What it Could Mean: hearing voices and seeing shadows or things that aren’t there

When someone starts hearing voices in their head (auditory hallucinations) or seeing shadows or things that aren’t there (visual hallucinations), it can be a sign of a serious mental health issue. These symptoms can be distressing, confusing, and isolating — for the person experiencing them and their loved ones.

What it Could Mean:

1. Psychosis:
   Hearing voices or seeing things that aren’t real are classic signs of psychosis. Psychosis isn’t a diagnosis itself — it’s a symptom that can happen in various mental illnesses.

2. Possible Causes:

   • Schizophrenia or schizoaffective disorder

   • Bipolar disorder (especially during manic or depressive episodes)

   • Severe depression with psychotic features

   • Substance use or withdrawal (alcohol, cannabis, stimulants, hallucinogens)

   • Medical conditions (e.g. epilepsy, brain injury, sleep deprivation)

   • Extreme stress or trauma

3. Not Always Illness:
   Some people hear voices or see things but lead functional lives without distress — this can be part of their neurodiversity, spirituality, or trauma response.

Signs It’s Time to Seek Help:

• The voices or visions are frightening, threatening, or telling the person to hurt themselves or others.

• It’s affecting their sleep, work, relationships, or ability to function.

• They’re feeling paranoid, confused, withdrawn, or detached from reality.

• You or they are just worried about what’s happening.

What to Do & Where to Get Help (UK-Based Options):

1. Talk to a GP:
   The GP can refer them to mental health services or a psychiatrist for assessment.

2. Crisis Support:

   • Call 999 if someone is in danger or can’t keep themselves safe.

   • NHS 111 for non-emergency mental health support.

   • Samaritans (116 123) – 24/7 listening support.

   • Local Crisis Teams – through NHS or mental health trusts.

3. Mental Health Charities:

   • Mind UK: Resources and support guides.

   • Rethink Mental Illness: Practical support and advocacy.

   • Hearing Voices Network: Community support for people who hear voices.

4. Digital Tools:

   • Mental health apps like Wysa, MyPossibleSelf, or Calm Harm can help with early support but shouldn’t replace professional care.

How You Can Help (as a friend, family member, or nurse):

• Stay calm, non-judgmental, and supportive.

• Don’t argue with what they’re experiencing — validate their emotions.

• Gently encourage seeking help, offer to go with them if needed.

• Help them stay connected to reality (routine, grounding exercises, safe environment).