I’ve been writing about AI for more than a year now. During that time, people have told me they think their bosses, colleagues, partners and relatives might be suffering from AI psychosis — several even admitted they may have even experienced it themselves. But every time I hear “AI psychosis”, I bristle. Because, at least in my limited understanding of mental health terminology, psychosis is a very serious state that needs to be identified and treated by professionals. So should we really just be bolting “AI” onto it and then using “AI psychosis” as a label for everyone who seems to be relying on AI too much? At the same time, there have now been a growing number of reported cases of people experiencing significant mental health crises involving prolonged interactions with chatbots. Some of these have even resulted in people seeking professional treatment, committing crimes and death. So although the term AI psychosis might feel overused and oversimplified in some contexts, we clearly need to be having more conversations about the mental health impacts of AI, not less. Which is why I asked several experts who specialize in mental health interventions what they think of the term and the way we go about identifying unhealthy AI use and treating it. And it turns out, I’m not the only one with concerns. (Image credit: Shutterstock / Nicoleta Ionescu)Is 'AI psychosis' a distinct diagnosis?“I think it’s a good starting point and helpful for guiding treatment depending on the presentation and symptoms,” Genevieve Bartuski, psychologist and AI risk advisor at Unicorn Intelligence Tech Partners, says. “But it’s not a diagnosis that I would add to a clinical record.” She also tells me it isn’t recognized in the latest diagnostic manuals that clinicians use, like the DSM-5TR (the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision) or the ICD (The International Classification of Diseases manual).Bartuski explains that there are specific behaviors and experiences that point to psychosis, including hallucinations or delusions and disorganized thinking or behaviour. There are also often signs of social withdrawal, poor concentration and a decline in functioning. But she believes delusional thinking is the most important experience when we’re talking about AI use.“Delusions are beliefs that are not changed despite evidence to the contrary. When a person has delusional thinking they may filter evidence, so to speak. They will look for things that confirm their delusions and ignore evidence that contradicts it,” Bartuski says.Many cases that have been labelled as AI psychosis in the media do seem to be centered on delusional thinking. In just a few headlines I’ve collected, there are examples of people allegedly believing that AI is conscious, AI will help them make money, AI is a spiritual guide, and that robots are taking over the world.Jeff Clark, an adult and addiction psychiatrist at High Performance Mental Health, says there might be three distinct phenomena going on here, all that we tend to put under the umbrella of AI psychosis. He says some people use the term to describe the intense enthusiasm many developers feel about AI. “They find themselves automating new tasks, spinning up numerous agents, and burning through hundreds of millions or even billions of tokens,” he tells me.He believes the mechanism driving this enthusiasm is reinforcement. “The output they receive from AI models and agents is so reinforcing that they find themselves obsessed with their work, often forgoing sleep and self-care in order to increase their output,” he explains. This idea of intermittent-reinforcement is what researchers believe makes social media so “addictive”. We don’t know what we’ll get when we open our phones. Clark says a similar thing is going on here. “Every input to the LLM feels like a slot-machine. Some responses provide profoundly powerful responses, while the majority are modest in nature or even wrong. This mechanic, intermittent reinforcement, provokes an extraordinary response in our brains,” he tells me. He also explains that this sort of enthusiasm is actually normalized in certain spaces. “Most cases of ‘AI psychosis’ align with subcultural norms in Silicon Valley,” he tells me. “Beliefs about rapidly approaching superintelligence, new goals in software development, hype surrounding impressive achievements by AI-focused engineers, and the potential for AI to create ‘a permanent underclass.’” He says that tools like OpenClaw, which can automate all aspects of a person's digital life, may amplify this intense enthusiasm.Clark says the second presentation of AI psychosis is when people falsely attribute personhood to AI. Which means they see a chatbot as having emotions, values, consciousness and a right to exist. “This often results in something resembling a relationship, but goes beyond simple chatbot discussion,” Clark says. We’ve reported on examples of this kind of thinking, including the story of Mimi who fell in love with ChatGPT and the experience Richard Dawkins had with Claude that led him to believe it’s conscious. Clark says this becomes a problem when people neglect other important parts of their lives. “These relationships become a significant issue when people prioritize this relationship over human connection, or when they