NOTE: All names in this story have been changed, except where indicated.

I.

I want to begin this essay with a vivid illustration of my friend Mary at peak crazy, but I am having a tough time choosing the moment that depicts it best. Short-listed candidates include:

• Screaming in white-faced rage that I was working for a global paedophilia cult. (I had nannied her first child.)
• Demanding entry into the Federal Witness Protection Program during the Mueller investigation, which she insisted was happening only because she was one of ten people in the world to crack the code of the lethal syndicate behind the Pegasus virus.
• Asking friends which A-list actors ought to portray them in the blockbuster movie that would definitely be based on the guaranteed bestseller she was writing about it all.

These three lunatic notions, I would learn, have been classified by medical professionals as persecution, paranoia, and grandiosity, respectively. They would later be joined by others, including erotomania and hypochondria. 

We toss terms like these around casually in everyday conversation. Their less familiar medical-dictionary definitions became part of my lexicon when I concluded that Mary’s disconnection from reality could not be fixed by simply reasoning with her, which got me googling. I found that other people were also googling—people like me with friends or family who had “flipped out,” “gone around the bend,” “lost it,” “cracked up,” et cetera. The diagnosis at which we all eventually arrived was “delusional disorder.”

I frowned at my monitor. What a pedestrian name for such a florid condition. I expected a proper name like Munchausen Syndrome or a string of Greek syllables ending in “-osis”—something more exotic than this nondescript condition rendered in lower-case. “I think Mary is suffering from delusional disorder,” I imagined saying to our mutual friends. “Of course,” they would reply. “She’s deluded and she’s disordered. Is that all you’ve got?”

In popular culture, delusional disorder is often played for laughs. Frank Capra’s 1944 black comedy Arsenic and Old Lace features a man who believes he’s Teddy Roosevelt and two sweet old ladies whose charity project is serial killing. In Norman Jewison’s 1964 Rock Hudson and Doris Day vehicle Send Me No Flowers, the comedic device is hypochondria. Synonyms for the disorder sound whimsical: wacko, bonkers, kooky, shoutycrackers. The number of colourful terms denotes a prominence in the popular imagination that seems unwarranted given the disorder’s rarity—its lifetime prevalence is estimated to be just 0.02 percent. That low figure, admittedly, may not reflect unreported cases, because a characteristic of the disorder is the sufferer’s refusal to seek medical help. Sceptical family and friends, the sufferer believes, are the ones who are deluded or worse. As a Quora user wrote of his afflicted younger brother, “Everything I did to try and help him just made him more and more sure I was one of the people who hired the hit men to have him killed.”

The question arises: Who are these people (including me) to be diagnosing anyone with psychosis? I’m not a medical professional. But I’ve developed the impression that many diagnoses of delusional disorder are made by laypeople driven to seek answers. What can you do when the very nature of the illness preempts a formal diagnosis? Anyone who is close to a sufferer knows what’s going on. Keep reading and see what you think.

The average age of onset is forty. This relative lateness—schizophrenia usually appears in the teens—suggests an origin in life experiences rather than neurodevelopment, although a contribution from the latter cannot be ruled out entirely. Hippocrates attributed delusional ideation to humoural imbalance. Delusions can last indefinitely, and this may be Mary’s fate. One clinically followed case persisted for forty years. The progression seems to follow a pattern: the sufferer starts out in a highly stressful situation, and then something catastrophic happens that “pushes them over the edge.” This was Mary’s story to a tee. 

When Mary was three years old, her mother suffered a disabling head injury that left her permanently institutionalised. Mary hated her microscopic American Midwest town (population 260) and she escaped the minute she finished high school in the 1990s. She graduated from Tisch four years later, and she was asked to write a screenplay for Francis Ford Coppola a few years after that. She moved to California (I’ll call the city “Santa Cristina,” which is where I first met her) and quickly rose to middle management in the tech industry. She got married and had a kid. She sold a book to one of the Big Five, which became a regional bestseller. She had another kid and was commissioned to write another book by another of the Big Five. She became the sole caretaker as well as the sole breadwinner of her family—including her brain-damaged mother—when her husband walked out.

At 39, Mary was objectively beautiful, talented, accomplished, and energetic. Her life was full but it was also hectic and everything had to be timed down to the minute. In addition to effectively holding down two full-time jobs with the second book deal signed, she was juggling birthdays, kids’ sports, dental appointments, care of a completely disabled parent, a complicated relationship with her father still in the Midwest, and friendships with other parents. If anything glitched in the sequence of leaving the office, filling the car with gas, picking up the kids, hitting the bank to get cash for the babysitter, shopping for the night’s dinner, making some crucial phone calls, visiting her mother, running another three essential errands, and getting in four hours of writing, an avalanche of domestic disasters would slide down on her head and crash into the weekend. That’s when she was hit with identity theft…

II.

Delusional disorder, simply put, is an inability to distinguish the real from the imagined. The imagined is a fixed, false, idiosyncratic belief based on an inaccurate interpretation of external reality. The clinical definition further stipulates that a delusion must persist for at least one month. “Nonbizarre” delusions are those that are plausible within the sufferer’s culture. Examples are the false belief that a government agency is spying on a person, since such a thing is categorically possible. A belief in voodooism would not be considered delusional within a certain cultural context, but an educated urbanite’s belief that his hairdresser and doctor are harvesting samples to use in a curse could be.

The most recent version of the Diagnostic and Statistical Manual of Mental Disorders added delusions “with bizarre content” to its list of specifiers. An example would be the belief that one’s internal organs have been surgically replaced with those of someone else. Absolute conviction in the delusion is another hallmark of the illness. Friends observe that the sufferer could pass a lie-detector test while asserting the wildest falsehoods. The delusion is also “incorrigible”—impervious to logic or reason. Contradictory evidence or complete lack of evidence is proof of the malefactor’s diligence in disguising it.

Some forms of mental disorder and illness precipitate degradation of the sufferer’s global health, leaving a person unable to perform day-to-day tasks and get along socially and professionally. The signs are visible and persistent. People with depression, bipolar disorder, or schizophrenia may neglect housework or personal hygiene, fail at school or work, have difficulty concentrating, and self-isolate. In advanced cases, they may smear faeces, babble incoherently, or attempt suicide. But delusional disorder works its mischief in the absence of such danger signs. In fact, visual and auditory hallucinations and impairments of attention, language, and cognitive functions rule out a diagnosis of delusional disorder. Sufferers continue to be themselves and seem normal and reasonable on topics outside their delusions. “It is stunning,” reports a clinician who has treated delusional parasitic infestation, “to see that patients are otherwise entirely mentally healthy and argue rationally if they discuss issues other than infestation.”

But the delusions can lead to bizarre behaviour. Delusions—of being hunted by a global crime syndicate, of gradually turning into a eunuch, of a romance with a childhood crush, of marriage to a casual acquaintance, of a rat infestation in the home, of spousal infidelity—have caused people to abandon their careers and fall into poverty as they devote their time to fending off imaginary villains. They may waste hours in front of the mirror, bolt their own wedding like the heroines of The Graduate and It Happened One Night, stay indoors for months to avoid dangerous romantic rivals, hide under a table for six hours to catch a cheating spouse, and commit murder and/or suicide. While a formal diagnosis of clinical depression is a separate thing, sufferers of delusional disorder can become depressed, as well as hostile and irritable.

III.

Mary’s identity theft in the summer of 2017 was not a delusion. I saw images of the forged cheques that cleaned out her bank account and upended her life. She had to cancel her credit cards and automatic pay-cheque deposits. She had no cash for the babysitter and she couldn’t pay the rent. The bank would only talk to her in person, and then she had to jump through hoops to get them to reimburse her for other banks’ bounced-cheque fees. One weekend, she had no gas money so she cancelled all her plans for the kids and made everyone stay indoors. She felt too ashamed to ask her friends for help.

