UBCNews - Business - Are Delusions & Hallucinations The Same In Psychosis? Mental Health Pros Explain

Episode Date: November 24, 2025

Welcome back, everyone. Today, we're tackling a question that comes up a lot when people are trying to understand psychosis: Are delusions and hallucinations the same thing? Because these terms get thrown around interchangeably, but they're actually quite different. A Mission for Michael (AMFM) City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://amfmtreatment.com/

Welcome back, everyone. Today, we're tackling a question that comes up a lot when people are trying to understand psychosis. Are delusions and hallucinations the same thing? Because these terms get thrown around interchangeably, but they're actually quite different. Yeah, they really are. And understanding the distinction matters because even though both involve a break from reality, they affect completely different aspects of a person's experience. Delusions are false beliefs. They're about how someone thinks. thinks. Hallucinations, on the other hand, are false perceptions. They're about what someone senses. So one is cognitive and one is sensory? Exactly. Think of it this way. A hallucination means you're seeing, hearing, feeling, smelling, or tasting something that isn't actually there in reality, like hearing voices when no one is around, or feeling bugs crawling on your skin when there aren't any. That sounds terrifying. And I imagine these aren't rare occurrences. Unfortunately, no. And delusions are equally powerful, but in a different way. A delusion is a strongly held fixed false belief that persists despite evidence to the contrary. For example, someone might believe they're being followed by the CIA, or that a TV show is sending them secret messages. I actually had a client years ago who was convinced their neighbor was controlling their thoughts through the walls. That's how really.

these beliefs feel. Wow. And I imagine these can happen together? They often do, especially in conditions like schizophrenia. What's interesting is that they can actually reinforce each other. Someone might hear voices, that's the hallucination, and then form a delusion based on it, like believing those voices belong to people who are plotting to harm them. Mm-hmm, makes sense. So they feed into each other, but can you have one without the the other. Absolutely. That's an important point. A person can experience delusions without prominent hallucinations, which is actually seen in something called delusional disorder. On the flip side, hallucinations can occur without a fully formed delusional belief system, particularly in certain

medical conditions like delirium or dementia, or in substance-induced psychosis. So psychosis isn't just one thing. It's more like an umbrella term. Right. Psychosis is a symptom of very various conditions, not a single illness itself. It can be caused by mental illnesses like schizophrenia, bipolar disorder, or severe depression. But it can also result from neurological disorders, substance use, or even trauma. The presence of either delusions or hallucinations or both indicates that break from reality. That point about the break from reality sets up our next piece. But first, a quick word from our sponsor. If you or a loved one is experiencing symptoms of psychosis, finding specialized care is vital. A mission for Michael operates

mental health treatment centers across Southern California, Minnesota, and Virginia. The team combines traditional psychotherapy with creative and wellness therapies to support individualized recovery. With thorough assessments and personalized treatment plans, their multidisciplinary teams focus on whole-person care. Learn more at AMFMtreatment.com. Picking up on that break. from reality, how do people experiencing this actually perceive their situation? Do they know something's wrong? That's one of the most challenging aspects. During a psychotic episode, most people don't know they have it because the symptoms feel completely real to them. This lack of awareness is actually a symptom itself called anosognosia. Wait, so it's not that they're in denial.

No, and that's worth grasping. Anosognosia is a neurological condition caused by changing in brain function, often in the frontal lobe. It's not a conscious choice to deny reality. To someone in psychosis, their experiences are indistinguishable from reality. They genuinely believe their hallucinations are real events, or their delusions are true beliefs. So you could say their reality is twisted or distorted? That's an accurate way to describe it.

Their internal experiences and perceptions are fundamentally altered. It's how their brain is processing information. processing information at that moment. And because it feels so real, they often don't see a need for treatment. This is a major reason for treatment non-adherence and higher risk of relapse. That must make it incredibly difficult for families. How do you help someone who doesn't think they need help? It's challenging. Friends and family are often the ones who first notice the signs, but arguing with them about their beliefs generally isn't helpful and can make them feel isolated. Instead, focus on building trust and encouraging them to see a professional. There's this

communication strategy called the leap approach, listen, empathize, agree, partner that's designed to help engage individuals with anisognosia by finding common ground and fostering collaboration toward treatment goals. So what should people listening be watching for? What are the early warning signs. Great question. Often changes happen gradually before a full psychotic episode. Watch for social withdrawal or isolation, increase suspicion or paranoia, and a notable decline in self-care or personal hygiene. You might also notice trouble concentrating, a sudden drop in school or work performance, or intense and inappropriate emotional responses, or sometimes a lack of emotion entirely. Sleep disruptions are common too. And beyond those, and beyond those,

warning signs, what are the main symptoms mental health professionals look for? Professionals identify symptoms in categories. We've talked about hallucinations and delusions, but there's also disorganized thinking. You can hear this in speech patterns that are illogical or jump rapidly between unrelated topics. Then there's disorganized behavior, which can be unpredictable actions or unusual movements. And finally, negative symptoms, which are reductions in normal functions, things like flat, effect, where emotional expression is diminished, or avalition, which is a lack of motivation. Those negative symptoms sound a bit like depression. They can resemble depression, definitely.

That's why accurate diagnosis matters so much. Distinguishing between hallucinations and delusions and recognizing all these other symptoms helps determine the underlying cause and the appropriate treatment approach. It's like putting together pieces of a puzzle. except the pieces keep changing shape. Right. That's a good way to put it. In schizophrenia, it's very common for individuals to experience both delusions and hallucinations simultaneously, and they're often linked. Someone might hear voices reinforcing a false belief that they're being persecuted. But here's what's interesting. In delusional disorder,

any hallucinations that occur are typically minor and directly related to the theme of the delusion. For instance, a person with a delusion of insolusion of insolusional disorder, any hallucinations that occur are typically minor, a person with a delusion of insect infestation might have brief tactile hallucinations of bugs on their skin. So the presentation really varies depending on the specific condition. Have you ever wondered how often families miss these early signs? That happens more than you'd think because the changes can be subtle at first.

And that's why early intervention is considered vital for better treatment outcomes. The specific combination and presentation help professionals determine the diagnosis. Because remember, psychosis is a symptom of various conditions. Whether someone experiences one symptom or both, the present signals that loss of contact with shared objective reality. That loss of contact is really what defines psychosis at its core.

To everyone listening, if you notice these signs in a loved one, reaching out to a health care provider or mental health professional matters, and in life-threatening situations, call emergency services immediately. Understanding the difference between delusions and hallucinations is the first step in getting the right help. Exactly. Knowledge empowers us to respond with empathy and patience because we now understand that these experiences feel genuine

and compelling to the person going through them. Together, we can support better outcomes through early recognition and intervention. Thank you so much for breaking this down today. It's been really enlightening. My pleasure. Thanks for having me.