SPOILERS:
It is vary much up to interpretation, but in my mind, people just don't give a fuck. All of the guys in the office look and act so similar that they don't even know who is who, which is why Patrick thought he had killed Paul but had actually killed somebody else instead (unless Paul was actually the man that he had killed and that guy from the office had seen someone that he had mistaken as Paul when he was on his vacation). All around, I think it's a mix of hallucinations and things that he is actually doing. For instance, the ATM machine obviously did not actually say "feed me a stray cat" that was just a hallucination on his part, but comment #41 explains this way better than I ever could (plus I haven't seen this in a while and I'm tired).

DON'T GIVE AWAY PLOT POINTS AND LEARN TO READ THROUGH OLDER COMMENTS TO SEE IF YOUR QUESTION HAS ALREADY BEEN ANSWERED.

fine, ill delete my comment, but i still feel unanswered, so I have no idea how I actually feel about this movie, other than I don't regret seeing it

SPOILERS:
It is vary much up to interpretation, but in my mind, people just don't give a fuck. All of the guys in the office look and act so similar that they don't even know who is who, which is why Patrick thought he had killed Paul but had actually killed somebody else instead (unless Paul was actually the man that he had killed and that guy from the office had seen someone that he had mistaken as Paul when he was on his vacation). All around, I think it's a mix of hallucinations and things that he is actually doing. For instance, the ATM machine obviously did not actually say "feed me a stray cat" that was just a hallucination on his part, but comment #41 explains this way better than I ever could (plus I haven't seen this in a while and I'm tired).

Lady-boys have assholes for a reason. Well, 2 reasons, actually.

I fucking hate burnt toast.
Like, the only time I like toast is when it's lightly toasted and golden brown, yet everyone looks at me like I'm weird for having toast that "isn't toasted enough"

I hate burnt toast. More than that, I hate untoasted bread sticking to the back of my teeth. Fuck.