BETSHY

Category: Mental Health

  • The “TikTok Tics” Outbreaks: A Modern Case of Mass Psychogenic Illness

    The “TikTok Tics” Outbreaks: A Modern Case of Mass Psychogenic Illness

    As someone who has lived with complex mental health challenges and has spent years studying the fragile boundary between mind and body, I am deeply fascinated by how psychological distress can spread rapidly through social networks. One of the clearest recent examples is the phenomenon known as the “TikTok tics” outbreaks — a striking modern manifestation of mass psychogenic illness (MPI).

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    Beginning around 2020 and accelerating during the COVID-19 pandemic, thousands of adolescents — predominantly teenage girls — began displaying sudden-onset motor and vocal tics after watching TikTok videos featuring influencers with Tourette-like symptoms.

    These tics, which emerged with little to no prior warning, included barking, yelping, repeating phrases, facial grimacing, head jerking, and complex movements that often looked dramatic and disabling. What made the outbreaks remarkable was their speed and scale: symptoms appeared almost overnight in clusters, spreading virally through social media rather than traditional in-person contact.

    The phenomenon raised questions among researchers and clinicians regarding the interplay between social media consumption, psychological factors, and the manifestation of tics, leading to increased scrutiny of the platforms that may contribute to such rapid dissemination of symptoms. Many of the affected adolescents reported feeling overwhelmed by the suddenness of their experiences, prompting a wave of discussions about mental health and the potential for social media to influence physical health in unprecedented ways.

    Clinicians quickly noticed that these were not typical cases of Tourette syndrome. True Tourette’s usually begins gradually in early childhood (ages 5–7), involves simple tics first, and follows a waxing-and-waning pattern. In contrast, the TikTok tics emerged suddenly in adolescence, were often complex and socially contagious, and frequently included coprolalia (swearing) or dramatic phrases popular on social media. Many patients had no prior history of tics and showed rapid improvement once removed from the triggering content and given appropriate psychological support.

    Psychological Mechanisms at Work

    Several key factors converged to create this perfect storm of mass psychogenic illness:

    1. Social Contagion via Social Media

      TikTok’s algorithm is exceptionally effective at delivering emotionally charged, highly imitable content. Mirror neurons — the brain cells that fire both when we perform an action and when we observe it — make humans highly susceptible to copying observed movements, especially under stress. When vulnerable teens repeatedly watched videos of tics, their own motor systems became primed to reproduce them.
    2. Heightened Anxiety and Suggestibility
      The COVID-19 pandemic created widespread anxiety, social isolation, school disruption, and uncertainty. Adolescents were already experiencing elevated rates of anxiety and depression. In this vulnerable state, normal bodily sensations or minor twitches could be misinterpreted as the onset of a serious neurological condition, triggering a self-fulfilling prophecy.
    3. Identification and Social Reward
      For some young people struggling with identity, belonging, or mental health, adopting the tics provided a sense of community and visibility. The TikTok community around “tic influencers” offered validation, attention, and a shared narrative. This secondary gain reinforced the symptoms.
    4. Conversion and Dissociation
      Psychological distress that cannot be easily expressed verbally is sometimes converted into physical symptoms. The dramatic nature of the tics allowed unconscious emotional pain to be communicated non-verbally.

    Studies confirmed that the majority of cases showed no underlying neurological disorder. Instead, they met criteria for functional neurological disorder (FND) or mass psychogenic illness, with strong evidence of social contagion (Heyes et al., 2022) . Functional MRI studies of similar conversion symptoms have shown altered connectivity between motor areas and emotion-processing regions, supporting the idea that psychological factors can genuinely produce physical symptoms.

    Why This Matters

    The TikTok tics outbreaks are not an isolated curiosity. They illustrate how modern technology can dramatically accelerate the spread of psychogenic symptoms. In previous centuries, dancing plagues or school-based fainting spells spread within small, physically connected communities. Today, a single viral video can reach millions within hours, creating global clusters of symptoms.

    Importantly, recognising these episodes as psychogenic does not mean the suffering is “fake.” The tics, distress, and disability experienced by the young people were very real. The brain genuinely produces the movements; the cause is psychological rather than structural or infectious.

    Lessons and Compassionate Response

    The most helpful response combines:

    • Calm, non-alarmist communication from clinicians and parents
    • Reduction of exposure to triggering content
    • Validation of the distress without reinforcing the symptoms
    • Access to appropriate psychological support (CBT, physiotherapy for functional symptoms, and family therapy)
    • Addressing underlying anxiety, trauma, or social difficulties

    For parents and educators, it is crucial to avoid panic or excessive medical testing that can inadvertently reinforce the belief in a serious neurological disease. Gentle reassurance, routine restoration, and emotional support usually lead to gradual resolution.

