When Parkinson's Changes What You See and Believe: Understanding Hallucinations and Delusions
If you or someone you love has Parkinson’s disease, you may have encountered something unexpected — a figure in the doorway that wasn’t there, or an unshakeable feeling that something was deeply wrong. These experiences have a name, a cause, and (importantly) effective ways to manage them.
Hallucinations and delusions are a recognized, researched, and treatable part of Parkinson’s. And understanding them is one of the most empowering things you can do.
More Common Than Most People Know
Parkinson’s is far more than a movement disorder. About 50% of people with Parkinson’s report experiencing hallucinations or delusions, and as the disease progresses over the years, that number increases, with some studies placing the range between 25–70% depending on how symptoms are measured and reported. Despite how common these experiences are, research shows that up to 90% of people don’t bring them up with their doctor proactively — often out of embarrassment or uncertainty.
Mighty contributor Charles Mickles captured why so much of Parkinson’s stays invisible, writing in 10 Things I Wish You Knew About My Life With Parkinson’s:
“So many things are affected that many do not ever see. Even when you can’t see the ‘shakes,’ there is a battle raging in our body.”
What These Symptoms Look Like
A hallucination is a false perception: seeing, hearing, or feeling something that isn’t there. Among people with Parkinson’s, visual hallucinations are most common, often involving people or animals. They tend to be vivid and happen at night, and they are usually not frightening. Some even become familiar over time.
A delusion is a firm, fixed belief in something that isn’t true: one that doesn’t shift with reassurance. Common themes include paranoia, suspicion about a partner’s faithfulness, or fear of harm from a trusted person. Delusions are less common than hallucinations, but can be more disorienting for everyone in the household.
In early stages of Parkinson’s, many people are aware that what they’re experiencing isn’t real. This insight may lessen gradually as the disease progresses, but it happens slowly and over time.
Mighty contributor Emma Stubbs, who lives with Parkinson’s, named hallucinations matter-of-factly alongside her other symptoms in Rage Against the Dopamine:
“Well, darling, it’s like this: Mummy’s going to get progressively slower at moving, talking, thinking. Falling might be an issue and periodic bouts of choking, falling, and hallucinations. All whilst she’s dancing a jig to no music.”
These are neurological events — not a reflection of character or willpower.
Why It Happens
There are many possible reasons for hallucinations and delusions. Sometimes they are brought on temporarily — by a medication change or illness — and resolve once those are addressed. Parkinson’s disease itself can cause these symptoms, but other factors can bring them on or worsen them, including certain Parkinson’s medications, unrelated conditions like a urinary tract infection or pneumonia, unfamiliar environments like a hospital stay, and vision or hearing loss.
The good news: many of these triggers are temporary and directly treatable. According to one study, the causes involve a combination of neurotransmitter changes, structural brain shifts, and medication effects — all of which are active areas of research and clinical management.
What Helps: For Patients and Caregivers
A stable, calm, familiar home environment is one of the most effective tools. Keeping spaces well-lit and clutter-free can minimize misperceptions and reduce injury risk. Offering reassurance — that the person with Parkinson’s is safe, loved, and that these symptoms are not their fault — can ease fear and shame. When an episode occurs, gentle redirection works better than debate.
Most importantly: bring it to your care team. These conditions are treatable when recognized, but clinicians may not screen for them, and people with Parkinson’s may not prioritize them alongside physical symptoms at appointments. Your doctor can review medications, rule out infections, and build a management plan tailored to your situation. Ongoing research continues to expand both medication and non-medication treatment options.
Stubbs, writing about her family’s approach to facing Parkinson’s together, offered a reminder that resonates for caregivers too:
“The bravery and honesty my children show about this disease is the best support and love I could receive. They trust me to cope, or to be honest when I’m not — and I trust them to do the same. Perhaps we are in this together after all.”
You’re Not Navigating This Alone
The Parkinson’s community on The Mighty is full of people who understand what you’re going through: patients, care partners, and families who have faced these same moments and found their way through them. Here are some places to find support and connect:
- The Mighty’s Parkinson’s Disease community — stories, perspectives, and connection from people living with Parkinson’s every day
- Michael J. Fox Foundation: Hallucinations & Delusions resources — patient-focused education and webinars
- Parkinson’s Foundation Helpline — call 1-800-4PD-INFO to speak with a specialist
Parkinson’s Foundation: Psychosis: A Mind Guide — a free downloadable resource for patients and caregivers