Influencers in psychotic states endanger young users
MDlinx Aug 16, 2024
Spiritual influencers—social media users who create content documenting their personal wellness practices related to living a more “spiritual” life—run rampant across platforms like TikTok and Instagram.
These content creators are eager to spread messages and learn from their spiritual experiences. In most cases, the advice and virtues they dispense to their followers (which can number in the millions
Blake S. [@shaninblake]. Posts [Instagram profile]. Instagram. Retrieved August 8, 2024.
) typically result from a specific shift in the creator’s lifestyle and mindset.
While some of these influencers are ultimately harmless, others may unknowingly be in the midst of a psychotic state—what is known, in these cases, as “spiritual psychosis.”
A state of psychosis
Spiritual psychosis involves delusional beliefs about a person’s spiritual practices. It becomes a wider issue when the person experiencing a state of psychosis touts their beliefs to followers who are young and impressionable—and therefore at risk to the spread of medical misinformation and negative mental health consequences.
Spiritual awakenings are common among these spiritual influencers. They may stem from things like temporo-limbic seizures, hallucinogenic drug use, or near-death experiences (such as cerebral hypoxia), and can include heightened awareness, hallucinations, and out-of-body experiences.
Eeles J, Lowe T, Wellman N. Spirituality or psychosis?—an exploration of the criteria that nurses use to evaluate spiritual-type experiences reported by patients. International Journal of Nursing Studies. 2003;40(2):197-206.
But when does a spiritual experience cross over into pathological territory? Recognizing the differences between spiritual experiences and clinical psychosis is important for diagnosing and treating an at-risk patient as early as possible.
Researchers in a study conducted on adolescents highlight differences between clinical psychosis and psychosis-like experiences (PLEs), which may include “perceptual anomalies, unusual beliefs, and distorted thinking."
Kline E, Thompson E, Bussell K, Pitts SC, Reeves G, Schiffman J. Psychosis-like experiences and distress among adolescents using mental health services. Schizophrenia Research. 2014;152(2-3):498-502.
They explain that some PLEs may be associated with religious beliefs and “imaginative experiences.” Delusions or hallucinations as part of what a patient believes is a spiritual experience may not necessarily indicate clinical psychosis, especially if they are low-severity and short in duration.
Recognizing psychosis
On the other hand, clinical psychosis symptoms are more severe and typically cause distress. A patient experiencing psychosis has lost touch with reality, with difficulties distinguishing between fantasy and reality.
The National Institutes of Health states that patients experiencing psychosis may experience false beliefs, hear voices, speak nonsense, and experience paranoia.
Understanding Psychosis. National Institute of Mental Health.
The distress of this psychosis can significantly disrupt a patient’s daily life. Psychotic episodes typically persist for longer durations than standalone spiritual experiences.
Physicians can look for indicators to differentiate a spiritual person from someone experiencing a psychotic episode. This can include the duration of the experience and whether or not the patient has a clear sense of self and their own reality.
Know the dangers
Alongside psychosis-related distress, psychotic episodes can disrupt a patient’s education and employment. Psychosis is also tied to an increased risk of violence and suicide. When left untreated, psychosis can put patients at risk for self-harm and higher mortality rates compared with the general population.
Understanding Psychosis. National Institute of Mental Health.
Farooq S, Sheikh S, Dikomitis L, et al. Traditional healers working with primary care and mental health for early intervention in psychosis in young persons: protocol for the feasibility cluster randomised controlled trial. BMJ Open. 2023;13(7):e072471.
Per authors publishing in the Journal of Nervous and Mental Disease, "In schizophrenia and other psychotic disorders, the lifetime risk of suicide death is estimated to be 5.6%. The risk is particularly high during the first year of the initial contact with mental health services, being almost twice as high as in the later course of the illness."
Nordentoft M, Madsen T, Fedyszyn I. Suicidal behavior and mortality in first-episode psychosis. J Nerv Ment Dis. 2015 May;203(5):387-92. doi: 10.1097/NMD.0000000000000296. PMID: 25919385.
For the safety and well-being of self-proclaimed spiritual gurus and their online followers, psychosis must be recognized and diagnosed as early as possible.
A patient’s age and possible substance use should be considered in screening. Psychosis may begin when a patient is a teen or young adult. If a young patient is using psychoactive substances recreationally or as part of a spiritual practice, they may have PLEs as a result. “Our findings support the notion that adolescents with PLEs have increased rates of substance use, and young substance users have increased rates of PLEs,” another study shares.
Matheson SL, Laurie M, Laurens KR. Substance use and psychotic-like experiences in young people: a systematic review and meta-analysis. Psychol Med. 53(2):305-319. November 15, 2022. doi: 10.1017/S0033291722003440.
In these cases where a patient uses substances, cessation treatment should be included in the intervention for psychotic illness.
Early recognition and diagnosis of psychosis are crucial, especially among patients with large followings on social media. Physicians should be vigilant in distinguishing between psychotic episodes and spiritual experiences, especially in young patients or those using substances, to ensure timely and appropriate treatment and prevent potential harm.
What this means for you
Many social media followers are young and impressionable, and therefore at risk of following an influencer's practices which may ultimately cause them harm. This becomes particularly dangerous when an influencer is actually experiencing psychosis. Patients in psychotic states may be difficult to distinguish from those reporting spiritual experiences. However, recognizing the differences—in particular the duration, severity, and the patient’s level of distress—is crucial for correct diagnosis and intervention.
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