Understanding the Role of Nonpsychotic Hallucinations in Mental Health

Although cultural perceptions suggest that hallucinations are a product of psychotic disorders, they are actually much more present in nonpsychotic mental health challenges like anxiety and depression than we previously believed. By opening up dialogue about hallucinations in nonpsychotic disorders, we canreduce the fear and stigma surrounding them, ultimately helping people struggling with this symptom, regardless of disorder, get the treatment that they need.

For two months straight, I encountered a woman on a daily basis that nobody else saw—yet I believed her to be completely real. Sometimes she seemed to speak to me in a language that I couldn’t understand, always disappearing after about five minutes. She always appeared when I was at my most anxious, and seeing her usually struck fear into me, a fear that escalated my anxiety. I later learned that this “woman” was a hallucination, a byproduct of my concurrent social anxiety and agoraphobia. Although I was shocked at the revelation, it was also eye-opening in the face of my diagnosis, because I always associated hallucinations with psychosis.

When you hear the word “hallucination,” you probably think of mental health challenges like schizophrenia. And if you’re experiencing them yourself, there’s a good chance that you’ll immediately start thinking your symptoms stem from just such a psychotic disorder. But this isn’t always the case: contrary to popular perceptions, hallucinations manifest in a wide range of mental health disorders such as anxiety and depression much more commonly than we previously thought.

Hallucinations are misunderstood as it is—inaccurate media representations of schizophrenia typically combine them with the symptomatology of dissociative identity disorder (DID), and often portray them manifesting as fully developed, unique personalities, which doesn’t actually happen. These kinds of inaccurate cultural perceptions of hallucinations in schizophrenia create a stigma that can prevent people living with it from seeking treatment due to fears of being misunderstood and pigeonholed into common stereotypes of the disorder. And if you’re living with anxiety or depression in the presence of hallucinations, these same fears and misunderstandings can affect you and prevent you from seeking treatment as well.

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Opening Up Dialogue About Hallucinations in Nonpsychotic Disorders

Depression and anxiety, two of the most common mental health challenges in the United States, are growing increasingly easier to talk about given the public focus and acceptance surrounding them. But if you have hallucinations, you might feel different and confused—like you’ve been pushed to the outskirts of the world of mental health, afraid to seek treatment. By shedding light on the reality of hallucinations, we can help people feel more comfortable talking about them and less isolated and alone in their struggle, ultimately guiding them towards treatment.

Even outside the realm of psychiatric disorders, research has shown that people in the general population experience hallucinations. Although they happen infrequently, the fact that they manifest at all supports the idea that some researchers refer to as the “psychosis continuum,” which suggests that the potential for psychosis and its symptoms is present in everybody. “We used to think that only people with psychosis heard voices or had delusions, but now we know that otherwise healthy, high-functioning people also report these experiences,” said John McGrath of the Queensland Brain Institute, who conducted research on this possibility.

Does that mean that hearing voices shouldn’t be cause for alarm? “If people are having regular experiences we recommend that they seek help,” McGrath said. Regardless, it’s an interesting field of research that highlights the possibility that hallucinations aren’t mystical phenomena that only happen in a small portion of people living with psychotic disorders—they can happen to nearly anyone, as a result of our brain processing information that it typically ignores while awake.

We’re not sure exactly why this happens in people with nonpsychotic mental health challenges, but research suggests that a number of brain structures responsible for processing sensory input from our surroundings (images, sounds, smells) are hyperactive in people with anxiety disorders as well as depressive disorders. And as of now, data suggests that the prevalence rate of hallucinations in people with nonpsychotic disorders is 12.6 percent, a number that should highlight the need for continuing to study them. Although hallucinations themselves are not dangerous, they can create fear and anxiety that exacerbates symptoms of your illness, especially when you’re living with concurrent schizophrenia.

Reducing Fear and Stigma

Regardless of what sort of mental health challenge you’re struggling with, knowing that hallucinations are more universal than we thought should bring you comfort and open the door to acceptance. Consider experiencing social phobia, agoraphobia, and panic attacks—hallucinations can not only strike fear into people living with these disorders, they tend to arise in moments of intense anxiety. Though hallucinations cannot cause you any direct harm, because they’re manifesting at a time when you’re already scared and anxious, they can exacerbate your fear and feed into the cycle that drives your mental health challenges.

Psychotherapies for anxiety disorders have a strong focus on identifying the thought processes linked to your fear and understanding what’s driving them in order to reach resolution. Given that our misconceptions about hallucinations are likely driving forces that cause many people to fear them, it only makes sense to try and resolve these misconceptions in order to help you and others suffering from nonpsychotic disorders begin recovery.

Inaccurate cultural perceptions are difficult to break—they burrow their way into our consciousness and remain there, influencing the way that we feel and think until they are addressed. In a comprehensive residential treatment program, you can address your mental health challenges and the hallucinations that accompany them in a setting designed to break these perceptions and overcome your fears. Through this process, you will learn to distance yourself from stigma and take control of your mental health challenges, focusing on the treatments conducive to your recovery instead of the perceptions that threaten to hinder it.

Bridges to Recovery offers comprehensive residential treatment for people with both psychotic and nonpsychotic disorders struggling with hallucinations. Contact us if you or your loved one needs guidance in addressing and understanding their hallucinations in order to achieve recovery.

Lead Image Source: Unsplash user Joshua Earle