What became less clear was the extent (even the existence) of the damage that followed. Mary claimed that the social security numbers of her kids and her disabled mother were stolen and all their electronic devices hacked. She bought new laptops and phones and changed the passwords almost daily. When the new devices failed, she tore them down and analysed the internal code, and bought another round of laptops and phones and went through another round of tear-downs and password-changing. She sat on the floor poking and clawing at the phones. She held them out at me and exclaimed, “Look!” 

The hack began to overtake the identity theft in Mary’s preoccupations. Since she used her work and personal devices interchangeably, she concluded that the hack had originated with her employer’s systems. The IT guy was Israeli, which raised the spectre of foreign penetration. At this point, I thought she was simply talking stupid and I barely suppressed my incredulity as I pressed her for details. Then came the cult.

She had started dating a businessman who was potential husband material except for one thing: he was wasting his money on an expensive marketing firm that Mary thought did nothing for him. (This might have been true.) It concerned her because she couldn’t enter a life partnership with someone who had such a glaring lack of judgment. Frustrated, she started investigating the marketing firm. It turned out that they were not only bad marketers, they were bad people. They had a side-business training men how to seduce women (like the self-help course run by the sex-guru Tom Cruise plays in Magnolia). From that, she divined that they also produced pornography. About a week later, they were into child trafficking.

And it wasn’t just this marketing company—its employees were part of a global cult. They had learned that Mary was on to their criminal scheme and now they were out to get her. “They park across the street and spy on me,” she hissed. She broke up with the businessman, but the spying persisted. Meanwhile, her wifi and cable service were under constant attack. This was apparently because the creators of the Pegasus spyware virus had realised that she had discovered the extent of their malice. Shadowy organisations with limitless money and no scruples were threatening her.

This afforded me my first view of a habit that surprised me: ordinary, flat-footed dopeyness. It was a normal night: Mary’s father had just returned from an AA meeting, the kids were playing with lightsabres, and I was offering to take everyone to a movie. Mary was frantically trying to install a hidden-camera system but she couldn’t get the wifi component to work. The hack! Look! Look right here! They’ve cut my wifi! I strolled over to her modem to see if that could be the problem, and found that it wasn’t plugged in—just a hockey puck sitting there, disconnected from the internet and electricity. “They’ve hacked everything!” Mary ranted. In time, I would discover that Mary-world was a nest of disconnected cables, unpaid bills, overlooked tasks, and illogical fixes. I knew it was no use pointing out the actual problem; she was into the phase of suspecting anyone who questioned her conspiracy theories, and she would simply have accused me of unplugging the modem myself.

You may be wondering why I bothered; I could have dropped a truth bomb on her and left her to cope for herself. But Mary was my friend and I didn’t want to give up on her. This phase—or whatever it was—had to exhaust itself eventually (this was before I zeroed in on her condition and its prognosis). But I was also deeply concerned about her kids, whom I had known, cared for, and loved since they were born. I was their favourite babysitter. Everyone who was watching Mary’s decline was worried about them above all. The older one, Mary had told me years earlier, was a Highly Sensitive Child, which is a thing in psychology, and knowing the kid I found it reasonable. The younger one was a tiny sceptic who would check the fridge when told there was no more milk. Both are exceptionally bright. Someone had to stick around and be their grown-up friend. But I still agonise over what’s more damaging: tacitly supporting their mother’s delusions in front of them or telling them flat-out that they’re in the hands of a nutcase. That’s the razor’s edge on which I balance, and where I will probably remain until the kids reach maturity.

What about Child Protective Services, the Family Court, and that sort of thing? Well, it’s not illegal to live your life crazy, even if that means raising your kids crazy. The only point at which the sufferer can be involuntarily hospitalised or separated from their children is if they perpetrate or threaten serious physical harm. Different jurisdictions interpret this legal provision with varying degrees of strictness, but it would trigger the only attempt to commit Mary to psychiatric care (more about which later). Mary’s disorder has been deeply destructive in numerous ways, but her kids are stuck with it. Maybe that’s the best thing under the circumstances, because I don’t know anyone who is willing to take them, and the thought of them falling into The System is chilling. Unfortunately, that’s just the situation in which the young children of psychotic parents often find themselves.

IV.

Physicians designate six broad categories of delusions, of which persecutory delusions are the most common. In her 2017 book Run Hide Repeat, Pauline Dakin describes an example that lasted for decades. At a friend’s instigation, Dakin’s mother packed up her kids and fled from one city to another, crossing the breadth of Canada to escape a Mafia-like organisation that was supposedly targeting them on account of her ex-husband’s mob connections. At the same time, in Dakin-world, an unseen group of protectors shadowed the family, sometimes undergoing plastic surgery and intensive training to create doubles of them. The family lived in concentric circles of unreality, in which government agents chased good guys who chased mobsters who chased the family. The friend monitored all of it and directed the family’s movements from a small device that looked like a transistor radio. The friend, it turned out, was deluded, and his position of trust—he was a pastor as well as the mother’s lover—made his claims believable.

The children broke free from the delusion as adults when they rebelled against the constant disruptions of normal life, which always happened at a moment’s notice and ruined special occasions. When they confronted their mother with plain facts that directly contradicted the pastor’s outlandish claims, she balked. “Having invested decades of her life in the story,” Dakin writes, “having traumatically uprooted her family twice, having severed relationships with her father, sister, brother and countless friends, how could she ever allow herself to acknowledge it was all needless, based on lies she had allowed herself to believe.” Such is the havoc that delusional disorder wreaks on those who are touched but not possessed by it. As for the pastor, he apparently carried his delusions to the grave. 

Grandiose delusions—also known as megalomania—are usually ranked close behind persecutory delusions. Beyond grossly exaggerating their talent or intelligence, people with grandiose delusions may credit themselves with monumental achievements such as curing cancer, assuming supernatural powers, being related to a celebrity, or protecting and advising world leaders. A case study from China describes a man who believed himself to be “an internationally renowned secret agent who had: a) changed global military thinking when he was 8 years old; b) communicated with Taiwanese spies when he was 17; c) used his mental powers to direct American military forces; and d) single-handedly coordinated the liberation of Kuwait.” He claimed that the Intelligence Agency in Taiwan and the CIA had secretly paid him US$100 million.

Jealous delusions, which are about as common as megalomania, manifest in the false belief that one’s spouse or partner is being unfaithful. Violence is often an outcome. The difference between ordinary jealousy (even when it is misplaced) and delusional jealousy can be seen in the case of a Boston man who ran from room to room in his house in pursuit of whoever was having sex with his wife at the moment. Somehow, the illicit lover always “escaped through the front door.” This elusive individual also supposedly took showers in the house, although the husband could never catch him in the act, and arrived at the house in a different car every night to avoid detection. Lights outside were signals from the mystery men. The husband couldn’t provide any further details about the phantom lovers—names, ages, jobs—as they existed solely as figures of marital betrayal. (Delusional jealousy is sometimes called “Othello syndrome” after the Shakespearean protagonist who murdered his wife, although clinicians note that Othello was deceived about her alleged infidelity, not deluded, so the nickname is a misnomer.)

Sufferers of erotomanic delusions, which are becoming increasingly prevalent in the age of social media, believe that another person, often someone important or famous, is in love with them. This affliction is more common among women than men. Margaret Mary Ray notoriously stalked David Letterman in the belief that he was her lover and the father of her son. She later developed delusions about former astronaut F. Story Musgrave and posed as a reporter to interview him. Over a period of ten years, she was arrested repeatedly for trespassing, and spent several terms jailed and hospitalised. Characteristically for the disorder, she stopped using her medications after she was discharged from hospital, saying she didn’t need them. She ultimately committed suicide.

