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Crazy Good: Does 'Madness' Make A Leader Great?

It's been almost 40 years since Missouri Sen. Thomas Eagleton, the 1972 Democratic nominee for vice president, revealed that he'd been hospitalized for depression and treated for the mental disorder with electroconvulsive therapy. The party's presidential nominee, South Dakota Sen. George McGovern, famously issued a statement indicating he supported Eagleton "1,000 percent," but nonetheless asked Eagleton to withdraw from the ticket shortly thereafter.

Politics have gone through some dramatic changes since then, but it's probably still safe to say that many Americans would feel uncomfortable voting for a candidate they knew to be mentally ill. But that attitude could be counterproductive, especially when it comes to times of crisis, claims psychiatrist Nassir Ghaemi in A First-Rate Madness. Pointing to the likely mental states of historical figures such as Abraham Lincoln, Mohandas Gandhi and Franklin D. Roosevelt, Ghaemi argues that "[w]e should accept, even celebrate" the possibility that our decision-makers have dealt with mental illnesses — disorders which, he writes, tend to promote the qualities of "realism, resilience, empathy and creativity."

His thesis might seem counterintuitive to voters who have long sought stability and composure in the officeholders they elect. After all, the country most recently elected as president Barack "No Drama" Obama, who, Ghaemi writes, "might be considered the epitome of mental health," over John McCain, who was criticized by his opponents for his "volatility." It's a testament to the author's nuanced and careful prose that his thesis comes across so clearly and convincingly — you might not agree with all of his conclusions, but he presents a cogent, persuasive argument for them.

It is, of course, impossible to know which psychiatric disorders, if any, public figures of the past have endured. But Ghaemi, through extensive historical research, makes educated guesses based on their biographies, paying special attention not just to symptoms and treatments but also to the family histories of the leaders. The details he uncovers along the way can be surprising: Abraham Lincoln was so depressed that he refused to carry a pocketknife because "he couldn't trust himself with it"; and Martin Luther King Jr. tried to kill himself twice as a teenager. But their experiences with depression might have enhanced their leadership skills. "Their weakness," Ghaemi writes, "is, in fact, the secret of their strength."

Nassir Ghaemi teaches psychiatry and pharmacology at Tufts Medical Center.
James Lawerence /
Nassir Ghaemi teaches psychiatry and pharmacology at Tufts Medical Center.

Some of the author's conclusions are bound to be controversial. Adolf Hitler, he argues, was not psychotic, as some assume — he had bipolar disorder that was worsened by his abuse of "opiates, barbiturates and amphetamines." Ghaemi also contends that many recent officeholders who likely did not have mental illness proved to be failures when it came to crisis leadership. He points to Richard Nixon, George W. Bush and Tony Blair as examples.

Ghaemi is a remarkably disciplined writer, and he examines both psychiatry and history with impressive clarity and sensitivity. A First-Rate Madness will almost certainly be one of the most fascinating books of the year, not just because of the author's lucid prose and undeniable intelligence, but because of his provocative thesis: "For abnormal challenges, abnormal leaders are needed."

Copyright 2023 NPR. To see more, visit https://www.npr.org.

Michael Schaub is a writer, book critic and regular contributor to NPR Books. His work has appeared in The Washington Post, The San Francisco Chronicle, The Portland Mercury and The Austin Chronicle, among other publications. He lives in Austin, Texas.
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