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

3.72  ·  Rating details ·  3,379 ratings  ·  512 reviews
In A First-Rate Madness, Nassir Ghaemi, who runs the Mood Disorders Program at Tufts University Medical Center, draws from the careers and personal plights of such notable leaders as Lincoln, Churchill, Gandhi, Martin Luther King, Jr., JFK, and others from the past two centuries to build an argument that the very qualities that mark those with mood disorders- realism, empa ...more
Hardcover, 340 pages
Published August 4th 2011 by Penguin Press
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Aug 23, 2011 rated it it was ok
Who writes history? Those who control the media and the winners of any conflict. This is a summary of some of history's greatest and worst leaders. It reads much like a dissertation only without statistical data to support the hypothesis but plenty of anecdotal which is soft data. The author asserts that the best leaders in war and other stress, were on the bipolar spectrum. The worst leaders under stress were mentally stable.

Many of the examples used are self-proclaimed sufferers of depression
Oct 19, 2014 rated it really liked it
Nassir Ghaemi describes a strong correlation between mental or mood disorders, and leadership. Many of the world's best leaders in times of crisis had mental disorders--not very severe, but sufficiently ill so that they handled challenges with more realistic outlooks than so-called "normal" people. However, they do not do well during normal times. They do not make good managers.

On the other hand, "normal" people--which he calls "homoclites", can be good leaders during normal times. But they oft
Feb 27, 2012 rated it it was ok
This book would have gotten three or four stars had its theme been slightly different. The author posits on p. 17, "The best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy." Had the book stuck to the specific cases, that is, something closer to "Here are some amazing leaders who had mental illness, and I would argue that their illnesses helped inform and shape their successful leadership," I could have backed that thesis 100%. I can't h ...more
Joselito Honestly and Brilliantly
Is President Rodrigo Duterte of the Philippines mentally ill?

If he is, then he could either be the worst type of leader or the best one for the country, depending on where the Philippines is now. For the theme of this book is summed up this way: “The best crisis leaders are either mentally ill or mentally abnormal; the worst crisis leaders are mentally healthy.”

Elucidating, the author wrote:

“In times of peace, mental health is useful. One meets the expectations of one’s community, and one is rew
Nov 26, 2011 rated it it was ok
I’m not sure what to make of this one. If I had some money, I think I would buy a few copies and pay some people who have been diagnosed with a mental illness to read this book. I’d really like to know what people with first-hand experience think of this. If you have a mental illness, could you, like, go to the library and then get back to me? Maybe?

Anyway, the basic premise of the book is that people with mental illness are better leaders in times of crisis and mentally healthy people are bett
Oct 28, 2011 rated it it was amazing
This book provides an interesting analysis of world leaders & how their mental health influenced their leadership. The author's analysis of such world figures as Lincoln, General Sherman, Hitler, FDR, Nixon, JFK and many others and how they reacted during crisis and non crisis situations depending on his interpretation of their mental health is fascinating. His conclusion is that leaders with certain types of mental illness (bipolar) handle crisis situations better than non mentally ill (normal) ...more
The Good

A First-Rate Madness has a fascinating premise: that in times of crisis, mentally abnormal leaders are more effective than mentally healthy ones. For various reasons, many of which are included in this book, I actually tend to agree with the author, and even if I didn't, his theory would be intriguing food for thought. Additionally, Ghaemi writes well and is consistently engaging, keeping his work from becoming dry as one reads.

The Bad

I have extreme reservations about the evidence Ghaemi
Sep 06, 2011 rated it did not like it
"And, isn't sanity really just a one-trick pony anyway? I mean all you get is one trick, rational thinking, but when you're good and crazy, oooh, oooh, oooh, the sky is the limit." - The Tick

From his eminent philosophical standing, the Tick nicely summarizes pretty much the only point in this work's introduction I could accept. The author's thesis, that mentally ill leaders are preferable in times of crisis while sane leaders are better at steering a straight course during non-crisis times, seem
Jun 18, 2012 rated it it was amazing
The psych student in me was extremely excited to open this delectable treat... and it certainly didn't disappoint as by page 2 I get: "in times of crisis, we are better off being led by mentally ill leaders than by mentally normal ones". If you aren't intrigued by that then I think there's an RL Stine or Twilight book out there that might be right up yer alley...

