Anxiety is often self-sustaining. When a person struggles with anxiety, they often have symptoms and experiences that can create more anxiety.
Although uncommon, one issue that is especially prone to creating more anxiety in anxiety-prone individuals is the presence of what are often called “hallucinations” – experiencing sights or sounds that are not actually there, that no one else can see or hear.
Hallucinations are more common in those with panic attacks and PTSD, but can affect anyone with any anxiety or stress disorder. They’re also a trigger for more anxiety, because a person that experiences a hallucination often finds that they experience either fear of the hallucination, or fear of what the hallucination means about their mental health.
But before we begin talking about anxiety-related hallucinations, it’s important to make clear that these are *not* true hallucinations. While many people experience a perception of hallucinations with anxiety, they’re not an altered reality. They’re not psychosis. Instead, they’re just a way our brain is responding to things (stimuli) that are happening around us, as well as our anxiety itself.
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What Causes These “Hallucinations?”
Anxiety related hallucinations are not necessary hallucinations, at least not the same way that psychosis can cause hallucinations. Instead, they’re perception issues caused by the mind and how it is processing information, as well as symptoms of anxiety that are being misinterpreted by our anxiety.
But that doesn’t mean that it’s not worrisome when you experience it. These symptoms are common, and can be caused by issues such as:
- Hypervigilance and Sensory Overload – Anxiety heightens your awareness of potential threats. This hypervigilant state can increase sensitivity to sound and sight, and create the illusion of auditory/visual input. In overstimulated environments, the brain may try to “fill in” missing sensory information, sometimes resulting in the perception of non-existent sounds.
- Stress-Induced Cognitive Distortion – Prolonged stress can impair the brain’s ability to differentiate between internal thoughts and external sounds. An anxious mind may interpret internal self-talk or intrusive thoughts as external voices, or may see unexpected movements or shadows as signs of danger.
- Sleep Disruption and Fatigue – Chronic anxiety often interferes with sleep. Severe sleep deprivation is known to cause perceptual disturbances, including visual and auditory issues, as well as make it much harder to calm an anxious mind and process various senses.
- Intrusive Thoughts with Sensory Characteristics – Some individuals with anxiety disorders experience intrusive thoughts that are vivid and have sensory qualities. These may be misperceived as external voices, especially during panic episodes or emotional distress.
- Anxiety Symptoms – Anxiety itself causes symptoms that can appear at first glance to be a hallucination. For example, it may cause changes to light perception, or buzzing in the ear. These can then be misinterpreted by the person’s anxious mind.
These are only a few of the examples of ways that anxiety can create a perception that there are hallucinations, despite no hallucinations taking place. Anxiety also makes a person more likely to worry about their mental health, increasing the risk further.
Types of Anxiety Hallucinations
Hallucinations can affect all of our senses, but are most likely to be auditory or visual. Examples of these hallucinations include the following, though this is not a comprehensive list.
Auditory Hallucinations
Most “hallucinations” from anxiety are going to be auditory (related to hearing). That is because, as we discussed earlier, most hallucinations are not true hallucinations but rather ways that our brain is perceiving other sounds and stimuli, and our ears are far more likely to be responsible for picking up “extra” information that we’re not otherwise paying attention to.
You can think of it like this: when you’re looking at an object, you know exactly what the object is, you can see it, and you’re focused on it. It’s in front of you.
But sounds can come from any direction. They can be loud or quiet. They can be unexpected, and they can’t be turned off when we’re not paying attention (we can’t close our ears and it goes away). This is why we are likely to be more prone to auditory hallucinations. For example:
- Name – We may hear someone calling their name when no one is there, or hear our name being talked about within a crowd when it was not actually said.
- Background Noise – We may perceive faint music, buzzing, or whispers.
- Weird Noises – We may experience distorted or exaggerated environmental sounds.
- Self-Talk – We may hear internal dialogue that feels louder or more intrusive than usual.
One weird auditory hallucination that we have yet to find the cause of is people that complain they hear a loud pop or bang. This is more common in those that have panic disorder. It’s not entirely clear what causes this noise. It may be that a slightly quieter banging noise is made loud by our sensitivity to anxious noises. But it does seem to be an experience that many share.
These experiences often occur during panic attacks, periods of severe stress, or chronic sleep deprivation, all common features of anxiety disorders. They may also occur for seemingly no reason at all in someone that has anxiety, because anxiety is more likely to cause sensitivity to anxiety-producing sounds.