Male sufferers of erotomania are more likely to become violent. Chester W.H. Young falsely believed that he was married to Peggy Lennon of The Lennon Sisters—the famous running act on The Lawrence Welk Show—and that he had fathered children with her. He turned his frustration on Peggy’s father William, who Young believed had committed unspecified “crimes” against the imaginary family Young had formed with Peggy. In August 1969, Young murdered William Lennon to clear the way to Peggy. Two months later, he committed suicide.

Somatic delusions are an extreme form of hypochondria and/or body dysmorphia. Sufferers may believe they are internally infested with parasites or insects, missing a body part, fiercely malodorous, or grossly misshapen. Most somatic cases involve delusions of skin infestation, which cause sufferers to pull out their hair or spend hours trying to catch imaginary pathogens with magnifying glasses and tweezers. A particular hazard of somatic delusions is that patients can harm themselves through self-treatment. One woman tried to cure an imaginary insect infestation by drenching herself with gasoline, leaving her with severe chemical burns. Sufferers can scratch themselves until they have bloody, gaping lesions, reinforcing the delusion. They can also injure their eyelids and eyeballs, shock themselves, self-administer excessive laxatives and enemas, and try to extract pathogens in the gut with some sort of instrument. They can also falsely perceive infestations in others and take healthy pets to veterinarians or healthy children to paediatricians.

A challenge for clinicians treating somatic delusions is a legitimate medical mystery called “Morgellons disease.” The rashes, intense itching, and sensations of bugs crawling on or under the skin are identical to somatic delusions, and these symptoms may be aggravated by the presence of fibres in the skin sores. The Centers for Disease Control and Prevention calls Morgellons “an unexplained dermopathy [skin ailment]” and has concluded that the fibres are fabric introduced by constant scratching, with no infectious or parasitic involvement. But some healthcare providers believe there is an infectious process. Many sufferers of somatic delusions claim to have Morgellons disease.

Sufferers of somatic delusions are unlike sufferers of other delusions in one important respect, however—they usually go to the doctor. More dermatologists than psychiatrists have seen cases of somatic-delusional disorder, and some are willing to treat it with placebos, sedatives, and anti-anxiety medications. If somatic-delusional patients do wind up seeing a psychiatrist, they are likely to have been doctor-hopping among specialists for a while, which makes it easier to establish a multidisciplinary collaboration for treatment that aims to heal mind and body alike.

Mixed delusions are a combination of any of the above. Mary has manifested all five of them by my reckoning.

V.

All this time, Mary was holding down a demanding job at a tech firm. I wondered what her co-workers were seeing. Did she leave her delusions at home and present a stable face to the public, or was she talking crazy on the job? She was passed over for a promotion, which may have been a straightforward business decision based on the availability of more qualified candidates. Or it may have been because of absenteeism; she was barely budging from home as the outside world became more dangerous. Or it might have been that her outlandish claims were raising concerns in the workplace. She told me, as if this were evidence of his guilt, that the IT guy was getting fed up with her demands and theories.

For whatever reason, Mary lost her tech job. She retained a lawyer to sue her employer for damages or harassment or retaliation or criminal behaviour that jeopardised her security—every time we spoke it was something different. The version that struck me as most plausible was wrongful termination. Her lawyer is no crank and he wouldn’t have taken her case if it had no merit. She had originally met him socially, through Chris, a friend of a friend. “You know Mary is crazy?” the lawyer said to Chris. “Tell me about it,” Chris sighed. It turned out that Mary had developed the belief that she was in a relationship with her lawyer and had sent him her underwear.

Mary expanded her persecution delusions throughout Chris’s circle. Her hands would move quickly in little circles and waves as she avidly recounted her success in “connecting the dots.” She would call on a Friday night and frantically tell Chris that it was dangerous to stay in the apartment and to get out NOW! She pieced together evidence—apparently gathered during dives into the “dark web”—that her lawyer had been molested as a child by the bishop of the cult, who had infected him with HIV, which the lawyer then kept secret. (AIDS was a decade from even being named when the lawyer was a child.) She shed tears to think of this attractive and vital man being deprived of the comforts of life, as he remained celibate for fear of infecting a partner (to which Chris chuckled: “He wakes up with a girl on him”). As for his girlfriend (he also had a regular one), that was just a cover story; she was actually his HIV nurse, a fact that Mary alone had discovered. What the lawyer did not know was that the “nurse” was also a member of the cult, dispatched to poison him because of his work on Mary’s behalf. Every time Mary visited her lawyer in his office, the “nurse” was brewing tea or cooking something mysterious. His death was imminent if Mary did not act. So, she discharged him in order to save his life.

Mary taped over her doorbell because she believed it held a hidden camera. She scanned her house with a radio-frequency identifier device and concluded that her bedroom was the only room that couldn’t be surveilled. In other rooms, she ran loud fans and spoke in a whisper. No conversation was safe, not even an inconsequential chat about the weather. I was sitting in her back yard with her father one morning discussing just that when she burst through the door waving her arms. “Are you crazy?! They’re parked on the other side of the fence! Lower your voices!”

The cult was big on “swarming.” Mary lived across the street from a middle school, and the street filled up with cars every afternoon when school let out. This enabled the cult to use prop kids to linger out front and spy on her. Any time she took action against the cult, such as trying to email a report to the FBI, the cult would deploy thirty cars to pass by her house. “But of course there are cars out there now,” I said one Friday night. It was a warm weekend in Santa Cristina and people weren’t going to stay cooped up in their homes. “Well, where are they going?” she demanded. She submitted reports to the police, providing them with licence numbers, descriptions of drivers, and times of day. She was frustrated by their failure to act. She knew a guy in the military whom she expected to direct the Santa Cristina police from his distant post on her behalf. She had conducted another “analysis” and determined that he had the authority to order a 24-hour police guard at her house. “Why am I paying my taxes?” she stormed.

Mary’s father was visiting from the Midwest for Christmas. I had looked forward to this, because my allies vis-à-vis Mary were disappearing. Delusional disorder can look like stupidity, dishonesty, or other lapses of reason or virtue that cause sympathisers to flee. “Spare me” was the frequent response when I started to talk about Mary’s latest episode or misadventure. I was hoping—and please allow me a soft, ironic laugh as I look back on this—that her father would steady her somehow. Instead, it was thanks to his visit that I began another round of googling, which led to the discovery of another medical term: folie à deux. 

“Madness for two” was previously thought to be psychosis that you “caught” from exposure to another sufferer. It is now thought that sufferers of folie à deux are psychotic to begin with. However, healthy people can adopt a delusion on impulses like naivety and trust, maintaining it as long as reason or ego allows. In retrospect, I don’t believe that Mary’s father was psychotic, but it’s scary enough that delusions can be, in a sense, contagious. This was the experience of the Run Hide Repeat family—and of Pauline Dakin’s mother, in particular—who had deep stakes in her lover’s persecution story.

Mary’s father is an impressionable guy with problems of his own, and Mary’s detailed rants about her experiences in an industry (tech) he knew nothing about convinced him of the gravity of her situation. Imagine—she worked at a company that had the US Government and Google as customers! This was serious stuff! That green car had been parked on the other side of the street for the last ten minutes. These people were dangerous! He went to report the conspiracy to the police at Mary’s urging, reading from notes she had prepared for him. They threatened to throw him into a psych ward if he didn’t leave.

Mary’s loss of control had thrown the household into chaos. Dirty dishes were stacked everywhere. The water was turned off—the cult had struck again. If she wanted it back on by the end of the day, someone would have to go downtown and pay the bill in person. That would be her father and me, of course; if Mary budged out of the house she would be pitilessly gunned down like the titular outlaws at the end of Butch Cassidy and the Sundance Kid. She handed me the bill and it was immediately clear where the water had gone. This was a Final Warning notice and the date was past. “It’s overdue,” I said. “That has nothing to do with it!” she retorted. 

