Brain Rot as Culture-Bound Illness
on digital disorders, ancient pathologies, and post-ironic posting
I.
“Culture-bound illnesses” are illnesses that only make sense in the context of a particular culture, and that only seems to affect people who are part of that culture. Unlike something like the flu, which presents in basically the same way across the world, culture-bound illnesses are a product of the values, beliefs, and customs of the cultures from which they emerge.
The most commonly-cited example is “koro”—also known as “shrinking penis syndrome”—a delusional disorder characterized by “an overpowering belief that [one’s] sex organs are retracting and will disappear, despite the lack of any true longstanding changes to the genitals,” causing considerable anxiety and, often, a deep fear of death.
While the earliest references to koro appear in ancient Chinese texts, cases flared throughout the twentieth century. It took hold of thousands of Singaporean and Malaysian men in the late 1960s, and outbreaks have since been reported in Thailand, Southern China, and, more recently, Nigeria. The most recent one I’ve read about took place in India in the 2010s.
While koro is the poster-child for culture-bound illnesses, there are lots of other examples. Hwabyeong, a syndrome reportedly affecting Korean people, causes chest pain, palpitations, and feelings of impending doom, said to stem from suppressing anger over social unfairness. In Malaysia, “amok syndrome”—from where we get the phrase "running amok"—describes a sudden violent rampage traditionally attributed to possession by an evil tiger spirit. Susto, which arises in some Latin American cultures, is described by the DSM-V as “an illness attributed to a terrifying event that causes the soul to leave the body and leads to unhappiness and illness, as well as difficulties in performing key social functions.” And so on.
I read about all this in Scott Alexander’s essay on the topic—itself a review of the 2016 book The Geography of Madness—and, finding it interesting, was left wondering: are all culture-bound illnesses constrained by geography? Or can they arise in digital environments as well?
II.
Five seconds of thought suggests ‘yes, and most of us have already contracted them.’
Consider: Oxford’s 2024 word of the year was “brain rot”, defined as “the supposed deterioration of a person’s mental or intellectual state, especially viewed as the result of overconsumption of material (now particularly online content) considered to be trivial or unchallenging,” or “something characterized as likely to lead to such a deterioration.”
While the term has literary roots—its earliest recorded use is in Henry David Thoreau’s Walden, where, reflecting on living a simple life in harmony with nature, Thoreau muses: “while England endeavours to cure the potato rot, will not any endeavour to cure the brain-rot—which prevails so much more widely and fatally?”—its current meaning and usage is clearly a response to how platforms have evolved to capture attention. In this, it fits with a cluster of online pathologies, like “doomscrolling” and the condition of being “terminally online.”
Can we learn anything about this new class of digital-first disorders by conceiving of them as culture-bound illnesses? I think so—here’s what stands out to me:
1. Social contagion and framing effects
Whatever else is happening to our brains while we scroll social media, they are not literally rotting. In this sense, “brain rot” is not a medically-legitimate illness, unlike, for example, aphasia. However, the symptoms of brain rot—like emotional numbness, reduced attention span and memory, and the creeping sense of a shrivelling intellect—are legitimately felt. Hundreds of millions of people experience such things. This is how it works with other well-documented culture-bound illnesses, too—the penis retraction may not be real, but the anxiety sure is. Confusion about the cause does nothing to lessen the symptoms.
From what I understand, culture-bound illnesses spread as follows. In the beginning, a few people experience unambiguous symptoms, whether biological or psychological. Word of their symptoms spreads to other community members, some of whom experience the same thing. Others, whose experiences are more ambiguous, now have a framework through which to interpret them—so they start identifying with the illness too. Soon the illness’ existence is common cause in the community, and having knowledge of it primes members to experience it.
With brain rot, I imagine many people independently realized that spending lots of time on social media feels bad—worse for some than others, since symptoms exist on a spectrum—but bad nonetheless, leading to them having trouble focusing, remembering stuff, and so on. Some subset of these people coin the term “brain rot,” and, because of its emotional resonance, it spreads as a meme, soon entering the consciousness of most people spending at least a few hours online per day. Now that the concept has taken root, people invoke it (consciously or subconsciously) to explain why using social media feels bad. A pathology is born.
The key thing here is that, just as with geographic culture-bound illnesses, brain rot is a self-reinforcing concept: the more you know of its existence, the more you see it in yourself. Whereas before you might have interpreted the sensations that arise from excess social media consumption as distraction, mental fatigue or overstimulation, now they serve as evidence of a condition.
