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In a nutshell
- Social media creates ideal conditions for psychological delusions to develop and intensify, especially for disorders involving distorted self-perception like narcissism and body dysmorphia.
- Unlike real-life interactions that provide reality checks through physical cues, social media removes these guardrails and creates feedback loops that reinforce distorted thinking.
- Researchers recommend that people with delusional disorders reduce social media use and suggest developing technologies that make online interactions more grounded in reality.
BURNABY, British Columbia — We’re living in a world of carefully curated selfies and picture-perfect Instagram feeds, but there’s something darker happening behind those screens. New research shows that social media isn’t just changing how we communicate—it’s becoming a breeding ground for full-blown delusions and distorted thinking in vulnerable users.
The study, bluntly titled “I tweet, therefore I am,” found something quite disturbing: the psychological disorders most strongly linked to heavy social media use all involve delusions. Think narcissism (where people believe they’re superior), body dysmorphia (obsessing over imagined physical flaws), anorexia (seeing an overweight person in the mirror despite being dangerously thin), and even erotomania (the false belief that a celebrity is secretly in love with you).
How social media creates ‘perfect conditions’ for false beliefs
Social media has completely transformed how we interact with each other, creating digital spaces where we exist as disembodied versions of ourselves. This might seem like no big deal, just part of our tech evolution, but researchers Nancy Yang and Bernard Crespi from Simon Fraser University spotted some troubling patterns.
Their review shows that people with psychological disorders involving distorted self-perception use social media at much higher rates than others. The researchers call this the “Delusion Amplification by Social Media” model, arguing that platforms like Instagram, TikTok, and Facebook create perfect conditions for false beliefs about ourselves to grow unchecked.
The scary part? In real life, other people’s reactions help ground us in reality. Online, we can create any identity we want. Unlike face-to-face interactions where others help shape who we are, digital identities can be entirely self-created. We filter photos, edit appearances, and curate an idealized version of ourselves. We can even throw away online personas and start fresh with new accounts whenever we want.
Who is most at risk?
For people with narcissistic personality disorder, this environment gives constant validation for their inflated self-image. Social media metrics—followers, likes, views—create measurable admiration that feeds narcissistic tendencies. These individuals flock to platforms like Instagram that let them self-promote through carefully crafted images.
People with body dysmorphic disorder find in social media a distorted mirror. In real life, other people’s reactions help challenge distorted perceptions. But online, users focus selectively on perceived flaws and search endlessly for validation of their skewed self-image.
The study found similar trends with eating disorders. Visual-heavy platforms reinforce idealized body standards, and comparing yourself to others online can worsen body dissatisfaction. People with eating disorders often use social media more, especially image-focused platforms.
Interestingly, one group tends to use social media less: people with autism spectrum disorders. They use these platforms less frequently and differently than others. While most people use social media to socialize, people with autism often prefer platforms like YouTube that focus on special interests rather than social networking.
Simply put, for vulnerable people, these platforms become echo chambers that strengthen unhealthy thinking patterns.
Platforms ‘cater’ to delusional thinking
Face-to-face interactions give us crucial feedback about ourselves and reality. When we meet in person, we sync up through body language, facial expressions, and tone. We watch each other’s reactions and adjust accordingly. These physical social cues help us distinguish what’s real from what we’ve imagined.
Social media strips away these reality checks. Online interactions lack physical feedback. Without these cues, people prone to distorted thinking become increasingly trapped in their subjective reality. This creates a dangerous loop—users seek validation online for distorted self-perceptions, get algorithmic content that reinforces these views, and sink deeper into their delusions.
“Social media is creating conditions where delusions can more easily be generated and sustained due to the presence of platforms and apps that cater to the disorder’s causes, plus the absence of effective reality-checking,” says Bernard Crespi, a professor of biological sciences at SFU, in a statement. “This research has important implications for the causes and symptoms of mental illnesses, and how they can be exacerbated by online social platforms.”
What’s particularly worrying is how social media platforms exploit our ability to infer, imagine, and anticipate what others are thinking. Success on social media depends on accurately predicting what will engage an invisible audience. This mental skill overlaps with traits already heightened in people with certain psychotic-spectrum disorders, potentially explaining why these individuals are drawn to these platforms.
