So I headcanon Pinkie Pie as having some form of mental illness [ mania, schizophrenia or psychosis, but I haven’t done enough research to point down which one she has ] and during Party Of One and The One Where Pinkie Pie Knows, she had episodes where she hallucinated and became extremely anti-social. Pinkie Pie takes medication and gets lots of support from her friends ever since that incident on her birthday, but that doesn’t mean that her episodes stop all together.

Not to mention that she still shows a lot of tell-tale behaviours that point to her having a mental illness and sometimes that can become a bit problematic [i.e that one time where Rainbow Dash attended Wonderbolts academy and Pinkie kept excessively checking her mailbox for three days straight].

Despite everything, she’s still Pinkie Pie and she still tries to keep a bright face regardless of how badly her mental illness acts up.

That meltdown on her birthday must still haunt her, the poor thing.

[ Btw, that x mark on Pinkie’s flank is paint, not blood! ]