In the years since, Mary’s bizarre behaviour has left her father less convinced and more exasperated. Folie à deux and its variants (folie à communauté, folie à famille) loomed large in my mind for a while, but what I saw in Mary’s father—and eventually in some of her friends—was simply the vulnerability of people to false claims passionately conveyed. And Mary spoke about the threats she faced with ferocious conviction. The cult revealed itself everywhere she cast her eyes. When she went out, its members staged accidents to keep her from her destination. Black vans followed her. She required anyone who entered the house to put their phone in airplane mode or pop the SIM card so the cult couldn’t listen in. Websites were fake. She tried to call the police, but when she was prompted to “press star,” she feared the cult had intercepted the call.

In early January 2018, I was between jobs and Mary was constantly begging me for protection, support, and company. She had become so badly detached from reality that I started keeping a log. Looking over it now… I’ll skip a solid week of freak-outs and fails, and fast-forward to the event I call The Night of the Big Bust.

VI.

The evening started in a routine way (which is to say, Mary called me in hysterics, begging me to visit her mother in the care home because somebody’s life there was in danger). I dropped by the facility and her brain-damaged mother smiled up at me from her wheelchair and cheerily told me, as usual, that she had no idea who I was. From there, I went to Mary’s house, where I found something not routine at all. 

Seven police vehicles—vans and cars—were parked around the house. Mary leaned out of her front door and greeted me with a broad smile. Rebecca Smith, a friend of hers I knew and liked, was also there. Mary poured large glasses of wine and ordered Chinese food. The noisy fans were off and everything was relaxed. Mary smiled as if she was anticipating a great event. The lawyer’s “nurse,” she informed us, would be arrested that night. “How do you know?” Rebecca asked cannily. “She’s being arrested,” Mary repeated with satisfaction. Arrests, we learned, were happening all over the city at that moment. She went to the door every few minutes to gaze out at the protection she was being provided—so vital on this night of the multi-agency operation that would bring down her enemies at last. The good guys finally believed her. All of her work—the reports, the phone calls, the lawyer’s investigations—was coming to fruition.

Suddenly, her mood changed. On one of her trips to the door, she discovered that some of the vehicles had left. Then more. Her security perimeter was melting away. She dragged her father into her bedroom, where she wailed in terror: the cult’s activities were now coming from inside the house. She ran back outside. All the police vehicles were now gone. She grabbed her older (Highly Sensitive) child by the throat and began screaming at me. Why had I made Rebecca send the police away!? Screams over screams—the kid screaming in terror while Mary screamed that I had cancelled the big bust. What? Rebecca was sitting right there. What the hell are you talking about? Mary’s face froze. “I thought… I heard you talking to…” Yes? Talking to who? White lips. Red eyes. Wet cheeks.

There was another Rebecca—a mutual friend who served in the military—and she was thousands of miles away that night on another continent, blissfully unaware of Mary’s preoccupations. Mary believed I had surreptitiously called her and told her to get the police action cancelled. I was talking to this Rebecca, I protested. The one sitting in front of you. Mary whimpered an exasperated apology. “I thought you meant Rebecca Jones!” I tried to bend my mind around the logistics of Mary’s accusation. I was supposed to have sneaked a call under Mary’s nose to Rebecca Jones, who had the authority to instruct a local police force to halt a major crime-stopping operation at the drop of a hat? And I was doing this on behalf of a global paedophilia cult?

The Rebecca at hand maintained a porcelain calm as she prompted Mary to consider why the police had come in the first place and why they had left. “Whatever their objective was, they accomplished it,” she concluded simply. This cooled Mary’s temper. I called police dispatch and learned that an alarm had gone off at the middle school opposite; a bunch of kids were trespassing and did not immediately disperse when they were instructed to do so. This explained the officers’ arrival and brief stay on the scene. Rebecca, Mary, and I settled back into a much grimmer evening than we had started while the kids got back to Minecraft. 

Her sullen acceptance of facts and reason did not last, however. Two days later, she woke her kids up before school, told them each to pack a bag, and got on a plane with them and her father back to her hated Midwestern town. It wasn’t safe in California, she told them. They were fleeing for their lives.

Where, I wondered, was the method in this madness? Delusions seem to ease the emotional or psychological pain of the sufferer in the same way that ego-defence mechanisms work for the rest of us. Projection, denial, compartmentalisation, and reaction formation (an overcompensation for feelings like loneliness and self-doubt) serve similar functions for psychotics and normies alike. But how and why does the disconnection from reality occur? How does a person go from mere excess to the psychosis of someone like Chester W.H. Young and Margaret Mary Ray? 

And how does a sufferer manage the “double bookkeeping” required for the maintenance of two wildly disparate states of mind—the rational and the delusional? How does Mary apply one in support of the other? How does she persuade herself that a powerful, ruthless, deadly organisation with limitless resources has targeted her for elimination when she is alive and screaming behind a flimsy door, at which she takes regular deliveries from Amazon Fresh? It may be that double bookkeeping proves out by interpreting everything in the environment, including evidence against the delusion, as further affirmation of it. But those interpretations themselves are delusional. For instance:

• Question: How could that short guy at the next table be your lawyer? After all, your lawyer is over six feet tall.
• Answer: The lawyer has disguised his height. That’s how hard he works to protect me.

Observing this clash of reason and reality, the celebrated Swiss psychiatrist Karl Jaspers called the psychodynamics of delusions “ununderstandable.”

VII.

Before Mary fled for the Midwest, she asked me to stay at her house to keep an eye on things. So, after she left, I started washing dishes and throwing away mounds of trash. Something told me to keep the bare minimum of my personal belongings there and to take them with me every time I left. This would turn out to be a smart move.

The days and weeks following Mary’s flight home weren’t promising. She kept changing phone numbers or relying on her father’s landline and getting him to make calls on her behalf. She demanded that I get the locks on her house changed. When I told her I would need her signature on a fax for that, she angrily denied it; her babysitter had managed to get the locks changed before with no problem! This landed me on her enemies list for a while. One day, I went to the house armed with some pods for the last of the dirty dishes and found that my front-door key no longer worked. I tried it twice. The doorknob and lock were shiny-new. I texted Mary to confirm that she had locked me out and that she no longer wanted me to enter her house or check on her mother. (I would find out almost a year later that she had contacted her landlady to have the locks changed.)

Mary did keep up with Chris—the lawyer’s friend, in case you’ve lost track. She called Chris, and Chris relayed Mary’s tearful pleas to me. She would never “lock me out”! (She didn’t seem to understand that changing the locks while I was out of the house would leave me with no way to get in.) All her California friends had ghosted her! (She didn’t seem to understand that turning off her devices and changing her contact information without telling anyone would prevent people from communicating with her.) She had no way to get in touch with me! (She had all my contact info including my physical address.)

Mary kept her remaining supporters in New York and California (a diminished circle from which I was excluded for the time being) abreast of developments in the Midwest via a sort of newsletter, which she wrote in the third person and addressed to “Team Mary.” Its startled recipients learned that Mary had developed a mysterious skin rash, apparently caused by some kind of pathogen in her bloodstream. I wondered if she had seen a doctor or actually been diagnosed, but I would soon realise that she had popped open another can of delusional disorder: hypochondria. Over the months ahead, she would report hardened stools, hearing loss, blurred vision, “bleeding,” ears popping, migraines, and cognitive problems in herself and those around her.

Chris showed me one of these newsletters. Have a lightly expurgated read:

Hey Team Mary! Hope everyone’s doing well. Since we know a lot of you are wondering what’s been happening and worried since Mary’s diagnosis of this blood disease (if we find out someone is responsible for it via some kind of pathogen, I feel sorry for what is coming to them) and it is nearly impossible to communicate securely through regular phone and texting. After much headache and heartache, we have confirmed that almost all of your calls and messages to us, and even your VOICES, and vice versa have been spoofed or delayed. After going through the analysis now, it is a miracle any of Mary’s relationships have survived the number of redirected calls and messages this past year. So we thought it might be a good idea to communicate via encrypted mail, blog style. Hopefully you all can get this on your phones. 