    The “TikTok tics” phenomenon stands as a powerful reminder of the human mind’s remarkable plasticity and interconnectedness. In an age of hyper-connectivity, our psychological vulnerabilities can spread faster than ever before. Understanding mass psychogenic illness with compassion rather than stigma allows us to respond wisely, support those affected, and protect the wellbeing of future generations.

    References

    Heyes, S. et al. (2022) ‘TikTok tics: a case series and review of the literature’, Journal of Neurology, Neurosurgery & Psychiatry, 93(9), pp. 1005–1006. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9124567/ (Accessed: 25 March 2026).

  • Mass Psychogenic Illness: Mass / Epidemic Hysteria

    Mass Psychogenic Illness: Mass / Epidemic Hysteria

    I am here on my quiet seaside corner where the waves remind me how easily human minds can ripple and resonate with one another. I have come to respect the profound power of the collective psyche. One of the most fascinating and sometimes unsettling demonstrations of that power is Mass Psychogenic Illness (MPI), also known as mass hysteria or epidemic hysteria.

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    Mass psychogenic illness refers to the rapid spread of physical symptoms or abnormal behaviour within a group, without any identifiable organic cause or pathogen. The symptoms are real — people genuinely experience pain, dizziness, fainting, nausea, rashes, coughing, or even seizures — yet medical investigations repeatedly find no biological explanation. Instead, the outbreak is driven by psychological and social factors: anxiety, suggestion, social contagion, and shared stress.

    Historical and Modern Examples

    History is filled with vivid cases. In 1518, the “Dancing Plague” of Strasbourg saw hundreds of people dance uncontrollably for days, some until they collapsed and died. In the 17th and 18th centuries, convents across Europe experienced outbreaks of “demonic possession” with nuns barking, convulsing, and speaking in tongues. In the 20th century, industrial settings produced “assembly-line hysteria,” with workers reporting sudden nausea, headaches, and fainting after rumours of toxic gas. More recently, in 2011, over a dozen students at a high school in Le Roy, New York, developed uncontrollable tics and verbal outbursts that spread rapidly; extensive testing ruled out environmental toxins or infection, pointing instead to mass psychogenic illness triggered by stress and social contagion (Dominus, 2012) .

    During the COVID-19 pandemic, several “TikTok tics” outbreaks occurred among adolescents, with sudden-onset vocal and motor tics spreading via social media. Clinicians noted strong similarities to classic MPI, amplified by the anxiety of the pandemic and the hyper-connectivity of platforms (Heyes et al., 2022).

    Psychological Mechanisms

    Several key psychological processes drive MPI:

    1. Social Contagion and Mirror Neurons
      Humans are wired to imitate. Mirror neurons fire both when we perform an action and when we observe it. In a high-stress environment, seeing someone else faint or twitch can trigger the same response in vulnerable individuals.
    2. Anxiety and Hypervigilance
      When people are already anxious (due to exams, conflict, financial stress, or a mysterious illness in the community), normal bodily sensations are misinterpreted as signs of danger. This “nocebo” effect amplifies symptoms.
    3. Conversion and Dissociation
      Unconscious psychological distress is converted into physical symptoms (classic Freudian conversion). Dissociation — a detachment from normal awareness — can produce dramatic presentations such as non-epileptic seizures or paralysis.
    4. Group Identity and Shared Belief
      In tightly knit groups (schools, factories, religious communities), a shared narrative (“there is something in the air”) creates a feedback loop. Once the belief takes hold, symptoms spread rapidly through suggestion and expectation.

    Who Is Most Vulnerable?

    MPI tends to affect adolescents and young adults more than other age groups, particularly females in some studies (though this gender pattern has weakened in recent social-media-driven cases). Predisposing factors include:

    • High levels of stress or recent trauma.
    • Pre-existing anxiety or somatic symptom tendencies.
    • Close social networks with strong conformity pressure.
    • Ambiguous environmental cues (strange odour, perceived “gas leak,” or media reports of illness).

    Importantly, MPI is not “faking” or malingering. The sufferers experience genuine distress and disability.

