Jules’s Story: Living with Hallucinations While Leading a Creative Life

Hallucinations—seeing, hearing, or feeling things that others don’t—are often misunderstood. They’re commonly associated with psychotic disorders, but they can also occur alongside trauma, severe mood disorders, eating disorders, and post-traumatic stress disorders (PTSD). While hallucinations are often portrayed as dramatic or dangerous, many people live with them long-term while continuing school, work, and relationships.

For some, treatment focuses on eliminating symptoms entirely. For others, the goal is learning how to coexist with hallucinations: reducing their intensity, understanding triggers, and staying grounded enough to move through daily life.

Columbia psychologist Alice Medalia, PhD, says treatment options for hallucinations include antipsychotic medications, which often diminish the quantity and vividness, and cognitive behavioral therapy for psychosis (CBTp), which treats the associated distress and provides skills to effectively manage triggers and daily challenges. Since hallucinations exist in the context of various disorders, it is important to also provide therapies to address those disorders.

“A combination of medication and psychotherapy has made living with conditions that cause hallucinations very possible,” Dr. Medalia says.

In order to share what it’s like to live with hallucinations, Jules Silverman, a participant in Columbia’s Lieber Recovery Clinic program, describes her daily experiences, how trauma shaped her mental health, and how she’s learned to build a meaningful life alongside her symptoms. Although everyone’s experiences with hallucinations or psychosis are different, this is Jules’s story.

I’m 23 now, and I’m a visual arts major at an Ivy League university. But I didn’t take a straight path to get here.

During my first semester at a previous college, I had a massive psychotic and manic episode. I ended up spending three weeks in a psychiatric hospital, followed by a couple of months in a rehabilitation facility. I had to take a medical leave and move back home. At the time, everything I had imagined for myself—school, independence, a career, and a future—felt like it collapsed overnight.

Now, I take two classes a semester. I’m almost finished with all my core requirements. It’s slower than I once imagined, but it’s real progress.

Outside of school, I walk—a lot. Sometimes seven to twelve miles a day around New York City. I listen to audiobooks while I walk, and it helps ground me. I love marine life, especially the underrepresented creatures: nudibranchs, eels, sea cucumbers, jellyfish. I’m obsessed with soup dumplings and could probably rank the best ones in the city. I’m also a huge Backstreet Boys fan.

But my main passion is art. I paint constantly, and someday I hope to publish my art in a book.

When I was little, I was very isolated. I liked being alone. I would draw in my room and listen to audiobooks, and I’d create these characters in my notebooks—except I didn’t think of them as imaginary. I saw them as fully flesh and blood. They had names, ages, occupations. People would say, “Oh, you have so many imaginary friends—you’re an artist.” I had notebooks filled with them.

That went on until I was about nine or ten. I genuinely thought everyone knew about these people. I would talk to my grandmother about them, about what they were doing. I remember her looking worried and saying she hoped I didn’t really see them.

I was always kind of different from other kids. I didn’t get a phone until I was 16, while everyone else had one at 11. I didn’t do extracurriculars. I kept to myself.

Everything escalated after I was sexually assaulted.

After that, I developed a severe eating disorder. That’s when the hallucinations became dark. I started seeing a shadow figure I called “Birdman.” His face looked like a bird, and he would torment me. I could feel him touch me. I started hearing whispering and couldn’t tell where it was coming from. Then came more visual hallucinations.

And I began to hallucinate all day, every day.

Finding treatment was incredibly hard. I started with therapy for sexual assault and PTSD, then eating-disorder treatment. One therapist finally recommended I see a psychiatrist after I began hallucinating during sessions. I was in and out of hospitals at least six times. I couldn’t find the right psychiatrist or the right treatment. I was diagnosed with almost everything you can think of.

Eventually, I found care at Columbia University’s Lieber Recovery Clinic, where I was put on antipsychotic medication. I also had multiple sessions of electric convulsive therapy at NewYork-Presbyterian. Combined, these treatments finally helped decrease the intensity of the hallucinations and allowed me to stay rational—to know that if they’re here, they can’t hurt me. I can bridge the gap between these things aren’t real and they exist with me.

At Columbia, I also started cognitive behavioral therapy for psychosis. I attended group sessions and, even though I didn’t open up much at first, hearing other people my age talk about their experiences made me feel less alone. I used to want to be an island. I don’t feel that way anymore.

Medication helps, but it doesn’t make them disappear. If I take a higher dose, they become opaquer instead of fully solid, and they’re quieter. But they’re still there. It can be disorienting. I’ll be walking down the street and suddenly there’s a giant eel swimming in my right periphery. I lose track of where I was going. I’m like, why is there an eel here? Why is it hissing at me?

I’ve learned to keep going anyway.

I try to work through whatever I’m seeing or hearing. Schoolwork helps. Painting helps. I believe in coexisting with the hallucinations. They’re there. They exist. I just don’t have to engage with them all the time. If you wake up every morning to hissing eels, eventually it’s like, okay, you’re here. Let’s go through the day.

Stress and exhaustion make everything worse. When I’m very tired or overwhelmed, the hallucinations intensify. That’s why walking and painting are so important for me—they ground me. When I’m not grounded, that’s when the hallucinations come in like vultures, like, she’s not grounded—bring in the big guns.

I want people to know that hallucinating every day doesn’t mean your life is over. It doesn’t mean you can’t have goals, interests, joy, or meaning. You can learn to coexist with them. You can make them benign—even the scary ones. You can put them in a box and say, I don’t want to deal with you right now. I have a life to live.

For me, that life includes painting, walking through the city, loving strange sea creatures, and slowly building a future that works for me—not the one I thought I was supposed to have.

I’m not cured. But I’m grounded. And that’s enough to keep going.