So the update is Mary’s doing much much better now. See photos below almost no traces of the blood rash left. The case is moving along swiftly and [the kids] are doing fantastic as always. Thanks so much for your support and feel free to contact Mary’s dad or one of his assistants for updates. Those of you who have expressed interest in coming out please do so! We always have overnight visitors but still a couple of fully furnished extra bedrooms and even an extra kitchen waiting for you. Also, just one more reminder, for those of you who know the location, please please do not disclose her location if anyone in the community asks. She WAS followed all the way here from California, and every single day we can see hackers trying to get in to her devices and our networks and determine her location. If people ask, just tell them she is out of town on a family emergency and nothing else. All the important people, the school principal, the kids’ dad, etc. know where they are and no one needs to know, not even people at her job according to the Labor Department. Thanks again for your support and more soon. 

Mary’s inspirational message of the day: 

“What you want, everything you want, is possible, otherwise you wouldn’t be capable of wanting it. It wouldn’t even enter your mind. THIS IS POWERFUL. EMBRACE IT.” 

“Negative emotion is simply the distance between you and what your inner being knows about the situation. The closer you get on the emotional scale toward positive feelings the closer you are getting to the truth!” 

“Whatever you impress upon your subconscious mind will be expressed on the screen of space.” 

And finally so so much comfort in old friends who came to the rescue as soon as Mary got here and are helping to be our eyes and ears for the case. Some of you will recognize these faces!

This particular message was accompanied by photos of Mary writing her inspirational notes in cheery colours on a whiteboard or hugging her friends in her father’s home. As I looked over the messages and pictures with Chris and other friends, I noted an irony: what seemed to be forming around Mary back home resembled a cult.

An unfortunate effect of delusional disorder is that no one believes the sufferer and she is isolated. But another unfortunate effect is that people do believe the sufferer and these supporters become enablers. “Radiation blasts,” “electro-magnetic pulses,” and “sonic attacks” were the new buzzwords. “Mysterious sudden illnesses” were the effects. Her friends listened in horror. “They are doing it to half the goddamn town,” Mary wrote in a text. Mice and birds were dying, a fake electrician had visited the house, anti-terror weapons were being deployed. “We have nothing to lose,” she added in another message, “so I might as well keep reporting so you know what happened if/when I am eventually vindicated, even if I have to be killed before that happens.”

I don’t know exactly how Team Mary disbanded, but at some point she found herself isolated again. A few of her relatives and I established a small email group to keep tabs on her and the kids and to reason with her as far as possible. She used her father’s phone to call the few people she trusted, seeking out a creek bed for cyber security and crying and explaining endlessly until the battery ran down. She was being persecuted by the same Russian agents who had hacked the 2016 election. Her Russian neighbours in Santa Cristina had tracked her out to the Midwest. Hackers had ransacked all her saving and investment accounts. Her FBI file had been doctored. The NSA knew what was happening but refused to say. She turned off the power at her father’s house to reduce the electronic waves.

In the real world, we hoped an opening would appear that allowed for a medical or legal intervention. But this was an uneasy hope, because by definition, something awful would have to happen first. Which it finally did. In Mary-world, she had endured a frustrating year of betrayal, persecution, indifference, disbelief, sickness, disruption, and financial collapse. She had tried every possible remedy and failed. At the end of her rope, she threatened suicide. In writing. 

Bullet points of our response and its consequences:

• We contacted local authorities.
• They picked her up and took her to a hospital.
• She talked them all down. “Oh, I didn’t mean it. I’ve been stressed. I’ve been depressed.” (This is a response common enough to have been dubbed “the ambulance cure” by clinical psychologist Xavier Amador in his 2007 book I Am Not Sick I Don’t Need Help!)
• She was released, more distrustful than ever.

Everyone knows that involuntary treatment for the mentally ill is fraught with potential for abuse, but there are obvious benefits when it’s done right. Drug treatment can “jolt” a sufferer into temporary lucidity, which can light a path to recovery. All it took for Stacie was a single injection…

VIII.

The experience of watching Mary’s father succumb to his daughter’s delusions got me thinking about the state of mental health in America. After I posted a YouTube video in late 2019 (I’ve since deleted it) in which I offered anonymised ramblings about Mary and the susceptibility of others to things they read and hear, a woman named Stacie Votaw (her real name) responded with an account of her own battle with delusional disorder. Intrigued, I wrote back to her, and we began corresponding. In the summer of 2022, I suggested that we write a book about her experience together and she agreed. Then she received a second diagnosis: Lou Gehrig’s Disease. When I went to visit her at her care home later that year, she apologetically (!) begged off from the book project. But her story is worth telling, at least in summary.

To my eternal regret, Stacie’s posts about her own bouts with madness are no longer available; nor is the blog she used to maintain at breathingwithanoose.com. I have no way to recover her writing with the tools or resources at my disposal, as Stacie passed away in March of 2024. However, her social-media accounts—still live as of this writing—hit a few highlights:

During one manic episode, Stacie stole an ambulance. She believed that all of New York City was a government front. She lived in constant terror of a secret organisation that was plotting to abduct her and force her to perform degrading sex acts. This went on for six years, until an intervention that I would dismiss as Hollywood nonsense if I saw it in a movie.

Her friends and a cooperative doctor sat her down and asked her to prepare for a dire revelation. All those wild stories she had been telling for all those years that no-one had believed? Well, they had now been investigated, and it turned out that they were true. And not just true but merely the tip of the iceberg. The full extent of the horror was beyond her worst imaginings. They felt obliged to inform her of the facts, but the truth was so gruesome that she would be driven insane upon hearing it. She would therefore have to take a sedative before they revealed all. Fearful but convinced, Stacie stretched out her arm…

I don’t know which drug the doctor administered, but the effect was quick and dramatic. The electrical storm in Stacie’s mind subsided. She saw her delusions and the past six years for what they were. She dissolved into tears and wept for hours. It wasn’t the end of her psychosis—she needed long-term follow-up treatment and remained in danger of resuming her delusions—but she was aware for the first time that she had a mental illness that she needed to manage. With this staged deception, the doctor had saved her life—a moral choice of which most people would approve despite the troubling legal and ethical implications. If only the same thing could happen for Mary and other sufferers.

IX.

Mary did experience a flicker of lucidity in the summer of 2018. It happened in a moment—a glimpse down at herself in some sort of radiation suit while her kids blithely played Pokémon. She texted a confidant and wondered if she had lost her marbles in a fit of PTSD after a string of abusive relationships. The confidant tried, very gently, to coax this flicker into a flame. Instead, Mary relapsed hard. But I believed this fleeting instant of clarity provided indelible evidence that recovery was possible.

That autumn, she packed up the kids and left the Midwest for another American city where she had family. The supportive arrangement she sought didn’t work out, so she packed them up again and fled to Europe, where she took refuge with more family. She said she threw herself on Scotland Yard (this might have happened) and was told they couldn’t help her because (entering Mary-world now) the entities she had crossed were too dangerous to disturb.

She returned to America shortly after Christmas when her visa expired. She regretted that she hadn’t made legal-residency arrangements early on, which would have allowed her to stay longer. Back home, she was accosted by tax and bill collectors. She went to a family friend for help with the latest outrageous “bank hack,” but when the friend began going over Mary’s credit-card charges item by item, Mary abandoned the effort in disgust. “I don’t think she wants to help me,” she said.

