Even if you don’t know much about schizophrenia, you might know this mental health condition commonly involves hallucinations.

A hallucination happens when you receive sensory information that doesn’t actually exist — it’s a disturbance in perception created by your brain. Hallucinations can affect any of your five senses, so you could hear, see, feel, taste, or smell something that no one else can sense.

Many people automatically link hallucinations to schizophrenia, and it’s true that many people living with schizophrenia do have them. Older research from 2010 estimates about 70 percent of people living with schizophrenia experience hallucinations.

But schizophrenia doesn’t always involve hallucinations, and you can also experience them for other reasons. To put it another way, hallucinating doesn’t automatically mean you have schizophrenia.

Below, we’ll explore key features of hallucinations that occur with schizophrenia and explain how they differ from other schizophrenia symptoms. You’ll also find more information on other potential causes, plus tips on getting professional treatment and support.

Schizophrenia primarily involves symptoms of psychosis, which disrupts the way your brain processes information. This can lead to a disconnect from reality.

The three main types of schizophrenia symptoms include:

  • positive symptoms, or the presence of perceptions, feelings, and behaviors you wouldn’t typically have
  • negative symptoms, or a decline in thoughts, emotions, and behavior you would typically have
  • disorganized symptoms, or confusion and disruption in your thoughts, speech, movements, and behavior

Get more details about schizophrenia and its symptoms.

Hallucinations fall into the category of positive schizophrenia symptoms. They can, in theory, involve any of your five senses:

  • Auditory hallucinations refer to things you hear, like music, voices, or a bell ringing.
  • Visual hallucinations refer to things you see, like absent loved ones, distorted images, or demons.
  • Olfactory hallucinations refer to things you smell, like sweet or foul odors, or something burning when it isn’t.
  • Gustatory hallucinations refer to things you taste, such as something metallic or bitter on your tongue or in your throat.
  • Tactile hallucinations refer to things you feel, such as the sensation of a hand on your shoulder or something slithering across your skin.

Learn more about the five types of hallucinations.

Evidence consistently suggests auditory hallucinations happen most often with schizophrenia. According to 2021 research, between 60 and 80 percent of people living with a schizophrenia spectrum disorder hear sounds other people can’t hear, including music, the voice of a loved one, or people speaking in a language you don’t recognize.

Visual hallucinations also happen with schizophrenia, though less commonly than auditory hallucinations. Some 2010 research suggests many people see surreal things like distorted people, body parts or objects superimposed on real people or objects, or strange and unusual objects they can’t identify. But you might also see things like animals, demons, or lights.

Olfactory, tactile, and gustatory hallucinations happen even less frequently. But older research notes a strong link between these types of hallucinations — if you experience one type, you may be more likely to experience the others. You might also experience them as some of the earlier symptoms of schizophrenia.

Schizophrenia hallucinations can also be multimodal, which means they involve more than one of your senses. Some evidence suggests multimodal hallucinations may be the most common type experienced with schizophrenia. In a 2016 study that included data from 750 people with a schizophrenia spectrum diagnosis:

  • About 80 percent of participants experienced some type of hallucination.
  • More than 50 percent experienced multimodal hallucinations.
  • About 27 percent experienced unimodal hallucinations, or those that involved only one sense.

Although many people living with schizophrenia will experience some type of hallucination at some point in life, you can have schizophrenia without ever hallucinating.

To receive a diagnosis of schizophrenia, you need to experience at least two of the five main symptoms on most days for at least 1 month.

These symptoms include:

  • hallucinations
  • delusions
  • confused or disorganized speech
  • catatonia, or disorganized or unusual movements and gestures
  • difficulty expressing emotion and experiencing enjoyment and interest in life

But at least one of the two symptoms you need for diagnosis must be hallucinations, delusions, or confused and disorganized speech.

In other words, if you don’t experience hallucinations but you do experience delusions with other schizophrenia symptoms, you could have schizophrenia.

Delusions also reflect a disconnect from reality, but they only involve thoughts, not sensory perceptions.

Experiencing a delusion means you have a fixed belief that isn’t actually true. This belief seems entirely real to you, though, so you hold on to it. But you have no proof to support it, and other people might offer evidence to counter it.

