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I honestly think that it's because he always got what he wanted. He never really got caught doing anything, and when he did no one did anything about it. So, he went through life doing these completely wrong things, that he didn't really realize was wrong. Then when everything he did caught up to him, he realized he wasn't a good person. Which just made him sick of himself.

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Q: In the book Tangerine what caused Erik Fisher's mental illness?
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