Is The Truman Show Syndrome Real?

The 1998 film The Truman Show follows Truman Burbank, a man played by Jim Carrey whose entire life is filmed and broadcast to the world without his knowledge. Everyone around him is an actor, including friends and family, and his every move is scripted for the entertainment of viewers. As time goes on, he starts to feel that something is “off” in his existence, causing him to question the authenticity of his surroundings.

The “Truman Show Syndrome”—also known as Truman Show delusion or, simply, Truman Syndrome—is a type of delusion in which a person believes they are the involuntary subject of a reality show (whose producers have scripted everything), or feels that they are being monitored by hidden cameras. This belief often leads to anxiety, paranoia, and a distorted sense of reality—where everyday interactions feel staged or artificial.

Interestingly, many more people experienced Truman Show Syndrome after the release of the film in the late nineties, as well as the rise in popularity of reality TV shows over the years. This caused some people to dismiss it and think it was imagined, not real.  

Keep reading to learn more about this psychological phenomenon, effective coping strategies, and when to seek professional treatment.

Is the Truman Show Syndrome real? 

First things first: “Truman Show Syndrome” isn’t recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Despite that fact, symptoms have been documented in a significant number of patients. Psychologists’ reports of cases of Truman symptoms include depersonalization and derealization—which can look like a feeling of dissociation, or disconnection, from oneself, one’s surroundings, or both.

It may sound like a made-up disorder, but many experts caution that the psychological phenomenon shouldn’t be dismissed (or worse, made the subject of ridicule). In fact, rather than being a form of narcissism, where people’s inflated egos lead them to believe all eyes are on them 24/7, Truman Show Syndrome is connected to serious mental health issues that are distressing and require attention. For instance, delusions can be a symptom of psychosis, schizophrenia, and delusion disorder. 

Truman Show delusion vs. fear of being watched

While Truman Show Syndrome is a symptom of psychosis, other mental health issues—ones that aren’t discussed enough—could also explain someone’s intense and persistent fear that they’re being watched.

Take obsessive-compulsive disorder (OCD), for instance. OCD is a chronic mental health condition characterized by obsessions, or recurrent and intrusive thoughts, urges, feelings, sensations, or images that cause distress or anxiety. As one Reddit user with OCD put it: “I remembered the first time I saw the Truman Show… it literally sent me into a panic/spiral of intrusive thoughts of constant fear that my life was all a TV show.”

The important distinction here? People with OCD experience a fear that they’re being watched. People with psychosis and related delusions actually experience the feeling that they’re being watched. In fact, people with Truman Syndrome hold onto their conviction that they are being monitored, despite overwhelming evidence to the contrary. They believe their family, friends, and co-workers are all in on it—reading from scripts, and making their home, workplace, and everyday life a reality TV set. 

“OCD and psychosis are not the same thing; they’re totally different,” explains NOCD therapist Tracie Ibrahim, LMFT, CST. Simply put: people with OCD may have a fear that they are experiencing Truman Show Syndrome but know that they are not actually being broadcasted on TV. “People who sit around worrying about whether or not they have the Truman Show Syndrome sound a lot more like people with OCD,” Ibrahim said. “People who are in psychosis usually don’t know that they are in psychosis because they have accepted that altered reality.” 

“So if anyone walked in my office and said, “I believe I have Truman Show Syndrome,” I’d say that’s OCD (when other OCD symptoms are also apparent). But if you just walked in my door and you said, “So, do you have hidden cameras in here as well?” I might think you’re going through psychosis,” notes Ibrahim.

Think your fear might be related to OCD? Key symptoms to know about

The two key criteria for an OCD diagnosis are obsessions and compulsions. When someone is wondering whether they have OCD or Truman Show Syndrome, it helps to understand if they’re experiencing these symptoms. 

Someone with OCD can have obsessive thoughts like: 

• What if I’m going crazy and I’m not aware?
• What if I’m experiencing delusions like the Truman Show Syndrome? 
• What if I hurt or kill people I care about? 
• What if I have to go to a psychiatric hospital?
• Am I experiencing psychosis? 

One particular subtype of OCD is called existential OCD, which is characterized by intrusive thoughts related to philosophical questions about existence and life. Obsessions related to existential OCD can include: 

• What if I’m not a real person? What does it mean to be a real person?  
• What if my whole life is a simulation? 
• Am I conscious? What is consciousness?
• What if I’m not really here? 

In response to their obsessive thoughts, someone with OCD performs compulsions, which are behaviors or mental acts done in an attempt to neutralize or counteract the obsession—essentially to try and escape their intrusive thoughts. Compulsions can look like: 

• Seeking reassurance from therapists or loved ones about what’s “really” happening, or asking whether you’re “losing your mind” or going insane 
• Checking to see if you have other symptoms of psychosis like hallucinations, delusions, or disordered thinking and speaking  
• Monitoring physical reactions in your body to “prove” that you’re real. This can include pinching yourself or self-inflicting pain to “see if you feel it.”
• Excessively researching or looking up symptoms of mental disorders
• Repeatedly telling yourself you’re not experiencing psychosis or other mental health conditions 
• Avoidance of books, people, or movies (includingThe Truman Show) that make you question your reality and consciousness

What to do about Truman Show Syndrome fears

If you suspect you are experiencing delusions—symptoms of psychosis or schizophrenia—reaching out to a mental health professional is critical. A person with psychotic symptoms needs a trained, qualified medical provider to provide a proper diagnosis and recommend treatment. Antipsychotic medicines are usually the first treatment for psychosis. For severe cases, inpatient treatment in a hospital or other treatment facility is sometimes necessary.

However, treatment looks different for someone with OCD fears, such as “What would happen if I had Truman Show Syndrome?” Exposure and response prevention (ERP) therapy is a specialized form of treatment that was created specifically for OCD, and it has been backed by decades of clinical research.

“The best thing you can do is stop asking yourself and trying to figure out if you’re in a reality show without your knowledge. Stop seeking reassurance. Stop trying to figure it out online. Stop googling it,” Ibrahim said. This sounds difficult, but you don’t have to do it alone, or figure out how you’re going to stop on your own. ERP is best done in partnership with a trained therapist, and there’s a very effective path for carefully confronting your triggers and intrusive thoughts, while teaching you to resist the urge to do compulsions.

For instance, instead of avoiding movies like The Truman Show and The Matrix, Ibrahim recommends that you watch these movies as exposures. “You make your OCD worse by practicing avoidance,” Ibrahim said. “It’s all about leaning in as far as you can so you can get your life back.”

The bottom line

It can be hard to open up about your experience with Truman Show Syndrome, especially if you doubt that a therapist will think your symptoms are “real.” But there are experts out there who are ready to help, and reaching out to them can make life a lot less unsettling.