->''You think this isn't real just because of all the vampires and demons and ex-vengeance demons and the sister that used to be a big ball of universe-destroying energy?''

A demon summoned by The Trio poisons Buffy, making her think her adventures had been all a delusion and she's really stuck in a mental hospital.

* AbsenteeActor: Anya. Possibly WrittenInAbsence, as Xander makes mention of it at the start of the episode, asking if anyone has seen her. The others reply she took off after the wedding.
* AdultFear: Losing your child to madness.
* AllJustADream: [[spoiler:OrWasItADream]]
* AmbiguousSituation: Buffy is injected with a poison that make her hallucinate... Or is it the other way around? According to a psychiatrist, who may or may not be a real person, she is in fact getting better -- She has been sick all along, and now she's finally waking up from years of catatonic schizophrenia. So, the whole series is either ThisIsReality or a mad AllJustADream with a dash of TheSchizophreniaConspiracy. In the end, Buffy choses her life in Sunnydale over her life in the mental institution, but the ending leaves it ambiguous whether or not the world she settled for is the real one. The fact that JossWhedon himself has said that either interpretation is just as legitimate as the other doesn't help things at all.
** Though it does make you wonder, is everything going on in ''Series/{{Angel}}'' also in her head somehow?
* AndYouWereThere: Buffy imagines her manager at the Doublemeat Palace is a doctor in the mental hospital.
-->'''Female Doctor:''' Come on, it's time for your drugs.\\
''[Flash back to the Double Meat Palace.]''\\
'''Buffy:''' (confused) What?\\
'''Lorraine:''' I said, if I didn't know any better, I'd think you were on drugs.\\
'''Buffy:''' (confused) Okay. Good.
* AnywhereButTheirLips: Willow is working herself up to ask ex-girlfriend Tara out for coffee and lesbian love when she sees her greet-and-kiss another girl. From her viewpoint it's difficult to see how intimate the kiss was, but she runs off anyway. Willow tries to tell herself later that she overreacted ("I press my lips against my friends all the time.")
* BadassDecay (InUniverse)
-->'''Spike:''' It might explain some things, this all being just in that brain of hers. Yeah, whips up some chip in my head, make me soft, fall in love with her. Then, turn me into her soddin' SexSlave.
* BasementDweller: The Trio, though this time it's because they're hiding from Buffy in an empty house.
* BattleInTheCenterOfTheMind, FightingFromTheInside, MentalWorld: From the Asylum-version reality’s POV.
* BelligerentSexualTension / HomoeroticSubtext: Between Xander and Spike -- lampshaded in a DeletedScene where JamesMarsters gives Nicholas Brendon a mock kiss right after calling him a "pathetic poof" in their graveyard fight.
* BondOneLiner
-->'''Xander:''' I altered ''his'' reality!
* {{Bound and|Gagged}} [[DuctTapeForEverything Duct-Taped]]
* BreakingSpeech: Spike gives one to Buffy. Becomes a "[[NiceJobBreakingItHero Nice Job Breaking It, Anti-Hero]]" moment when it causes Buffy to pour away her antidote.
* ContinuityNod: Buffy looks at a family photo of her parents with herself as a child -- the same child actress used in Season 5's "The Weight of the World".
* CuckooNest
* DescriptionCut: Willow says that Xander has help finding the demon; cut to Xander and Spike stalking through the woods. The doctor's description of this years BigBad as "just three pathetic little men who like playing with toys" to the Trio in their lair.
* DespairSpeech
-->'''Buffy:''' (very quietly) I feel so lost.
-->'''Willow:''' I know. You're confused. It's, it's that crazy juice inside you.
-->'''Buffy:''' It's more than that. (Willow frowning) Even before the demon ... [[EmptyShell I've been so detached]].
-->'''Willow:''' We've ... all been kind of slumming.
-->'''Buffy:''' Every day I try to ... snap out of it. Figure out why I'm like that.
* DiscreetDrinkDisposal: Willow asks Spike to make sure Buffy drinks the mug of [[BuffySpeak yummy antidote goodness]], but Spike gets into an argument with Buffy and leaves, giving her a chance to pour it away.
* DownerEnding: [[spoiler:The Buffy in the asylum goes into permanent catatonia]].
* EducationThroughPyrotechnics: Willow mentions that her previous attempts at making the antidote "went boom twice" before she got it right.
* {{Elseworlds}}
* {{Foreshadowing}}: For "Entropy" -- Spike threatens to tell the Scoobies about their affair if Buffy doesn't do so.
* FryingPanOfDoom: Buffy hits Xander with one, then drags him to the basement where he and Willow and Dawn can be eaten by the MonsterOfTheWeek.
* FridgeLogic: The revelation that Buffy's parents had her put in psychiatric care for seeing vampires makes Joyce's WeirdnessCensor in the first couple of seasons a bit less plausible.
* GroupHug: Xander gets a hug threesome when he returns home.