2. Irony is no defence
Perhaps the core difference between geographic and digital culture-bound illnesses is that everything online is soaked in irony. Whereas people suffering with koro literally believe their genitals are retracting, people with brain rot do not literally believe their brains are rotting. ‘That would be dumb! It’s just a joke lol,’ I imagine them saying.
The thing is, in my experience, beliefs held ironically (and actions taken ironically) soon become unironic through repeated exposure. The first time I said ‘lol’ aloud in conversation, I thought I was being wry. By the fiftieth, I had to acknowledge the term was now just part of my lexicon (alongside tbh, which I continue to defend irl). Irony provides the cover by which beliefs enter.
Moreover, online discourse is perhaps better understood as “post-ironic”—a central element of which, Wikipedia tells me, is “the obfuscation, ambiguity, watering-down, degradation, or simple lack of meaning and intent in statements and artwork, whether the creator or disseminator intends this to be celebrated, decried, or met apathetically can itself be part of this uncertainty.” So I don’t think ostensibly-ironic engagement with a concept can prevent us from sincerely believing it (hence the importance of ‘joking about the outcomes you want’, as @visakanv often puts it). We don’t seem to be built that way.
3. Features of online culture
Besides post-irony, several features of today’s online environment accelerate the spread of digital pathologies.
First, platforms are designed to amplify whatever content is “stickiest”: whatever provokes a strong response in people. So if you watch a few reels about brain rot (some serious, some ironic) the algorithms are only too happy to serve you (and everyone like you) a few more, and more, and more. It’s not at all surprising that a catchy phrase like brain rot would systematically outcompete any more nuanced interpretation of why social media feels bad.
Second, and relatedly, platforms encourage us to identify with our conditions and beliefs, and to sort ourselves into subcommunities, to a far greater extent than was the case before their dominance. “Brain rot” provides a label and an identity that is much easier to parse and to share than “excess social media is inducing in me a bunch of weird and hard-to-describe sensations.” Labels also enable people to rally around them, forming community and connection in the process. All of this further reifies the condition.
Third, platforms have billions of users distributed over a hundred countries. Geography is no constraint to the spread of an idea. Literally the whole world—at least, everyone who spends a lot of time on social media—can start saying stuff like “rizz” and “girl dinner” overnight, and others will know what they mean. This is true of both individual words/phrases and the conceptual frameworks that underlie them. “Brain rot”, conveniently, seems to be both. And thanks to these same forces, memetic phrases and ideas can disappear as quickly as they arise.
While brain rot is perhaps best thought of as a chronic condition, there have been cases of the internet inducing more acute dysfunction. During the pandemic, for example, reports emerged of people (mostly teenage girls) across the world developing tourettes-like symptoms, which seemed to abate once they were reintegrated to post-pandemic life.
III.
“Historically, things that are physical have been considered real and things that are mental have been considered not real, or imagined, or psychosomatic.” So says Frank Bures, author of The Geography of Madness, in a 2016 interview about his book. He contrasts this against a “biolooping model” where “our ideas, our mindsets, and our beliefs feed back into the biology and change [it] in a way you can measure. It’s real but it’s not physical first. It's mental first.”
Whether or not something is a “culture-bound illness” is not in itself a particularly interesting question. It may cache out as a “mere semantic distinction” (a phrase a friend often uses with what I’d call loving derision).
What is interesting is noticing how, throughout history, our beliefs have shaped our experiences. Some beliefs are empowering, if delusional (“I can do anything!”), some are benign, and some actively hurt us even while purporting to explain our suffering.
My brain is not rotting, even though I spend entirely too much time on twitter. Probably something bad involving dopamine is taking place. But I will not cede ground to the narrative that I am afflicted with “brain rot”, because framing things in this way feels bleak and disempowering to me (perhaps you feel differently). I’m not even sure we’ve got the right thing in focus. I recently read the phrase “platform derangement syndrome” somewhere online, and that appeals to me more—it more cleanly locates the cause of the so-called derangement as being baked into the structure of digital platforms, rather than a result of individual failings (though it’s still folk psychology).
In any event, though I remain uncertain on the exact contours of the problem, I’m pretty certain the solution is to read a book (ideally fiction). I just finished “So Long, See you Tomorrow”: I thought it was pretty good, and didn’t induce fear of brain decay even once.