Hallucinations and Delusions are very common symptoms of a range of psychosis-related conditions.

These two symptoms have many similarities, and are treated in a similar manner. However, there are some differences between them.

This article explores these differences, and looks at the way they are treated too.

There are many similarities between hallucinations and delusions


Here are the key definitions:

Hallucinations: This is where a person sees or hears something that doesn’t exist outside of their mind. It is also possible to smell, feel or even taste something too while hallucinating. A common hallucination is hearing voices. When someone hears voices, they may believe they are being ordered to do something by the voice, or sometimes the voice may be critical, or abusive. One of the most damaging parts of a hallucination is that the person who is hallucinating believes fully that what they are experiencing is real.

Delusions: A delusion is where an individual has a belief that they believe steadfastly in, though isn’t true. The person involved will be adamant that their belief is true. In the majority of cases however, they will not be correct. Delusions can take on a wide array of forms. An example of a delusion is paranoia – such as the feeling an individual is being spied on. As such, the delusion can have a marked effect on the day-to-day life of the individual.

The Similarities

As you can see from the above definitions, there are some similarities between the two.

They involve a person having altered perceptions of reality which feel very real to the person that is experiencing them.

Furthermore, both are a symptom of psychosis. They are symptoms often seen in conditions like Schizophrenia, the manic phase of Bipolar Disorder, Schizoaffective Disorder, or as a result of substance misuse.

The Differences

The main difference is that hallucinations involve a person experiencing something related to their senses. For example, touching, hearing or smelling something.

Delusions meanwhile occur when a person believes something that isn’t based on reality. So it isn’t sense related, with this belief purely being in their mind.

So put simply, a hallucination is a sensory perception, whereas a delusion is an incorrect belief.

Does a person always have Hallucinations and Delusions together?

It should also be pointed out that people don’t necessarily experience both hallucinations and delusions at the same time. Rather, they often take place separately.

Numerous studies have looked into this topic. One study found that in cases of Schizophrenia up to 80% of study participants experienced hallucinations [1].

Other research has suggested that up to 90% of people with Schizophrenia have delusions [2].

The above studies though focused on Schizophrenia. As discussed earlier, there are many conditions that involve hallucinations and delusions, so the above is only a guide.

Treatment of Hallucinations and Delusions

Hallucinations and delusions are treated in the same way. But the underlying condition should be treated as a priority.

For example, if someone with Bipolar Disorder hallucinates during their manic phase, it would make sense for them to have a mood stabiliser at first.

However, if someone hallucinates and is then diagnosed with Schizophrenia, then an antipsychotic would be more sensible.

Therefore, medication is the main approach used. However, a form of talking therapy may also be of use, especially if there have been some traumatic experiences in the past that may have triggered the psychotic episode.

Psychoanalytical Psychotherapy, Dialetical Behavioural Therapy or Cognitive Behavioural Therapy are all potential types of talking therapy.


Both hallucinations and delusions are very difficult symptoms to live with. It is important for anyone with these conditions to seek treatment.

As discussed, there are some similarities between hallucinations and delusions, but there are a few differences.

See Also


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[1] Lim, A., Hoek, H. W., Deen, M. L., & Blom, J. D. (2016). Prevalence and classification of hallucinations in multiple sensory modalities in schizophrenia spectrum disorders. Schizophrenia Research. 176 (2-3): p493-499. DOI: https://doi.org/10.1016/j.schres.2016.06.010.

[2] Baker, S. C., Konova, A. B., Daw, N. D., & Horga, G. (2019). A distinct inferential mechanism for delusions in schizophrenia. Brain. 142 (6): p1797-1812. DOI: https://doi.org/10.1093/brain/awz051.