Examples of delusions include:

  • Persecutory delusions. These delusions, sometimes referred to as paranoia, typically involve extreme suspicion of others. You might believe people want to harm or steal from you or are conspiring against you.
  • Somatic delusions. These delusions involve the belief that there’s something wrong with your body or health. You might believe certain body parts are misshapen or that something has grown inside your internal organs.
  • Erotomanic delusions. These delusions involve the belief that someone else, typically someone famous or with more social status, has fallen in love with you.
  • Grandiose delusions. Also called delusions of grandeur, these involve the belief that you have some unique and special ability, talent, wealth, or connection with someone famous or divine, like a religious deity.
  • Religious delusions. These involve the belief that you’re a god or deity, or that one has chosen you to act for them to carry out their desires.
  • Control delusions. These involve the belief that some outside organization or force has control over your thoughts, feelings, and behavior.
  • Thought insertion and withdrawal delusions. With these delusions, you believe some outside source has inserted certain thoughts into your brain, or removed your thoughts.

Delusions and hallucinations can sometimes occur together. You might, for example, believe you have the ability to communicate with the dead, in part because you often hear voices you believe belong to those who have passed on.

Or, you might believe you have some kind of parasite living under your skin. The fact that you often feel prickling and itching and see your skin rippling and bulging out, even though your partner assures you nothing looks different to them, only reinforces your belief.

Experts aren’t entirely certain why hallucinations happen, with schizophrenia or any other condition.

Current theories generally link them to spontaneous activation in certain parts of your brain. These activations trigger the sensory details associated with the hallucination — the sounds, images, or sensations no one else notices.

Brain imaging studies also suggest people living with schizophrenia have increased activity in certain parts of the brain, including the hypothalamus and paralimbic regions, and decreased activity in others, including the temporal lobes.

Experts have also found that people living with conditions that primarily involve symptoms of psychosis have reduced gray matter in areas of the brain.

The neurotransmitter dopamine may also play a part. Evidence links positive symptoms of psychosis, like hallucinations, to high levels of dopamine in the mesolimbic pathway. This pathway has a key role in your brain’s reward system. Research from 2019 also points to dopamine imbalances within the nigrostriatal pathway, which is important for motor function.

In short, hallucinations likely relate to irregularities in brain chemistry, structure, and processing. But they’re far more common than many people realize.

As a matter of fact, it’s possible to experience hallucinations with any of the following:

While it might seem fairly obvious that hallucinogenic drugs can also cause hallucinations, know that other substances can, too. For example, according to a 2012 study, you could experience hallucinations after drinking heavily or during alcohol withdrawal.

Less commonly, hallucinations can happen as a side effect of certain medications, including medications that treat:

If you experience hallucinations, professional treatment can help.

Of course, you might not feel the need to treat rare hallucinations that don’t bother you, like:

  • a faint sound of music
  • the sense of a comforting presence
  • occasionally seeing an animal no one else notices

It’s always worth getting professional support, though. Schizophrenia typically doesn’t improve without treatment, and hallucinations can also happen as a symptom of other conditions. A healthcare professional can help identify possible causes and offer more guidance on the most effective approach to treatment.

Since plenty of stigma and misunderstanding still surrounds mental health conditions that involve hallucinations and other symptoms of psychosis, you might hesitate to get support due to concern over what your therapist might say.

Keep in mind, though, that a good therapist will offer compassionate support, not judgment, as they help you explore your symptoms and possible triggers or causes.

While treatment may not make hallucinations go away completely, both therapy and medication can make a difference.

  • Medication. A psychiatrist will typically prescribe antipsychotics to treat schizophrenia symptoms. These medications help address dopamine imbalances in your brain by blocking dopamine receptors.
  • Therapy. A therapist can teach coping strategies and distraction techniques that ease any distress hallucinations cause and help you feel more in control. Potential approaches might include cognitive behavioral therapy, hallucination-focused integrative treatment, or acceptance and commitment therapy.

It’s important to reach out for support right away if your hallucinations leave you feeling afraid, or with thoughts of hurting yourself or other people.

Learn more about potential treatments for schizophrenia.

Hallucinations might feel comforting, confusing, or frightening, depending on what they involve.

But a trained mental health professional can help you identify possible causes, including schizophrenia, address any other symptoms you experience, and recommend helpful treatments to reduce hallucinations.

Crystal Raypole writes for Healthline and Psych Central. Her fields of interest include Japanese translation, cooking, natural sciences, sex positivity, and mental health, along with books, books, and more books. In particular, she’s committed to helping decrease stigma around mental health issues. She lives in Washington with her son and a lovably recalcitrant cat.