“Twitter Psychosis”? I’m Skeptical

[Content note: mental illness & delusions]

Over at the Daily Dot, I did some mythbusting about this alleged “Twitter Psychosis.” For whatever reason, it’s hard for me to pick out an excerpt, so I’ll just go with what I think is the most relevant part of this story, but you should go read the full thing to get the background:

Unlike most other published psychological research, the study about Mrs. C and “Twitter psychosis” is a case study— a type of research in which researchers study one particular person, or case. Something you should know about case studies is that they’re the least scientifically rigorous experimental design possible. There’s obviously only one subject or participant, and a particular person’s psychology is so idiosyncratic and impacted by so many factors that we may or may not even notice that it’s difficult to draw any firm conclusions. Unlike other studies, that compare some group to some other group, case studies don’t allow us to see what happens if certain conditions are different.

This study was further an observational case study, not an experimental one. In experiments, researchers change something or do something to the participants and see what happens. In observational studies, they can only observe what’s already going on. This means that it’s impossible to tell what causes the observed phenomena to occur.

That said, case studies are useful sometimes. When researchers are first discovering a new phenomenon, or when people with a particular condition are very rare, there might be no choice but to study a single individual. Observational studies in particular are useful when it’s unethical or impossible to tweak some variables to see what happens. Twitter psychosis, if it’s a real thing, is probably quite rare. We would have to study thousands of participants to find cases of it. And if Twitter really can cause psychosis in certain people, it’s clearly unethical to purposefully expose them to it to see what happens. So, case studies, including observational ones, are often the first step of studying something new.

My main concern with this type of research—and with other recent warnings by mental health professionals that the Internet (and social media in particular) can cause or aggravate mental illnesses—is that people dealing with mental health problems may be pressured by friends, family, or doctors to stay offline. Of course, sometimes staying off the Internet (or off social media specifically) can be a wise choice for someone for any number of reasons. However, the general trend of anti-tech alarmism makes it likely that “stay off the internet” will be a piece of advice too often and too easily given.

People with mental illnesses can be vulnerable to persuasion and even coercion by those with authority over them, including therapists and psychiatrists. If a person with a Ph.D. says, “I think you need to stay off Twitter,” they may take their advice without any grains of salt.

You might ask why this matters. It matters because the Internet can also be an incredible source of support and information for people with mental illnesses. Tumblr, in particular, is known for its supportive community, but it’s not the only one. Reddit has subreddits dedicated to every major mental illness where users can post stories, ask for advice, and support each other. Twitter’s hashtags make it easy to find tweets about your illness, and mental health organizations and professionals are very active there, posting supportive messages, advice, and news about clinical research.

And Facebook is where many people “come out” about their mental illnesses for the first time, finding it easier to share with many people at once rather than with individuals—but without having to show it to the whole world. (Incidentally, Facebook is also where I run a support group for atheists dealing with mental health problems, which many of the participants have told me has been really helpful.)

It’s possible that Twitter can trigger psychosis in some people with other risk factors, and researchers should conduct more studies to find how whether, how, and why this happens, and how it can be prevented. But we should be careful not to cut suffering people off from a potentially vital source of support.

Read the rest here.

 

Faith is not a Mental Illness

I’ve been seeing a disturbing tendency among atheists to compare religious belief to mental illness. Sometimes this comparison is made explicit, as in this article. Other times, however, the comparison is more implicit–for instance, when words like “crazy” and “delusional” are used to describe religious people or their beliefs (hi Dawkins).

These comparisons are inaccurate and offensive to both religious people and people with mental illnesses.

First of all, being religious is a choice. Being mentally ill is not. While it’s a bit arguable whether or not faith itself is a choice–I certainly can’t make myself believe in god, but perhaps others can–the existence and success of religious proselytism proves that choice is at least part of the equation. Only a completely ignorant person, on the other hand, would attempt to proselytize mental health (although it obviously does happen).

Regardless of whether or not you can choose to believe in god, you definitely get to choose whether and to what extent you observe a religion (unless you’re a child, but that’s different). People with schizophrenia don’t get to choose which hallucinations they have and how often. People with OCD don’t get to choose their compulsions. People with phobias don’t get to choose which phobias they have or how they manifest themselves.

Second, suggesting that religious people are mentally ill is sanctimonious and offensive. It insinuates that they are incapable of consciously and purposefully choosing to be religious, and that their religious beliefs are just as meaningless as a symptom of mental illness. It reminds me of when I used to bring up concerns with friends who would respond, “Oh, that’s not such a big deal, you just feel that way ’cause you’re depressed.”

As I mentioned, being religious is a choice. For most people, it’s a choice made with one’s own best interests in mind. Comparing that to a schizophrenic delusion is a wee bit condescending.

(Of course, delusions that are religious in nature do exist. Some people with schizophrenia believe that they are possessed by religious spirits of some kind, that they have spoken to god, or that they are the messiah. However, this is vastly different from the way most religious folks experience their faith, and is obviously a symptom of mental illness.)

Although I’m an atheist who kinda sorta wishes religion didn’t exist, the fact is that it does, and I refuse to believe that all of the billions of religious people in the world are just mentally ill. No, they’re onto something. It’s just not something that I’m interested in myself.

Finally, these comparisons trivialize the suffering that people with mental illnesses experience. The distinction between mental health and mental illness is not that mentally healthy people do not believe in supernatural things and mentally ill people do. The difference is that (most) mental illnesses interfere with the person’s functioning and make them feel, well, bad.

Religion, for all its flaws, often does the opposite–it provides people with community, teaches them to behave morally and charitably, and helps them cope with illness, death, and other challenges in life. (A caveat: I’m talking about religion at its best, not at its worst, and these same effects can be found elsewhere.)

So when you imply that the definition of mental illness is believing in things without evidence, you miss a lot about what it’s like to be mentally ill. Namely, you ignore the emotional pain, cognitive distortions, thwarted goals, ruined relationships, physical fatigue, and all the other things that are part of the experience of mental illness.

There are many interesting, intelligent, and non-offensive ways for atheists to argue against destructive religious ideas (for instance, here’s an example I read today). Calling religious people mentally ill is not one of those ways. Let’s put that kind of useless rhetoric back on the shelf where it belongs.