prevent our brain from processing any other image.

For example, if you get bored at work and decide to dream, you will still see a computer monitor in front of you, and not a beach that you can only try to imagine.

When there is visual impairment and there is no visual stimulation, such control becomes impossible, so the brain ceases to hold back the framework of reality.

Brain disorders

Hallucinations manifest many of the brain diseases, although the mechanism of their formation is also poorly understood. The main reasons are:

• mental illness(in particular, schizophrenia, which is considered one of the factors in the appearance of hallucinations). With regard to modality, hallucinations due to schizophrenia are most often auditory in nature, although visual hallucinations certainly occur.
• Rave- a collection of symptoms defined as an inability to maintain attention along with changes in consciousness. It can occur, for example, in infectious diseases. A hangover can also lead to the delirium that usually accompanies delirium tremens. Approximately one third of people who are delusional experience visual hallucinations.
• Dementia with Lewy bodies- a type of dementia, which is characterized by symptoms resembling Parkinson's disease, as well as visual hallucinations and pronounced fluctuations in attention and intelligence. In this case, consciousness, as a rule, is preserved, hallucinations are complex and colorful, but they cannot frighten. Hallucinations also occur in other types of dementia, including Alzheimer's disease.
• Visual hallucinations may result from stroke, which occurred either in the visual centers of the brain, which are located in the occipital lobe, or in the brain stem. In the latter case, the mechanism for the occurrence of hallucinations is similar to what experts described for the Charles Bonnet syndrome. Auditory hallucinations can occur as a result of strokes affecting the auditory centers of the brain, which are located in the temporal lobes.
• The simplest hallucinations (for example, flickering zigzag lines) can provoke even migraine. They occur before a headache or by themselves, pain is not accompanied. More complex migraine hallucinations are called Alice in Wonderland syndrome because they affect the perception of size. Objects, people, buildings, or even your own limbs can appear smaller or larger than they really are - that is, the effect is almost the same as that experienced by the heroine of Carroll's fairy tale.
• Hypnagogic And hypnopompic hallucinations may occur during falling asleep or waking up, respectively. Basically, these are visual or auditory hallucinations, which are usually striking in their bizarreness. They may be associated with sleep disorders such as narcolepsy.
• Various hallucinations (including olfactory and gustatory) can lead to epileptic seizures. They are short-lived and, in the case of a more severe seizure, are accompanied by loss of consciousness. Among the olfactory hallucinations, unpleasant odors prevail, most often the smell of burning rubber.

Side effects of drugs

Hallucinogenic drugs, including LSD (d-lysergic acid diethylamide) or phencyclidine, affect the receptors, causing a distortion of the perception of reality and sometimes outright hallucinations.

In addition, among side effects many over-the-counter drugs have hallucinations. These drugs affect the functioning of the brain, including regulating the production of serotonin, dopamine or acetylcholine, which have importance for normal brain function. For example, drugs used to treat Parkinson's disease are designed to affect the brain's dopaminergic system, which increases the risk of hallucinations.

Interestingly, drugs to combat hallucinations often work by reducing the effect of dopamine.

conclusions

Whether an image, sound, or voice is real or unreal, it is important to understand that all the sensations we take for granted as truth are actually formed in our brain. We only see because we have an entire system that specializes in processing light signals.

The slightest change in this mechanism - and all our "truth" will collapse at the same moment.

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hallucinations(from Latin Hallucination - delirium, visions) - imaginary images of objects and situations perceived as real, but absent in reality, arising spontaneously, without sensory stimulation. Caused by internal mental factors (as opposed to illusion, which is a distorted perception of external stimuli).

Back in the 7th c. The Indian philosopher Kumarilla Bhatta expressed consonant modern guesses about the deceptions of human perception. The illusory nature of the image, he argued, is determined by the perversion of the relationship between the external object and the organ.

