If someone you care about is experiencing PTSD alongside hallucinations, you may be confused or worried. While hallucinations are not typical of PTSD alone, they can occur in complex trauma cases or alongside co-occurring conditions. Understanding the difference—and knowing what to do next—can make all the difference.
At Rockland Recovery Behavioral Health’s PTSD clinic in Boston, providers are trained to treat PTSD and co-occurring disorders with effective evidence-based treatment. Learn more about how we can help today.
Understanding complex PTSD
According to the World Health Organization, complex PTSD can develop due to exposure to particularly horrifying and repeated traumatic events that are difficult or impossible to escape, such as torture, genocide, repeated childhood sexual or physical abuse, continuous domestic violence, genocide, or slavery. In addition to the four categories of PTSD symptoms, people with CPTSD experience particularly severe impairment in forming and sustaining relationships, and functioning in educational, professional, social, and personal settings and interactions. Dissociation and hallucinations are common side effects of PTSD.
Can PTSD cause hallucinations? Not directly, but severe trauma can lead to hallucinations and other psychotic presentations. PTSD psychosis is one way to understand the challenging and complicated symptoms of severe PTSD that co-occur with psychotic symptoms like dissociation and hallucinations. These symptoms are treatable. With professional, evidence-based therapies provided in a secure setting, healing can happen.
What kind of hallucinations are caused by PTSD?
Research is ongoing about the co-occurrence of hallucinations with PTSD. In a study published in the Delaware Journal of Public Health, dissociative disorders co-occur with PTSD and chronic post-traumatic stress disorder (CPTSD) more than other disorders, such as schizophrenia or schizoaffective disorder. Dissociative disorders commonly result from repetitive trauma, often starting in childhood, and can present with hallucinations, among other signs.
While PTSD itself does not typically cause hallucinations, trauma-related dissociation or co-occurring conditions like psychotic depression or schizophrenia may. Common trauma-related hallucinations include:
- Auditory hallucinations (e.g., hearing voices)
- Visual disturbances
These symptoms can resemble flashbacks, but are different:
- Flashbacks are vivid, involuntary re-experiencing of traumatic events
- Hallucinations are sensory perceptions (sights, sounds, smells) without an external trigger
What does PTSD psychosis look like?
“PTSD psychosis” is not a formal diagnosis, but it’s a term sometimes used when trauma-related symptoms are accompanied by psychotic features like hallucinations or delusions. These experiences often stem from co-occurring disorders or severe dissociation and require professional evaluation.
Other common symptoms of PTSD
PTSD can affect people in many different ways, both emotionally and physically. Some people who experience traumatic events develop PTSD. The symptoms are typically broken down into four categories:
- Re-experiencing: including flashbacks and nightmares
- Avoidance: steering clear of triggers and reminders, and avoiding painful feelings and thoughts
- Distorted and negative beliefs and thoughts: these lead to loss of hope and feelings of unworthiness
- Arousal and reactivity: characterized by a highly activated nervous system, hypervigilance, outbursts, and trouble with concentration
Someone with PTSD can experience each of these equally, or they can experience one group of symptoms much more than the others. Dissociation and hallucinations are an added challenge for some people with trauma disorders.
What is trauma-related dissociation?
Trauma deeply impacts an individual’s sense of safety, challenges their ability to trust the world around them, and often impacts their sense of reality. In addition to the common symptoms of PTSD, dissociation affects many people coping with the long-term effects of trauma. Someone with trauma-related dissociation may:
- Become disconnected from their own thoughts and feelings
- Detach from memories of the trauma
- Lose their anchoring sense of self
- Mentally escape from reality
- Experience hallucinations
Auditory hallucinations—hearing voices—are the most common for individuals with trauma-related dissociation. In a desperate attempt to defend someone from the horror of experiences that still feel overwhelming, the brain disrupts its own processing of information and memories, which can lead to dissociation and hallucinations. Those who experienced childhood trauma and those with a diagnosis of complex PTSD (CPTSD) are the most likely to dissociate and hallucinate.
Begin healing from PTSD and co-occurring conditions at Rockland Recovery Behavioral Health
If your loved one is living with PTSD or complex PTSD and also experiencing hallucinations or dissociation, help is available in Massachusetts. Our Boston-area PTSD clinic offers specialized dual diagnosis treatment grounded in evidence-based care. Therapies like EMDR, CBT, and DBT can help individuals process trauma and reclaim their lives. Call 855.520.0531 or complete our secure online form to start today.