* HellBentForLeather: Buffy changes into the Black Leather Jacket Of Ass-Kicking while searching for the Trio, but not the Red Leather Pants of Death -- she's not quite her old self yet.
* AHouseDivided: The Trio are starting to fray.
* IJustWantToBeNormal
* IKnowYoureInThereSomewhereFight: Dawn tries this, but Buffy is too far gone by that stage.
* LeaningOnTheFourthWall: Plenty of this.
-->'''Doctor:''' Buffy, you used to create these [[BigBad grand villains]] to battle against, and now what is it? Just ordinary students you went to high school with. No gods or monsters ... just three pathetic little men who like playing with toys.
* LeaveYourQuestTest
* LotusEaterMachine: In the asylum Buffy has no responsibilities, and her parents are alive and still together.
* MindScrew
* TheNicknamer: Xander calls Spike "[[BadassDecay Willie Wannabite]]", and Buffy "Sane Girl" -- right before she clonks him with a frying pan.
* NoMereWindmill: Buffy reveals that her parents had her sent to a mental clinic for two weeks after she first told them about seeing vampires.
* OutOfGenreExperience / SlasherMovie: The scene where Psycho!Buffy stalks her sister through their home.
* PersonAsVerb: Jonathan says he's "[[Film/TheShining going Jack Torrence]]" cooped up in the basement.
* {{Retcon}}: Buffy is revealed to have been briefly institutionalized when she first learned about vampires, which you'd think would have come up a few times before, like when Joyce finds out she's the Slayer. The common fanwank is that this is part of the timeline that was altered by Dawn's creation. Another possibility is that it's merely a side effect of the demon's venom, since it's never referenced again after the episode and Dawn never confirmed the story.
* RousingSpeech: Joyce gives one to Buffy, that ironically has the opposite effect of what she intended.
* SayingTooMuch: Spike vents about how his BadassDecay led to Buffy using him as a sex toy. Fortunately Xander thinks it's just some stupid Spike fantasy.
* SchrodingersButterfly: Is Buffy the Slayer dreaming she's insane? Is she insane dreaming she's the Slayer? Are both true? GOD DAMN YOU JOSS
* ShoutOut: When the Trio are planning a heist Andrew says, "I still think we need eight more guys" and Warren replies, "I should never have let you see [[OceansEleven that movie]]."
** [[ShoutOut/ToShakespeare Shout-Out To Shakespeare]]: Xander quotes Mark Antony's eulogy in Theatre/JuliusCaesar.
-->'''Xander:''' Friends, Romans, [[TheTriple anyone]]?
* SmashCut: From the demon injecting Buffy to Buffy being injected in the mental hospital.
* StaircaseTumble: Tara's BigDamnHeroes moment is stopped by Buffy tripping her up from beneath the staircase.
* SummonMagic
* SurrogateSoliloquy: Willow rehearsing asking Tara out.
-->'''Willow:''' "Hello, Tara. Would you like to go out with me for coffee, food, kisses and gay love?"
* TeensAreShort: Buffy notes that she should be taller than her 'little' sister.
* TeethClenchedTeamwork: Spike and Xander capturing the demon.
* TestosteronePoisoning: Spike and Xander work out their frustrations over their recent relationship cock-ups on each other.
* ThatCameOutWrong
-->'''Buffy:''' Some kind of gross, waxy demon-thing poked me.
-->'''Xander:''' And when you say poke...
-->'''Buffy:''' In the ''arm''.
* ThousandYardStare
-->'''Buffy:''' (vacantly) I'm okay, Dawn.\\
'''Dawn:''' The, uh, thousand-yard stare really helps sell that.
* TranquillizerDart: The anti-Oz rifle makes a reappearance. InstantSedation is averted -- the Glarghk Guhl Kashma'nik demon takes several darts, plus Xander and Spike bashing away at it, before it's subdued.
* TwistedEchoCut
-->'''Willow:''' Dawnie, you can help me research. We'll hop on-line, check all the--
-->''[SmashCut to Buffy in the asylum. A doctor is talking to Buffy's parents.]''
-->'''Doctor:''' --possibilities for a full recovery, but we have to proceed cautiously.
* TheUnpronounceable
-->'''Spike:''' [[OhCrap Oh, balls!]] You didn't say the thing was a Glarghk Guhl Kashma'nik.
-->'''Xander:''' That's 'cause I can't say Glarma-- ''(demon hits him)''
* WhatTheHellHero: Even if her life did seem more unrealistic in comparison to the Asylum-containing version, Buffy still decided to start [[spoiler:killing her friends]] without running any Litmus Paper tests on both “realities”. If she’d have researched her condition she would’ve discovered some neet mind tools like the [[http://en.wikipedia.org/wiki/Brain_in_a_vat Brain in a vat]] thought experiment and would’ve found some rationally stable strategies for dealing with such conditions (checking information inflow level, for example, in regards to which the Slayer-reality was winning over the Asylum-one so far).
** Which she might have done...if the poison wasn't making her completely delusional.