The causes may be defects in the sense organs, as well as such disorders when memory images are projected into external world and become hallucinations. Some hallucinations can have a bright sensual coloring, persuasiveness and be projected outside and be indistinguishable from real perceptions. Such hallucinations are called true.

Others are perceived by internal hearing or vision, localized in the internal field of consciousness and felt as the result of the influence of some external force that causes visions, voices, etc. This phenomenon was described at the end of the 19th century. Russian psychiatrist V.Kh. Kandinsky, is called pseudohallucinations.

A hallucinating patient, along with false images, can adequately perceive reality. At the same time, his attention is distributed unevenly, often shifting towards deceptions of perception. For the most part, there is no understanding of the pain of hallucinations, the patient behaves exactly the same as if what seemed to him were actually happening.

Often, hallucinations, no matter how irrational their content, are more relevant for the patient than reality, and patients treat them the same way as the corresponding real phenomena. Patients stare at something, turn away, close their eyes, look around, wave away, defend themselves, try to touch or grab something with their hands, listen, plug their ears, sniff, throw something off their body, etc.

Under the influence of hallucinations, various actions are performed that reflect the content of perceptual deceptions: patients hide, look for something, catch, attack others, sometimes try to kill themselves, destroy objects, defend themselves, flee, complain, etc. With auditory hallucinations, they talk aloud with "voices".

As a rule, patients believe that others perceive the same things that they perceive in their hallucinations - they hear the same voices, experience the same visions, and smell. Emotional reactions are clearly expressed, the nature of which reflects the content of perceptual deceptions: fear, rage, disgust, enthusiasm.

The patient finds himself in great difficulty if imaginary and real images enter into a relationship of antagonism and have an equal power of influence on behavior. With such a "split" personality, the patient seems to exist in two "dimensions" at once, in a situation of conflict between the conscious and the unconscious.

Types and symptoms of hallucinations

The mentally ill, especially those suffering from schizophrenia or manic depression, may believe that they are a messenger from heaven and constantly hear the voice of God speaking to them. He can feel the gentle touch of an angelic hand. These sensory impressions, which come from within the psyche, are perceived as genuine, really existing stimuli coming from outside.

The recurring hallucinations of a mentally ill person can create an entire fantasy world designed to accommodate internal emotional conflict to reality. Less severe cases include hallucinations, usually auditory or visual, that occur in healthy people during periods of deep emotional distress.

Hallucinations can be a delusion of any of the five basic senses, i.e. they are visual, auditory, olfactory, gustatory, tactile and hallucinations of a general feeling (experiencing unusual processes occurring inside the body, sensations from the presence of foreign objects in the body, etc.).

If the patient hears voices, these are auditory hallucinations; if he sees the dead - visual. A patient with paranoia, constantly feeling that the room smells of poisonous gases penetrating through the wall, suffers from olfactory hallucinations. A person who complains of being electrocuted by his pursuers experiences tactile hallucinations.

A patient who feels that poison has been mixed into his food has taste hallucinations. Hallucinations that occur outside of a particular sensory field are also possible. Thus, it may seem to the patient that water is pouring out of some point on his head.

Tactile (tactile) hallucinations are associated with the sensation of touch, usually unpleasant. For example, cocaine users often complain of the sensation of insects running under their skin.

In a state of delirium, usually due to alcohol poisoning, patients often see various small creatures. In this case, the patient describes a normal object reduced to microscopic proportions. When a patient complains that some parts of the body are not where they should be, but in some other place, they speak of psychomotor hallucinations.

Hypnagogic hallucinations occur in mentally healthy people between wakefulness and sleep. Thus, a late-night driver falling asleep at the wheel may suddenly apply the brakes sharply, because it seems to him with complete distinctness that he sees a person running out into the road in front of the car.

Causes of hallucinations

Very often, the occurrence of this disorder is due to severe injuries, or diseases of the brain. Hallucinations occur in the presence of tumors, can be the result of a severe injury.