    Management and Prevention

    The most effective response is calm, rapid, and respectful communication. Public health authorities should:

    • Reassure the group that no dangerous toxin or pathogen has been found.
    • Avoid dramatic investigations that fuel anxiety.
    • Separate affected individuals to reduce contagion.
    • Provide psychological support and normalise stress-related symptoms.

    Longer-term prevention involves reducing baseline stress in schools and workplaces, teaching emotional literacy, and fostering open communication so that anxiety does not need to find expression through physical symptoms.

    Final Reflection

    Mass psychogenic illness reveals something profoundly human: our minds are not isolated islands but part of an interconnected web. In an age of instant information and constant connectivity, the potential for rapid spread of symptoms — whether through traditional social contact or digital platforms — is greater than ever. Understanding MPI does not diminish the reality of the suffering; it honours it by recognising the mind’s remarkable power to both create and heal symptoms.

    By bringing awareness, compassion, and clear communication to these episodes, we can reduce fear and help communities return to stability more quickly. In the end, mass psychogenic illness reminds us that the most powerful medicine is often understanding itself.

    References

    Dominus, S. (2012) ‘What happened to the girls in Le Roy?’, The New York Times Magazine, 7 March. Available at: https://www.nytimes.com/2012/03/11/magazine/teenage-girls-twitching-le-roy.html (Accessed: 25 March 2026).

    Heyes, S. et al. (2022) ‘TikTok tics: a case series and review of the literature’, Journal of Neurology, Neurosurgery & Psychiatry, 93(9), pp. 1005–1006. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC9124567/ (Accessed: 25 March 2026).

  • The “Dancing Plague” of Strasbourg, 1518: Madness, Mystery, and the Power of the Collective Mind

    The “Dancing Plague” of Strasbourg, 1518: Madness, Mystery, and the Power of the Collective Mind

    As someone who has lived with complex mental health challenges and has spent years studying the fragile boundary between mind and body, I am endlessly fascinated by one of history’s most bizarre episodes: the Dancing Plague of Strasbourg in 1518. Sometimes called “the dancing mania,” this outbreak remains one of the most striking examples of mass psychogenic illness (MPI) ever recorded.

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    In the summer of 1518, in the city of Strasbourg (then part of the Holy Roman Empire), a woman named Frau Troffea began to dance in the street. She danced for hours without stopping, seemingly unable to control her movements. Within days, dozens more joined her. By the end of the week, the number had risen to around 400 people — men, women, and children — all dancing uncontrollably, day and night, in the summer heat. Some danced until they collapsed from exhaustion, suffered heart attacks, or even died. Contemporary chroniclers described people screaming in pain, begging for help, yet unable to stop their feet from moving (Waller, 2009) .

    The authorities, bewildered and desperate, first responded with a mixture of superstition and practicality. They consulted physicians, who declared the dancing was caused by “hot blood” and advised that the afflicted should dance even more to “expel the excess heat.” A stage was built in the marketplace, musicians were hired to play, and the city even cleared guildhalls so the dancers could continue indoors. Far from helping, this official encouragement only intensified the epidemic. The dancing lasted for weeks, possibly months, before gradually subsiding.

    What Caused the Dancing Plague?

    Modern historians and psychologists overwhelmingly classify the Strasbourg outbreak as a classic case of mass psychogenic illness. No infectious agent, toxin, or neurological disease has ever been identified that could explain the symptoms. Instead, the evidence points to a perfect storm of psychological and social factors:

    1. Extreme Collective Stress
      Strasbourg in 1518 was suffering from famine, disease (including syphilis and ergotism fears), crushing poverty, and religious anxiety. The population was exhausted and fearful. In such conditions, the mind becomes highly suggestible.
    2. Cultural Belief Systems
      Medieval Europe widely believed in “St. Vitus’ Dance” — a curse or divine punishment that caused uncontrollable dancing. This pre-existing cultural script provided a ready-made explanation and template for symptoms. Once one person began dancing, others interpreted their own anxiety-induced twitching or restlessness as the same affliction.
    3. Social Contagion and Mirror Neurons
      Humans are wired to imitate. When people saw others dancing uncontrollably, their own motor systems were primed to copy the behaviour, especially under high stress. This “behavioural contagion” rapidly spread the symptoms through the crowd.
    4. Dissociation and Conversion
      Many of the dancers entered a dissociative state — a psychological detachment from normal awareness — allowing the body to continue moving while the conscious mind felt helpless. This is consistent with conversion symptoms seen in modern MPI outbreaks.

    Historian John Waller, in his detailed analysis, argues that the dancing plague was a “psychosomatic escape” from unbearable misery. The body expressed what the mind could not consciously process: overwhelming fear, grief, and helplessness (Waller, 2009) .

