Hallucinations

Hallucinations are hearing, seeing, smelling, tasting or feeling things that seem real but aren’t there. Hearing voices is the kind people most often mean. Causes range from psychosis and delirium to drugs, high fever, grief and the edge of sleep, and some kinds are normal. What matters is the cause and how much they disturb your life.

Also called: hearing voices; seeing things; “hallucinating”. When hallucinations come with fixed false beliefs and loss of contact with reality, the state is called psychosis.

Types

Hearing (auditory): voices, your name being called, music or noises nobody else hears
Seeing (visual): people, shapes, lights or animals that aren’t there
Touch (tactile): being touched, insects crawling on the skin, or organs moving inside you
Smell and taste (olfactory and gustatory): an odour or taste with no cause
Body sense: feeling that you’re floating or flying

Causes

Mental health conditions: schizophrenia, bipolar disorder during mania, severe depression, psychosis after childbirth, and PTSD.
Drugs and alcohol: cannabis, heavy drinking and withdrawal from it, and stimulants. Up to about 4 in 10 people who use methamphetamine (mkpuru mmiri) have psychotic symptoms; most clear within days of stopping, but they can persist.
Illness: high fever and malaria, infections, HIV, head injury, dementia and Parkinson’s disease. Sudden confusion with hallucinations in an older or ill person is delirium, a medical emergency.
Medicines and surgery: some prescription medicines, and the hours after anaesthesia.
Loss of sight or hearing: the brain fills the gap with images or sounds.
Grief: hearing, seeing or sensing someone who has died is common after bereavement. Small studies report it in 3 to 6 of every 10 widowed people, most with no mental illness. It isn’t madness.
Sleep: in a UK survey of 4,972 people, 37% had hallucinated while falling asleep and 12.5% while waking. They’re commoner with insomnia, and they’re part of sleep paralysis.
Hunger, exhaustion and migraine can cause brief ones too.

Across 61 studies, about 7 in 100 people report a psychotic-like experience at some point. In about 8 of 10, it fades without becoming a disorder.

Treatment

Treatment follows the cause. A doctor will check for fever, infection, drugs, alcohol and medicines first. When hallucinations are part of a mental health condition, a psychiatrist may prescribe antipsychotic medicine, alongside talking therapy and support for the family. Sleeping more, drinking less and stopping drugs reduce hallucinations whatever the cause. Grief hallucinations usually need no treatment at all, only someone to tell.

In Nigeria

Hearing voices is often read as a spiritual attack or “madness”, and fear is heavy: in a 2005 survey in three Yoruba-speaking states, almost everyone believed people with mental illness are dangerous. That fear keeps people from getting help, and household data show most Nigerians with a mental disorder get no treatment at all. In hospital studies, many people with psychosis had seen a traditional or faith healer first. Faith can support recovery, but hallucinations from malaria, drugs or psychosis need medical care, and the National Mental Health Act 2021 bans chaining anywhere, including at healing centres. Hearing a dead parent’s voice in the months after a burial is a normal part of grief, not a sign of illness.

Hallucinations vs illusions, delusions and imagination

An illusion is misreading something real: a wrapper on the floor looks like a snake for a second.
A delusion is an unshakeable belief in something untrue, such as being followed. Hallucinations and delusions often come together in psychosis, and the person usually can’t tell they aren’t real.
Imagination, dreams and flashbacks are experiences you know are in your mind, even when they’re vivid.

When to get help

Get help now if you or someone else hears voices telling them to harm themselves or anyone else, is very agitated, is suddenly confused, or has hallucinations that are quickly getting worse: call 112 (or 767 in Lagos), or Safe Place Nigeria on 0800 800 2000. The full list is on our helplines page. The Federal Neuro-Psychiatric Hospital in Yaba runs a 24-hour emergency unit.

See a doctor about any new hallucination, especially with fever, drug use or a head injury. Once medical causes are handled, a therapist can help with the fear, sleep and stress around the experience. You can book a licensed therapist on Mytherapist.ng for general mental health, alongside a psychiatrist’s care.