On to the next after studying psych here's what I can tell you: Ghaemi is brilliant for those who don't know in-depth psych -
Mar 06, 2015 rated it liked it
I'm a little disappointed because I expected to like this book a lot more than I actually did. I was quite intrigued by the book initially - Ghaemi's thesis being that mental illness lends certain qualities to its sufferers which aid them in becoming more resilient, more realistic, creative and empathetic individuals and thus, more excellent leaders in times of crisis.

So far, so good. However, this cannot be generalised to every leader and the reverse idea that mental health corresponds with po
Nov 12, 2012 rated it did not like it  ·  review of another edition

Let's begin... I never took a psych class in college, and I am essentially self-taught in history, but I could tell almost immediately that I was going to agree with virtually nothing Ghaemi said. First, his definition of madness is purely limited to mania and depression, which I find insulting to anyone who finds themselves on the bipolar spectrum. It is also very clear that Ghaemi found very specific leaders to analyze and then picked out certain characteristics to fit into his thesis. For exa

Nov 12, 2011 rated it it was amazing
Shelves: ui-lib
I found this book not only fascinating but a compelling idea. The author contends that the best leaders during times of crisis are those with a mental illness. He suggests this is the case for only certain illnesses which are severe depression, mania, bipolar disorder, and hyperthymia . His idea is that depression makes one a realist and empathetic while mania makes on creative and resilient. He gives numerous examples including General Sherman, Abraham Lincoln, Winston Churchill, MLK, FDR, JFK ...more
Apr 16, 2019 rated it it was ok
Shelves: library, 2019
Was not impressed with this book's argument that mental illness correlates with great leadership in times of crisis. People who struggle with mental illness absolutely can make great leaders but this thesis was structured quite poorly and buttressed by examples that were almost all white straight male military leaders (and chapters about Gandhi and Dr. King were frustratingly shallow).
Apr 12, 2017 rated it it was ok
I read this book for my psych discussion group, and we disagreed with so many of his claims. He didn't have very much evidence for some of the people he analyzed, and some of his diagnoses seemed like major reaches. There were some strong chapters, but he could have done without probably half of the book. One statement that really bothered me was about how all of Germany was guilty for the Holocaust. I think that isn't a claim anyone can make...either you blame the Nazi party and Hitler, or all ...more
   Our leaders cannot be perfect; they need not be perfect; their imperfections indeed may produce their greatness. The indelible smudges on their character may be signs of brilliant leadership.
   We make a mistake, however, when we choose leaders like us. This is our own arrogance, as normal homoclitic people. We overvalue ourselves; we think, being normal, that we are wonderful. We stigmatize those who differ from us, whether because of race, sex, habits, culture, religion—or, perhaps more vis
Jan 28, 2012 rated it it was amazing
Shelves: favorite
Excellent book. Profiles Lincoln, General Sherman, Hitler, Gandhi, Churchill. MLK. FDR. JFK and Ted Turner.

Original writing. Interesting parallel between this book and How Great Generals Win, which also extensively profiles General Sherman, among other strategists.

Dr. Ghaemi focuses on "manic-depression" (or bipolar disorder), and compares this to what we call "normal" personalities, IE, people with a "general feeling of well being".

