The Truman Show Inspired a Real Psychological Condition

Life imitating art took a uniquely modern and unsettling turn in the years following the 1998 film about a man whose entire existence was a television set. Psychiatrists began encountering patients with a peculiar and specific delusion: they were convinced they were the unwitting stars of their own personal reality show. The pattern was so distinct that brothers Dr. Joel Gold and Dr. Ian Gold, a psychiatrist and a neurophilosopher, respectively, informally coined the term "the Truman Show delusion" to describe the phenomenon they were observing in multiple patients.

This condition is not a new mental illness, but rather a culturally-specific manifestation of existing psychotic disorders, such as schizophrenia or bipolar disorder. The underlying delusions of persecution and grandeur are common, but their content is often shaped by the technology and anxieties of the time. Before the age of mass media, a person might have believed they were being spied on by a secret government agency; today, that same paranoia can be filtered through the lens of reality television and constant online surveillance.

These cases often involve a powerful blend of grandiosity and paranoia. The patient may feel they are the secret center of the world, important enough to be filmed 24/7, while also feeling trapped and persecuted by the unseen "producers" and "actors" around them. In one famous case, a patient traveled to New York to confirm that the World Trade Center had actually fallen, believing its destruction might have been an elaborate plot twist written just for his show.