Can Social Media Spread Epidemics?
Why is mass psychogenic illness becoming more common?
Posted Sep 23, 2013
Danvers, Massachusetts has a long and, well, unusual history.
Originally known as Salem Village, the mid-sized town (with a population of 26,493 according to a 2010 census) is best known for the Salem witch trials and being the site of one of Massachusetts’ oldest psychiatric hospitals. While rarely appearing in the news otherwise, the town of Danvers got more international publicity that they likely wanted starting in January 2013. That was when about two dozen teenagers at the Essex Agricultural and Technical School in Danvers began reporting bizarre symptoms including “mysterious” hiccups and vocal tics. After the Massachusetts State Health Department ruled out any physical cause for the outbreak, the epidemic gradually subsided over the next few months. Despite speculations that the outbreak may be due to mass psychogenic illness (MPI), the State Health Department has not made any official statement on the cause to date.
While the location of the outbreak seems ironic given Danvers’ legendary history, epidemics of MPI have become increasingly common over the past few years, especially in the United States. According to New Zealand sociologist and skeptic Robert Bartholomew, the Danvers epidemic resembles other cases that occurred. Bartholomew has studied over 6,000 cases of MPI dating back to the 16th century and argues that social media may be playing a strong role in the recent upsurge of cases.
Formerly known as “mass hysteria”, MPI is defined as “the rapid spread of illness signs and symptoms affecting members of a cohesive group, originating from a nervous system disturbance involving excitation, loss or alteration of function, whereby physical complaints that are exhibited unconsciously have no corresponding organic aetiology.” Episodes of MPI have occurred around the world and throughout history with common factors including:
- Symptoms with no known organic basis
- Symptoms with rapid onset and recovery
- Symptoms that are typically transient in nature
- Occurring in a specific group
- Extreme anxiety
- Symptoms are spread by word of mouth or through popular media
- Spreading down the age scale from older to younger victims
- Predominantly female victims
Symptoms linked to MPI outbreaks can include nausea, headaches, abdominal cramps or pain, fainting, chest pain, vomiting, diarrhea, and anxiety attacks. According to British psychologist, Simon Wessely, MPI can manifest itself as either “mass anxiety hysteria” with episodes of acute anxiety (primarily in schoolchildren), or as “mass motor hysteria” involving abnormal motor behaviour.
Cases of mass anxiety hysteria often begin with a single stress-inducing belief, such as the presence of a noxious smell or toxic influence in the environment though this type of outbreak usually dissipates fairly quickly. Robert Bartholomew estimates that there are hundreds of undocumented outbreaks of mass anxiety hysteria occurring in the United States alone each year.
Cases of mass motor hysteria can be more serious as the outbreak in Danvers demonstrates. Though usually more common in high-stress environments seen in developing countries, such as factories and refugee camps, they can occur in Western countries as well. “People are repressed, and that’s when you get the motor symptoms,” Bartholomew said. “The twitching, the shaking, the trance-like states…and it builds up, over weeks or months, and it does not go away.” With outbreaks of MPI, the search for answers can lead to incidents of violence such as in attacks on suspected witches and exorcisms following unexplained death or illness.
While MPI is not included in the DSM-V, a similar syndrome known as conversion disorder can have many of the same characteristics. Originally regarded as a form of hysteria, conversion disorder is classified as a somatoform disorder involving the “conversion” of emotional distress into physical symptoms. In MPI outbreaks, a single common stressor can lead to similar conversion disorder symptoms in a group of individuals who believe themselves susceptible. Despite previous research suggesting that people with low IQs or greater suggestibility are more vulnerable to MPI, there is no consistent evidence that this is the case. The greater incidence of MPI among females rather than males is difficult to explain as well.
Along with the new outbreak in Danvers, MPI has also been implicated in a recent epidemic affecting more than four hundred garment workers at a factory in Bangladesh earlier this year. The workers, who were mostly women, blamed their reported symptoms, including vomiting and nausea, on the impure water provided by the factory. Epidemiologists have tested the water and other factory conditions and have since suggested that the reported problems are psychogenic in nature. The presumed cause of the anxiety that led to the outbreak is assumed to be lingering trauma relating to the April collapse of a garment factory that killed more than 1,000 garment workers.
It is this overlying fear that has been linked to other outbreaks in the region including several schools in Afghanistan in which teenaged girls reported developing symptoms after smelling gas led them to suspect a Taliban attack. In many cases, episodes of MPI are often linked to larger political fears and can be aggravated by news stories of chemical and biological attacks occurring in neighbouring countries.
But why has there been an upsurge of cases in the United States? An outbreak of MPI occurred In the town of Le Roy, New York, in 2011 when eighteen teenaged girls developed bizarre symptoms including uncontrollable twitches and motor spasms with no apparent cause. Perhaps even more remarkably, the reported victims also included a thirty-six-year-old nurse who was not directly involved with any of the other victims. Though the possibility that the symptoms might be due to toxic waste from Le Roy’s manufacturing plants was raised, that was ruled out fairly quickly. After extensive medical testing of the victims and environmental factors found no physical basis for the epidemic of symptoms, medical experts concluded that MPI was to blame.
Although word of mouth has been implicated in previous MPI cases, the Le Roy case has demonstrated the role that mass media can play in spreading psychogenic symptoms. With increasing media coverage of the outbreak, including a high-profile investigation launched by Erin Brockovitch, the symptoms grew worse despite only affecting teenaged girls. Along with the news reports suggesting that the victims in the case were “faking it”, social media also played a role with recriminations and reports of new symptoms being spread by Facebook and other sources. In the case of Marge Fitzsimmons, the 36-year old nurse who also developed symptoms, almost all of the information she had on what was happening in Le Roy came from Facebook.
While the epidemic in Le Roy subsided, Robert Bartholomew suggests that many of the lessons learned from that outbreak have been quickly forgotten. In a recent interview with Atlantic magazine, Bartholomew stated that there is “potential for a far greater or global episode, unless we quickly understand how social media is, for the first time, acting as the primary vector or agent of spread for conversion disorder.” Though the prospect of “catching” a disease from Facebook or Twitter seems bizarre, the risk may be very real for those believing they are vulnerable. For many of the Le Roy victims, their symptoms only began after seeing a YouTube video posted by Lori Brownell, a girl with severe tics living in a neighbouring city.
With social media allowing social interaction to a far greater extent than ever before, the sort of MPI contagion that used to depend on face-to-face contact can now happen among people who might never meet in person. Along with spreading symptoms, Facebook messages can also relay the emotional distress that people are experiencing which gives the epidemic an added push. In a recent paper titled, “Mass psychogenic illness and the social network: is it changing the pattern of outbreaks?”, Bartholomew suggests that social media is changing MPI outbreaks in new and disturbing ways. In his paper, he writes that “Local priests, who were inevitably summoned to exorcise the ‘demons’, faced a daunting task given the widespread belief in witchcraft, but they were fortunate in one regard: they did not have to contend with mobile phones, Twitter and Facebook.”
For many MPI victims coming to terms with their symptoms, the best solution often involves avoiding social media sites completely, at least until the epidemic passes. Though Facebook, Twitter, and phone texting has brought the world together in new ways, the dangers of interconnectedness have become greater as well. The hysteria that once make old Salem Village famous is already resurfacing and may even be more common than ever. Recognizing the strong link between the mind and the body and that age-old problems such as mass hysteria can be spread by modern communications can help defuse new outbreaks and possibly save lives in the process.