Understanding Hallucinations: What Do People With Schizophrenia See?

When someone has schizophrenia, they may experience changes in their thoughts, moods, and behavior. They may also hallucinate. It can be common for schizophrenia to make people hear things that aren’t there, but some people may also see things that aren’t there, which are often referred to as visual hallucinations. Those experiencing visual hallucinations may see people, animals, shadows, and more. Often, hallucinations and other schizophrenia symptoms can be managed with various treatment options.

You don’t have to manage schizophrenia symptoms on your own

Get support from a mental health professional

What is schizophrenia?

Schizophrenia is a serious mental illness that can affect the ways people think and act. We don’t know exactly what causes it, but brain chemistry, environment, and genetics may all be involved. People with schizophrenia may develop unusual beliefs, withdraw socially, or behave in unusual ways. They may also go through periods when they lose touch with reality. These are sometimes called “psychotic episodes.” People with schizophrenia may have multiple psychotic episodes throughout their lives. 

Schizophrenia is usually viewed as a spectrum disorder. This generally means it can cause a wide range of symptoms that look different for different people. Brief psychotic disorder and delusional disorder can serve as other examples of schizophrenia spectrum disorders. 

Understanding schizophrenia symptoms

Schizophrenia symptoms are often labeled as either “positive” or “negative.” Positive symptoms can be defined as thoughts and behaviors that are present in people with schizophrenia but are usually not present in those without the disorder. Hallucinations are one example. Other positive symptoms may include the following:

• Delusions: Delusions can be thought of as false beliefs that can’t be changed with proof or logic. These can take multiple forms. Some examples include grandiose delusions (believing you’re rich or superhuman), persecutory delusions (believing others are out to get you), and somatic delusions (believing something is physically wrong with you). 
• Disorganized thinking: Disorganized thinking typically refers to having trouble thinking clearly. A person may jump between ideas, struggle to make plans, or have trouble making logical decisions.
• Disorganized speech: Disorganized thoughts may also present as disorganized speech. For example, someone might go off on tangents, make up words, or talk in a way that others can’t understand. 

Negative symptoms of schizophrenia can be defined as thoughts and behaviors that are absent in people with the disorder. Some examples include those listed below:

• Lacking the motivation to do things like bathing, getting dressed, or going to work
• Lacking the ability to feel pleasure
• Lacking the desire to socialize
• Lacking the ability to express emotions

These symptoms can have significant effects on a person’s daily life and relationships. They may also contribute to other mental illnesses, like anxiety disorders and depression. 

What happens when people with schizophrenia experience hallucinations? 

Hallucinating can be thought of as experiencing something that seems real but isn’t. Hallucinations may seem so real that they can be hard to distinguish from reality. 

Schizophrenia can cause several types of hallucinations:

• Auditory: People having auditory hallucinations may hear voices or other sounds, such as static, banging, knocking, or whispering. According to some estimates, 60% to 80% of people with schizophrenia may experience auditory hallucinations. 
• Visual: Visual hallucinations generally refer to seeing something that isn’t there. They are thought to be the second most common type of schizophrenia hallucination, although updated research may be necessary.
• Tactile: This can describe feeling physical sensations without being touched. For example, someone might sense that insects are crawling on their skin, even when there’s nothing there. 
• Gustatory: Gustatory hallucinations can make people taste phantom flavors in their mouths. The flavors may be metallic, rotten, sharp, salty, or bitter. 
• Olfactory: Olfactory hallucinations usually take place in the form of smelling something that isn’t there. Examples can include the smell of burning food, chemicals, metals, garbage, and smoke. 

Some people with schizophrenia may experience only one type of hallucination. Others may experience multiple types. 

A closer look at visual hallucinations

Now that we’ve reviewed the symptoms of schizophrenia, let’s zoom in on one: visual hallucinations. What causes them? What do people with schizophrenia see when they hallucinate? These can be common questions, so let’s explore what we know so far. 

In general, visual hallucinations are considered rarer in schizophrenia than auditory hallucinations. Researchers have estimated that they happen for around 27% of people with schizophrenia. However, schizophrenia can also cause other types of visual symptoms, like visual distortions. These tend to be subtle changes in what people see, and they don’t usually rise to the level of full-blown hallucinations. Some examples include the following:

• Blurred vision
• Sensitivity to light
• Temporary blindness
• An altered sense of space or distance
• Changing colors

Visual distortions tend to be more common than visual hallucinations in people with schizophrenia. According to a recent review of vision-related schizophrenia symptoms, visual distortions may occur in up to 60% of people with the disorder. 

That said, full-blown visual hallucinations are also possible. These visions may be temporary, but they may also last for multiple hours. They are often, though not always, in color. The images may be complex, like people or objects, but they can also be more abstract, like lights and geometric patterns. It can be common to see things like:

• Loved ones
• Supernatural beings
• Faces
• Animals
• Shadows

Visual hallucinations are often distressing. In a different review of existing data from 2014, researchers noted that visual hallucinations often involve frightening images, like fires, religious figures, distorted faces, and snakes. (Note that because mental health research is always evolving, older sources may have been reevaluated since their original publication.)

The exact causes of visual hallucinations are still being researched. However, studies of brain activity in people with schizophrenia may reveal some clues. In a 2015 study, researchers took MRIs of people with schizophrenia who reported having visual hallucinations. Their brains were frequently found to have high levels of connectivity between the amygdala and the visual cortex. The amygdala is a structure that usually plays a role in emotions, especially fear and anxiety. Meanwhile, the visual cortex is generally responsible for receiving and interpreting information from the eyes. It’s possible that these two structures interact in unique ways in people who hallucinate visually. 

You don’t have to manage schizophrenia symptoms on your own

Get support from a mental health professional

Getting help for hallucinations

Hallucinations can be distressing, no matter the type, but they can often be managed. Usually, people with schizophrenia require lifelong treatment, but with the right support, it’s often possible for them to improve their symptoms. At least one in three individuals with schizophrenia may recover from their symptoms completely. 

Working with a mental health professional is often the first step in managing schizophrenia. In addition to medication, your doctor may recommend other forms of mental health support, like therapy. This may be especially helpful for learning healthy ways to cope with hallucinations. 

If hallucinations are causing you distress, it may not always be easy to leave the house for in-person therapy sessions. Online therapy platforms generally enable you to receive therapy from the comfort of your home. This may make them more accessible than in-person therapy if you’re living with schizophrenia. However, some individuals experiencing acute symptoms may need to seek care in person.

Research shows that internet-based treatments may be helpful for people with schizophrenia. In 2016, researchers used a telehealth program to support veterans with schizophrenia who were at risk of suicide. They found that online treatment led to positive responses and improvements in symptoms for most participants. 

If you are experiencing suicidal thoughts or urges, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text 988 to talk to someone over SMS. Support is available 24/7. 

Takeaway

Schizophrenia is a mental illness that can cause changes in beliefs, emotions, and behavior. Hallucinations tend to be a common symptom for those living with this disorder. While schizophrenia may be known for causing auditory hallucinations, some people can also experience visual hallucinations. The content of these hallucinations can range from abstract to complex. People may see figures, faces, animals, shadows, or other images, which can be distressing. However, hallucinations, like other schizophrenia symptoms, can often be managed with proper treatment, which often includes a combination of doctor-prescribed medication and online or in-person therapy.