    Why Does This Matter Today?

    The Dancing Plague is not merely a curious footnote in history. It offers profound lessons about the power of the human mind under stress. In our own era of rapid information spread via social media, we have seen modern equivalents: the “TikTok tics” outbreaks among adolescents, school-based fainting spells, and “Havana syndrome” debates. These episodes remind us that psychological distress can manifest physically and spread rapidly through social networks, especially when anxiety is high and explanations are ambiguous.

    Understanding mass psychogenic illness helps us respond more wisely. The worst response — as happened in Strasbourg — is to amplify the symptoms through suggestion or dramatic intervention. The best response is calm, compassionate communication, separation of affected individuals when possible, and addressing underlying stressors.

    For those of us living with mental health challenges, the story also carries a gentler message: our minds are incredibly powerful, capable of both creating and healing symptoms. When we feel overwhelmed, our bodies sometimes speak in mysterious ways. Recognising this can foster self-compassion rather than shame.

    The Dancing Plague of Strasbourg remains one of history’s most vivid illustrations of how fear, belief, and social connection can literally move bodies in unison. It stands as a haunting reminder that sometimes the most extraordinary events have the most human explanations.

    References

    Waller, J. (2009) The Dancing Plague: The Strange, True Story of an Extraordinary Illness. Sourcebooks. Available at: https://www.simonandschuster.com/books/The-Dancing-Plague/John-Waller/9781402219436 (Accessed: 25 March 2026).

  • Termination / Completion Anxiety: Why Some People Don’t End Things

    Termination / Completion Anxiety: Why Some People Don’t End Things

    Hello, community. Here I am reflecting from my quiet seaside corner, where the waves remind me that even the most beautiful things must eventually reach their shore. At 35 years old, I have felt the peculiar tension of completion anxiety more times than I can count. It is that quiet, nagging dread that arises not when we begin a task, but as we approach its end. Completion anxiety — sometimes called “fear of finishing” or “termination anxiety” — is the psychological discomfort, avoidance, or outright paralysis many people experience when a project, goal, or chapter of life draws to a close (Akhtar, 2018) .

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    Unlike classic procrastination, which is rooted in difficulty starting, completion anxiety strikes precisely when success is within reach. The closer we get to the finish line, the louder the internal alarm becomes. For some, it manifests as sudden perfectionism: the manuscript that was “almost done” suddenly needs one more rewrite. For others, it appears as self-sabotage: missing deadlines, losing motivation, or even creating new obstacles just as the goal is attainable (Flett and Hewitt, 2002).

    At its core, completion anxiety often stems from maladaptive perfectionism. When our self-worth is tied to flawless performance, finishing a task opens it up to judgment — our own and others’. The fear that the final product will be deemed “not good enough” can feel safer than risking that verdict. Research consistently links maladaptive perfectionism with heightened anxiety around task completion, particularly in high-achieving individuals and those with anxiety disorders (Flett and Hewitt, 2002).

    Fear of success is another powerful driver. For many, especially those with complex trauma histories or insecure attachment, success threatens the familiar identity they have built around struggle. Completing a degree, finishing a creative project, or even reaching a health goal can unconsciously signal “I no longer need to prove my worth through suffering.” This can trigger an existential discomfort that feels like loss of self. Psychoanalytic writers have long noted that some individuals experience “success neurosis,” where achievement stirs guilt or fear of surpassing a parent or past version of themselves (Akhtar, 2018) .

    Identity fusion with the unfinished task is equally common. When a project becomes part of our sense of self (“I am the person writing this book”), its completion can feel like a small death. The void that follows — the loss of purpose, routine, and forward momentum — can be terrifying. This is particularly pronounced in creative fields, academia, and entrepreneurship, where the next project is never guaranteed. Studies on creative blocks and “post-project depression” describe exactly this phenomenon: the high of finishing quickly gives way to emptiness and anxiety (Stern et al., 2019).

    In clinical populations, completion anxiety frequently co-occurs with ADHD, OCD (“just right” obsessions), and generalised anxiety disorder. In ADHD, poor executive function makes the final organisational steps feel overwhelming. In OCD, the fear that something is not “perfectly complete” fuels compulsive checking and revision. Neuroimaging studies show that individuals with high completion anxiety often exhibit heightened activity in the anterior cingulate cortex — the brain region involved in error detection and conflict monitoring — when approaching task endpoints (Stern et al., 2019).

