Psychosis visuals are sensory experiences of seeing things that are not present. These are perceptions that occur without any external visual stimulus and are a symptom of an underlying condition, not an illness in themselves. They signal that a person’s brain is processing reality in an altered way. The experience varies greatly and is often part of a broader set of symptoms requiring medical attention.
Types of Visual Disturbances in Psychosis
Visual disturbances during psychosis range from simple images to detailed scenes. Simple hallucinations are basic and lack specific form, manifesting as flashes of light, geometric patterns, or indistinct shadows. They can also appear as squiggling lines or unstructured shapes that are fleeting or persistent.
Complex hallucinations are clear, fully formed images of objects, animals, or people that seem entirely real. Examples include seeing insects on the walls, a fire that doesn’t exist, or interacting with a person no one else can see. These hallucinations are often life-sized, three-dimensional, and can appear in full color with movement and detail.
Individuals may also experience visual distortions or illusions, which are misinterpretations of a real stimulus. For instance, a person might perceive walls as breathing or see faces as distorted. These perceptual abnormalities are distinct from hallucinations but can co-occur, adding to the disorientation of a psychotic episode.
These visual experiences can be distressing, with the content often being frightening. The person experiencing them may feel confused or fearful in response to what they are seeing. They might recognize that the vision is not real (a state known as preserved insight) or be fully convinced of the reality of the hallucination.
Underlying Causes and Triggers
Visual hallucinations are linked to psychiatric, substance-related, and medical conditions. A primary cause is psychiatric disorders that feature psychosis, such as schizophrenia, schizoaffective disorder, severe bipolar disorder, and major depressive disorder with psychotic features. In schizophrenia, while auditory hallucinations are more common, a significant percentage of individuals, estimated between 27% and 50%, also experience visual ones.
Substance use and withdrawal are also prominent triggers. Hallucinogenic drugs like LSD and psilocybin are known for inducing visual experiences, while stimulants like methamphetamine can cause hallucinations. Withdrawal from substances, particularly alcohol in a state known as delirium tremens, can lead to vivid visual phenomena. High-THC cannabis has also been linked to substance-induced psychosis.
A broad range of medical and neurological conditions can be the source of these disturbances. Delirium, resulting from an infection or metabolic issues, is a common cause, especially in hospitalized patients. Neurological diseases, including brain tumors, epilepsy, and stroke, can also be responsible. Neurodegenerative diseases such as Parkinson’s disease, Lewy body dementia, and Alzheimer’s disease often feature complex visual hallucinations.
Differentiating From Non-Psychotic Visuals
It is important to distinguish psychosis-related visuals from common, non-psychotic phenomena. Many people experience visual events not linked to a psychotic illness. The context and absence of other psychotic symptoms, like disorganized thoughts or delusions, are key differentiators.
Common non-psychotic visual events include:
- Hypnagogic and hypnopompic hallucinations, which are visual experiences that happen while falling asleep or waking up.
- Migraine auras, which involve seeing disturbances like zig-zag lines or shimmering lights before a headache.
- Eye floaters, which are tiny specks or lines that drift across the field of vision caused by clumps of cells in the eye.
- Charles Bonnet syndrome, a condition where individuals with significant vision loss experience complex hallucinations as the brain generates its own images.
Medical Evaluation and Management
A thorough medical evaluation is the first step to determine the cause of suspected psychosis visuals. This process begins with a detailed psychiatric assessment to understand the hallucinations and screen for other symptoms. A doctor will also conduct a physical exam and may order blood tests or brain imaging, such as an MRI or CT scan. These tools help identify or rule out medical causes like infections, tumors, or neurological diseases.
Once a cause is identified, management focuses on treating that root condition. If the visuals are a symptom of a psychiatric disorder, antipsychotic medications are the primary treatment. These medications work by helping to rebalance neurotransmitters in the brain to reduce or eliminate hallucinations. The choice of medication is tailored to the individual’s needs.
Psychotherapy also plays a supportive role in management. Cognitive Behavioral Therapy for psychosis (CBTp) helps individuals develop coping strategies for their experiences. This therapy does not aim to eliminate the visuals but rather to change the person’s relationship to them, reducing distress and improving function. Combining medication and therapy allows individuals to manage their symptoms effectively.