Billy AlexanderWe’ve been talking a lot about delusions and hallucinations lately,so lets end our discussion with the differences and ways to cope.

Families and caregivers are uninformed about the type of psychosis their loved one may be experiencing. For many therapists, including myself, observing and correctly identifying symptoms can be extremely perplexing. Before a correct diagnosis is made, therapists must do a comprehensive assessment using informal tools (information from family, friends, and caretakers) and formal tools (tests, questionnaires, observations) to get clarity and direction.


Psychotic disorders are essentially a disturbance in perception and thought. They can entail a host of symptoms. Here is a listing of current psychotic disorders listed in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders:

  • Schizophrenia (hallucinations, delusions, flat affect, lack of motivation, social isolation)
  • Schizo-affective disorder (major depressive disorder and symptoms of schizophrenia)
  • Delusional disorder (non-bizarre delusions)
  • Brief psychotic disorder (delusions, hallucinations, incoherent speech): onset =less than 1month
  • Shared psychotic disorder (a delusion develops in an individual in a close relationship with another individual who has delusions). See my website, Anchored In Knowledge, for more information.
  • Substance-induced psychotic disorder (psychotic-like symptoms due to substance abuse)

For the family, friend, or caretaker living with an individual experiencing some of the above symptoms, life can be very disturbing and emotionally draining. What is even more draining is not having a complete understanding of what you are observing. It’s important to know that the difference between delusions and hallucinations:

  1. Delusion: Has to do with our belief system. It is a belief strongly held to be true despite evidence that the belief is not true.
  2. Hallucination: Has to do with our senses (hearing, seeing, feeling, smelling, tasting).


Delusions and hallucinations can be dangerous for the individual experiencing them and those around the individual. Hallucinations can cause people to act on their emotions. For example, an auditory hallucination is often in the form of voices telling an individual to do something dangerous such as harm themselves or others.

Delusions can turn into rooted beliefs that cause the individual to act. For example, a woman who writes letters to Alex Baldwin begins to believe he is sending her messages that he is in love with her,  may attempt to buy tickets to all of his shows and cyber stalk him. A strong delusion such as this can lead to emotional (and maybe even) financial distress.


Delusions and hallucinations are not easy to cope with. But here are a few things to try:

  1. Do not argue facts: I always encourage families to refrain from arguing with their loved one about their delusions or hallucinations. The key is to be mindful that the delusion or hallucination is very real to them. So if you go against the delusion or hallucination, you are “going against them.” Although not true, this is often the experience of people in these shoes.
  2. Understand their emotions: Hallucinations and delusions often have an emotional component of some sort. The woman attracted to and writing Alex Baldwin may feel “emotionally connected” to the point of behaving as if she “knows” him on a personal level. If you find there is a strong emotional connection with the delusion or hallucination, try to talk with your loved one and calmly discuss your concerns.
  3. Get inside their head: Individuals experiencing delusions or hallucinations may be difficult to talk to, especially if they do not believe they are impaired/ill. So wait until the individual brings up their experience and discuss it without judgment. Try not to ask questions that would make your loved one feel condemned or “crazy.” You want to try to understand, no matter how unstable their reasoning is, their thought processes. This is good “data” for if you ever have to discuss your case with a psychiatrist.


The most important thing to do in such cases is to be compassionate and understand that your loved one is going through something quite serious. Reaching out for help is important, but so too is showing love and understanding, even if the delusions or hallucinations are unrealistic.


I always enjoy hearing your thoughts, post below.

All the best

©Photo Credit: Billy Alexander



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    Last reviewed: 7 May 2013

APA Reference
Hill, T. (2013). Psychotic Disorders: Differences & Ways To Cope. Psych Central. Retrieved on October 31, 2014, from


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