Online Virality as a Persecutory Experience: A Psychodynamic Case Study.
Giselle Appel, M. Garrett, Samuel P. Greenstein, Anshuman Srivastava
The Psychoanalytic Review September 1, 2026 DOI: 10.1521/prev.2026.113.3.259 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 21-year-old man with bipolar disorder and cannabis use disorder |
| Key findings | The authors propose that online virality, combined with inconsistent antipsychotic adherence, daily cannabis use, and a traumatic arrest, triggered paranoid and persecutory delusions in a 21-year-old man with bipolar disorder; he described feeling as if his life was being broadcast. Symptoms improved with antipsychotic optimization. The authors argue that digital platform use should be assessed when evaluating psychotic decompensation. |
Abstract
Online virality can generate sudden destabilizing visibility in individuals with mood or psychotic disorders. This case report describes a 21-year-old man with bipolar disorder and cannabis use disorder who developed paranoid and persecutory delusions shortly after a video he posted went viral, worsened by an arrest that led to insomnia, withdrawal, hypervigilance, and the belief that he and his family were in danger. During hospitalization, he described feeling as if his life was being broadcast, an organizing explanation for his distress. His decompensation reflected inconsistent antipsychotic adherence, daily cannabis use, a traumatic arrest, and viral visibility. The shift from grandiosity to guilt to projected threat suggests paranoid-schizoid regression triggered by the online virality. Symptoms improved with antipsychotic optimization. This case underscores the need to assess digit platform use when evaluating psychotic decompensation.