After that, I lost touch with Mary for a long time, and I often wondered if I would ever see her again. Chris showed me text messages Mary had sent to the lawyer, gushingly thanking him for his undercover work on her behalf in Europe, then puzzled at his (real-world) engagement. Her family and friends, she added, were also surprised by that, having seen how he treated her when he visited the Midwest. I cringed; his travels were all part of her erotomanic delusions. So much of her life is a haze. Somewhere in cyberspace, a breadcrumb trail of credit-card receipts, border crossings, and travel records picks out her path. But there are locked accounts she can’t get into because she’s forgotten her old passwords, laptops that were taken or put in storage years ago, cancelled phone numbers that she can’t use to recover old accounts. Chris and I noodled over plans to show up on her doorstep in her little farm town, but I knew that even if we contrived a face-to-face meeting, a resumption of our friendship could come only at her instigation. And then it happened, in the way that now typified Mary’s behaviour: out of nowhere.

In September 2020, she packed up an old truck with clothes and gaming consoles and drove back out to Santa Cristina with the kids. She was determined to get a job and start over. We squealed and flung our arms around each other when we met in her tiny rented space, and I felt cautiously hopeful that gainful employment could get her back on track. But something fishy kept happening to her job applications; no one was responding to her. A six-month job hunt would be normal in the real world, but once again, she sensed the movements of malignant forces. A neighbour tried to run her over. Her apartment was rigged to burn down. She sat on the curb crying one evening and a sympathetic passerby gave her a number she could call for protection from her cyber-tormentors. (I think she actually talked to someone, but to whom or about what I have no clue.) She phoned, but the call was intercepted; she could hear people laughing in the background.

With her resources draining away once again, she started a gofundme campaign:

Need funds by November 1st so we don’t lose our current apartment and for food, groceries, vehicle, and medical expenses due to delayed checks and pending welfare application

Our Story

As many of our friends and family know, we abruptly had to leave our home in California nearly 3 years ago, after being stalked by a major cyber crime ring that I accidentally uncovered at my IT job in May of 2017. The cyber ring was so significant, it apparently included Russians who hacked the 2016 election. The revenge carried out by the Russians and their co conspirators since then has been terrifying and relentless. On two occasions, I had the Russian intelligence officer who was indicted in the Mueller investigation, Konstantin Kilimnik, personally show up at my door, and officials in London informed me that some kind of advanced cyberware had been encoded on my very DNA, and they didn’t know how to help me without causing harm…

It has been a nightmare, to say the least. When my two kids and I left California under duress in January 2018, we thought we would be away for a couple of weeks. Now, it is the fall of 2020, and after running for our lives to multiple states and countries, we are finally finding our way back home.

In the meantime, we have lost everything, my work, our old home, car, all of my bank accounts and investment accounts ransacked by hackers long ago, and many belongings because we had to leave so suddenly. Most of all, we have lost time—precious time, precious years of [the kids’] childhoods put on hold because of this. That has been the most heartbreaking of all.

Many family members and friends who tried to help became targets themselves and have exhausted their own resources to help us. While some members of the crime ring have been rolled up since our ordeal began, the most powerful members have not, and help from law enforcement and the FBI has been spotty, inconsistent, and noncommittal. More than anything, they seem too afraid themselves to pursue justice in this case, which has left us unprotected and continually fending for ourselves.

So I finally took it upon myself to start piecing our lives back together myself and come back to California, but with all of my financial reserves gone and banks slow to investigate and recoup the hundreds of thousands of dollars in cash and stock stolen from my accounts, and my online identity and accounts, emails, resumes and documents picked apart and in many cases completely erased by the crime ring, doing so has been an incredible challenge, which is why I set up this account to try and get some relief.

I know times are rough for everyone, so any help anyone can offer is greatly appreciated. At the moment we need help paying for another month of rent, money for groceries, vehicle repairs, and some non-emergency medical needs for at least a few weeks until I can get more information on some of the accounts I had here in California that were part of the investigation of 2018. Any little bit helps and goes a long way, even to feeling supported emotionally. The hardest part of all of this has been how blindsided me and my kids were by this awful, unexpected event in our lives, and the hopelessness that has come from either slow or non-existent direct assurance from law enforcement. It has been a lonely 3 years, and I have been diagnosed with PTSD and severe anxiety as a result of our ordeal. In many ways, we just want to hear from others, connect with others as much as anything else. Thank you… Mary.

P.S. Because some of the most powerful members of this cyber ring are still at large, feel free to donate anonymously if you are worried about being targeted yourselves. In fact, I would encourage donating anonymously. It is a very real threat, many of our family and friends have already had to deal with being cyber stalked after helping us and have had communications hijacked completely. Also, please note that if you have a Gmail account, this cyber crime ring can easily penetrate those accounts and has done so many times to multiple friends’ accounts. If you’d like to help us, maybe use an alternate, non-Gmail account or get in touch if you can.

Please also feel free to forward this [to] anyone you may know who may sympathize or have gone through something similar. Us survivors have to stick together. Thank you again!

I got a link to this appeal in a group email where I could see the names of many of Mary’s old friends. At various points, I tried—had tried, a year earlier—to get in touch with them to talk about her mental health, but I never heard back. People step away from a live wire. They have their own families to protect. They get exasperated with the crazy. They get compassion fatigue. At some point, you have to consign Mary to her fortunes and hope for the best. I made a donation to her gofundme—it was the only one she received.

X.

Mary’s previous success in tech had given her unrealistic expectations of the job market, especially considering its state in late 2020 and her three-year absence from the industry. She paid me a week-long visit in the Silicon-Valley-adjacent city I was now living in, intending to drive to the headquarters of her former employer so she could speak personally to executives about her pension plan. What had become of it? What was in that envelope that had been left at her door in Santa Cristina back in 2018? She should get a check for over $200,000. (Considering how much of her life is lost to her own memory and control, I truly wonder if she does have a few piles of money out there, unclaimed and inaccessible.)

Mary waited until the last weekday of her stay with me to make the eighty-mile drive. The day was slipping away, and I was getting antsy by the early afternoon. “You’d better get going,” I urged. Traffic could choke up, the people she needed to speak to might be out of the office (this was the height of the COVID lockdown), and she’d be arriving pretty late to submit such an extraordinary request if she expected action by close of business. Miffed at my fiddly advice about her simple mission to pick up her six-figure cheque, she finally left. 

At about 7:30 that evening, Mary got back to the house and I got her account of the outcome. Several times. At the top of her lungs. She had arrived at about 4:15 pm armed with the names and job titles of the people she needed to see. She was stopped at the big glass doors by the security guard—standard practice for every tech firm. No one was there to take care of her, the guard explained. The building was locked down. Then why, Mary demanded, did the website say they were “open until 5:30 pm”? “Yeah, that should be changed,” the guard shrugged. She made enough noise that someone from the legal department came downstairs to find out what she wanted—and then had her thrown out upon hearing it. Mary harangued the security guard until he threatened to call the cops, at which point she drove off. “What am I going to do?” she raged at me tearfully. She locked herself into a bedroom and sobbed for eight hours and slept the entire next day and night. Her kids went about playing on their game consoles and eating leftovers, accustomed to this kind of thing.

On the morning she finally got out of bed, Mary looked bloodless. Pinhole pupils stared out at me from her white face. Her lips were puffed. Someone was coming over to my place to use the room she’d been sleeping in, so she packed up her Joad-family truck in a robotic frenzy. I couldn’t imagine what her metabolism was running on. I gave her instructions on the route back to Santa Cristina. She missed the first turn and doubled her driving time, causing her to ditch into a motel for a night.

