[House of Cards] Frank Underwood is a patient and the White House is a mental hospital

Theory submitted by James Watson

Frank Underwood is delusional and is locked in a mental hospital. He is occasionally moved but is sent back to the hospital. Claire is also a patient that eventually recovers. Frank's psychosis gets worse as the series progresses, starting with his initial incarceration in season 1 and progressing to a worse (and now famous) state by the end of season 3. In season 1 Frank, after being locked away, attempts a break out with Zoe and others but this fails.

• Frank frequently talks to the audience. This could be either a sign of schizophrenia or he may be explaining to a physiatrist how he sees his delusions.
• Frank and Claire smoke secretively together. This could be because the hospital doesn’t allow smoking and they try to avoid detection.
• Raymond Tusk is a doctor trying to help another patient, Garret Walker (‘the president’). Frank tries to drag Garret back into his delusions and thus comes into conflict with Tusk.
• The Russian president, Viktor Petrov, is a doctor from another hospital. He initially meets Frank and Claire in their hospital (‘the White House’) and then they are briefly sent to his own hospital (‘Russia’ and later ‘the Middle East’). Viktor takes a liking to Claire as shown in their flirtatious interactions and he eventually helps cure her, resulting in Frank and Clair arguing when they leave ‘Russia’. Michael Corrigan is a patient in ‘Russia’ who is also partly delusional, being treated by Petrov. He kills himself as a result of his delusions which Claire is a witness to.
• Claire is a patient that is Frank’s wife. She partakes in his delusions but in the 3rd season as he gets worse, she gets better. Clair is helped a lot after their visit to ‘Russia’. At the end of the 3rd season she finally leaves Frank after realising that his delusions are unhealthy to participate in.
• Edward Meechum is a patient that is in the same ward as Frank and Claire; he is delusional and suffering PTSD after serving in the marines. He develops a devotion to Frank and Claire.
• Doug Stamper is a recovering alcoholic and also a delusional patient. He suffers split-personality disorder and rotates between being in the hospital and living outside. When he is inside he believes that he is working for the Underwoods, but when he’s outside his persona of working for the Underwoods kicks in resulting in him imagining going on missions for them. These malfunctions in personality when he’s outside resulted in his brain damage from the attack by ‘Rachel’ and the murder of ‘Rachel’ among others. ‘Rachel Posner’ is a delusion created by his alternate personality that he is determined to find, the reason ‘Rachel’ moves around a lot is because he manifests her in different women of the same description.
• Zoe Barnes is a nurse at the hospital who initially is convinced by Frank to help him escape. Frank often imagines having sex with her. After she realises the extent of his delusions she attempts to undo her help which results in Frank murdering her.
• Peter Russo is also a recovering alcoholic like Doug. He is a patient that Frank initially includes in his escape plan but after he becomes difficult to work with, frank kills him.
• Gaffney is actually the town where Frank is from. He occasionally visits there when he shows signs of improvement but is always sent back after bad relapses, such as when he publicly urinates in the first episode of season 3.
• Tom Yates, a university phycology lecturer, decides to write a book about Frank as Frank's psychosis has now become worse and is now a famous psychology case. He interviews Frank  and others to gain an insight into what started Frank's delusions and why he believes himself to be the president. Frank believes this book to be about his ‘America Works’ program.
• Frank's friends from his time at the Sentinel visit him in season 1 and realise that he is completely insane. Frank calls one of them when the book is being written but they try to avoid him.
• All the other characters in the show are either made up delusions by Frank, other patients that share his psychosis (like Remy, Seth and Jackie Sharp), or people that work in the hospital.