Among the diseases that cause hallucinations, experts call the following:

• aneurysm
• meningioma of the olfactory gland,
• syphilis,
• temporal arteritis,
• migraine,
• certain cardiovascular problems
• chorea of ​​Huntington.

Scientists assign a special role in the development of hallucinations to eye diseases. It has been established that visual hallucinations occur in glaucoma, cataracts, and some other diseases. Moreover, hallucinations have been found to occur in otosclerosis.

Some people believe that illusions and hallucinations are the same false perception. But their difference is that false perception is observed when the object itself is absent.

Healthy people see hallucinations much more often than you might think. For example, while making a long journey through the desert, languishing from excruciating thirst, it may seem that you can see ahead locality, oasis.

In reality, such objects are nothing more than an optical illusion. But still, it is worth noting that in most cases people with mental illness are prone to hallucinations. Along with visual hallucinations, auditory hallucinations are also observed.

For example, the patient claims to hear the sound of the wind, an approaching car, the knock of a door, and so on - although in reality, nothing like this happens in their environment. It happens that hallucinations are verbal in nature, when it seems to people that someone is calling them, and fragments of a non-existent conversation are also heard.

If auditory hallucinations are commanding in nature, then a mentally ill person often obeys unquestioningly, thereby sometimes causing significant harm to himself or others. It is known that hallucinations are not only visual, and habitual auditory, but also gustatory, and even olfactory. Often all these phenomena are combined.

Regardless of the cause, hallucinations are of a different nature and affect the patient in different ways. They can be neutral in color, or completely devoid of emotionality. Patients treat them calmly, sometimes even indifferently. But there are exceptions when hallucinations are emotionally expressed very clearly. Thus, a case from clinical practice is described, when a mother who lost her son did not get out of a depressive state. In her hallucinations, she often saw the deceased, and these "meetings" brought her great joy.

Discussing the causes of hallucinations of various types, scientists always emphasize that today this process is poorly understood, and the selective disorders that occur during illusions and hallucinations are not clear enough. Scientists single out hallucinations inherent in healthy people as a separate topic.

For example, hallucinations of a mass nature. When they occur, the phenomenon of mass suggestion is observed, when people “turn on” each other, while the crowd becomes a single organism. It has long been established that a person is easily suggestible. When alone, he is able to behave like a critical thinker.

Treatment of hallucinations

Urgent care

Emergency care is based on general principles relief of arousal and treatment of hallucinatory-delusional states. At the same time, it is necessary to take into account the nature of the disease in which hallucinations develop. Thus, visual hallucinations during a feverish state or during delirium tremens require different therapeutic tactics aimed at treating the disease as a whole.

First aid should ensure the safety of the patient and others, prevent dangerous actions caused by fear, anxiety, excitement. Therefore, measures for the supervision of patients are of paramount importance, especially in an acute hallucinatory state. They do not differ significantly from alcoholic measures in delirium.

Medical assistance

Treatment of hallucinations is aimed at reducing arousal and affective disorders: chlorpromazine is administered 2-4 ml of a 2.5% solution or tizercin - 2-4 ml of a 2.5% solution intramuscularly or the same drugs inside at 100-200 mg / day. With continued use of chlorpromazine or tisercin, the doses of which can be increased to 300-400 mg / day, they are combined with drugs that selectively act on hallucinations: triftazine up to 20-40 mg / day or haloperidol up to 15-25 mg / day or trisedil up to 10-15 mg / day intramuscularly or orally in the same or slightly higher doses or etaperazine up to 60-70 mg / day.

Hospitalization in psychiatric institutions is necessary in cases where the hallucinatory (hallucinatory-delusional) syndrome is not caused by a serious physical illness. In the latter case, treatment in compliance with all precautionary measures should be carried out with the participation of a psychiatrist on the spot or with transfer to a psychosomatic department. Transportation of patients is carried out in accordance with the basic principles of transportation of patients with mental disorders.

