Q: I’m interested in your opinion on simple visual hallucinations. I have experienced them as long as I can remember, multiple times a day. Generally, I see human forms in my peripheral vision. The forms are not specific or detailed, and do not move. If I walk past a bedroom with the door open I usually see a form sitting on the bed. If I glance at the stirs,I may see someone standing there. Upon a second glance the form disappears.I have never believed that the forms are real or felt fear toward them. However, many people perceive me as jumpy because I sometimes mistake a real person in my peripheral vision for a hallucination and startle if they move or speak. In college I experimented with psychedelics and cannabis. While high I stopped seeing the forms, and rarely hallucinatory to the extent that my friends did. After the effects wore off, the forms returned with no change in nature or frequency. I have never told anyone about what I see, but I sometimes worry that I am doing my psychiatrist a disservice by concealing such things. On the other hand, I have had my treatment history reviewed as part of the security clearance process and know that it will be examined again in the future. I am currently prescribed Welbutrin for depression and Listaril and Ativan as needed for anxiety and trouble sleeping, respectively. Are the hallucinations clinically relevant and something I should disclose, or an unnecessary risk to my ability to maintain security clearance? I am currently taking Welbutrin for depression and Ativan occasionally as a sleep aid.
– Lauren W
A: These “hallucinations” you describe seem not to have intrinsic meaning. They are not of a particular meaningful figure. They are not threatening to you. They do not seem to have an influence on you. They seem to have gone on for a long time without progressing in any way. They are similar to the ghost stories one hears about from time to time. Men and women who have used psychedelics in the past may have continuing flashbacks of any sort of character. Since they disappear when you look at them head on, they are not quite characteristic of visual hallucinations–which are more likely to reflect an “organic” state rather than a functional psychosis. There are other sorts of things I would have to know about you to put these visual phenomena in context. For that reason, your psychiatrist should be able to tell you what to do next. In any case, I do not see how you can profit from psychotherapy unless you are frank with him. A neurologist might want to examine you and order tests as a matter of principle. These illusions do not sound to me like the sort of formed hallucinations patients experience sometimes with occipital lobe lesions–but I am not a neurologist, and I am just guessing.
I have had patients in the army who hesitated to see a psychiatrist because it would mean losing their security clearance. Consequently, they only came to therapy after something bad happened.
– Dr. Neuman