Coping Tools for Delusions and Hallucinations with Schizophrenia

Schizophrenia is a complex and often misunderstood mental health disorder that affects about 1% of the global population. One of the most challenging aspects of this condition is the psychotic symptoms it can present—especially hallucinations and delusions.

For individuals living with schizophrenia and their families, understanding and managing these symptoms can feel daunting. Below are practical strategies to help cope with these experiences, along with support and guidance for those affected.

What Is Schizophrenia?

Schizophrenia is a mental health disorder that can involve episodes of psychosis, including hallucinations, delusions, and disorganized thinking.

Learn more from the National Institute of Mental Health (NIMH):
Schizophrenia — https://www.nimh.nih.gov/health/topics/schizophrenia

Understanding Hallucinations and Delusions

Hallucinations

Hallucinations are sensory experiences that appear real but are created by the mind. They can affect any of the senses—vision, hearing, smell, taste, and touch.

  • Auditory hallucinations (hearing voices) are the most common type in schizophrenia.

Delusions

Delusions are strong beliefs that someone holds despite clear evidence they are not true. These beliefs can vary widely, but common themes include:

  • Paranoia: Believing others are monitoring, controlling, or planning to harm them

  • Grandiosity: Believing they have special powers, abilities, or importance

Hallucinations and delusions can be frightening and confusing, leading to significant distress. It’s important for both the individual and their support network to develop coping strategies that promote safety, stability, and hope.

Coping Strategies for People Living with Schizophrenia

1. Medication Management

Antipsychotic medications can be very effective in reducing hallucinations and delusions. It’s important to work closely with a healthcare provider to:

  • find the right medication and dosage

  • discuss side effects

  • adjust the treatment plan as needed

2. Recognize Triggers

Understanding what triggers hallucinations or delusions can help reduce how often they occur. Common triggers include:

  • stress

  • lack of sleep

  • substance use

Tip: Keeping a diary of symptoms (what happened, when, what was going on that day) can help identify patterns.

3. Therapy and Support

Cognitive Behavioral Therapy (CBT) can help individuals recognize and change thought patterns connected to hallucinations and delusions. Support groups can also help by providing:

  • shared experiences

  • coping strategies

  • encouragement and connection

4. Establish a Routine

A stable daily routine can reduce symptom intensity. Helpful routines include:

  • consistent sleep and wake times

  • healthy meals

  • daily movement or exercise

  • regular social connection

  • time for relaxation

5. Grounding Techniques

Grounding techniques help redirect attention and anchor someone in the present moment. Examples include:

  • mindfulness or meditation

  • listening to calming music

  • gardening

  • focused breathing

  • simple sensory exercises (touching a textured item, noticing five things you can see, etc.)

Coping Strategies for Families and Caregivers

1. Learn About Schizophrenia

Education reduces fear and misconceptions. The more caregivers understand symptoms, treatment, and recovery, the more effectively they can support their loved one.

2. Practice Supportive Communication

Open, honest, and non-judgmental communication matters. Instead of dismissing what someone is experiencing, try asking:

  • “What are you noticing right now?”

  • “What would help you feel safer?”

  • “How can I support you in this moment?”

3. Create a Safety Plan

If hallucinations or delusions lead to unsafe behavior, it helps to have a plan in place. Safety planning can include:

  • early warning signs

  • calming strategies that work

  • when to call a clinician or crisis support

  • emergency contact numbers

4. Caregiver Self-Care

Supporting someone with schizophrenia can be emotionally and physically demanding. Caregivers should protect their own well-being by:

  • taking breaks

  • seeking counseling or support groups

  • maintaining sleep, nutrition, and social connection

5. Advocacy and Community Support

Organizations like NAMI Montana can provide resources, support programs, and advocacy opportunities that strengthen recovery and reduce stigma.

Conclusion

Living with schizophrenia is challenging—especially when hallucinations and delusions are present. But with the right support, treatment, and coping tools, individuals and families can manage symptoms and build meaningful lives.

At NAMI Montana, we’re committed to providing support, education, and advocacy to empower Montanans affected by mental health conditions and their families.

For more resources or to get involved, reach out to a NAMI affiliate in your area or contact NAMI Montana.

Together, we can build a supportive community and improve the lives of all Montanans affected by mental health conditions and their families.

Related Research

Psychosocial and psychological interventions for relapse prevention in schizophrenia (systematic review and network meta-analysis)
Bighelli I, Rodolico A, García-Mieres H, et al. Lancet Psychiatry. 2021 Nov;8(11):969–980.
https://pubmed.ncbi.nlm.nih.gov/34653393/

Aerobic exercise improves cognitive functioning in people with schizophrenia (systematic review and meta-analysis)
Firth J, Stubbs B, Rosenbaum S, et al. Schizophrenia Bulletin. 2017 May 1;43(3):546–556.
https://pubmed.ncbi.nlm.nih.gov/27521348/