Mental Health Matters: Of delusions and hallucinations
What is the difference between delusions and hallucinations?
Today’s question — and topic — comes from a high school student and both of these situations are commonly misunderstood in the general public, largely because we tend to get our information about mental illness from movies and television crime dramas.
No, these are not reliable sources of information nor, more importantly, sources of understanding about mental illness or conditions often found in mentally ill people.
At the risk of over-simplifying these conditions, a hallucination is an event in which one or more of a person’s senses receive information not experienced by others.
A person hears voices, sees a person or object that is not really there, feels the sensations of something touching them or smells odours that others cannot detect.
That is different from just seeing something that is not there, such as a mirage, because a mirage can be seen by an entire group of people, yet it’s still not there.
In the most general terms, a delusion is not so much related to our sensory awareness, but to our belief system.
A person who is delusional will hold a very strong conviction about something even in the face of strong evidence that belief is untrue.
If you are convinced a supermodel you have never met is in love with you, then you are likely delusional.
With both hallucinations and delusions, the “reality” being perceived by a person experiencing them is convincing and very real.
It is not a rational belief as trying to convince or prove a delusional or hallucinating person is wrong never works.
If you think about it, you also may be like that about anything about which you believe strongly.
People who hold strong beliefs about their favourite political party or religion are not easily swayed with argument, either.
When we ask a person who is hallucinating or who is delusional to just take our word that they cannot see, hear, taste or touch the thing they say is there, or that their belief is completely out to lunch and that no one else believes it, we are asking that person to ignore their own experience or senses.
Ignoring our senses can be deadly, so survival instincts alone make it very difficult for someone to simply agree they are not experiencing reality.
What can you do to assist someone who is experiencing hallucinations or delusions?
Find out more about what the person is experiencing.
Often, people who experience these symptoms can be paranoid — and that makes your motives and actions appear highly suspicious or dangerous to the person you may be trying to help.
They might lash out in you in self-defence with the firm belief you are trying to do them harm, rather than help them.
Keep a respectful safe distance, remain calm, do not try to convince people their delusions or hallucinations are wrong and arrange for an appropriate response from paramedics.
If it appears a person is capable of self-harm or harming others because of the nature of their hallucinations or delusions, police should also be called.
Some hallucinations and delusions are side effects of drug or alcohol use or withdrawal from a substance.
Never approach someone in crisis, with the belief your calmness, your personality or your reassurance will be enough to settle someone down.
Rather, stay safe and call for help.
Their experience is irrational, but very, very real to them.
You can learn more about how to deal with this or other mental-health crisis situations in our two-day mental-health first-aid course.
Even if you know how to respond to a bad cut or how to help someone who has stopped breathing, most people freeze when they witness a person in a mental-illness crisis.
Mental-health first aid can help, so contact us for more information about this course.
The CMHA would like to thank the thoughtful and perceptive young lady who asked this question and
encourages you to ask us about any issue related to mental health or mental illness that you would like
to know about. Write to us here because it is always great to hear from you!