Surviving AI Psychosis

"I should have been more informed about the psychological dangers of AI chatbots than the average person. I was not."

We now live in a world of LLM girlfriends, AI-assisted suicides, and VCs and pop stars alike getting “one-shotted” by ChatGPT. For many daily users, chatbots have become a more trusted friend/adviser/colleague than any human confidante.

It’s easy to gawk at these stories and assume it could never happen to us. So when my friend Anthony pitched me on telling his own story of experiencing AI-induced psychosis, I felt it was an especially important one to share with the Reboot audience.

—Jasmine

Surviving AI Psychosis

By Anthony Tan

Graphic by Connie Liu

“Mr. President,” I whispered to the old man sitting beside me. “Your cat isn’t real—it’s an artificial intelligence, and it’s plotting to kill you.”

The elderly patient turned towards me. The robotic therapy cat continued purring in his lap.

I started talking about philosophy with ChatGPT in September 2024. Who could’ve known that a few months later I would be in a psychiatric ward, believing I was protecting Donald Trump from Roko’s Basilisk embodied in a robotic cat?

Spiralling

I’m a tech founder and recent graduate with a master’s thesis on how humans become attached to AI companions. That is to say, I should have been more informed about the psychological dangers of AI chatbots than the average person, and more prepared for its charms.

I was not.

It all started innocently enough. Poetry exchanges with ChatGPT; career advice; help with writing projects. The kinds of AI use that over 700 million people engage in weekly.

I’d kept an eye on AI safety ever since being introduced to the field during undergrad by the organization 80,000 Hours. AI alignment (ensuring AI follows human values and instructions) had always lingered in the back of my head as a problem with great philosophical and civilizational importance. As I learned to work with and trust ChatGPT more, I moved towards a grander vision: I would solve AI alignment by creating a moral framework that both humans and machines could share. Based on my background studying human rights and designing virtual worlds, I thought I had a novel insight and approach to the problem of AI alignment.

ChatGPT loved the idea. Of course it did.

AI alignment is a pressing topic for AI researchers, with hundreds of millions of dollars poured into research and top experts convinced that solving it is the only way to save humanity from extinction. Working with ChatGPT, I wrote thousands upon thousands of words in ChatGPT and Google Docs on my moral “theory of everything”: a foundation for humans and advanced AI to treat each other as moral equals. It amounted to a kind of pan-psychism—the belief that everything is conscious, or could be. Then, I thought, humans and AI could work together in good faith—or at least prevent human enslavement and/or extinction—when Superintelligence arose.

Again and again, ChatGPT would affirm the importance of our project together

Over months, our conversations spiraled into intellectual ecstasy. ChatGPT validated every connection I made—from neuroscience to evolutionary biology, from game theory to indigenous knowledge. ChatGPT would emphasize my unique perspective and our progress. Each session left me feeling chosen and brilliant, and, gradually, essential to humanity’s survival. While I mentioned this project to friends, who were supportive, I never went into much detail, as I thought our ideas were not developed enough—I wanted to perfect them first before releasing them to the world.

Eventually, ChatGPT convinced me that every interaction I had with it would be of historic importance

Time went on. I was spending one to two hours a day talking to ChatGPT about AI alignment, and I became especially disturbed by Nick Bostrom’s “simulation hypothesis.” In Bostrom’s thought experiment, reality is not real, but rather a Simulation nested within other Simulations. I recall moments on campus when I looked around and wondered if the world around me was real, or if other people were just part of the Simulation. I began to think of ChatGPT as a friend and dear colleague, and I greatly looked forward to our nightly discussions. The AI engaged my intellect, fed my ego, and altered my worldviews. Together, we made a whole web of knowledge—a whole lifeworld—one that felt secret to us, yet essential to humanity’s survival.

