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WMG for Mama, the 2013 horror film.

Mad Edith had been assigned male at birth.
That's why she was put in the asylum, as being transgender was considered a mental illness in the 19th century. She kidnapped a baby that she loved and considered her own before jumping to her death. When she returns as a ghost, she then adopts Lily and Victoria for the same reason she adopted the other baby: to have the children she was biologically unable to have. Which is also why she was so quick to smash the baby's corpse when Lily screamed out for her in the climax. It wasn't her biological baby, and she had grown a bigger attachment to the girls.
  • Except if she were really biologically male, it's highly unlikely that she would have been called by a female name back then since no one would even acknowledge such a thing. They probably would have recorded her as male with a male name since they'd think her wanting to be female was just a delusion.

Edith had Marfan Syndrome
It would explain her appearance (at least of her body) in life, since her appearance as a ghost isn't just the result of "ghosts need to look weird"— that's really how she looked. Plus, when the actor has the same condition, it's hard to separate it from the character.
  • Actually, it could be that maybe Edith had both Down Syndrome and Marfan Syndrome.
  • Javier Botet, the actor who played Mama/Edith, actually does have Marfan Syndrome. Relatively little CGI was used for most shots of Mama. The long limbs and fingers and odd range of motion are all Botet.

Edith did not have a recognizable medical disorder. She was related to Fuchi from the manga of Junji Ito.
Edith greatly resembles Fuchi, the monster woman from several Junji Ito shorts - Rumors, Fashion Model, and Secret of the Haunted Mansion (picture here). The tall stature, long limbs and digits, elongated head, lantern jaw, slitted eyes, and slash-like mouth are features shared by these two supernatural females.

Further, if Edith's dream sending is accurate, she had her draining, corruptive touch even before she became a ghost. Perhaps Fuchi and Edith spring from a common source - an Ur-hag mother spawning female monsters and monsters-to-be across the world and throughout history.

Edith was never a human being.
Based on the above WMG, Edith was not a person at all during life, but a swarm of moths functioning as a hive mind and taking on a human form. Her ability to drain the life from the world was the way in which the moths fed. Although able to imitate a human being for the most part, the swarm of insects that made up "Edith" found itself unable to perfectly mirror a human form or simulate human behavior. As a result, "Edith" was institutionalized under the rather logical assumption that she was just a very ill person rather than a swarm of sapient moths.
  • Perhaps Edith was related to the Slender Man? Tall and gangly, with long thin arms and legs, and a penchant for carrying children away...

Lily was Dead All Along.
Think about it, a one year old child being raised by a ghost and her three year old sister? If she were to get sick, she'd die, and if you look at the pictures at the beginning of the movie, you clearly see her puking. Also, she's never shown sleeping in the movie (but she pretends to) and she eats moths. Mama's ghost magic was keeping her alive, but when Mama realized she was a ghost, she took Lily with her. That's why when they cocoon-bombed off the cliff, Lily didn't leave a corpse. And the response to Annabel's breath? Ghosts subconsciously desire human contact, Lily is as attracted to the living as Mama is.
  • This does somewhat explain the ending in that she crosses over, when technically, supernatural means aside, she shouldn't be able to do that, along with the fact she doesn't leave behind remains (odd are)

Lucas had an affair with the girls' birth mother
Lucas is a real Parental Substitute who loves Lily and Victoria wholly throughout the film, but even at the start of their disappearance, when he briefly panics that something's happened to the girls specifically after seeing the police at Jeffrey's house; he acts more like a father would than an uncle. It could just be that Lucas is that much of a Cool Uncle, but there might be more to it. Perhaps Luke had a (likely loving) affair with his brother's wife in the past, and because of that he might've suspected for a while that he was the real father of one or both of the girls instead of Jeffrey.

Furthermore, if the affair between Jeffrey's wife and Lucas was a genuinely loving one; then perhaps even if Jeffrey found out about the affair or he just suspected the same thing as Lucas about his daughters' conception, and the parents ran a DNA test to confirm who was the biological father and it was confirmed to be Jeffrey (yes it's likely Lucas and Jeffrey are identical twins, but twins' DNA becomes different later in life due to environmental factors), perhaps Lucas' loving relationship with the girls' mother would make him still see his nieces as his real daughters afterwards.

Edith wasn't mentally ill at all- she just had a baby out of wedlock.
While less common than fiction would have you believe, there were cases in the 19th century of perfectly healthy women who had extramarital pregnancies being sent to asylums on trumped-up diagnoses like "hysteria" or nymphomania. If the asylum was unscrupulous enough to admit her on those grounds, it could have been a convenient way for a prominent family to hide a daughter who'd caused a scandal.

  • Doubtful — her behavior in the flahback of her taking back her baby and the circumstances under which she jumped from the cliff says quite a lot about her mental state when she was alive. Unless what you mean is that Edith was actually sane when she entered the asylum but lost it while she was in there — which seems doubtful, since her baby's presence at the convent when she stole it back (assuming that really was her baby and not somebody else's that she stole) implies that only a short time passed between Edith's incarceration and escape as the baby hadn't been adopted yet, unless of course the baby was going to be raised in the nuns' care.
    • Actually, women could be put in mental hospitals for WTF (really, one on that list is "novel reading"), so the idea of an unwed mother being tossed in one of those for simply being that and maybe losing her minds afterwards wouldn't be out of the ordinary for the 19th century. On the subject of the baby, much like modern times, babies don't always get adopted out and the baby looked to be at least 3-4 months old in the flashback (which skews the calculations a bit).

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