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A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness

Nassir Ghaemi · 4 HN comments
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Amazon Summary
The New York Times bestseller “A glistening psychological history, faceted largely by the biographies of eight famous leaders . . .” — The Boston Globe “A provocative thesis . . . Ghaemi’s book deserves high marks for original thinking.” —The Washington Post “Provocative, fascinating.” —Salon.com Historians have long puzzled over the apparent mental instability of great and terrible leaders alike: Napoleon, Lincoln, Churchill, Hitler, and others. In A First-Rate Madness, Nassir Ghaemi, director of the Mood Disorders Program at Tufts Medical Center, offers a myth-shattering exploration of the powerful connections between mental illness and leadership and sets forth a controversial, compelling thesis: The very qualities that mark those with mood disorders also make for the best leaders in times of crisis. From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain, A First-Rate Madness overturns many of our most cherished perceptions about greatness and the mind.
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I'd imagine a lot of people are like this, and I'd imagine HN is overrepresented by this, but I just really feel emotions. When I'm on and am really into something I get hyperfocus and feel like the world is my oyster, but inevitably that high is going to end and if I'm not careful with certain emotional situations I put myself in (romantic relationships), I can reach that low of lows where I honestly just don't want to be here. I mean I guess we all feel this at times, I don't want to imagine it is special, but there are just times in those lows where every doorframe and every rope looks like an out. I absolutely am not interested in it and I know that if I stick it out, that time is going to pass, but I absolutely feel it deep in my stomach and I understand when people who are in that state exacerbate it (if it's alcohol, don't drink alcohol) and we get these tragedies.

For me, personally, this is the first time in 15 years that I've felt normal, which is to say my entire adult life. Some of that is just growing up, but it took a few tries with psychologists (the second much more successful than the first), being cognizant of what issues put me in a funk and avoiding them, getting the appropriate medication (for depression this is invaluable - the main thing it does for me is make sure those valleys aren't so low) and then within the last year realizing that I might also be adhd (all this shit is comorbid) and seeing a pyschiatrist and getting on the proper meds for that. I know we've got our Scientologists and resident HNers that think the healthcare industry is just a joke, but my counselours have always been my friends, it's as much me guiding and us learning about what works and doesn't work as them, and you know, it's been life-changing. This last part is in response to your "we don't know" comment. We have no fucking clue on the brain works, which is why I'm even saying this. I see people that are ashamed to take medication or admit they have.

But the depression is never going to completely go away. Two books that have given me a lot of hope, taught me a lot are:

> https://www.amazon.com/Lincolns-Melancholy-Depression-Challe...

> https://www.amazon.com/First-Rate-Madness-Uncovering-Between...

I'm sure someone's going to say that here's popsci, but I dunno, was good stuff for me. Great insights into mental disorders and how they can be worked around, even embraced. This is all feeling way too male...I guess a final thing that's been vital for me (and again, just getting older) is the power of empathy. I think there are a few shows like Mad Men or HaCF which really show a variety of people working through issues like this.

effingwewt
Jesus I feel you. There were years I couldn't take a bath because I couldn't be sure I could resist slipping under. For me depression isn't thinking about things and wanting to die. It's actively fighting the ever-increasing...I don't know, need?..to just be done.

Gonna give the books a look, glad you found something that works for you!

heymijo
I really really appreciate your response. I’ll be thinking about this.
bpiche
Hey I just wanted to chime in and say that your story is very inspiring and I really appreciate the vulnerability it took for you to share it with us. Thanks for the book recommendations too. And keep fighting the good fight.
https://www.amazon.com/First-Rate-Madness-Uncovering-Between...

Historians have long puzzled over the apparent mental instability of great and terrible leaders alike: Napoleon, Lincoln, Churchill, Hitler, and others. In A First-Rate Madness, Nassir Ghaemi, director of the Mood Disorders Program at Tufts Medical Center, offers a myth-shattering exploration of the powerful connections between mental illness and leadership and sets forth a controversial, compelling thesis: The very qualities that mark those with mood disorders also make for the best leaders in times of crisis. From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain, A First-Rate Madness overturns many of our most cherished perceptions about greatness and the mind.

bemmu
Link didn’t work, but seems the book is “A First-Rate Madness: Uncovering the Links Between Leadership and Mental Illness“
gustavo-fring
Thank you. I fixed it, but that is the book.
solveit
> From the importance of Lincoln's "depressive realism" to the lackluster leadership of exceedingly sane men as Neville Chamberlain

I find these comparisons deeply suspicious. If there indeed were a strong link between leadership ability and mental illness, there cannot be a very big difference between Lincoln and Chamberlain for the reason that both men were surely at the very tails of the relevant distributions. One does not become a British Prime minister by being average. I fully expect the book to be full of cherry-picked data supporting narratives built largely on popular stereotypes about successful and unsuccessful leaders of dubious accuracy.

gustavo-fring
You can judge the whole book based upon your beliefs or you could read it and learn.
solveit
There are many books, but only so many hours in the day. Conveniently there are also many HN readers who have also read the book (presumably, you included) who could tell me if I'm wrong and the book is worth reading. That being said the NYT review (https://www.nytimes.com/2011/08/11/books/a-first-rate-madnes...) does not inspire confidence in me.
This book A First-Rate Madness by Nassir Ghaemi [0] is about that. He looks at various historical leaders and how one half of them make good wartime leaders, but bad peacetime leaders, and the other half -- the opposite. Some of his case studies are, as far as I can remember (couldn't find a summary online): generals in US civil war (Lee and the scortched-earth-guy), Chamberlaine, Churchill, Hitler, JFK, Lincoln, Napoleon, Nixon, Bush. US centric, but still pertaining to anyone.

[0] https://www.amazon.com/First-Rate-Madness-Uncovering-Between...

sangnoir
> the scortched-earth-guy

William Tecumseh Sherman, of "Sherman's march to the sea"

May 10, 2013 · dmd149 on Depression Part Two
You might appreciate this book: A first rate madness. It's about how some of the best crisis leaders are manic-depressives. Depressive periods give them the ability to see the world as it is, and the mania gives them the energy to do something about it.

http://www.amazon.com/First-Rate-Madness-Uncovering-Between-...

mikecane
Oh wow. Thanks for that recommendation. That looks like it belongs with Kay Redfield Jamison's book and Arnold Ludwig's.
trentlott
Everything's well and good until they walk in to a lake.
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