I was wondering how Psychiatrists weed out what is an inappropriate joke and what may be humor due to a break in reality. I'm sure that comes up a lot in the Doctor's office. I mean everyone that sees a Psychiatrist has gotten that look from their Dr. after telling a joke that something has gone off the rails or something is strange. Especially after adjusting meds a patient can be (slightly or tragically) disconnected from themselves fairly easily. A little too much lethargy, irritability, agitation or whatever can mess with your head pretty well.