Creating a viral TikTok video requires anticipating what an invisible audience will find engaging, positioning yourself to create fake eye contact with the camera, and focusing on points of virtual attention—all without immediate feedback. These skills match the hyper-mentalization seen in conditions like paranoia and schizotypy.
How do we help individuals at risk?
The researchers suggest that certain disorders—narcissism, body dysmorphia, eating disorders, and erotomania—share key features. They all involve delusional thinking about the self, altered perception of reality, and social isolation. Social media creates an environment where these delusions can thrive because the self exists in a purely mental space, without the reality testing that happens in face-to-face interactions.
While social media can build communities and help people feel connected, Crespi and Yang point out that high-risk individuals often suffer from excessive use. This relationship works both ways: people with these psychological traits gravitate toward social media, and using social media intensifies their symptoms, creating a vicious cycle that worsens psychological distress over time.
According to the researchers, social media itself isn’t inherently bad, but virtual worlds—combined with social isolation in real life—create environments where people maintain delusional self-identities without anyone challenging them.
The authors also call for more research on specific features of social media that encourage delusions and ways to make online interactions more grounded and real-life-like. They suggest exploring eye-contact technology, 3D perspectives, avatars, and other immersive technologies to help.
And of course, having a strong support system or a mental health counselor who you feel comfortable having an open and honest conversation with can help bring attention to harmful behavior.
Next time you feel that urge to check Instagram for the twentieth time today, ask yourself: are you looking for connection, or just confirmation? And at what point does that digital reflection stop resembling the person you really are?
Paper Summary
Methodology
The researchers took a comprehensive approach, following the PRISMA guidelines (a fancy way of saying they used a standardized method for reviewing research). They searched through two major scientific databases—PsycInfo and PubMed—using terms that combined “social media” with various psychological disorders. Starting with over 2,600 studies, they narrowed it down to 155 articles that met their quality standards. They looked for papers describing social media use related to psychotic spectrum traits or autism spectrum disorder, including both statistical analyses and observational studies. This broad approach let them spot patterns across multiple studies and develop theories to explain what they saw.
Results
The study found clear patterns in how social media relates to psychological disorders. For narcissism, a whopping 60 out of 70 papers showed positive associations between narcissistic traits and greater social media use, especially self-promotional behaviors like posting selfies. For body dysmorphic disorder and eating disorders, more than half of the 32 studies found links between social media use and increased body dissatisfaction or eating disorder symptoms, particularly on image-focused platforms. Interestingly, 7 out of 9 studies on autism found that people with autism tend to use social media less than others and for different reasons—often focusing on special interests rather than social networking. The researchers also found evidence suggesting schizotypal traits might be associated with increased social media usage, though fewer studies explored this connection.
Limitations
The researchers admit their review has some weak spots. First, there’s not much data on social media usage for some disorders, including autism, schizophrenia, and bipolar disorder. Second, most studies on psychosis and social media are individual case reports rather than large-scale research, making it hard to prove cause-and-effect relationships. Third, many studies lump all social media together, ignoring that different platforms serve different purposes and attract different users. Fourth, some studies treat eating disorders as one big category, potentially missing important differences between specific conditions. Finally, most research has focused on cultural explanations when these relationships might be better understood through how disorders affect our sense of physical self.
Discussion and Takeaways
The researchers propose that social media creates an environment unlike anything humans have experienced before, one that alters how we perceive reality in ways that can intensify psychological vulnerabilities. In real life, social interactions provide crucial physical cues that help us test reality—distinguishing what’s real from what we imagine. Social media removes these guardrails, potentially creating feedback loops that reinforce distorted thinking. Their “Delusion Amplification by Social Media” model suggests that people with underdeveloped sense of self, combined with social isolation, may use social media to create and maintain delusional identities. For mental health professionals, understanding how virtual environments interact with psychological traits could improve treatments. For tech designers, this raises questions about how platforms could be redesigned to minimize psychological harm.
Funding and Disclosures
The research was supported by the Natural Sciences and Engineering Research Council of Canada through Discovery Grant 2019-04208. The authors declared no conflicts of interest.
Publication Information
This systematic review was published in BMC Psychiatry (2025) volume 25, article number 95, under the title “I tweet, therefore I am: a systematic review on social media use and disorders of the social brain” by Nancy Yang and Bernard Crespi from the Department of Biological Sciences at Simon Fraser University in Burnaby, British Columbia, Canada. The paper is available under open access license.
