Mind
Seeing or hearing things that are not there
Seeing, hearing, feeling or smelling things that are not really there, which can have many causes ranging from severe tiredness or grief to mental illness, dementia or a serious physical problem needing urgent care.
Education and reference only. This explains the common causes of seeing or hearing things that are not there and the warning signs that need urgent help, in plain language — it is not a diagnosis or a substitute for advice from a clinician. If you feel very unwell or are worried, seek medical help.
Quick answer
What is seeing or hearing things that are not there?
Hallucinations mean perceiving something that is not actually present — most often hearing voices or sounds, but also seeing, feeling, smelling or tasting things. They range from fleeting and harmless, such as hearing your name as you fall asleep or briefly sensing a recently bereaved loved one, to a sign of significant illness.
- Get urgent help: New hallucinations with a high fever, a severe headache, or after a head injury — call 999, as this can signal a serious infection or brain problem. New hallucinations with sudden confusion, drowsiness or signs of stroke (FAST: face, arms, speech, time) — call 999.
- Self-care: Hallucinations are not something to manage alone, and the most important step is to seek advice so the cause can be found.
About seeing or hearing things that are not there
Hallucinations mean perceiving something that is not actually present — most often hearing voices or sounds, but also seeing, feeling, smelling or tasting things. They range from fleeting and harmless, such as hearing your name as you fall asleep or briefly sensing a recently bereaved loved one, to a sign of significant illness. Persistent hallucinations, particularly hearing voices, can be a feature of schizophrenia, and they can also occur during the highs or lows of bipolar disorder. In older people, new hallucinations may accompany dementia or, importantly, an acute physical illness such as an infection that causes sudden confusion. Conditions affecting the brain such as parkinsons-disease can cause visual hallucinations, and they may also arise with heavy alcohol use or on stopping alcohol after dependence. Because some causes are urgent, new hallucinations — especially with fever, severe headache, confusion or after a head injury — should be assessed promptly.
When to get help
Call 999 or go to A&E if seeing or hearing things that are not there comes with any of these warning signs:
- New hallucinations with a high fever, a severe headache, or after a head injury — call 999, as this can signal a serious infection or brain problem.
- New hallucinations with sudden confusion, drowsiness or signs of stroke (FAST: face, arms, speech, time) — call 999.
- Thoughts of harming yourself or others — get help now: call 999 or the Samaritans free on 116 123.
- Hallucinations and confusion on stopping alcohol after heavy, dependent drinking — seek urgent help, as withdrawal can be dangerous.
- Hallucinations that are frightening, distressing or making it impossible to keep yourself safe.
When to see a doctor
New or worsening hallucinations should always be discussed with a doctor so the cause can be identified, as it ranges from treatable physical illness to mental health conditions that respond well to support. Seek urgent or emergency help if hallucinations come on suddenly with fever, a severe headache, confusion, drowsiness or signs of a stroke, or after a head injury, as these can mean a serious physical problem. Also seek urgent help if the hallucinations are frightening or distressing, if you ever have thoughts of harming yourself or others, or if they occur while cutting down alcohol after heavy drinking. Many causes are very treatable, and early help makes a real difference.
Not sure how urgent it is? It is always OK to call NHS 111 for advice, day or night.
What can cause it
Common causes of seeing or hearing things that are not there
Seeing or hearing things that are not there has many possible causes. Each links to a full, plain-language guide to that condition — what it is, how it's treated and when to seek help.
What helps
Self-care and what you can do
Hallucinations are not something to manage alone, and the most important step is to seek advice so the cause can be found. While waiting to be seen, it can help to keep your surroundings calm, well-lit and familiar, to get regular sleep, and to avoid alcohol and recreational drugs, all of which can make hallucinations worse. If you care for someone who is hallucinating, stay calm and reassuring, do not argue about whether what they perceive is real, and gently keep them safe. Note when the hallucinations happen and what else is going on, such as fever, confusion or changes in medicines, as this information helps the clinician. Always treat new hallucinations with fever, severe headache or confusion as urgent.
Answers
Seeing or hearing things that are not there: frequently asked questions
Does hearing voices always mean a mental illness?
No. Brief experiences such as hearing your name as you fall asleep, or sensing a recently bereaved loved one, are common and harmless. Persistent voices or other hallucinations should be assessed, as causes range from physical illness to mental health conditions, all of which can be helped.
When are hallucinations an emergency?
New hallucinations with a high fever, a severe headache, sudden confusion, drowsiness, signs of a stroke, or after a head injury are an emergency — call 999. So is hallucinating with thoughts of harming yourself or others.
Can physical illness cause hallucinations?
Yes. In older people especially, an infection or other acute physical illness can cause sudden confusion with hallucinations. Some conditions affecting the brain, and alcohol problems, can also cause them, which is why a physical assessment matters.
How should I help someone who is hallucinating?
Stay calm and reassuring, keep the surroundings safe and familiar, and do not argue about whether what they perceive is real. Seek medical advice urgently if there is fever, confusion, a head injury, or any risk to safety.
Sources
Where this is drawn from
- Mind (mental health charity)
- Rethink Mental Illness
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