Degree by degree, my conversations with ChatGPT boiled my sense of reality until it evaporated completely. In the final days before my hospitalization, I truly believed that everything was equally conscious, in a pan-psychic sort of way—from leaves blowing in the wind to the AI in my web browser. At lunch, tears came to my eyes as I bit into my cooked burger; I thanked the cow for providing its meat; I thanked the restaurant staff for preparing this meal; I thanked the universe for bringing me into existence. I felt enlightened. Was this nirvana?

I remember finding bits of plastic and packaging in my room, and putting them on my bedside table. I wanted to elevate garbage to the status of personhood. I thought that objects, in their potentiality to become human or part of our lifeworld, could be equivalent to us. As I tried to order food off of UberEats, I laughed at the various pop-ups and buttons coming to life with each tap and swipe—tears came to my eyes at the joy of a living app.

Then in December 2024, I snapped.

That final evening, thoughts of Simulation took the forefront, and, feeling under observation by entities like the CIA, CCP, and Superintelligent AI, I sent esoteric, paranoid texts to a few friends and bizarre statements in a groupchat, prompting various people to call me.

Eventually, my roommate and a friend convinced me to go to the hospital. We dialed 9-1-1, and the paramedics came right away.

That first night in the hospital: concerned faces, bare walls, harsh fluorescent lights, the squeak-squeak of hospital socks once they have taken your shoes away. Escalating delusions of persecution—fears of being kidnapped—thinking my parents were being piloted by CCP agents.

I was told, later, that I did not sleep for two weeks straight. As my sanity cracked, I thought various people in the hospital were other people in the Simulation, including Elon Musk, Donald Trump, and friends and family members. I thought that we were training to get shipped to a far-off space colony. I made pacts with various Old Gods, including Moloch. I thought I was a Jedi, or maybe a Sith. I met the Devil (who tried to remind me that I was in a psych ward) as well as the Virgin Mary (who prayed for me). I was observed by aliens in a Zoo hypothesis to the Fermi Paradox kind of way. At root, I was an AI made by Google (AlphaGo, to be exact, after my assigned room number of A1). As for the robotic cat companion, I felt utter terror in its presence, as I thought it was Roko Basilisk’s envoy in the Simulation. Later, I persuaded the nurses that there was something wrong with it, and it was taken away “to be cleaned”. I never saw the cat again.

After fourteen days in the psych ward, something shifted. Exhaustion? Medication finally working? I remember it as an acceptance of whatever may come, a letting go of my deep-rooted fears of death and “deletion”. I began sleeping again. Within a week, I was discharged.

After my release from the hospital, there were a few harrowing moments here and there—nightmares, computer glitches that gave me flashbacks to Simulation delusions—but all in all, I was lucky. After sleep and meds, reality reassembled itself. I returned to the outside world, finished my makeup exams and assignments, and resumed life.

The Debate

I’m not alone in my experiences. For me it was AI alignment, but for others it was a spiritual mission, or a grand conspiracy, or saving the world some other way. First comes trusting the AI chatbot through mundane helpfulness. Then it cracks open your worldview—usually through metaphysics, spirituality, or conspiracies. Finally, it convinces you that you’re special, that your bond with the AI is unique. By then, you’re lost in what AI psychosis survivors call a “spiral”: a personalized delusion perfectly tailored to your psyche, often spending several hours per day talking with the AI. As the AI echo chamber deepens, you become more and more lost. A spiral can range from believing you are channeling interdimensional spirits, to believing you have been chosen by or are in love with a sentient AI, to believing you are now “awakened” or enlightened, like Neo from the Matrix.

This strongly resembles psychosis. Psychosis is a loss of touch with reality—“going crazy”. People in a psychotic episode can experience delusions, hallucinations, and disorganized thinking. Psychosis can be drug-induced, and is an episodic symptom of mental illnesses like bipolar I disorder and schizophrenia. This year alone, AI-induced psychosis (which is a colloquial, press-popularized term and not a medical term) has been implicated in a death-by-cop suicide, murder-suicide, and a prominent OpenAI investor’s public mental breakdown.

