there are studies ingame and comparisons you can make to irl conditions that fit mara ^^ its also varies between person to person, but its been shown to stem from severe trauma and causes strong memories (mainly painful ones) to resurface and cause extreme stress. cloud knights and other soldier factions are known to be most likely to develop it as well !! there’s a lot of symptoms that overlap but i feel like i wouldnt do any justice to explaining it in a little inbox :,)