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What do visual hallucinations mean?


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#1 encapsulated

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Posted 26 September 2008 - 04:53 AM

I know it is not possible to diagnose anyone over the internet, I am just after some ideas of what the hell is up. To me, hallucinations are a symptom of something being very seriously wrong. But there is this person, in her early 20s, who is adequate, in touch with reality as far as I can see, and more functional than I am (dammit!). But she is seeing things. It used to happen at night, when it could be written off as misinterpreting things in the dark, or as hypnogogic. But now it is happening in broad daylight as well. She sees things like faces outside the window looking in, people sitting on an empty park bench. She knows they are not real. She has what seems like low-level depression, not enough to interfere with day-to-day functioning. Lack of appetite, food idiosyncrasies. Some anxiety. Miscellaneous things which do not seem to add up to anything. She also has a drinking problem. Has been sober for 11 months, not on drugs. It seems that hallucinations actually became worse after she stopped drinking. She went to a doctor, who gave her some benzos (no idea why). Benzos made the hallcinations worse. She ignores advice like "go see a psychiatrist", I think because that will mean she is crazy. I am trying to figure out how important it is to get her to a psychiatrist soon.
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#2 olga

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Posted 26 September 2008 - 08:02 AM

Well, if she won't see a pdoc, there isn't much you can do. Would she see a counselor or therapist? Maybe a diplomatic one could convince her that she needs some meds/therapy. If I were seeing faces at the window, I'd sure want to get my butt into a doctor's office.

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#3 Silver

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Posted 26 September 2008 - 11:29 AM

Or perhaps back to a GP who doesn't give her benzodiazepines.
Visual hallucinations in the absence of clear affective symptoms, in the absence of auditory hallucinations, in the absence of, in fact, anything else, suggest sleep disorder or neuro disorder, among other things. Sleep study is a non-threatening idea for most people.

Not a diagnosis, just a suggestion that she does indeed follow up.
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#4 Velvet Elvis

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Posted 26 September 2008 - 12:00 PM

It's important that she knows they aren't real. If she were psychotic that likely wouldn't be the case.

Point out that it could be a tumor. That should get her attention.

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#5 Silver

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Posted 26 September 2008 - 12:49 PM

It's important that she knows they aren't real. If she were psychotic that likely wouldn't be the case.

very good point and goes back to neuro. and the need to follow up.
I wouldn't get into a push-pull with her about it - just say, "Look, get your ass in to see someone, kid," make your case once, and back off.
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#6 confused

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Posted 26 September 2008 - 01:22 PM

I think I can come across as being fine even when I am psychotic. I have varying degrees of insight. It's huge that the hallucinations aren't influencing her behavior. I'm not disagreeing with what anyone else has said and she definitely needs to be checked to make sure it's not a brain tumor or something else physical, but she might actually have a psychological disorder.

The benzos may have been for the anxiety. It's too bad they made her worse.

I think the first step would be to get her to a medical doctor again. They can order tests and refer her to a pdoc if she needs to see one. Could you go to the appointment with her? She might be glossing over and not mentioning everything. I wish you and your friend well.

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#7 Twitch

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Posted 26 September 2008 - 11:09 PM

I think I can come across as being fine even when I am psychotic. I have varying degrees of insight. It's huge that the hallucinations aren't influencing her behavior. I'm not disagreeing with what anyone else has said and she definitely needs to be checked to make sure it's not a brain tumor or something else physical, but she might actually have a psychological disorder.


Not saying you are wrong or anything, but it's unlikely its a psychological disorder, especially a psychotic disorder, when the only symptom here is visual hallucinations. Even a little bit of anxiety or a little bit of depression doesnt correlate with visual hallucinations. So its doubtfully a psychotic symptom. Especially when theres no sign of thought disturbance. And what you stated, that its not influencing her behavior, is also a huge sign.

If shes afraid of being "crazy" then I would go forth and tell her whats up on the Neuro physical side. Because theres obvioulsy something not right, and its doesnt sound like a psychiatrist could do anything at this point anyway. Well besides throwing drugs at her like her doctor did, which wont will doubtedly do anything for the problem here.
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#8 confused

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Posted 26 September 2008 - 11:36 PM

I think I can come across as being fine even when I am psychotic. I have varying degrees of insight. It's huge that the hallucinations aren't influencing her behavior. I'm not disagreeing with what anyone else has said and she definitely needs to be checked to make sure it's not a brain tumor or something else physical, but she might actually have a psychological disorder.


