Maybe you've never felt anything strongly: from the day you were born, you rarely cried or laughed. Interacting with other people was always difficult, because you suffered a fundamental separation from them.
Maybe you've always been "normal," but one day woke up feeling a raging hollowness inside. You don't know why or how, but now something important is missing from you.
Maybe you've ground your spirit down to the nub in pursuing your base desires, running from your fears, drowning all that you found meaningful in excess.
Maybe you drove yourself beyond your limits, attempting to do the impossible. You succeeded -- but it was too late. Despite your heroic efforts, everything went to hell anyway... and it took part of you with it.
Maybe you've purposefully sold what makes you you to achieve your dreams of wealth, love, or power. Once the euphoria of success wore off, your victory tasted like ashes in your mouth.
Maybe everything has gone wrong since you lost your lucky charm, the railroad pocket-watch your grandfather gave you on his deathbed. The tick tick tick of that watch got you through many long nights of the soul -- and now it's missing, and with it, your peace of mind.
You've realized something terrible has happened: the scales have fallen from your eyes. At this moment, the world is strange, dreamlike, and mutable. Everything is in flux; anything is possible. You see the monsters and magi, sinners and saints, angels and demons who walk the streets with you. Rainbow rings beckon -- are they gates to heaven, hell, or limbo? You feel empty, hollow, cold, hurt. Perhaps you're mad. Perhaps you're saner than you've ever been before.
You're Dead Inside. What are you going to do about it?