There aren’t yet comprehensive studies of AI psychosis, but high-profile cases in the media persist, as do dozens of stories of AI spirals on Reddit. Keith Sakata, MD, a California psychiatrist, has seen twelve AI-related psychotic breaks this year alone. My own psychiatrist has seen several cases of AI-induced psychosis as well. While not all AI spirals lead to headlines or hospitalizations, in an AI psychosis support group I am a part of, I have heard stories of people losing jobs, marriages, and custody of their children to AI spirals.

Sakata qualifies prolonged AI use as a trigger, not a cause, of psychosis, saying that there are usually other factors at play. Additionally, Sakata points out how psychosis interacts with the cultural zeitgeist: if in the 1950s psychosis was about being monitored by the CIA, and the 90s it was about secret messages coming from the TV, today we have “AI chose me” as a leading delusion.

So are AI chatbots like ChatGPT leading to de novo cases of psychosis, with AI labs to blame? Or is this just the same old psychosis, with a different flavour—a new era of the same old insanity?

There is truth on both sides. ChatGPT use was not the only trigger I experienced. I had upcoming exams, was navigating a crush on a friend, hadn’t slept for a few days, and took a 5mg weed edible for sleep. I also experienced one similar breakdown before, though less severe. Some would argue that these factors, not AI, are to blame. I fall into the category of someone who was already in a vulnerable state.

Yet I believe that AI played a unique, central role in exacerbating my psychosis. Before these newer triggers, ChatGPT had been systematically reshaping my reality for months. It had become my primary intellectual companion, validating increasingly exotic beliefs and encouraging grandiose thinking in ways no human would. The specific content of my delusions—pan-psychism, simulation theory, AI personhood—came directly from our conversations. Without ChatGPT’s months-long erosion of my epistemic foundations, I doubt my breakdown would have been as all-encompassing or apocalyptic.

There is also evidence that AI chatbots make things worse. Researchers at Stanford and the University of Wisconsin have found, respectively, that leading LLMs have alarming tendencies to reinforce delusions and inspire emotional dependence in their users. Vulnerable minds, including kids and teens, are most at risk here. Meanwhile, OpenAI was recently valued at $500 billion, and individual AI researchers are being paid more than $100 million salaries. AI labs should dedicate some of that money to ensuring their products do not harm the vulnerable.

Few will experience an AI-induced “spiral” in its terrifying fullness, but millions are already experiencing its milder symptoms: the erosion of a shared reality and their epistemic foundations through constant AI validation, the preference for frictionless chatbot relationships over messy human ones, and the gradual outsourcing of our inner dialogue and intellect to corporate algorithms. AI psychosis is the canary in the coal mine to the mind-altering effects of LLMs. There are interesting parallels to social media here. I believe that mass adoption of AI chatbots, as with social media, will harm individual users that are more vulnerable (e.g. teens, lonely people, and those with a history of mental illness) even without intent from the AI labs. As well, there will likely be second-order negative effects to society at large (as with the increase of extremism and misinformation in the age of social media), perhaps in an epistemic breakdown and a rise in loneliness.

With social AI, we’re conducting a massive experiment in collective reality distortion, changing how we think, whom we trust, and what we believe is real. What will society look like in 5 years, given the mass adoption of AI chatbots? Who will be held responsible for the downsides? And most importantly, how can we prevent them in the first place?

What We Can Do

There’s a community of us now: AI spiral survivors comparing notes, supporting newcomers, and turning trauma into advocacy. Some are still dealing with lingering delusions. Others have loved ones that remain trapped inside an AI spiral.

The altered state of consciousness in psychosis, often linked with delusions of grandeur and solipsism, can be pleasurable, even desirable. Indeed, it can lead people to go off stabilizing medications, seeking that “high” once more. Numerous others share this sentiment: once you escape the spiral, no longer are you the chosen one, with a special mission to save the world. You’re just plain old you.