Visual Hallucinations
Visual hallucinations are less common with anxiety, but can still occur. When they do, they’re not that different from auditory hallucinations, in that they’re more likely to be misinterpretations of more common visual experiences, or issues caused by anxiety itself.
For example, anxiety causes the pupils to dilate, which brings in more light. It can also causes “tunnel vision,” which is where you’re able to see better directly in front of you while the sides of your vision may appear blurry or checkered. Like with auditory hallucinations, a person may also overreact to visual stimuli. Examples of these visual hallucinations include:
- Fleeting shadows or flashes of light
- Movement in the peripheral vision with no identifiable source
- Visual static or “visual snow” during panic or hyperventilation
- Seeing patterns, blurs, or spots that resolve quickly
- Perceiving shapes or outlines that disappear upon closer inspection
As you can see, many of these are related to your eyes letting in more light. Hyperventilation can also affect your vision, and people with anxiety are prone to eye pain/discomfort, eye tiredness, and more.
Anxiety is also going to cause people to be more fearful of what they see, and possibly interpret it as dangerous. A tiny unexpected shadow may appear to be a person to someone with anxiety, and their imagination can make them feel like a person is hiding near them, leading to more anxiety symptoms.
All of these are examples of how a person might experience what feels like a “visual hallucination” but is instead just anxiety leading to misinterpretation of normal visual experiences.
Other Hallucinations Caused by Anxiety
Most of our “hallucinations” are going to come from our eyes and ears. But we might also experience what we think are hallucinations caused by other senses. For example:
- Unexplained Smells – Anxiety can heighten our senses and make us more sensitive to different smells. This means that not only might we smell things that others cannot, but also we may interpret those things as unpleasant or scary because of our anxiety.
- Weird Sensations – Anxiety, panic attacks, and related symptoms like hyperventilation, can cause a person to experience a combination of hypersensitivity and “Self monitoring.” This is where they are subconsciously scanning their bodies for weird feelings, and then experiencing those feelings stronger than a person might otherwise. This can make it feel as though you’re hallucinating a touch or other feeling.
- Odd Tastes – This may not be so much a hallucination, but a symptom of anxiety. Many people experience a change in their taste buds with anxiety, with bad tastes or metallic tastes that show up while eating or while nothing is in your mouth at all.
These are other examples of issues that may be viewed as “hallucinations” in some form, but are otherwise normal.
Difference Between Anxiety Hallucinations and Psychosis
When a person experiences these types of strange hallucinations, one of their biggest fears it that they’re experiencing a form of psychosis. That fear itself can also cause more anxiety. Luckily, there are many ways to tell that this is anxiety and not another mental health issue.
The biggest tell is that you’re aware of it – that you have the concept that what you’re seeing isn’t real. Someone with psychosis typically believes that what they’re seeing and feeling is real, and so the very act of questioning whether or not you’re truly hallucinating is itself a sign that you are not. Other examples include:
- Content – Anxiety-related disturbances are often vague or brief (e.g., hearing one’s name called), and may not include ongoing complex or commanding voices.
- Frequency – Anxiety-induced hallucinations tend to be less common, and not part of a persistent pattern of sensory disruption.
- Anxiety-Triggers – Anxiety-related hallucinations tend to trigger anxiety as they occur, or happen during periods of anxiety. Psychosis related hallucinations rarely trigger anxiety unless the content of the hallucination is specifically frightening, in which case it’s because the person is perceiving it as real.
Only a therapist or doctor can truly identify what is anxiety and what is psychosis, but most individuals that struggle with psychosis are unaware of it, and are not experiencing anxiety in the same way as someone with an anxiety disorder.
What Happens Next?
If you’re experiencing anxiety-related hallucinations, it’s almost always a sign that your anxiety has become difficult to manage. Whether it’s panic attacks, generalized anxiety disorder, post-traumatic stress disorder, or something else, feeling like you might be hallucinating is a sign that your anxiety is in need of professional support.
Here at Flourish Psychology, we provide mental health treatment in New York for those that are looking for help with their anxiety or other mental health issues. We can teach you skills to help you manage your anxiety, and train your mind to experience less fear if and when you do have these manifestations.
For more information, or to get started, please reach out to Flourish Psychology, today.