Hallucination/ Delusion

Hallucinations are sensory experiences that occur in the absence of an external stimulus. The most common type is auditory hallucinations (i.e., hearing sounds or voices that others cannot hear).

Delusions are unshaken beliefs in something despite conflicting information or even when lacking in any supportive evidence. Some examples include belief that someone is after him / her (persecutory delusion), belief that unsuspicious occurrences refer to him/ her in person (delusion of reference). Delusion may be deemed odd or bizarre if they do not derive from ordinary life experiences.

People experiencing these symptoms often feel anxious, vulnerable and lonely as the experience of delusion and hallucination can seem real and be overwhelming. They may encounter cognitive, academic, interpersonal, and emotional difficulties.

Medical treatment helps managing these symptoms. However, due to various reasons, such as impact of the symptoms, stigmatization and misunderstanding of others, not everyone is ready to seek help.

How to Respond and Support

People showing early symptoms or those who have never experienced psychosis may have no or very low insight into their problems.

In order to establish trust, try to understand and address your friend’s needs or concerns, so that they would consider seeking professional support as relevant and helpful. You may take a “soft” approach to initiate engagement:

Make the environment safe and comfortable for both you and your friend. The psychotic experience can be terrifying for your friend and they may be sensitive to people, noises, etc
Be non-judgmental towards their experiences even though they may look odd and irrational
Avoid getting into debates, arguments or confrontations about the truthfulness of the hallucinations or delusional content
Reassure them you are trying to help and support
Check if they feel concerned or distressed with anything (e.g., poor sleep, concentration difficulties, fears, interpersonal stress, etc., which may be less intimidating reasons to advise them to seek medical help)
Explore if your friend know anyone who are aware of their struggles and gently ask for permission to get in touch with them
In case your friend is behaving in a way that may cause harm to themselves or others, call for emergency support
Seek advice from CEDARS-CoPE (3917 8388 / cedars-cope@hku.hk)

References:

Jones, N., Bower, K., Furuzawa, A., & Tyler, D. (2018). Back to school: Toolkits to support the full inclusion of students with early psychosis in higher education. Alexandria, VA: National Association of State Mental Health Program Directors.
IPEP. (2014). What is psychosis?. Retrieved from http://ipep.hk/en/psychosis/what-is-psychosis