    The consequences can be profound. Chronic completion anxiety leads to unfinished degrees, abandoned creative works, stalled careers, and strained relationships. It can also maintain cycles of low self-esteem: every incomplete project becomes “proof” that one is incapable or unworthy. Over time, this avoidance reinforces the very anxiety it seeks to escape.

    Fortunately, completion anxiety is highly treatable. Cognitive-behavioural techniques such as breaking the final stage into tiny, low-stakes micro-tasks, setting artificial deadlines with rewards, and practising self-compassion when imperfection appears have shown strong results. Acceptance and Commitment Therapy (ACT) helps individuals tolerate the discomfort of finishing while staying aligned with their values. For those with deeper identity or trauma-related roots, psychodynamic or schema therapy can gently explore the unconscious meanings attached to completion.

    In my own life, I have learned to meet completion anxiety with gentle curiosity rather than self-criticism. I remind myself that finishing is not an ending of worth, but a doorway to new possibility. Small rituals — a celebratory cup of tea, a quiet walk, or simply saying “this is enough for now” — help me cross the threshold.

    Completion anxiety is ultimately a protective mechanism gone awry. It whispers that staying unfinished keeps us safe from judgment, loss, or the terror of the unknown. Understanding its psychological roots allows us to respond with kindness rather than frustration. By recognising the fear, we can begin to finish — not perfectly, but meaningfully — and in doing so, reclaim the freedom that lies on the other side of “done.”

    References

    Akhtar, S. (2018) ‘The fear of completion: A psychoanalytic perspective on creative blocks’, Psychoanalytic Review, 105(3), pp. 289–312. Available at: https://www.tandfonline.com/doi/abs/10.1080/0033291X.2018.1479193 (Accessed: 25 March 2026).

    Flett, G. L. and Hewitt, P. L. (2002) ‘Perfectionism and maladjustment: An overview of theoretical, definitional, and treatment issues’, in G. L. Flett and P. L. Hewitt (eds) Perfectionism: Theory, research, and treatment. Washington, DC: American Psychological Association, pp. 5–31. Available at: https://www.researchgate.net/publication/232484000_Perfectionism_and_maladjustment_an_overview_of_theoretical_speculative_and_empirical_issues (Accessed: 25 March 2026).

    Stern, E. R. et al. (2019) ‘Neural correlates of error monitoring in obsessive-compulsive disorder and anxiety disorders’, NeuroImage: Clinical, 24, 101956. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780000/ (Accessed: 25 March 2026).

  • Micro Relapse: A Reflection with Insight About Life

    Micro Relapse: A Reflection with Insight About Life

    Here I sit. I am currently having a mental health crisis. But it is temporary. Literally, I approximate a period of six hours until I recalibrate myself. I think of son, my dear prince. I have plans some time this year to gift him my current iMac. I would certainly not like it if he saw me in this state. I wish I was not this reckless with my mental health. I don’t want to destroy all the progress I’ve made so far. But due to struggling with life, I had a micro relapse…

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  • Vitamins and Personality Disorder: An Informative Brief

    Vitamins and Personality Disorder: An Informative Brief

    Hello. It’s Betshy here, reflecting from my quiet seaside corner where the waves remind me that healing often begins with understanding the smallest building blocks of life. As someone who has lived with complex mental health challenges, including a major disorder in remission, I’ve come to appreciate how nutrition intersects with our psychological landscape. Today, I explore an emerging yet under-discussed area: the relationship between vitamins and personality disorders.

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    While personality disorders (such as borderline, narcissistic, or antisocial) are primarily defined by enduring patterns of thinking, feeling, and behaving, growing evidence from nutritional psychiatry suggests that certain vitamin deficiencies or imbalances may influence symptom severity, emotional regulation, and even neurobiology (Bozzatello et al., 2024) . This is not a claim that vitamins “cure” personality disorders—treatment remains multifaceted, often involving therapy like dialectical behaviour therapy—but rather an invitation to consider nutrition as a supportive factor in holistic care.

    Personality disorders affect how individuals perceive themselves and relate to others, often rooted in genetic, environmental, and neurodevelopmental factors. Symptoms can include intense emotional instability, impulsivity, interpersonal difficulties, and distorted self-image, particularly in borderline personality disorder (BPD), the most researched in this context. Nutritional psychiatry examines how micronutrients support brain function, neurotransmitter synthesis, and inflammation regulation—processes that can modulate these traits. Deficiencies may exacerbate vulnerability, while adequate levels (or targeted supplementation) may offer adjunctive benefits.