Not saying you are wrong or anything, but it's unlikely its a psychological disorder, especially a psychotic disorder, when the only symptom here is visual hallucinations. Even a little bit of anxiety or a little bit of depression doesnt correlate with visual hallucinations. So its doubtfully a psychotic symptom. Especially when theres no sign of thought disturbance. And what you stated, that its not influencing her behavior, is also a huge sign.

If shes afraid of being "crazy" then I would go forth and tell her whats up on the Neuro physical side. Because theres obvioulsy something not right, and its doesnt sound like a psychiatrist could do anything at this point anyway. Well besides throwing drugs at her like her doctor did, which wont will doubtedly do anything for the problem here.


Thanks. I didn't mean to give any misinformation.

schizoaffective bipolar type, social anxiety, depersonalization disorder
abilify, lamictal, lexapro, wellbutrin, seroquel

It just may be a lunatic you're looking for

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http://psychcentral....isorder/0001564


#9 encapsulated

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Posted 27 September 2008 - 12:44 AM

Yes, I did think it could be neurological also. There may be things she is not telling, yes, but she never mentioned hearing something when her hallucinations occur. Visual hallucinations by themselves sound odd to me also. She went to another doctor who tried to refer her to a pdoc, she didn't want to do that. She keeps asking for advice but doesn't take in what she doesn't like, and is somehow hoping it might go away, I suspect, trying to minimise the problem. I am not sure if she would want to be looked at by a neurologist, but I agree it is a good idea. A neurologist sounds less threatening, unless you are in fact afraid you have a tumour. So I'd rather not suggest that, in case she freaks out over that as well.
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#10 Silver

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Posted 27 September 2008 - 12:04 PM

It's rarely a tumor. In any case, imaging resolves the question quickly.
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#11 Guest_fatchick_*

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Posted 27 September 2008 - 03:07 PM

I know it is not possible to diagnose anyone over the internet, I am just after some ideas of what the hell is up. To me, hallucinations are a symptom of something being very seriously wrong. But there is this person, in her early 20s, who is adequate, in touch with reality as far as I can see, and more functional than I am (dammit!). But she is seeing things. It used to happen at night, when it could be written off as misinterpreting things in the dark, or as hypnogogic. But now it is happening in broad daylight as well. She sees things like faces outside the window looking in, people sitting on an empty park bench. She knows they are not real. She has what seems like low-level depression, not enough to interfere with day-to-day functioning. Lack of appetite, food idiosyncrasies. Some anxiety. Miscellaneous things which do not seem to add up to anything. She also has a drinking problem. Has been sober for 11 months, not on drugs. It seems that hallucinations actually became worse after she stopped drinking. She went to a doctor, who gave her some benzos (no idea why). Benzos made the hallcinations worse. She ignores advice like "go see a psychiatrist", I think because that will mean she is crazy. I am trying to figure out how important it is to get her to a psychiatrist soon.


Someone I know had hallucinations because of one of his prescription drugs. I can't recall which drug, but he had a heart problem & did take Ambian. His drugs were replaced or lowered & the hallucinations were gone. Bugs on the walls is what he saw. Just a thought.

#12 graduation day

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Posted 27 September 2008 - 05:20 PM

Just to put in my five;

It's possible to be in the schiz spectrum and have hallucinations without being fully psychotic - personally I have schizotypal disorder and experience various hallus (auditive, visual and tactile, each on their own, and I'm fully aware of what's going on) and strange thoughts plus negative symptoms (mild depression). In my case, it's good that they discovered it because left on it's own, it can develop into a full blown psychosis. What you describe sounds like classic negative schiz-spectrum symptoms to me (anhedonia, avolition) along with positive symptoms (hallucinations, various preoccupations)

Please do what you can to have her checked out.

Edited by graduation day, 27 September 2008 - 05:20 PM.