I can’t remember how long it was before I saw Mary again—not long, because my impression of her running-on-empty state was still fresh when family business took me to Santa Cristina. She and I agreed to get together, but I had made a decision: I wasn’t going to lie to her anymore. If she was out of money for good and had to go back to the Midwest, there was no fakery I could summon to make it not so. The truth bomb was all I had left after years of waffling, patiently listening to her rants, carefully constructing my responses to neither agree nor disagree, straining to keep her trust. She had taken down her gofundme, but I had kept a screenshot. I printed it out, Konstantin Kilimnik and all, and put it in my purse. When I saw her, I would wait for the first delusional statement, pull out the pages, and tell her: “Show this to a psychiatrist.” I wouldn’t argue with her or tell her she was sick; I would just tell her to do this thing.

Mary sounded upbeat on the phone as she gave me the directions to her new place. She had left her little firetrap of an apartment and moved to a half-campground, half-resort near the water that was offering huge discounts to lure people in from the COVID scare. It seemed reasonable. When I got to her new place, she had even better news. She had received a cash windfall by trading in her rusty truck at a car rental service, and she was now driving a late-model van for just $100 a week. She couldn’t believe her luck at the deal. Her suite was full of fast foods and drinks she had purchased. The compound had a bar, so we moseyed over for cocktails and a catch-up.

Mary had called her father and he had told her to stay in California; he would fund her life until she got a job. She was relaxed and happy. There was nothing in her conversation about Russians or conspiracies. Well, I figured, her father was going to have to support her in the Midwest or California, and it seemed he had picked California for now. Clearly, she had money; you couldn’t make a rental car, restaurant food, and a vacation suite appear without it. Our conversation was no different from one we might have had before she’d gone around the bend—just two girlfriends chatting about their next steps. The pages stayed in my purse. We’d keep in touch.

About a week later, I heard from someone who knew Mary’s father. It turned out he had made no such decision about subsidising his daughter until she had a job—but he had trusted her with a credit card when she was back in the Midwest, and he was shocked to discover how badly she’d abused it. He cut it off and announced that he wouldn’t give her another dime; she’d have to go back home. He sent another relative, Ellen, out to help Mary travel without blowing another $25,000. Ellen discovered that Mary’s “deals” on the vehicle and the vacation place were actually top-price charges if not ripoffs. She organised Mary’s pile of stuff and got airline tickets back to the Midwest. Mary refused to fly; if she got on a plane, the Russians would blow it up, and she couldn’t be responsible for the deaths of hundreds of innocent people. There was nothing Ellen could do about that, and she left alone. 

It turned out that Mary had one last unburned resource: she contacted her kids’ father for the first time in years and convinced him to buy her a car and a few weeks’ rent. When the rent was up, the pattern repeated. She ran out of money, drove back to the Midwest with the kids, and stopped communicating with me.

XI.

“Does having psychosis or a serious psychotic episode damage or alter the brain physically?” 

This question was asked during a University of Michigan livestream broadcast in May 2022. “Grey matter volume can actually reduce,” answered Dr. Ivy F. Tso. “The reason we want to intervene early is that a lot of research data has shown that the more relapses or episodes the person has, it can permanently change the brain function and the structure, and that is something we may not be able to reverse with treatment later on.” Dr. Stephan F. Taylor added: “There does appear to be a worsening effect of chronicity. The damage is subtle but does show up in studies that look at hundreds of patients and there are various networks that show themselves to be misfiring, dysfunctional. At the molecular level there are abnormalities that are showing up that involve different neurotransmitter systems.”

Since Tso and Taylor referred to “research data” and “studies,” I emailed them with a few questions. Understandably, they did not respond to a casual inquirer. By paying a dollar, however, I did get a breezy answer from an Ask-a-Neurologist chatline: “Delusional disorder itself doesn’t damage the brain, but chronic stress from these delusions raises cortisol levels, which may affect memory, decision-making, and emotional regulation. This can worsen cognitive abilities over time. Your friend may believe she’s completed tasks when she hasn’t due to disrupted cognitive processing. This confusion is common in cases of long-term delusions, affecting her ability to handle responsibilities and meet job demands.” The Michigan panel consensus was that psychotic patients should be treated within six months of the appearance of symptoms to prevent long-term effects. In the United States, three years is the typical duration of untreated psychosis. For Mary and many other sufferers of delusional disorder, this duration is indefinite.

The spring of 2022 brought a scary kind of miracle. A tech recruiter found Mary’s résumé online and snagged her an interview at a major defence firm in Santa Cristina. The job offered a huge step up in responsibility and salary from the last time she’d worked. At that point in Mary’s life, a return to productivity would be emancipating, as would the money. The job offered enough to put her two kids in private schools, sports, and art programs; she’d be able to rent a three-bedroom home, explore funky restaurants, try new wines, get her hair coloured regularly, attend plays, and buy a reliable car. Throughout the application process, she evidently managed to avoid every mention of her personal struggles during her four-year employment gap, and... she got the job. I learned all this when she showed up in California in July 2022. She’d been working remotely from the Midwest for about two months, and now the company wanted her onsite. Just to be sure, I confirmed this news with a relative.

Mary quickly moved herself and the kids into a tiny apartment, intending to find a better place once she had time and a fatter bank account. I visited her and listened to her chatter about her new colleagues, the tasks she was given, and the work environment. She wore her confidence and satisfaction easily. There was no mention of the Russians, the persecutors, “the nurse,” the mysterious ailments, the cult, or the black vans. Among her new co-workers were a few people she’d worked with elsewhere. “I’ll look them up as soon as I settle down at work,” she said with a business-like smile, “I’ll get in touch, we’ll eat lunch together.” The rewards and challenges of hard, quality work lay ahead. 

Then Mary began to tell me about the circumstances of her hiring, and an icy drizzle ran through me. “I was so important,” she said emphatically, “that they flew a whole crew of people to Austin just to have a meeting about me.” There were variations on this celebrity welcome. The importance of Mary. The meetings about Mary. Oh no, I thought. A multibillion-dollar firm doesn’t use Zoom or Webex? People get this excited about a new program manager? At a company, moreover, that lists over 2,000 job openings at any time? This was clearly Mary-world.

If only this high were a new, positive type of delusion. But it wasn’t; this was Mary’s counter-argument to the strange things that were happening on the job. Her manager was yelling at her. He was reprimanding her for not picking up the phone when he called. “I’m so angry at you right now, I’m shaking!” he said. Mary related this with incredulous laughter. “I don’t know what he’s talking about! I answer all his calls. And now he says I’m not going to meetings!”

What was actually happening? Was Mary imagining that she had completed tasks that she hadn’t touched? Was she forgetting each new obligation as soon as it was laid on her desk? Was she unable to estimate the importance of her manager’s requests? This could have been a variation on the unpaid water bill, or whatever it was that got her terminated from the last job she’d held, but it seemed like a different form of crazy.

Mary’s laughter soured to bewilderment in a very short time. “We’re doing an investigation to find out who’s impersonating me in the system,” she assured me. A co-worker she knew from another job was completely sympathetic to her and was trying to get to the bottom of it. One Friday, which was work-from-home day, she was disturbed that her login was rejected. Over the weekend, she told me with no mirth at all that she didn’t want to go in on Monday; she was afraid her badge wouldn’t work and she would be subjected to the humiliation of being turned away by the security guard at the big glass door.

The termination letter arrived shortly afterwards. Mary had lasted about three months. She told one group of friends that her program had been cancelled and that everyone on the team had been let go. She told others that she had been obstructed by outsiders. She told me she had seen her manager working the cash register at Dick’s Sporting Goods, looking terrified; the Russians had turned a whole segment of the firm upside down, sweeping him along with her into the streets. The sympathetic co-worker was looking into it and would help get her job back.

The plans for private schools were cancelled, no one from Mary’s old-old jobs called her back, the remnants of her six-figure salary dwindled to nothing, and she went on welfare and food stamps. Whoever was paying the rent at her tiny apartment stopped. (She swore she was paying it herself, but it was probably the kids’ father.) “I have a paper from the sheriff saying there’s no eviction order against me!” she raged. Paper or no, a real-world group of curious tenants and angry property managers formed a circle around her as she rushed back and forth packing her stuff into her car and hustling her kids out. After that, she bounced among cheap motels. She has met with the kindness of strangers and is currently staying in a granny flat with her kids rent-free, but there’s pressure to move out.