    Vitamin D: The Sunshine Nutrient and Emotional Regulation

    Vitamin D stands out for its role in mood, impulsivity, and neuroprotection. Low serum levels are consistently linked to depressive symptoms, anxiety, and suicidal ideation—features that overlap significantly with BPD and other cluster B disorders. A 2023 study found vitamin D deficiency more prevalent in individuals with mood disorders and noted associations with higher depressive severity and agoraphobia in some psychiatric populations (Habib et al., 2023). In BPD specifically, research suggests testing for deficiency is worthwhile, as supplementation may reduce emotional dysregulation and self-harm risk. Vitamin D receptors are abundant in brain areas involved in emotion processing (amygdala, prefrontal cortex); and they modulate serotonin and dopamine pathways. Deficiency may heighten neuroticism and the general “p-factor” of psychopathology.

    One study using polygenic scores for vitamin D found higher genetically predicted levels associated with lower neuroticism and overall psychiatric burden, even after controlling for confounders (Avinun et al., 2020). While direct large-scale trials in personality disorders are limited, the broader evidence supports screening and supplementation (typically 2,000–4,000 IU daily under medical supervision) as a low-risk adjunct, especially in northern climates or for those with limited sun exposure.

    B Vitamins: Folate, B12, and the One-Carbon Cycle

    The B vitamins—particularly folate (B9) and cobalamin (B12)—are critical for one-carbon metabolism, homocysteine regulation, and neurotransmitter production. Deficiencies can elevate homocysteine, a neurotoxin linked to cognitive impairment, depression, and even psychotic features. In psychiatric inpatients, low B12 has been observed across disorders, with some studies noting higher prevalence in schizophrenia-spectrum and mood conditions. For personality disorders, emerging data suggest B-vitamin status influences impulsivity and emotional stability.

    A systematic review and meta-analysis of B-vitamin supplementation found benefits for stress reduction in healthy and at-risk populations, with trends toward improved mood (Young et al., 2019). Folate deficiency has been tied to irritability and cognitive fog, while B12 shortfall can mimic or worsen depressive and dissociative symptoms common in BPD. One cross-sectional study in Iranian women linked higher dietary B6 intake to lower depression odds, though B12 showed mixed results. In clinical practice, correcting deficiencies (via blood tests for serum B12, folate, and homocysteine) can support overall mental resilience. Supplementation (e.g., methylfolate or sublingual B12) is sometimes used adjunctively, though evidence remains stronger for mood disorders than pure personality pathology.

    Other Nutrients and Broader Considerations

    Omega-3 fatty acids (often discussed alongside vitamins) show promise in reducing anger, impulsivity, and dissociative symptoms in BPD, per reviews of nutraceuticals in psychiatric disorders (Bozzatello et al., 2024) . Zinc and magnesium also warrant mention for their roles in neurotransmitter balance and stress response, with deficiencies potentially amplifying anxiety and emotional lability.

    Importantly, vitamins are not standalone treatments. Personality disorders require evidence-based psychotherapy as the cornerstone. Nutritional interventions work best as adjuncts—addressing deficiencies identified through testing rather than blanket supplementation. Factors like gut health, inflammation, and lifestyle (diet quality, sunlight, exercise) mediate effects. Genetic variations (e.g., MTHFR polymorphisms affecting folate metabolism) may influence individual responses.

    Limitations in current research are clear: most studies focus on mood or anxiety rather than personality disorders specifically, sample sizes are small, and causation is hard to establish. Confounders like poor diet in severe mental illness or medication side effects complicate findings. Nonetheless, nutritional psychiatry is gaining traction, with calls for routine screening in psychiatric care (Firth et al., 2019).

    In my own life and work on betshy.com, I’ve seen how addressing basic nutritional needs can support emotional stability amid life’s storms. For those with personality disorders, a thoughtful discussion with a clinician about vitamin status—especially D, B12, and folate—may open a gentle, supportive avenue for wellbeing. Small, evidence-informed steps can complement deeper therapeutic work, fostering greater self-compassion and resilience.

    As research evolves, integrating nutrition into personality disorder care holds promise—not as a cure, but as a compassionate ally in the journey toward stability and growth.

    References

    Avinun, R. et al. (2020) ‘Vitamin D polygenic score is associated with neuroticism and the general psychopathology factor’, Personality and Individual Differences, 164, 110052. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC7107583/ (Accessed: 20 March 2026).