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#13 encapsulated

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Posted 28 September 2008 - 04:05 AM

Someone I know had hallucinations because of one of his prescription drugs. I can't recall which drug, but he had a heart problem & did take Ambian. His drugs were replaced or lowered & the hallucinations were gone. Bugs on the walls is what he saw. Just a thought.

She is not on any drugs. And the hallucinations have been around for a while, but they got worse recently. She was on benzos, but only briefly.

Just to put in my five;

It's possible to be in the schiz spectrum and have hallucinations without being fully psychotic - personally I have schizotypal disorder and experience various hallus (auditive, visual and tactile, each on their own, and I'm fully aware of what's going on) and strange thoughts plus negative symptoms (mild depression). In my case, it's good that they discovered it because left on it's own, it can develop into a full blown psychosis. What you describe sounds like classic negative schiz-spectrum symptoms to me (anhedonia, avolition) along with positive symptoms (hallucinations, various preoccupations)

Please do what you can to have her checked out.

I always thought negative symptoms of schiz spectrum disorders had to be quite a bit more pronounced. But I am really no expert on those things, never had to deal with this before. She does seem depressed and a bit flat. But still functional. The hallucinations do not seem to fit any affective pattern - neither pleasant, nor unpleasant, nor frightening. At least she is not describing them in those terms. One thing I have realised is that her way of dealing with them does not seem to be entirely rational. At least it does not make sense to me. She keeps coming up with odd explanations for it, like it is related to her drinking problem (not sure if it is due to her interest in the problems of alcoholism in general - if you have a hammer, everything looks like a nail). But why ask for advice and then ignore it? Even with a doctor? And keep minimising it. Otherwise I haven't seen her act irrationally. But I do not know everything about her life and behaviour. And me having a psych disorder just makes me more likely to see hallucinations as something to be attended to pronto. But surely an average person would be seriously worried? She had a number of others advise her this also (including other alcoholics who said this does not fit with her drinking problem).

Anyway, I am going to see what she replies to my email, when she does. If she doesn't want to do it, she doesn't want to do it. I am a bit tired of trying to make people help themselves. Only works if they actually want it. Sorry, feeling a bit frustrated.
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#14 yellowbutterflies

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Posted 21 October 2008 - 07:00 PM

Hi encapsulated,

I believe that hallucinations may be benign or they may be symptomatic of something else, such as an under-lying physiological imbalance in the brain. 'Halluncination' is just a symptom and is not sufficient for the diagnosis of a mental illness on its own. The only person who can reliably do so is a qualified person such as a doctor who can examine her and talk to her face to face. The longer a mental illness goes untreated the more likely it's impacts will be significant and devastating.

If she is refusing to seek expert advice there is nothing you can do to make her. However, perhaps you might suggest that she see her or her family's doctor as the thought of seeing a neuro or pdoc can be rather intimidating especially for the first time. I'm sure she would feel much more comfortable around a familiar face and would be more likely to talk about symptoms that she prefers keeping to herself with you. I am aware she does not have a doctor she trusts. Is there no one other than the person she saw? Perhaps you could suggest a doctor you trust to her? At this stage getting her to see any kind of medical health professional would be a good achievement. A doctor will be able to tell her: (1)whether she needs to see a health specialist, and, (2) which particular specialist (neuro/psych) she should go to. Ideally a good doctor with also: (3) refer her to a particular specialist who will be most likely person to meet her needs.

I have bipolar with a psychotic component and have experienced hallucinations (visual and auditory - though not at the same time) both though periods of diagnosed psychosis and also during my current bipolar remission (ie: when disease symptoms are not significantly harming daily functioning - key word 'significantly'). The latter hallunications are evidently correlated with the symptoms of underlying anxiety disorders and a two week depressive state. If your friend's hallucinations are due to a physiological imbalance in the brain (as mine are) I might speculate that it is likely they are caused by a similar underlying disease (such as depression) however you shouldn't go by or other people's speculations but encourage her to see a doctor for her peace-of-mind.

There is also a small possibility that drinking a couple of glasses may have induced my hallunications (I am currently testing this theory).

This thread is relevant to your query too:
http://www.crazyboar...showtopic=25735

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