Fall/Winter 2022, titled Manic Melancholic Madness, came at a time when Alexander was frustrated with how his time in New York was going and was the first step to restructuring his brand into what it is today. The collection consisted of made-to-order and ready-to-wear garments, the most diverse offering from Alexander to date.

The collection was was inspired by the Rider-Waite Tarot Deck. Alexander reworked Pamela Smith's famous illustrations to retell the story of the fool through the major arcana, highlighting mental health and substance abuse. The collection was shown at a street-fashion show at New York Fashion Week February 2022 in collaboration with Emma Rogue, outside of her vintage shop in Manhattan's Lower East Side.