Why Do Psychotic People Strip Naked?

Answers to your questions about the news.
May 29 2012 7:22 PM

Naked Lunch

Why do allegedly psychotic people such as the Miami face-eater take off their clothes?

Rudy Eugene
Rudy Eugene

Photo courtesy Miami-Dade County Medical Examiner

A naked man now identified as 31-year-old Rudy Eugene was shot dead Saturday after he refused to stop eating another man's face. Police have speculated that the man may have suffered from psychosis, perhaps induced by cocaine or LSD. In March, during what was also deemed a psychotic episode, “Kony 2012” director Jason Russell ran around San Diego naked. Why do psychotic people strip naked?

Many times it’s because the voices in their head told them to. Public nudity by the mentally ill seems to occur most often as part of other hallucinations and distortions of reality. Some feel that God or some other powerful entity has commanded them to reveal the radiance of their whole body, or they suddenly believe themselves to be an exotic dancer. After such an episode is over, many will remember having those thought processes, while others find the urges inexplicable. It is widely accepted that drugs like LSD and methamphetamine can trigger psychotic episodes. Such behavior is not surprising among psychotic individuals, but psychotic nudity may seem more common in the public’s eye than it actually is because the displays are so shocking and offensive.

Among those with mental illness, sudden and uncalled-for nakedness is most closely associated with catatonia. Catatonia is usually an expression of mental disorders like bipolar disorder or schizophrenia, but it could also come from other medical problems, such as a brain tumor. Nakedness is not among the top symptoms associated with catatonia (more often catatonics are thought to be waxy or frozen or have other difficulties with motor control), but a person unexpectedly found to be running around naked in public is likely to suffer from that condition. In the case of each of these illnesses, the behavior occurs in a very small percentage of sufferers.

In other cases, people with dementia may also strip down in public and at unsuitable times; this behavior is usually unrelated to any kind of psychosis. Rather than being delusional, dementia patients seem to just be confused. Additionally, bipolar people experiencing a manic episode may simply lose their inhibitions, which can result in flashing or streaking or other inappropriate nudity, but that seems to be a less common cause than delusions.

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In a similar incident of psychotic cannibalism—nudity-free, it’s worth noting—in which a Canada bus passenger suddenly cut off another man’s head and reportedly began to eat him, the attacker later revealed that he’d heard the voice of God and believed the victim was an alien.

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Explainer thanks Charles Raison and Ole Thienhaus of the University of Arizona.

Forrest Wickman is a Slate staff writer. Email him at Forrest.Wickman@slate.com.