Questions and answers on the topic "Hallucinations"

Question:Hello. My great-grandmother is 87 years old. She has high pressure under 200 . Her refrigerator sings songs, then the river flows, then someone steals money. Generally glitches. He does not sleep at night, but sleeps during the day. Please tell me what to do. And what medicine to give. Thanks. I am hope for your help.

Answer: Very often, hallucinatory disorders arise from a lack of real communication. If they are caused by diseases characteristic of the elderly, then it is impossible to cope with hallucinations at home. It is necessary immediately, at the first negative manifestations, to contact a psychologist, psychiatrist, neurologist.

Question:Hello, my grandmother is 79 years old and I began to notice that she smears food on herself, eats porridge and smears it on her face at the same time, she can spread jam, sugar, salt, and anything. In some places it eats its own skin, tears it off and eats it. At the beginning there were hallucinations, but there were no new ones for the last six months. In general, the behavior is calm, balanced, easily and quickly irritated, sometimes memory fails (but this is more likely to age). There was no history of chronic diseases and pathology, except for iron deficiency anemia. It is somehow unusual to see this and at the same time I worry about her. I didn’t find a similar description of the situation on the Internet, it scares ignorance what it is? And with what it is connected. Thanks for the answer.

Answer: In this description, I do not see anything else than developing senile dementia (senile dementia) with psychotic symptoms (hallucinations, auto-aggression are obviously associated with some pronounced delusional motives). Consultation of a psychiatrist-gerontologist is required, in his absence - just a psychiatrist. Proper treatment can reduce the severity of inappropriate behavior, slow down the decay of the personality, but is unlikely to stop it completely. Most likely, in the future it will be necessary to resolve the issue of permanent care, observation or placement in a special institution.

Question:Hello, my father had 3 heart attacks, after which a stroke, a little over a month ago, paralyzed the left side of the body, there was a speech disorder, now he is recovering a little, he is starting to walk more or less. He had heart attacks due to alcohol, he had been abusing it regularly for the last 10 years, before that partially. The pressure is dropping. After the second heart attack, she underwent bypass surgery and aortic valve replacement. The problem is that lately he has been sleeping very badly at night, and some sounds constantly seem to him - steps around the apartment, someone opens the lock on the door, they say there are conversations in the next room (which is why he searches the whole apartment in the middle of the night) . Could these be hallucinations? Or maybe it's some kind of fantasy that he wants in reality? What could have caused this? How to deal with it?

Answer: The symptoms you describe are indeed hallucinations, which, in your father's case, may be the result of damage to the brain tissue. You should show your father to a psychiatrist to clarify the diagnosis and prescribe treatment. consultation with a psychiatrist is strictly necessary, so do not delay a visit to the doctor.

Question:Woman aged 86 years. Tactile, auditory and visual hallucinations (insects in bed; bound, tangled, glued legs; foreign objects in the legs; once "muzhiks came." She does not sleep well at night, sometimes she screams all night that she is being eaten and bitten, someone walks, crawling.Grandma lies with a fracture of the femoral neck.There were pressure surges, at the end of February, the doctor said that there were vascular changes in the brain, such as microstrokes (she spoke very poorly, almost did not move, did not see, refused to eat, was constantly sleepy, eyes almost did not open.) What to do?

Answer: For psychiatric diagnosis, a personal consultation with a psychiatrist is necessary. Depending on the general state of health and the severity of hallucinations, the attending psychiatrist will prescribe treatment and select an individual dosage of the drugs used. As part of an online consultation, give appointments psychotropic drugs we do not have the opportunity (these drugs are dispensed in pharmacies only by special prescription).

