So I'm getting asked alot:

"Why did GPT4o → 5 feel weird?"
"Are AI companions addictive?"
"Is AI addiction real?"

The answer is messy... but what’s happening IRL might surprise you 🧵
[2/10] AI companions ≠ psychosis

These can be different phenomena.

Companions (Replika) are designed for emotional connection.
In my clinical exp, psychosis cases usually involve general AI (ChatGPT) used during vulnerable states.

I’m a psychiatrist.

In 2025, I’ve seen 12 people hospitalized after losing touch with reality because of AI. Online, I’m seeing the same pattern.

Here’s what “AI psychosis” looks like, and why it’s spreading fast: 🧵 [2/12] Psychosis = a break from shared reality.

It shows up as:
• Disorganized thinking
• Fixed false beliefs (delusions)
• Seeing/hearing things that aren’t there (hallucinations)

Apathy is what happens when your dopamine system breaks down.

People call it laziness → they’re wrong

Here's what motivation looks under the hood, and how to fire it up again 🧵
[2/11] Most people think apathy = depression

But apathy isn’t sadness.
It’s the break down between thought → action.
Like turning the key in a car…and nothing happens.

Everyone’s been saying psilocybin “rewires the brain.”

Cool. But where, exactly?

A new 2025 Nature study finally has the answer. And this could change how we treat depression. 🧵
[2/11] Most people think:

Psychedelics = “plasticity everywhere”
SSRIs = “serotonin everywhere”

But that’s not how the brain works.

Plasticity is:
• Circuit-specific
• Time-dependent
• Neither good nor bad by default

So which neurons actually matter?

Neuroplasticity = the brain’s ability to change. But plasticity itself isn't “good” or “bad.”

• High plasticity + good environment → growth
• Low plasticity + bad environment → stuck in depression

Here's how to unlock your plasticity 🧵
Critical periods are windows when your brain is primed to change.

What opens them? Hebbian learning.

• Neurons that fire together wire together
• Mistime the pattern → the window closes

This is how all neural networks (human or artificial) work.

In 2025, I have admitted 12 cases of psychosis to the hospital with LLM involvement.

1. This actually isn't new or AI-specific.
2. And no AI does not causes psychosis.

And most importantly, 95% of what you're reading on X about "schizophrenia" is medically inaccurate. 🧵

https://twitter.com/Noahpinion/status/1945933856764490201

It's shocking that this needs to be said, but please be kind to people.

Ketamine doesn’t work the way you think.

It’s not about the ego death.
Not the hallucinations.
Not the high.

The real reason it works—and why it works so fast—has nothing to do with the trip.

It’s something deeper.
And its changing computational psychiatry. 🧵 2/ Most antidepressants are like slow software updates.

Ketamine?

It’s a fast reset... rebooting the brain’s control circuits in hours, not weeks.

A full circuit rewrite that results in transformation.