Do QAnon Followers Have High Rates of Mental Illness?

One writes about QAnon with some reluctance and trepidation. Reluctance because we do not wish to spread interest in the conspiracy theory group by even mentioning its name. Trepidation because QAnon has now been linked to violent crimes, including playing a role in the January 6, 2021, Capitol Hill insurrection. Nevertheless, an article in The Conversation titled “Many QAnon followers report having mental health diagnoses” did catch our eye and perhaps deserves some discussion.

Written by Sophia Moskalenko, a research fellow in social psychology at George State University, the article asserts that members of QAnon, which probably now numbers millions, have high rates of mental illness. “I noticed that QAnon followers are different from the radicals I usually study in one key way: They are far more likely to have serious mental illnesses,” Moskalenko writes in her March 2021 piece. She goes on to state that “I found that many QAnon followers revealed—in their own words on social media or in interviews—a wide range of mental health diagnoses, including bipolar disorder, depression, anxiety, and addiction.”

As further evidence of this notion that psychiatric illnesses play an important role in QAnon, she cites court records following the January 6 insurrection in which “68% reported they had received mental health diagnoses.” This is opposed to the rate noted by Mental Health America of 19% in Americans in general. Moskalenko speaks about a “mental health crisis in the United States” and advises that a solution to the problem of conspiracy theorists like QAnon is “to address the mental health needs of all Americans—including those whose problems manifest as QAnon beliefs.”

Are People with Mental Illnesses More Likely to Believe Conspiracy Theories?

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To be sure, the beliefs espoused by QAnon are bizarre. You can read more about QAnon’s history and beliefs here; their core belief is that a cabal of Democrats led by Hillary and Bill Clinton are running a pedophile ring whose members cannibalize captured children. They hold that ex-President Trump is the savior who was supposed to reveal the pedophile members and arrest them during a second term in office. Although some initially dismissed this, the idea turned violent during the PizzaGate affair when John Maddison Welch drove from North Carolina to Washington, D.C., with assault rifles hoping to free children allegedly being held by Hillary Clinton’s followers in the basement of a pizzeria. He shot up the restaurant, fortunately without injuring anyone, and was arrested and subsequently sentenced to four years in prison. The incident brought the QAnon conspiracy theory to national attention.

It is quite common to see some defaulting to mental illness as the reason behind unsavory behavior. People blame mental illness for mass shootings for example, even though few perpetrators of mass shootings have ever been diagnosed as mentally ill. In this case, there is no evidence that people with illnesses like depression, bipolar disorder, and anxiety disorders are especially prone to believe wild conspiracy theories. People with paranoia as part of their psychiatric illness, such as people with the paranoid subtype of schizophrenia or who have paranoia induced by chronic use of amphetamines or cocaine, might entertain such theories, although the form of paranoia seen in these disorders is most often disorganized and not as intricately detailed as the QAnon conspiracy theories.

Very Thin Evidence for Mental Illness Connection

More importantly, the evidence Moskalenko seems to rely on to relate QAnon conspiracy theories to psychiatric illness are two-fold: self-report and court documents. The latter are clearly suspicious, of course: As part of a defense to try to stay out of jail, many people might try to blame their actions on being mentally ill. These are not a reliable source of information about mental illness diagnoses. Nor can we take self-report at face value. Lots of people suffer from transient feelings of depression and anxiety, for example, without meeting criteria for an actual psychiatric diagnosis. We have no idea from what Moskalenko writes about the rate of true psychiatric illness among QAnon members. To know that would require that mental health professionals examine each individual, obtain a careful history, and make a diagnosis using the accepted DSM-5 criteria.

If that were to be done, we doubt that anywhere near 68 percent of QAnon members would receive formal psychiatric illness diagnoses. There is now extensive scientific literature on conspiracy theory belief. At its most fundamental level, conspiracy theories serve basic functions that are part of human cognition, such as the need to find simple patterns in complex datasets. Conspiracy theories also serve to “satisfy unmet psychological needs,” including the need for certainty. With respect to the current pandemic, for example, we are besieged with a constant influx of information to the point that it is easy to be overwhelmed and confused. A simple but terribly wrong way to reduce all of these data to one graspable belief is to embrace the QAnon notion that the coronavirus pandemic is a hoax perpetrated by left-wing politicians in an effort to control the public. Given that one survey showed that 17% of Americans believe QAnon’s most outlandish conspiracy theory—the one about the Democratic pedophile ring—it is not so difficult to understand that many people might embrace a conspiracy theory capable of explaining away all the discomfort and restrictions with which we now have to live because of COVID-19. Importantly, many people with impressive intellectual credentials are part of QAnon, so it does not seem to be exclusively an issue of knowledge deficit.

Certain personalities may be most prone to believing conspiracy theories, including those associated with impulsivity, negative affect, and general distress. Feelings of powerlessness, despair, and marginalization are known to stoke belief in conspiracy theories. These are undoubtedly prevalent feelings, especially during times of economic downturn or crisis as we have now during the pandemic. A person who feels powerless because of a personal economic setback may describe themselves as “depressed” and someone who is worrying about the implications of COVID-19 might say they feel “anxious.” Such individuals are probably more prone to accepting conspiracy theories that at least give them explanations for what is happening and connect them to a social group. They do not necessarily have clinical depression or anxiety disorders, however. As psychiatrists Ronald W. Pies and Joseph M. Pierre point out, belief “in conspiracy theories is distinct from psychosis, and more closely resembles extreme but subculturally sanctioned religious or political beliefs.”

We believe we are on firm ground asserting that most people who do have psychiatric illness do not endorse outlandish conspiracy theories like those QAnon spreads. Ascribing false and potentially violence-inducing conspiracy theories to mental illness seems another way of stigmatizing people who suffer with psychiatric illness. The evidence that conspiracy theories serve an unmet psychological and sociological need is quite strong, but the evidence that it is part of mental illness or that most of its purveyors are psychiatrically ill is extremely thin. Let’s understand QAnon for what it is: a dangerous organization that foments hate, anti-science ideas, white supremacy, and violence.