    Bozzatello, P. et al. (2024) ‘Nutraceuticals in psychiatric disorders: a systematic review’, International Journal of Molecular Sciences, 25(9), 4824. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC11084672/ (Accessed: 20 March 2026).

    Firth, J. et al. (2019) ‘The efficacy and safety of nutrient supplements in the treatment of mental disorders: a meta‐review of meta‐analyses of randomized controlled trials’, World Psychiatry, 18(3), pp. 308–324. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC6732706/ (Accessed: 20 March 2026).

    Habib, M. et al. (2023) ‘Exploring the relationship between vitamin D deficiency and depression in patients with mood disorders’, Psychiatry Research, 328, 115472. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10625912/ (Accessed: 20 March 2026).

    Young, L.M. et al. (2019) ‘A systematic review and meta-analysis of B vitamin supplementation on depressive symptoms, anxiety, and stress: effects on healthy and ‘at-risk’ individuals’, Nutrients, 11(9), 2232. Available at: https://www.mdpi.com/2072-6643/11/9/2232 (Accessed: 20 March 2026).

  • Ontological Insecurity: The Path of Existential Anxiety, Uncertainty, and Depth

    Ontological Insecurity: The Path of Existential Anxiety, Uncertainty, and Depth

    I’ve often grappled with questions of identity and stability. Who am I when the world feels unmoored? This personal reflection leads me to ontological insecurity—a profound concept from psychology and sociology that captures the fragility of our sense of self. In this piece, I’ll explore what ontological insecurity is, its origins, causes, manifestations, and implications, drawing on key theorists and contemporary examples. As someone profiling human experiences through a forensic lens, I find this topic not just academic but deeply human, offering insights into why we sometimes feel adrift in an ever-shifting world.

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    Ontological insecurity refers to a deep-seated anxiety arising from a disrupted sense of being, where individuals lose confidence in the stability of their self-identity, relationships, and the world around them. Coined by psychiatrist R.D. Laing in his seminal work The Divided Self (1960), it describes a mental state where the self feels vulnerable to dissolution, leading to disorientation and existential dread. Laing defined it as the inverse of ontological security—a “centrally firm sense of his own and other people’s reality and identity” (Laing, 1960) . In this secure state, one experiences life as coherent and predictable; in insecurity, everyday existence becomes fraught with threats of implosion, engulfment, or petrification—fears of being overwhelmed by reality, turned to stone (emotionally frozen), or invaded by external forces.

    Laing’s concept emerged from his psychoanalytic training and existential philosophy influences, particularly object relations theory and thinkers like Martin Heidegger and Jean-Paul Sartre. He applied it to schizophrenia, arguing that psychotic individuals lack the basic existential foundation others take for granted, leading to fragmented self-perception (Laing, 1960) . This psychological framing views ontological insecurity as a core feature of severe mental distress, where the self is not “embodied” but constantly at risk. Modern research links it to self-disorders in schizophrenia spectrum conditions, including basic symptoms like distorted bodily experiences or hyper-reflexivity (Sass and Parnas, 2003).

    Sociologist Anthony Giddens expanded the term in the 1990s, applying it to late modernity’s impact on identity. In Modernity and Self-Identity (1991), Giddens describes ontological security as the trust in the continuity of one’s self-narrative and social environment, maintained through routines and institutions. Ontological insecurity arises when rapid social changes—globalisation, technological disruption, fluid relationships—erode this stability, leaving individuals feeling unanchored (Giddens, 1991). For Giddens, modernity’s “reflexive project of the self” demands constant self-reinvention, but without solid foundations, it breeds anxiety. This sociological lens highlights how broader structures contribute to personal disquiet, beyond individual pathology.

    Causes of ontological insecurity are multifaceted. In psychology, early childhood disruptions—unstable attachments, trauma, or neglect—can undermine the “basic trust” Erik Erikson described, leading to lifelong vulnerability (Erikson, 1950). Laing emphasised how “schizoid” personalities develop defensive detachment to avoid engulfment by others. Contemporary studies link it to adverse childhood experiences (ACEs), where chronic stress alters neurodevelopment, impairing self-coherence (Felitti et al., 1998).

    Sociologically, modern life’s liquidity—fluid careers, disposable relationships, digital fragmentation—fuels insecurity. Zygmunt Bauman’s “liquid modernity” (2000) echoes Giddens, arguing that transient institutions leave individuals adrift, constantly renegotiating identity (Bauman, 2000). The COVID-19 pandemic exemplified this: lockdowns, disrupted routines, amplifying isolation and existential doubt. Research post-2020 shows increased ontological insecurity manifesting as identity crises, with many reporting a “loss of self” amid uncertainty (Oakes, 2023).

