When Reality Isn’t Real

Becoming detached from reality can be extremely frightening to oneself or to those around. There are several psychotic disorders that may have an end result of loss of touch with reality. Sometimes the cause for delusions and hallucinations are more concrete and can be dealt with. Substance abuse and even medical conditions are treatable causes for loss of reality. Other times, psychotic disorders must be dealt with in psychological ways that may or may not prove helpful. Occasionally, a person may respond to logical conversation dealing with their skewed perceptions. Other times, they may be hopelessly convinced of the reality of unreal situations or events. Hospitalization may be necessary if the person poses a serious threat to themselves or to others. There are two main categories that refer to a loss of touch with reality.

Delusions
A delusion is the state of being convinced of a fact that is not true. Often delusions are not only false beliefs, but are also highly unlikely or even impossible situations. Common delusions are placed into a few categories. A delusional person may believe that others are conspiring against him. He may believe that large groups of people or just individuals are attempting to hurt him or cause him loss. Another common delusion is of jealousy. A spouse or girlfriend may invent and be convinced of situations in which the husband or boyfriend has been unfaithful. Usually these delusions are persistent and without any causation whatsoever. Some delusions center on the unrealistic importance of the person having the delusion. He may believe that he has a super-power or a supernaturally appointed mission to help, or hurt, all of mankind. The delusion of being the center of another’s love interests can result in stalker situations and severe discomfort for the victim of the delusion. Some delusions have to do with some serious illness that cannot be identified with any human technology. Delusions also take the form of totally impossible possibilities. The extent of the imagination is the only limit on delusion.

Hallucinations
Hallucinations are different from delusions. Instead of general untrue beliefs, hallucinations are actual sensory experiences that have no basis in reality. A person may hear, taste, feel, see or smell things that do not exist. Hallucinations are sensory experiences without stimulus. Sounds are the most common hallucinations. Music, voices or other sounds will seem to come from the outside of a person, but they are sounds that other people cannot hear. The voices may be the most disturbing because of their ability to change one’s perspective or direct actions that may be harmful. Hallucinated sights can also be upsetting to people, but they usually do not take any distinct form. Instead of human or animal forms, a person will usually see distortions or colors. Smells, tastes and sensations are often uncomfortable, but no more than that.

The loss of realistic understanding is often a psychotic disorder requiring treatment. Very often though, the reasoning behind the disorder is no more than a physical problem due to substance abuse or a medical abnormality or treatment. In any case, a person experiencing such symptoms should consult a psychiatrist for the best treatment route.

Frances, Allen MD and First, Michael B. MD. Your Mental Health: A Layman’s Guide to the Psychiatrist’s Bible. New York: Scribner, 1998.