I think some hereditary aspects come into play, with DNA having a negative play with our sanity. And also environment, as I grew up on a poor council estate, which had many criminals in the area, resulting in my being paranoid of their endeavours seeking illicit treasures. Mother Nature seems to nurture some being unwell, as I've suffered some personal torment from her with my condition, as in hearing her voice in my head, leaving me at times wanting to be dead. Blessings to you.
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