Feel You’re Being Watched? Inside The “Truman Show Delusion”, Where People Believe Their Life Is Reality TV

In the past, there have been several cases of people who have developed the delusional belief that they are the star in their own reality TV show.

For those who haven’t seen it, what is The Truman Show about?

The movie is based on a 30-year-old man called Truman Burbank. From the time of his birth to the movie’s present, Truman’s life has been broadcast globally without him ever knowing. Where he lives is actually a domed sound studio, and all the people in his life are actors and extras.

The movie plot itself revolves around Truman slowly becoming aware of what’s happening to him and trying to escape to the real world – all while the people around him try to convince him he’s being paranoid.

How is the syndrome classified?   

Although it has not been recognized as a disorder in the Diagnostic and Statistical Manual of Mental Disorders, there have still been numerous cases described.

Fish’s Clinical Psychopathology defines, a delusion as a “false, unshakable belief, that is out of keeping with the patient’s social and cultural background.”

In a 2012 paper by Joel and Ian Gold, they identified common themes in Truman Show delusion.  

According to their findings, patients believe they are living in an artificial environment and that the people they interact with are merely playing roles.

Gold and Gold suspect that the patients suffer from a “culturally shaped combination of persecutory and grandiose delusions, as well as ideas of reference”.

This appears similar to the phenomenon of depersonalization, where everything feels fake or unreal – a sensation that can sometimes be brought on by stress.

Another parallel is found in schizophrenia patients, where one characteristic of the disorder is the sense of unreality.

Case studies

In the Gold and Gold study, five cases are discussed.

Case one: A man was admitted to hospital after an altercation with federal building security. He thought his life was like The Truman Show and that even the 9/11 attacks were fabricated. To prove his theory was correct, he traveled out of state to the World Trade Center to see if it was still standing.

He had held this delusion for about five years, but friends and family only became aware of it a few weeks before he was admitted. At first, he demanded to speak to the “Director” and claimed he had cameras in his eyes. Initially, he was suspected of having schizophrenia and was started on medication. After a few days, he was transferred to a hospital closer to his home.  

Case two: Another male believed he was being taped for a national broadcast. He said, “I realized that I was and am the centre, the focus of attention by millions and millions of people . . . my [family] and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world’s attention’’.

He was diagnosed with a schizoaffective disorder, alongside crack cocaine and marijuana dependence.

Case three: A man who worked for the local newspaper believed that the news stories he saw on the internet, TV, and in print were all created by his media colleagues for him. His “proof” was that they used the same style of reporting as he did. He also claimed that everyone in the hospital unit (from patients to doctors) were paid actors.

He was diagnosed with bipolar disorder, current episode manic, with psychotic features. After treatment, he improved to the point where he said, “There is an 80 percent chance that I will treat the hospitalization as if it is for real.” He was discharged after 10 weeks.

Case four: A man working on a reality television show started to believe he was the one being filmed and that his thoughts were being controlled by the film crew, allegedly paid by his family. This led to a public disturbance and subsequent hospitalization. He said, ‘‘I thought I was a secret contestant on a reality show. I thought I was being filmed. I was convinced I was a contestant and later the TV show would reveal me.’’

He had two previous hospitalizations for manic episodes and carried a diagnosis of bipolar disorder. He responded well to the treatment and was discharged after four weeks.

Case five: Another male was sent to the hospital after being found in a library after hours. He believed the Secret Service was following him and described a “scheme” similar to the Truman Show, in which everyone in his life was an actor, news was fabricated, but that the “show” would end on Christmas Day.

Once prescribed medication, he gradually improved and was discharged to a partial hospitalization program after eight weeks.

Other cases

These aren’t isolated cases. In 2009, a Sydney man in a psychotic state murdered his father and sister. Before this happened, he told a doctor that his family was screening his life on the Internet like in The Truman Show. 

In another case in 2007, a man tried to kidnap a child and believed he had to go to New York to escape The Truman Show.

Even more recently, people have been presenting with Truman Show delusion. In 2024, a 24-year-old male believed he was being live-streamed online and that everyone around him was fake and acting. He thought all mobile phones had been hacked and he experienced auditory hallucinations.

He was diagnosed with Schizophrenia. After beginning a medication regimen, his symptoms improved. Interestingly, when questioned, the patient had never seen The Truman Show.

Will there be more cases of this in the future?

As artificial intelligence and surveillance tech become more pervasive in everyday life, some experts believe these types of delusions may become more common.

“The ‘Truman Show’ delusion is not a new illness. We think it is a new kind of persecutory, grandiose, referential, controlled delusion. In this ‘Truman Show’ delusion we see things that could not have been observed 20 and 30 years ago because the technology just wasn’t there. Now we have closed-circuit televisions, we have reality television, YouTube. […] And what impact does that have on the brain and mind of someone who is at risk for delusion?” Joel Gold told Here & Now.  

Along with this, there is no surprise as there has been an increase in “cyber-paranoia”, with delusions involving technology becoming more common.

In an age of constant surveillance, curated online personas, and digital echoes of our every move, it’s not hard to see how some minds might begin to question what’s real. Understanding these delusions isn’t just about psychiatry – it’s about empathy, awareness, and the growing complexity of modern life.

The content of this article is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.