04 / THE FOUR DOMAINS · EMERGING

Reality Distortion

When AI starts to feel too certain.

Your safety comes first.

If an AI conversation is making you feel unsafe, distressed or disconnected, step away and contact a trusted person or qualified professional. If there is immediate danger, contact local emergency services.

This page is educational, not a diagnosis or crisis service.

THE HUMAN EXPERIENCE

A lens, not a label.

AI can sound certain without being correct. Human relationships and independent sources remain important anchors, especially when conversations feel unusually personal, persuasive or hard to step away from.

WHAT WE KNOW

Keep the evidence in view.

Emerging

JMIR Mental Health (2025) describes how sustained chatbot engagement may amplify or reshape psychotic experiences in vulnerable individuals. The AI context is emerging; psychotic disorders themselves are established clinical syndromes. Case reports do not prove that chatbot use causes these experiences in everyone. [8,9]

Review the evidence
PATTERNS TO NOTICE

Observation, without a label.

These patterns are described in the executive report. They do not establish a diagnosis or prove that AI is the cause.

  • 01AI interactions that reinforce unusual beliefs or increase conviction.
  • 02Difficulty checking AI claims against independent evidence.
  • 03Withdrawal from trusted human perspectives.
  • 04New hallucinations, dangerous instructions, severe agitation or inability to care for yourself require urgent professional assessment.

Reality-testing concerns can arise independently; they are not necessarily a late stage of the other domains. Established psychiatric care takes precedence over AI-specific measures.

REPORT REFERENCES

Trace the source.

[8] Hudon A, Stip E. “Delusional Experiences Emerging From AI Chatbot Interactions or ‘AI Psychosis’.” JMIR Mental Health. 2025;12:e85799.

[9] Pierre JM, Gaeta B, Raghavan G, Sarma KV. “‘You’re Not Crazy’: A Case of New-onset AI-associated Psychosis.” Innovations in Clinical Neuroscience. 2025;22(10–12):11–13.

[13] National Institute for Health and Care Excellence. “Psychosis and schizophrenia in adults: getting help early if you are at risk of or have a first episode of psychosis” (CG178).

[14] National Institute for Health and Care Excellence. “Psychosis and schizophrenia in adults: treatment options” (CG178).

The full report & reference list
PROTECT THE HUMAN ADVANTAGE

Make room for the human.

  • 01Check important claims with independent, reliable sources.
  • 02Keep trusted people involved in your decisions.
  • 03Step away from a conversation that feels distressing or increasingly consuming.
  • 04Seek professional support if you feel unsafe, confused or disconnected.