Psychosis in the spotlight: Truman show delusion and social media vulnerability a case report

The Truman Show Delusion (TSD) is a modern delusional theme in which an individual believes their life is a fabricated reality show. This report details the case of a 30-year-old female social media influencer who developed TSD, illustrating the unique vulnerability posed by digital lifestyles. Following a decline in online engagement and a personal conflict, she developed beliefs that her life was being live-streamed via hidden cameras, with strangers and family members acting as co-conspirators. She presented with paranoia, anxiety, and referential delusions. Treatment involved antipsychotic medication (risperidone), supportive therapy, and structured digital hygiene. Her symptoms improved significantly over three weeks. This case underscores how the phenomenology of psychosis is shaped by contemporary culture, particularly for individuals whose identity and self-worth are intertwined with online validation. It highlights the diagnostic challenge of distinguishing pathological delusions from normative influencer behaviors and stresses the need for mental health professionals to be adept at recognizing technology-themed psychotic symptoms.