BOOK REVIEW:

A first-rate madness : uncovering the links between leadership and mental illness

When you look at the problems that face world leaders, especially in times of crisis, you might think, "You have to be crazy to want to do that job." To psychiatrist Nassir Ghaemi, being "crazy", or, more precisely, having some form of mental illness may be just what is needed for some leaders to be able to accomplish great things during times of great need.

Ghaemi examines, in varying detail, the lives of world leaders whom he believes had some form of mental illness in their lives: Franklin Roosevelt, John F. Kennedy, Abraham Lincoln, William T. Sherman, Martin Luther King, Jr., Mohandas K. Gandhi, and, as an example of how things can go terribly wrong, Adolf Hitler.

The author's theory is that people with certain forms of mental illness, especially bipolar disorder or clinical depression, have certain abilities that help them in times of crisis. For example, Ghaemi explains how a person with bipolar disorder might have the ability to accomplish more than someone who is mentally healthy. And a person with depression may have more empathy to those who are suffering (Gandhi and King are the examples used by Ghaemi to illustrate this point).

It's important to note, Ghaemi adds, that not everyone suffers from mental illnesses in the exact same way - some are more severe than others, and not everyone exhibits every symptom of a disorder. Kennedy and Hitler are presented as two men who led differently, in part, because of how they were treated medically. Ghaemi believes that both Kennedy and Hitler suffered from some form of bipolar disorder. Kennedy's mental health was further complicated by a dangerous hormonal imbalance known as Addison's disease.

Hitler was treated by various Nazi physicians with dangerous concoctions of anabolic steroids as well as intravenous doses of amphetamines. These treatments served to make a dangerous mental condition into a horrific one. Kennedy was sick most of his life and preoccupied with death. He was also treated with steroids, some of them anabolic. For much of his life, there was little rhyme or reason to their use. Around 1962, Kennedy's medical treatment became more regulated, which Ghaemi believes led to a far more successful presidency for Kennedy.

Ghaemi makes a good case for showing how people with forms of mental illness can show more empathy, be more creative, and make better decisions better during crises. However, he also notes that the stigma against mental illness is such that most people would never knowingly choose someone to be a leader if they knew that he or she suffered from a disorder. And, in peaceful times, a mentally ill person could be the last person you want in charge.

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