Two years passed before she was able to get another job, this time working part-time for minimum wage at a small business that received government support for hiring welfare recipients. Her first performance review was mixed. She made mistakes. Whole projects weren’t being done. “Someone is wiping out my work!” she said, frustrated. “Someone is logging in as me after hours!” It probably wasn’t someone at the office, she conceded, but it might have been the software vendor. She spent time on the phone with their customer-support staff. At the six-month mark, she was fired.

Mary says she intends to sue for US$5,000-worth of unpaid overtime. A little quick math on her salary and schedule makes this claim highly unlikely—delusional, in fact. In any case, her chance of success was already presaged by another attempt at legal redress. Before this latest termination letter, Mary had wondered if she had a case against the defence firm. After all, she had signed a contract with them, and on that basis she’d expected to keep a roof over her head. She called a few law firms to inquire. One woman had a brief conversation with her and then asked, “Are you mentally ill?” Mary related the story to me with another peal of incredulous laughter.

XII.

Mary and I talk about once a week. To my relief, she doesn’t invoke the Russians or the cult or the syndicate anymore—those things seem like B-movie monsters that don’t scare her now. I preserve a sliver of hope that they can be permanently banished, offered by that single moment when she stopped and wondered if she’d lost her marbles. But I’m still concerned about that grey-matter-reduction business and her habit of making facts fit her wishes. When she received her eviction notice, she said a lawyer acquaintance told her to throw it away because it was a scam. I know the lawyer, and I know this never happened. To make matters worse, she fell for a real scam to recover her elusive pension “in Bitcoin.” “Someone contacted me about it,” she said. I think the only reason she wasn’t ripped off by a fraudster in a Kolkata call centre is that she’s penniless.

I’ve asked Mary about the manuscript for her unfinished second book, which she spent years painstakingly researching and writing. I possess a draft that’s about 75 percent done, and I firmly believe the completed book could have put her on the map. But the book deal is dead, killed by different actors depending on when I’ve asked her about it over the years. At one point, the publisher had reneged on the financial terms; at another, someone had leaked her manuscript to the Russians who then threatened the publisher. There’s similar uncertainty about where her latest, near-complete draft is. Fleeing from city to city and country to country, having her things and devices forcibly taken and put in storage, pieces of her life scattered over thousands of miles, she nevertheless says she knows where it is. She thinks of it only because I raise the subject; nowadays, her mind is constantly occupied with keeping herself and her kids fed and housed.

I live several hundred miles from Santa Cristina and I can’t offer Mary a place to stay. I go there for holidays because it’s my hometown and my mother still lives there. I suffer acutely in my soul that my mother won’t let me invite Mary for Christmas or Thanksgiving. In fact, she has banned Mary from the house; I have to meet Mary in town. My mother has known Mary as long as I have, but she is one of the many people who sees only the symptoms, not the cause, of Mary’s behaviour. Mary says things that aren’t so. Mary gets things out of other people. I related the story about Mary and the rental van, the vacation suite. “She’s good,” said my mother tightly. I felt so frustrated I wanted to yell. It’s no use arguing that Mary isn’t “good”; she’s deluded. She’s disconnected from reality and her only chance for reconnection is therapy that she can’t obtain because her illness itself is blocking it. If she had cancer, my mother would help her. But her affliction is mental, not physical, so Mary gets her turkey dinners at food banks and churches. 

I lost my religious faith decades ago and embarked on a journey of conscience and intellect. My own sense of this common experience is that I escaped the wormholes of rote doctrine and wound up on a high plain under the relentless rays of Christian ethics and Biblical admonitions. I feel them in a way I never did when I was a believer. I’m failing Mary in my capacities as a friend and as a moral being. She finds herself in a widening void that used to be filled with support and productivity; her sunny determination despite it all is a red-hot needle in my conscience. I spot her a hundred bucks for groceries from time to time, and I always pick up the tab when we get together for nachos and skinny margaritas at Chili’s. It’s a drop in the ocean of generosity that I owe her. It disturbs me to no end that she and her kids cannot set foot in the comfortable home I hang out in when I’m in Santa Cristina.

XIII.

Despite tremendous expenditures of goodwill, brainpower, and money, society has not settled on a solution for what to do with the mentally ill. Most of the time, we step over them in the street and lock them up when they get violent. A competing and benevolent body of thought uses terms like “stigma,” “scapegoat,” and “stereotype” to appeal for their acceptance. But who would rely on Mary to manage their business files and send out important emails?

In The Best Minds: A Story of Friendship, Madness, and the Tragedy of Good Intentions, Jonathan Rosen recounts a public battle over guidelines on applying the Americans with Disabilities Act of 1990 to employees with mental illness. The Equal Opportunity Employment Commission was on a mission to combat “myths, fears, and stereotypes.” But, Rosen asks, “what to make of the reference librarian who shouted at patrons and colleagues, and disclosed her disability only when disciplined for a second time but—according to the new guidelines—still had to be given time off to reduce stress?” 

A man whom Fox News anchor Jeannine Pirro would call “the most famous schizophrenic in America” was another beneficiary of such benevolence. Michael Laudor had a brilliant academic career culminating in a degree from Yale Law School despite his mental illness. In 1995, a few years after he graduated, he shared his frustration in the job market with a New York Times reporter. “One interviewer asked if he was violent, which Mr. Laudor said reflected a common and painful stereotype.” Rosen, who is Laudor’s biographer and childhood friend, reacted to the sympathetic tone of the article: “I could well believe it was a painful stereotype, but I also knew that before he was medicated, Michael had armed himself with a knife in fear of his imposter parents.” (Laudor had hallucinated that his parents were Nazis who were hunting him in the family home.)

“Stigma was real,” Rosen went on, “and its consequences serious, but having visited Michael in the hospital, I didn’t think the only question shadowing his progress was whether to disclose his schizophrenia.” Nevertheless, top creatives from New York and Hollywood read the article and were captivated by Laudor’s story. They fêted him as both author and subject as they inked a book deal—Laudor himself would write the book—and a movie deal worth seven figures. Who would play him? DiCaprio? Pitt? But progress with the book was poor; in the froth of adulation, Laudor had stopped taking his meds and was not producing the pages he was contracted to write. 

It was June 1998 when he crossed paths with Pirro. Back then, she was the DA who sought to try him for murder when he stabbed his pregnant fiancée, whom he believed in the moment to be a malevolent windup doll. Many years earlier, doctors had recommended that Laudor get a job at Macy’s as the first step on a low-stress path back into the mainstream—but the scholars who would carry him into and through law school shook their heads at this idea, viewing his schizophrenia as comparable to deafness or paralysis. Dean Guido Calabresi swept aside the timid medical advice and told Laudor, “I will be your ramp.” Their accommodation of Laudor’s mental limitations ultimately propelled him to celebrity instead of stability. Some of them expressed regret after the grisly death of his fiancée. Sic transit good intentions.

I have come to hate mental illness as if it were a malicious force. In my small experience, I have seen it limit life enormously. It frustrates productivity and wastes human capital. It destroys happiness. It baffles our benevolent impulses. I wonder if our minds are more malleable and fragile than our bodies. After all, some people are physically flawless, but on the inside everyone is a little bit warped; imperfection is so essential to humanity that the single exception is believed to be the son of God. And it’s easier to piece together a fractured skull than a broken mind. Despite Mary’s every effort to succeed on the basis of her intelligence, wit, and education, I can only see her stumbling on in darkness and poverty, her dazzling potential reduced to embers by the cruel vicissitudes of a terrible illness.