Far from simply being crazy, Gail appears to be suffering from a specific mental illness called paranoid schizophrenia. While all forms of schizophrenia are invasive and frequently debilitating, Gail appears to be high functioning, able to hold down a job and take basic care of herself and sometimes her elderly mother.
- Delusions of grandeur
Gail believes that she is of exalted birth, that she is Empress of Russia, has won several Nobel Prizes and is a professional writer, cook, or whatever else she attempts to do regardless of success.
- Delusions of persecution
Gail feels she is targeted by the Jesuits, which can also encompass everyone in her surrounding environment including family and coworkers.
- Delusions of reference
Gail believes that the writers of Star Trek: TNG have referenced her in their episodes, that movies have similarly followed either her or her life, and that the Holy Bible makes references to her. She often feels as though the news and random videos on the Internet are directed toward her specifically.
- Delusions of control
Gail feels as though she can order her men to immediately fix any dilemma that arises, can ask God to smite whoever is currently bothering her, or nuke entire cities by making YouTube videos.
- Disorganized speech
Gail is exhaustively wordy, often rambling into unrelated tangents in the middle of speaking and repeating herself several times verbatim. She creates her own words and phrases.
- Auditory hallucinations
Gail physically hears the voices of her men and other characters speaking to her.
Defined as an overwhelming, compulsive urge to write, this is Gail's most noticeable trait.
Gail reports early symptoms beginning in May of 1988 shortly following the birth of her son, including insomnia and hallucinations. If her own account is to be believed, she was initially diagnosed with postpartum depression, and later, manic depression. The possible discrepancy with this account is that during the time that Gail claims she was diagnosed with manic depression, and admitted to Coral Reef Psychiatric Hospital, she was prescribed lithium and perphenazine (Trilafon), two of the most common drugs used to treat schizophrenia, and meanwhile took part in therapy groups geared toward schizophrenics. Although this evidence points to a diagnosis of schizophrenia as opposed to any form of depression, the peculiar thing about Gail's condition is that if she was ever officially diagnosed with schizophrenia at any point in time, she absolutely refuses to mention or acknowledge the word, even in the context of denying it. The likelihood that the diagnosis was at the very least given the attention of being explored by doctors is high, and it is unusual for Gail not to elaborate on medical diagnoses of even the smallest significance.
As with all cases of schizophrenia, the true cause of Gail's illness is unknown, but it can be speculated that it was brought on postpartum. It is possible that any instances that would indicate psychosis before this period in time could be Gail retroactively changing her memory of past events in accordance with the new warped perspectives brought on by her illness.
During various stages of her illness, Gail has been issued trimipramine (Surmontil), perphenazine (Trilafon), carbamazepine (Tegretol) and lithium. From May 1999 until August 2012, Gail was off all psychiatric medications.
Genetics factor heavily in the prevalence and onset of schizophrenia. Instances of mental illness, predictably, run in Gail's family. In a phone call with Terry Gail revealed that she has a half sister who was diagnosed schizophrenic, and describes their shared biological father who very likely has schizoid personality disorder, a disease with a close genetic link to schizophrenia. It is probable that Gail inherited the gene from her father, and may or may not have passed it to her son Erich Schuler, who may carry the disease even if he never presents symptoms.