Hallucinations: What Happens in the Brain and How to Recognize Them

Hallucinations are often frightening and seem inexplicable. Yet there is a clear internal logic to them — and understanding it matters, because it helps recognize when the brain needs professional attention.

Where Hallucinations Come From

At their core, hallucinations are ordinary thoughts — the same kind everyone has. The difference lies in intensity. Dr. Saulitis describes this through the image of a rising temperature: normal thoughts are like 36.9 °C. As "mental temperature" climbs, thoughts grow so powerful that a person no longer merely thinks them — they begin to *hear* them. The impulse becomes so strong that it creates the sensation of an external voice. If the process continues, the brain adds an interpretation: the voice acquires an "owner" — a name, a face, a personality. The person starts to perceive this voice as a real interlocutor.

True Hallucinations vs. Pseudohallucinations: A Key Distinction

Clinically, it is important to tell these two apart:

• True hallucinations — the person perceives a non-existent object as fully real and located in the external world. A classic example: someone in a state of intoxication hears a voice coming from a wall socket. These are more commonly linked to organic causes — intoxication (including alcohol), encephalitis, and other toxic effects on the brain.

• Pseudohallucinations — the person is already immersed in a psychotic experience, and a second, inner reality overlays the ordinary one. The images and voices feel almost as vivid as external ones, yet are experienced as coming from "inside." Pseudohallucinations are more characteristic of endogenous conditions, where the underlying cause is a neurotransmitter imbalance within the brain itself.

This distinction is clinically decisive: it points to the nature of the disorder and shapes what comes next.

How to Recognize: From Neurosis to Psychosis

Dr. Saulitis describes a continuous spectrum. At one end is situational neurosis: someone upsets you, and thoughts about it keep running in the background while you go about your day. Most people know this feeling. If the stress does not let up and pressure on the mind continues, neurosis can deepen — all the way to post-traumatic stress disorder, delusional disorder, and ultimately psychosis. Which specific form this process takes depends largely on a person's genetic constitution and the environment they live in.

Signs worth paying attention to:

• Voices or sounds that only you can hear
• A sense that people are talking about you when no one is nearby
• Images or figures that only you can see
• A fear or conviction that thoughts or voices are being inserted from outside

None of these signs automatically means a particular diagnosis — they are a signal to consult a specialist.