Answer :
In the passage, the narrator can be considered unreliable for several reasons:
1. The narrator begins by insisting that they are not mad despite exhibiting behaviors that suggest otherwise. This contradiction raises doubts about the narrator's mental stability.
2. The narrator's heightened sense of hearing, claiming to hear things in heaven, earth, and hell, indicates a possible delusional state or hallucinations, contributing to the unreliability of their perspective.
3. The narrator's assertion of speaking healthily and calmly while describing intense feelings of nervousness and dread presents a contradiction, casting doubt on the narrator's self-awareness and credibility.
Overall, the narrator's inconsistent behavior, delusional claims, and contradictions between their words and actions contribute to the impression of unreliability, leading the reader to question the accuracy of their account.