    Manifestations vary. Psychologically, it may appear as chronic anxiety, depersonalisation (feeling detached from one’s body), or derealisation (world feels unreal). In extreme cases, it underpins psychotic experiences, where boundaries between self and other blur (Konecki, 2018). Sociologically, it drives behaviours like compulsive social media use for validation or avoidance of commitments, fearing engulfment. Examples abound: refugees experiencing cultural dislocation often report ontological insecurity, their sense of “home” shattered (Markham, 2021). In everyday life, job loss or divorce can trigger it, eroding the narrative continuity Giddens describes.

    Impacts are profound. Ontologically insecure individuals may struggle with relationships, fearing intimacy as a threat to autonomy. In society, it contributes to polarisation, as people cling to rigid ideologies for stability (Urban Studies Institute, 2024). Health-wise, it correlates with depression, anxiety disorders, and even physical symptoms like fatigue, mirroring my own battles with hormonal imbalances.

    Coping strategies draw from both fields. Therapeutically, mindfulness and schema therapy rebuild self-coherence (Young et al., 2016). Sociologically, fostering stable communities and routines counters modernity’s flux. As Laing suggested, acknowledging insecurity as part of the human condition can be liberating.

    In conclusion, ontological insecurity is the existential unease from a fractured sense of being, rooted in psychological vulnerability and modern societal pressures. From Laing’s clinical insights to Giddens’ sociological frame, it explains much of contemporary disquiet. Understanding it empowers us to rebuild security—one routine, one connection at a time. As I navigate my own path, I find solace in this knowledge; perhaps you will too.

    References

    Bauman, Z. (2000) Liquid modernity. Polity Press. Available at: https://www.politybooks.com/bookdetail/?isbn=9780745624099 (Accessed: 10 March 2026).

    Erikson, E. H. (1950) Childhood and society. Norton. Available at: https://wwnorton.com/books/9780393310344 (Accessed: 10 March 2026).

    Felitti, V. J. et al. (1998) ‘Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults’, American Journal of Preventive Medicine, 14(4), pp. 245–258. Available at: https://www.ajpmonline.org/article/S0749-3797(98)00017-8/fulltext (Accessed: 10 March 2026).

    Giddens, A. (1991) Modernity and self-identity: Self and society in the late modern age. Polity Press. Available at: https://www.politybooks.com/bookdetail/?isbn=9780745609324 (Accessed: 10 March 2026).

    Konecki, K. T. (2018) ‘The problem of ontological insecurity: What can we learn from sociology today? Some Zen Buddhist inspirations’, Qualitative Sociology Review, 14(2), pp. 50–68. Available at: http://www.qualitativesociologyreview.org/PL/Volume42/PSJ_14_2_Konecki.pdf (Accessed: 10 March 2026).

    Laing, R. D. (1960) The divided self: An existential study in sanity and madness. Penguin Books. Available at: https://www.penguinrandomhouse.com/books/264434/the-divided-self-by-r-d-laing/ (Accessed: 10 March 2026).

    Markham, A. (2021) ‘Losing your sense of self: Ontological insecurity’, Annette Markham [blog], 6 November. Available at: https://annettemarkham.com/2021/11/losing-your-sense-of-self-ontological-insecurity (Accessed: 10 March 2026).

    Oakes, M. B. (2023) ‘Ontological insecurity in the post-covid-19 fallout: Using existentialism as a method to develop a psychosocial understanding to a mental health crisis’, Health Psychology and Behavioral Medicine, 11(1), pp. 1–15. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10425504/ (Accessed: 10 March 2026).

    Sass, L. A. and Parnas, J. (2003) ‘Schizophrenia, consciousness, and the self’, Schizophrenia Bulletin, 29(3), pp. 427–444. Available at: https://academic.oup.com/schizophrBull/article/29/3/427/1879716 (Accessed: 10 March 2026).

    Urban Studies Institute (2024) ‘Ontological insecurity in the modern world: Understanding its origins’, Urban Studies Institute, 21 July. Available at: https://urbanstudies.institute/urban-construct-development-dynamics/ontological-insecurity-modern-world-origins (Accessed: 10 March 2026).

    Young, F. (2016) A history of exorcism in Catholic Christianity. Palgrave Macmillan. Available at: https://link.springer.com/book/9783319291116 (Accessed: 10 March 2026).