Been rereading RH Junior's Parting Words when I had a sudden epiphany: All that stress of being Celestia's student, all that studying, all those tests from both the school and her mentor, Twilight must have had quite a stressful foalhood. All that stress at such a young age, it's no wonder Twilight's so neurotic and and anal-retentive, and a gods-damned miracle that she's not suffering from a more serious medical condition.

But what if she did?

What if, before the start of the series proper, while Twilight's still a filly, all that stress actually causes the likes of a psychotic break, or even a full-blown stroke or heart-attack (just a few examples, feel free to use what you want.)?

The idea wouldn't be about whether or not she recovers (she does, at least to a point), but how much things would change if such a thing were to happen. How would Celestia react? How would Twilight's family react? How would Canterlot, and possibly all of Equestria react? How much would Twilight change? How much would Twilight's relationship with Celestia change? How much would the future change?

Just had a thought: You know how Pinkie Pie threw a surprise party for Twilight on her first day in Ponyville? Imagine that if Twilight had a heart condition due to a heart-attack during foal-hood. I can see Twilight trying to keep herself calm, less she has another heart attack, and Spike coming to Twilight's defense and scolding Pinkie.

An interesting concept!

I suspect most ponies would be "treading on eggshells" around Twilight.

And Shining Armor might have some serious doubt about taking on a higher ranking position in the guard versus being more available to protect his younger sister --- after all, his cutie mark is protecting ponies. I suspect that started with protecting Twilight. I imagine some heated drama with Twilight not wanting Shining to give up on his dreams; Shining sitting Spike down and telling him to look our for Twi on behalf of both of them.

How would Celestia react?

Awkward pauses. Halting lessons for fear of taxing her student too much. Twilight perpetually feeling down because she thinks the Princess doesn't believe she can handle her lessons.

Would she still go and send Twilight off to Ponyville? All by herself, only with Spike?

Nope. Definitely post some guards in town first. And even then, sending her "most fragilefaithful student" into battle against a deity would be a very tough decision, if she thinks sending Twilight to Ponyville is akin to wagering her life. She might even change her mind halfway-through and try to abort the plan but then it is too late.

Nightmare Moon's mere appearance might cause Twilight to have a close call. Spike and the others (who have only just met her) would probably try to stop her from going after NMM.

Also, afterwards? Twilight's parents and her brother are going to murder Celestia. Verbally, anyway.

Though, maybe using the Elements of Harmony would help Twilight's medical condition? At least temporarily?

Twilight's so neurotic and and anal-retentive

[...]

[...] and scolding Pinkie.

You know, someone did write a story where Twilight's mental condition is actually worse. Where her surprise welcome party leads to an "episode", and subsequent mental breakdown in front of half the town. Though she deals with the Nightmare Moon situation much better, ironically.

Now if only I could recall the name of that story...

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6247367
I would really like to do this idea if nobody has taken it yet.

6937520
pabrony83 was doing a story along these themes, Cause And Distress, but they haven't updated the story in over a year.

If you want to use this idea for a story, I say go for it, just be sure to post the link here when you do.

6937630
Ah, nevermind then. I may incorporate it into a different story though.