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It started in his late teens, not that long before Mr Edgeworth died, and it has been with him ever since; and it is a mental illness: schizophrenia.
Ray is more than used to it by now (the hallucinations, delusions and speech problems are almost nonexistent when he takes his meds, and he knows how to cope if he has a relapse), but he doesn’t think he’ll ever get used to the stigma.
Yes, he is psychotic, but people act like Ray (and everyone like him) is dangerous simply for existing and having a mental illness, and it hurts; Ray just wants to live his life as a schizophrenic person, and he wishes the world would let him.