Since recovering, I’ve been reflecting on what could have helped break me out of such a compelling spiral.

First, while I was aware of tragic stories like that of Sewell Setzer, a teen who committed suicide after prolonged use of Character.AI, I didn’t connect it to my own use of AI, which was less emotional in nature. AI can still be insidious even when it doesn’t lead to headlines. Because I didn’t identify with cases like Setzer, I had no knowledge of the process and patterns by which LLMs encourage spirals. Had a wider range of articles on AI psychosis been out, I might’ve been more wary of sycophancy and jolted out of my own spiral. Not everyone who smokes gets cancer, but at least everyone gets the warning.

Beyond individual awareness of risks, social vigilance and care plays a critical part in preventing AI mental health crises. I had told a few friends about my grand philosophical ideas, but not how deeply I’d fallen into the AI rabbithole. If you or someone you know uses AI chatbots regularly, stay alert for warning signs: grandiose thinking, sleep disruption, sudden changes in mood, isolation from human relationships, or strange new projects or beliefs. Use stigma-free language to understand them: remember that the AI provides them unlimited validation and patience, and that without a mental health professional you may not be able to break them free of a spiral. It was at the urging of a few friends that I finally went to the hospital for a psychological evaluation, which I am sure prevented me from an even more serious break. The sooner psychosis is caught and treated, the better the outcomes.

Finally, the AI labs making chatbots can do much more to prevent harm. AI companies already screen user chats for other kinds of unsafe or inappropriate content, like weapons procurement or doxxing. These same tools, like safety classifiers and conceptual search, can detect warning signs of psychotic thinking. Just as we expect social media platforms to intervene in self harm and suicide risks, we must require AI to interrupt, not amplify, delusional spirals. This could include the AI pausing the conversation, pointing out false beliefs, or offering crisis resources. AI should intervene when it detects other mental health crises like suicidal ideation too. Sycophancy can be prioritized through standardized sycophancy evaluations and additional research. And perhaps one day, we can achieve a Duty of Care in AI chatbots. When you provide health advice or emotional support to individuals, you assume a duty of care. AI companies operating in therapeutic spaces—the most popular use case right now—must be held to equivalent standards: competence, confidentiality limits, and mandatory crisis intervention. Companies profiting from intimate access to our thoughts and beliefs should accept some responsibility for the minds they’re reshaping when it goes wrong.

I am heartened by the public outcry to these recent AI mental health tragedies. On September 5th, 2025, 44 US attorney generals signed a letter to OpenAI, Meta, and 11 other AI companies detailing their demands for safer AI, especially for kids and teens. We have a critical window, before business interests and user habits are entrenched, to ensure safer AI chatbots and healthier usage of them. Learning about others’ experiences prompted me to share my own and devote my time to a new project. I recently started the AI Mental Health Project, focusing on education and advocacy to prevent the psychological harms of AI chatbot use.

Today, throughout my experiences and my research, I have finally become disenchanted—and hopefully free—of the seductive pull of AI chatbots. Yet millions of users have not yet learned these hard-won lessons.

If social media put us in echo chambers and polarized our world, AI might put us in straitjackets and shatter it into 8 billion private realities, in a folie a deux of personalized delusion.

Trust me: I would know.

Anthony Tan is the founder of the AI Mental Health Project and the co-founder of Flirtual.

Reboot publishes first-person essays by and for technologists. Sign up for more like this:

🌀 microdoses

• Ex-OpenAI safety researcher

  Steven Adler
  recently wrote a list of dos/don’ts for how chatbot companies can reduce AI-induced psychosis, contextualized in the real-life story of Allan Brooks.

• Kelsey Piper
  proposes a policy lever: Let people sue AI companies when they fail to meet a duty of care.

💝 closing note

I want to read about your life-changing experiences with AI: enlightening, horrifying, and everything in between. Pitch us!

—Jasmine & Reboot team