Psychotic disorders are my specialty. Here’s what I wish people understood before commenting online.
Being delusional is much more than a questionable Instagram post.

The speculation around Britney Spears' and other celebrities' mental health needs to stop.
Oh goodness, here we are again watching the media and "experts" speculate on the mental health of a celebrity. After nearly two decades working with a population deemed to have "severe and persistent mental illness," I'd like to weigh in a bit. The term "severe and persistent mental illness" is a catch-all for serious mental health conditions from bipolar disorder to schizophrenia and everything in between.
I've worked with a variety of clients over the years, many of whom refused medication, though their psychosis caused them to have extreme paranoia and terrifying visual hallucinations. I've also worked with several folks that have been under a guardianship, which is equivalent to a conservatorship in California.
As I watch the media, fans and professionals speculate about whether a celebrity needs to be hospitalized or placed in a conservatorship, I often wish they had a better understanding of what severe mental illnesses looked like. Not only that, but what constitutes a concern and what's just normal for that person. But let's be real for a minute. The media continuously guessing if you've rounded the bend is likely enough to be the cause of a mental breakdown, even in a mentally stable person.
So here's what I wish people understood about these severe and persistent mental illnesses. When people enter a psychiatric facility against their will, it's a trauma. The effects of that trauma can stunt brain development and create coping mechanisms that may seem a bit odd to others. This doesn't mean that they're off of their medication or need to go back. It just means they came out of it a little differently than they went in and we have to adjust.
Everything about their behavior isn't related to their mental wellness. I've seen this a lot with families after a loved one gets released from the hospital and is doing well. If the client gets upset because someone ate all of their favorite cookies, instead of looking at the cause of the person's anger, immediately the thought goes to, "They must not be taking their medicine."
The same happens when it's just plain silly behaviors, like Britney Spears getting the human equivalent to the zoomies and talking in a fake foreign accent. Suddenly it's front page news and people are concerned, but if you take away the information of her being previously hospitalized, the concern would likely be nonexistent.
There's also a misunderstanding about what can actually be done if someone is in need of acute psychiatric care. There are generally two reasons someone can be hospitalized against their will: if they're a danger to themselves or if they're a danger to others. Outside of it being the person's first psychotic break, it's extremely difficult for someone to be forced into help and there's good reason for that. No matter your mental health status, you're entitled to autonomy.
Back in the olden days (think the 19th century), husbands could commit their wives because they got too sassy or independent. Parents could drop off their children or family members with mental disabilities, just because they found them difficult to care for. Do you know what happened to those sassy independent wives? They got lobotomies to make them more docile. Others deemed mentally unfit were sterilized against their will.
This is why it's difficult to commit someone, and while it makes my job more difficult sometimes, I'm happy it's hard to do. Even when I know a client is reaching the point of danger but still doesn't meet the criteria, I'd rather make a safety plan with the family than make the committal process easier where ill-intentioned people could take advantage.
woman in white and red shirt printed with words "you matter"
Photo by Eneida Hoti on UnsplashThe public speculating on what warrants intervention or not mostly comes from a place of concern, but it's often incorrect. There are licensed therapists that struggle with identifying it as well because we have different areas of expertise. While I couldn't tell you all the ins and outs of treating an eating disorder, a therapist that specializes in eating disorders could. My area is psychosis and other severe mental illnesses, so I stick to what I know when speaking authoritatively.
Specializing in psychotic disorders has taught me more about the human condition than anything else. Getting to know the incredible people that hear voices that I cannot or believe things no one else does has been one of the most fulfilling experiences of my life.
People living with severe mental illnesses still deserve respect and basic human autonomy. They're allowed to be weird. They're allowed to be silly. They're allowed to be angry. They're allowed to be boring. They're allowed to just be and we should let them.
- Our obsession with celebrity mental health needs to be matched with equal parts compassion ›
- The new Britney Spears documentary is making people completely re-think the pop star's life ›
- Parents react to video of Britney Spears 'yelling' at her kids and it's a great teaching moment ›
- Fans applaud Amanda Bynes after learning of 72-hour hold - Upworthy ›
- How professor with schizophrenia thrives despite hospitalizations - Upworthy ›
There's a reason why some people can perfectly copy accents, and others can't
Turns out, there's a neurodivergent link.
A woman in black long sleeve shirt stands in front of mirror.
Have you ever had that friend who goes on vacation for four days to London and comes back with a full-on Queen's English posh accent? "Oooh I left my brolly in the loo," they say, and you respond, "But you're from Colorado!" Well, there are reasons they (and many of us) do that, and usually it's on a pretty subconscious level.
It's called "accent mirroring," and it's actually quite common with people who are neurodivergent, particularly those with ADHD (Attention Deficit Hyperactivity Disorder). According Neurolaunch, the self-described "Free Mental Health Library," "Accent mirroring, also known as accent adaptation or phonetic convergence, is the tendency to unconsciously adopt the accent or speech patterns of those around us. This linguistic chameleon effect is not unique to individuals with ADHD, but it appears to be more pronounced and frequent in this population."
Essentially, when people have conversations, we're constantly "scanning" for information—not just the words we're absorbing, but the inflection and tone. "When we hear an accent, our brains automatically analyze and categorize the phonetic features, prosody, and intonation patterns," writes Neurolaunch. For most, this does result in copying the accent of the person with whom we're speaking. But those with ADHD might be more sensitive to auditory cues. This, "coupled with a reduced ability to filter out or inhibit the impulse to mimic…could potentially explain the increased tendency for accent mirroring."
While the article explains further research is needed, they distinctly state that, "Accent mirroring in individuals with ADHD often manifests as an unconscious mimicry of accents in social situations. This can range from subtle shifts in pronunciation to more noticeable changes in intonation and speech rhythm. For example, a person with ADHD might find themselves unconsciously adopting a Southern drawl when conversing with someone from Texas, even if they’ve never lived in the South themselves."
People are having their say online. On the subreddit r/ADHDWomen, a thread began: "Taking on accents is an ADHD thing?" The OP shares, "My whole life, I've picked up accents. I, myself, never noticed, but everyone around me would be like, 'Why are you talking like that??' It could be after I watched a show or movie with an accent or after I've traveled somewhere with a different accent than my 'normal.'
They continue, "Apparently, I pick it up fast, but it fades out slowly. Today... I'm scrolling Instagram, I watch a reel from a comedian couple (Darcy and Jeremy. IYKYK) about how Darcy (ADHD) picks up accents everywhere they go. It's called ADHD Mirroring??? And it's another way of masking."
(The OP is referring to Darcy Michaels and his husband Jeremy Baer, who are both touring comedians based in Canada.)
Hundreds of people on the Reddit thread alone seem to relate. One comments, "Omfg I've done this my whole life; I'll even pick up on the pauses/spaces when I'm talking to someone who is ESL—but English is my first language lol."
Sometimes, it can be a real issue for those around the chameleon. "I accidentally mimicked a waitress's weird laugh one time. As soon as she was out of earshot, my family started to reprimand me, but I was already like 'oh my god I don’t know why I did that, I feel so bad.'"
Many commenters on TikTok were shocked to find out this can be a sign of ADHD. One jokes, "Omg, yes, at a store the cashier was talking to me and she was French. She's like 'Oh are you French too? No, I'm not lol. I'm very east coast Canada."
And some people just embrace it and make it work for them. "I mirror their words or phrase! I’m 30. I realized I start calling everyone sweetie cause my manager does & I work at coffee shop."