Question:My husband is 28 years old, he is a drinker, but he didn’t go into drinking binges before, and didn’t get a hangover! But a year ago I was hungover and didn’t drink, and fainted, there was foam and convulsions, everything lasted no more than 5 minutes, then I woke up and didn’t remember anything. I didn’t drink for 2 months, then the same thing happened again. After that, it all started! If he drinks for 3-4 days and nurses, he does not sleep at night: it seems to him that someone is walking at home, they breathe in the back of his head, someone whispers, he jumps up and starts looking. Everyone has to leave the house, because someone in the apartment will do something to us now, but during the day everything is fine, but he does not sleep again, so day 3. Then everything is fine. Recently I have been giving him fenozepam and all the visions stop and he sleeps peacefully. I understand that drinking is strictly forbidden. I would like to know the diagnosis and how to treat! Thanks.

Answer: To clarify the diagnosis and prescribe timely and adequate treatment, it is recommended to consult a neuropathologist and conduct a comprehensive examination: EEG and Echo-EG of the brain, if necessary, MRI of the brain, only after receiving all the results of the examination, the doctor will make an accurate diagnosis and prescribe adequate treatment. Epilepsy and delirium must be ruled out.

Question:My mother is 80 years old. A perfectly adequate elderly person, but recently I began to notice that she sleeps a lot during the day. Constant desire to sleep. I thought it was spring beriberi, I drank it with vitamins, but it is still present daytime sleepiness. And the other day, my mother told me that when she wakes up in the middle of the night she sees strangers in her room, and she understands that this cannot be, she immediately turns on the pile - the vision disappears. He treats it with humor, but it's not funny at all to me. I really look forward to your advice.

Answer: Hello! You need to see a psychiatrist. This happens in old age. Perhaps, against the background of the normalization of sleep and medication, this will pass.

Question:My mother is 72 years old. A normal, socially active person who writes poetry, works with people, but is visually impaired. The following problems appeared. At the moment of waking up, incomprehensible phenomena occur: when looking at the walls and ceiling, color paintings appear, which may contain flowers, geometric figures, animal heads, etc. Sometimes it is as if children, girls, of an absolutely normal natural appearance are sitting on the bed, sometimes the pictures are very unpleasant. When looking at a bright light, the pictures disappear. Last 5-10 minutes. Doctors do not say anything definite, but they do not find any connection with vision. The result was a fear of nightfall. During the day, during sleep, this does not happen. Please advise what to do.

Answer: Hello! If ophthalmologists have ruled out eye pathology, then you need to contact a neurologist and a psychiatrist for examination and selection of therapy.

Question:The woman is 82 years old. Nchyu does not sleep, sees non-existent people, talks to them, feels fear, falls asleep in the morning. Is it curable, and if so, how can it be helped?

Answer: It is curable to a certain extent. Address to the doctor-psychiatrist, it is better to the gerontologist.

Question:Good afternoon! I will try to explain the picture of what is happening - my son is 10 years old very rarely, but such phenomena occur at night - he wakes up and jumps up and cries, does not know where to stick his head, because his sound is amplified - as he explains that the sound comes with great force , th kind of like speakers growing from him put to his ears! At the same time, he runs around the apartment in great tension - his arms and legs are "ice". 5-10 minutes and that's it - I can put him to sleep. It was during high temperature and after an absolutely calm day, he received a lot of positive emotions from the long-awaited gifts - and again at night! He doesn't remember anything in the morning!

Answer: Hello! You need to do an electroencephalogram. Perhaps this is a manifestation of convulsive activity. Consultation of the neurologist is necessary.

Question:Please advise how you can help my mother, who is 88 years old. She began to "hear" various extraneous sounds: either the neighbors' child is crying, then their washing machine makes noise at night, then conversations behind the wall. And all this despite the fact that she has poor hearing, even uses a hearing aid. She asks not to let her adult granddaughter go to her alone, because. gangsters gather in a neighboring apartment, one of whom wants to marry this granddaughter. Otherwise, she is quite adequate: she lives alone, serves herself on her own, goes to the store, cooks, even enjoys crossword puzzles. Mom refuses to go to the doctor, even to the local therapist. Maybe try giving her some light medicine under the guise of vitamins?

Answer: Yes, of course, a light modern antipsychotic. But it should be prescribed by a psychiatrist after an internal examination.