Both he is in a different world and is mentally ill becaue of it depression anxiety paranoia ect
Serious Spoiler****************
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He's not really mentally ill. Though he's under a crazy amount of stress. He's still linked to his body in his original (kind of parallel) world that is slowly dying under the crushed building. When he gets 'triggered' by anxiety the connection gets stronger causing pain and bleeding, and him to actually see what his other dying body sees (not hallucinating). His memory's are also spotty because of this. Dude's seriously got it rough.
Oh shit
Exactly (￣∇￣") I'd read the novel or let it marinate, it's a long ride...
Someone give me spoiler please is he mentally ill or is he really in a different world