Unstable perception is both subject and form
The corpus contains extensive language of panic, paranoia, dissociation, voices, hallucination, psychosis and diagnostic uncertainty. The transgressive element is not that mental illness appears. It is that some works deliberately deny the reader a stable boundary between symptom, metaphor, fiction, perception and compositional method.
The early self-description problem
It’s Mental Health Awareness Month Somewhere mixes self-description, jokes, threat perception, family material and performance. Later works become more formally unstable: Quantum Entendre makes signal/noise ambiguity productive; Actual Attack Documentation repeatedly describes the city and conflict as hallucinatory while also supplying concrete material detail.
Do not convert aesthetics into diagnosis
The wiki's Psychiatric Vocabulary, Altered States & Self-Description page keeps a necessary boundary: literary instability does not license diagnosing author, narrator or character. A work can use paranoia as form without proving a clinical state, and clinical vocabulary can appear as quotation, satire, self-report, fiction or external labeling.
Why it unnerves
Ordinary suspense promises that the mystery will eventually resolve. Psychic disturbance in this corpus often withholds that promise. A voice may be noise, a coincidence may be pattern, a memory may be artifact, a character may be correct for the wrong reason. The reader is asked to keep several explanations alive.