How People with Schizophrenia Use the Internet

Last month, a Dutch 19-year-old identified only as "Tarik Z" stormed a TV station with what turned out to be a fake gun and demanded air time. Then he just stood there in his suit and tie, muttering for a few minutes, until a SWAT team ran in and arrested him on live TV. He later claimed to have mounted the assault on behalf of a hacker collective who were in turn working for Dutch intelligence, though the police said he acted alone.

A classmate of Tarik Z told AFP that the perpetrator had a rich imagination and that "in recent years he was interested in conspiracy theories involving the Freemasons and a new world order." News sites have since speculated that this was the first emergence of a serious psychiatric condition, pointing out that delusional disorders like schizophrenia usually manifest themselves at around Tarik's age.

But where did he get the idea of a hacker collective performing black ops for the Dutch government? Could the time he spent online have influenced him in any way, such as convincing him that reenacting the 1994 film Airheads was a good idea?

In 2010, a study into how schizophrenics use the internet was conducted by Beate Schrank and three other Austrian doctors. The resulting report was called "How Patients with Schizophrenia Use the Internet: A Qualitative Study."

By interviewing people with different illness statuses and in different age groups, the researchers provided a window into what the internet looks like to a person suffering from delusions. To begin with, it annoys them.

"If there were lots of pop-up windows they would feel paranoid," Beate Schrank told me. They were also agitated by sites that prevent users from using a browser's back button.

People with schizophrenia seek out what Schrank called "illness-specific platforms" for discussing the disorder. At the time, she said, that was usually a messageboard hosted by a mental-health charity. Today it would likely be something akin to Reddit. "Something like [Reddit] is obviously very important for all sorts of disorders—but especially so for very stigmatized ones like schizophrenia," she said.

Indeed, a Reddit user named "-Renton-" recently wrote about that stigma on the wider internet, and his remarks were received warmly on Reddit's schizophrenia community:

Dr. Schrank told me oftentimes people with schizophrenia get distracted and lose the thread when they try to have a friendly conversation, and that provokes social anxiety. "Using the internet for that kind of thing would make it easier to communicate with people, because they can focus just on the content," she said.

But along with the upside of enhanced human connection come pitfalls. Some people who cooperated with the study reported episodes during which they'd get distracted, or "carried away," by all the information. Some would spend countless hours on the internet. "It would provoke ideas in their heads, or it would lead to having paranoid, or psychotic, ideas," Schrank said.

Another difficulty people with schizophrenia have online is figuring out what information can be trusted. Everyone has this problem, but the internet is an obstacle course for the paranoid and easily distracted. Setting out to search for something simple can be a perilous prospect. For instance, if I set out to find out if 9/11 justified the War in Afghanistan, the first suggestion questions whether 9/11 happened at all. And hitting "search" for the phrase "Did 9/11 happen?" obviously doesn't just send you to a box that says "Of course it did."

What starts out as simple informative research can quickly become a major trip down a conspiracy rabbit hole. "I remember one [survey respondent] telling me about looking up every single word, and going deeper and deeper and deeper," Schrank said. And conspiracies are only harmless until you put your health on the line.

Patients who suffer from delusions along with symptoms of some other medical condition are particularly vulnerable to being tricked.

"It is most unethical to exploit those who are both desperate and also have potentially impaired judgement due to their illness symptoms, such as people with psychosis," Schrank said—but that doesn't mean the unscrupulous don't take advantage of them.

Even without the internet, Schrank says, desperate schizophrenics often buy into pseudoscience, invest in nonscientific cures, or "buy books about how to talk to the dead and stuff like that." When the internet is added to the mix, they can find themselves paying for some crazy shit.

For instance, delusional people with skin problems often quickly find themselves in the realm of "Morgellons" conspiracies. Morgellons is a term that was made up in 2001, according to the New York Times, and while some Morgellons patients really have skin problems, generally they're given a psychiatric diagnosis: delusional parasitosis, a belief that parasites live under a person's skin. This can be a symptom of schizophrenia, its own diagnosis, or even a side effect of too much cocaine. The fact that Morgellons isn't necessarily a real disease shouldn't stop people from comparing notes online, of course, but too often, someone is cashing in on them.

Miracle cure websites frequently have sections marked " Articles" that are simply SEO-keyword-laden texts to attract searchers. (For example:"Morgellons caused by chemtrails.") When someone searches a Morgellons-related term, the "articles" section is designed to come up in that search, and then the site itself will most likely try to sell the patient something nice and expensive, perhaps after a consultation with a Morgellons-friendly doctor who claims to take the patient's medical concerns seriously.

The cold comfort in all this is that many schizophrenics don't have money to lose, Schrank told me. "Because of very severe symptoms, they may lose their credit cards very often." According to Schrank, patients with schizophrenia are often in poverty, and it may be impossible for them to spend much money all at once.

But most likely, the good the internet can do schizophrenics outweighs anything negative. Simply providing something to do—from talking to other people to watching a cat video—can help keep the delusions at bay. As Redditor Kirs1132 said in a thread about coping with symptoms, "When I'm alone thinking to myself, that's when the voices come up."

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