A First-Rate Madness

The contemporary prevalence of antidepressants and other mood-regulating drugs has forced us to re-examine our categorizations of mental health and illness. Characteristics previously seen simply as personality traits or normal human responses to suffering are now medical problems in need of a medical cure. In the words of one author, the pervasiveness of depression today is not the result of discovering a new disease, but rather “the reconstitution of a broad swath of human experience as illness.”

Our natural response to this new understanding of mental health is to guide our desires and aims by it: if mental health is possible, it should be pursued. It is worth asking, however, whether this response is universally correct. Perhaps there are goods more essential to human flourishing than mental wellness, even if they come at the expense of our individual peace of mind. Indeed, it seems genuine service to the common good is rarely accomplished without suffering and mental anguish. While there are legitimate medical situations in which we do need to medicate mental conditions, we should not let this fact make us generally hostile to all suffering, whether mental or physical.

A First-Rate Madness, by psychiatrist Nassir Ghaemi, challenges the notion that a happy, mentally healthy life ought to be our ultimate goal. On the contrary, he argues that mental illness can be a valuable, even essential, part of life. By examining the lives of successful leaders from the past several centuries–from General Sherman to Ted Turner, Winston Churchill to Gandhi–he attempts to understand what links them together. Why did these men succeed in great trials and times of crisis, while many of their seemingly capable counterparts failed? His conclusion is a surprising one: sane leaders do well in times of peace and prosperity, but “in times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones.”

While a conclusion this absolute may be controversial, Ghaemi makes a good case for how the mental struggles of a leader may serve the greater good. He identifies four qualities essential to leading well in times of crisis—realism, resilience, empathy, and creativity—and focuses on how these qualities develop. There is ample evidence that they occur most strongly in those who have suffered from mental illness (specifically, major depression and bipolar disorder). By examining the history of each leader’s illness, we can see how their sickness contributed to their success. For every one of these successful crisis leaders, he concludes, “Their weakness is the secret of their strength.”

This conclusion provides much-needed balance to belief that mental illness must be eliminated at all costs. Contemporary culture too frequently proposes a conception of human flourishing that is rooted in emotional wellness, subjective happiness, and self-fulfillment. In contradistinction to this popular prejudice, Ghaemi points to a more comprehensive idea in which the full range of human emotions is appreciated. Particularly in times of great crisis or struggle, those experiencing more sober and realistic emotions seem to thrive. These emotions lead us to deeper engagement with a broken world and point us closer to truth.

Ghaemi’s discussion of empathy is particularly telling on this point. Perhaps empathy, that ability to feel and experience both the sufferings and the triumphs of others, is an essential trait of a successful human character. Ghaemi first shows that empathy is not an invented concept but “a neurobiological fact,” and that humans are “wired…to feel the movements, emotions, and pain of others.” This quality is, he explains, often most strongly present in those who have experienced episodes of major depression.

Martin Luther King Jr. is one of Ghaemi’s examples here. While King was “not chronically depressed” throughout his life, there is evidence he experienced at least three major depressive episodes. These episodes helped King clarify his mission: he saw America as a patient suffering from racism; he desired to be a physician who helped the country heal. His well-developed sense of empathy was key to this strategy. While he was deeply troubled and saddened by racism, he also felt a strong sense of compassion toward his oppressors, rather than anger. His non-violent resistance was realized through loving his enemies, seeking to understand them and lead them to change.

King is just one example of how an individual leader’s suffering can benefit the common good. While we worship mental well-being today, we should question where this will lead us. After all, Jesus praised the “poor in spirit” and “those who mourn,” rather than the unceasingly happy and the self-fulfilled. Our emotions are best evaluated not as isolated mental states, but in reference to our larger narrative and context: are our responses appropriate to the people and situations in our lives? When someone we love dies, for example, it’s good to feel bad. As Ghaemi shows through the example of many of our greatest leaders, perhaps pleasure and good feelings should not always be our ultimate goal.