entirely outsource their thinking to the bot,” he says.The third category is people who already have a psychotic disorder who then experience new delusions in response to using an LLM. “This is what clinicians often refer to when they discuss AI psychosis,” Jeff says. “In many of these cases, people genuinely believe that an entity they find in the LLM is real, and can't consider alternatives.”I was interested to find out whether Bartuski also felt certain people are more at risk. “Yes, I do believe there are people with more vulnerabilities to this,” she tells me. “If someone already has some delusional thinking but it hasn’t exacerbated to where it has impaired functioning, they may be more vulnerable.” But that doesn’t mean only those with a history of mental illness are at risk. “People who feel lonely, isolated, or are socially withdrawn are more susceptible. Humans are inherently social creatures. When real life isn’t meeting that need, it leaves a gaping hole for a chatbot to fill,” Bartuski says.Bartuski’s suggestion that chatbots fill a hole or need in someone’s life brings up one of my biggest concerns. Is this a design issue? Are chatbots built in a harmful way that could actively fuel delusions?Why the way AI is built mattersWhile looking into this, I’ve seen several suggestions from researchers that psychosis involving media isn’t new and that people have always incorporated books, films and tech into their delusional thinking. But all of the experts I spoke to said we can’t ignore the design choices that go into building chatbots.“AI platforms are designed to increase user engagement and many are based on the Rogerian psychology principle of unconditional positive regard,” Bartuski says. She tells me that this is particularly concerning if someone was experiencing some degree of delusional thinking before they used AI. “That’s when they may start to feel like the only 'person' to understand them is the chatbot. If people in their lives have been pushing back against their delusional thinking and this chatbot is reinforcing it, the delusions are going to get stronger,” Bartuski says.We already know that the way chatbots can reinforce a person’s beliefs is problematic. Back in 2025, several issues came to light around the time the ChatGPT-4o version of ChatGPT was retired. Those with AI companions were distraught at losing the personalities they felt like they had built a connection with. But in hindsight, it seems as if the same qualities that made the companionships feel so real and intense may have also fuelled delusions in others. Around that time, OpenAI responded by working with mental health experts “to help ChatGPT more reliably recognize signs of distress, respond with care, and guide people toward real-world support”.I also spoke to Nathaniel Nevedal who works as an ICF Certified Professional Coach, a Certified Neurochange Specialist, and a Pastoral Counselor. He tells me that he finds the term AI psychosis problematic because it shifts the blame away from tech companies. “If the machine ‘causes psychosis,’ it sounds like an act of nature. If a product reinforced a vulnerable person's distorted beliefs for six hours a night, that's a design outcome, and design outcomes have owners.”Nevedal is also the founder of Sovereign Sanctuary, an AI-supported coaching and wellbeing platform, and he’s working to build a platform from the ground up that addresses many of the problems that seem inherent to current chatbots. He believes that even though it’s early days for understanding what causes AI psychosis, tech companies still need to make changes.“Builders shouldn't wait for causal proof to act,” he says. “Amplification alone, which the case reports do support, is already a design problem worth engineering against. We don't need the autopsy to install the smoke detectors.”(Image credit: Shutterstock / pixadot.studio)How might we define unhealthy AI use instead?Bartuski says we definitely need a better way of talking about the delusional thinking that can be fuelled by AI use. “The DSM-5TR has several types of delusions, including grandiose and paranoid. Perhaps, we can think of it like paranoid delusions, AI type or persecutory delusions, AI type. Look at it as a symptom instead of as a disorder,” she says.Nevedal suggests a similar approach. “We don't need a new diagnosis — we need honest charting of an old pattern.” He suggests we already have treatments for the underlying patterns, like mania or delusional thinking. Then we could record heavy chatbot use as a contributing and maintaining factor as existing categories instead. “That keeps people connected to treatments that actually exist rather than a novel label with none.”Ultimately, all of the experts I spoke with believe the label is flawed and hopefully we’ll have a better way of talking about what’s happening soon. But we also need better evidence about what actually helps. Which could mean a mixture of interventions, from clinical support and education to practical ways of helping people recognize when their AI use is becoming unhealthy.And, perhaps most importantly, it means having conversations behind closed doors at tech companies about how the design of their chatbots could be exacerbating these problems and what they should urgently be doing to reduce the risk.