Great leadership benefits from a few qualities that the "mental
Sep 22, 2012 rated it liked it
As asocial studies teacher and a mental health professional, this book grabbed me right away. I enjoyed learning about his theory and how some of the characteristics of mental illness can be a benefit to leaders. I also think it does a good job of alleviating some of the stigma associated with mental illness. My respect for leaders was also increased when I learned of their struggles and at the same time how much they led a nation or group of people. That being said, I think it is important to r ...more
Sep 24, 2011 rated it really liked it
This book was fantastic. It made me think about what it means to be a leader and what it means to be mentally ill. While the author's evidence for the mental illness of many of his historical subjects is not always entirely convincing, that doesn't end up being the point. Instead, the point is to recognize that people who have the ability to be visionaries and leaders in crisis are often the ones who are not happy with the current state of things. Those who are 'normal' and happy have no reason ...more
Avis Black
Oct 06, 2011 marked it as dnf
The author has let his political opinions determine how he makes his psychiatric analysis, which is poor professional judgment. His main idea is that a dose of madness makes a leader better. He does not consider that some leaders are talented despite their illness, not because of it. Nor has he bothered to perform the sort of comprehensive survey that might back up his point. His cherry-picking carefully avoids leaders like Idi Amin, or the Emperor Nero, or Ivan the Terrible, all of whom had Gha ...more
An engaging look at how the range of mental health affects leaders in crisis situations, with a thorough examination if existing records. One of the best books that I have read, where the author admits finding results different from his original hypotheses and weaknesses or gaps in his approach. I particularly liked how he addressed living and contemporary leaders and shed light on the cross-cultural biases against mental illness if any degree. *Rounded up from 4.5 stars.
Nov 08, 2013 rated it it was amazing
Recommends it for: Anyone
Oh my gosh. This is such an amazing book! I have been drinking in every word, sometimes reading his sentences two or three times because I wanted his words to really sink in. He is so brilliant, and makes wonderful observations. Also, I don't really enjoy history as a general rule, but found myself absolutely gripped by this history-laden tome. I don't really know why I picked this book up, but I am so glad I did.
Rebecca Budd
Apr 25, 2012 rated it really liked it  ·  review of another edition
Shelves: 2012, politics, health
A First-Rate Madness was a page turner. The argument that in times of crisis insanity, rather than sanity, produces good results is a worthy starting point for a robust discussion. And he speaks of people that we know and respect: Churchill, Gandhi, Martin Luther King, Jr., Lincoln and JFK.
Michelle Cristiani
Solid investigation of the link between mental illness and able leadership through history. I learned a lot about many historical figures I didn't know battled depression. Ghaemi makes as good a case as one could using only historical evidence. Solid conclusions, even if most of it is just guess work...but I tend to agree with his findings.
Kelly McCloskey-Romero
Aug 25, 2019 rated it really liked it
I saw this book at a second-hand bookstore and then ended up finding it at the library because it intrigued me. Ghaemi posits that mental illness in leaders can make them better in a crisis. He claims that the empathy, compassion, grit, and perseverance that come from some combination of bipolar disorder, hyperthymic personality, and mental struggle made leaders from Churchill to Gandhi to MLK excellent leaders in chaotic situations. Conversely, mentally healthy people like George W. Bush are me ...more
Sep 07, 2018 rated it it was ok
The history was captivating. I could even see myself making some of these diagnoses over sips of tea and conversation with a friend. But, the speculation and storytelling was really extreme.

If you can put aside the main point, the mental health diagnoses, this is a very entertaining and satisfying read.
Oct 29, 2020 rated it did not like it
Shelves: shit-books
This book is garbage
Feb 11, 2017 rated it it was ok
Awesome concept, but ignores an entire gender.
Gale Jake
Jul 22, 2012 rated it liked it
Insightful in its basic concept, ie: leaders who tend toward manic are good in times of crisis, poor in times of peace and tranquility. Leaders who tend toward depression are good in times of peace and normal times, poor in times of crisis. He makes some good points.

His approach was to focus on the psychological history of leaders versus the actions of the leaders. What impact did the leader's state of mind have on the actions and outcome? Why did they behave as they did?

After a good start, the
Thomas Edmund
Mar 26, 2014 rated it it was amazing
If anything else, Ghaemi's general thesis is fascinating in itself: The ideal that mentally healthy leaders, while often successful, make poor decisions during times of crisis. According to Ghaemi leaders with poorer mental health make good leaders during times of crisis and difficulty.

Does he convince? The piece A First-Rate Madness does present some compelling arguments - Winston Churchill in particular provides a clear example of a poor peace-time leader and an iconic wartime prime minister.
Yong Lee
Dec 25, 2016 rated it really liked it
Nassar Ghaemi's A First Rate Madness: first rate book about mental illness and crisis leadership from JFK to Lincoln. Awesome read.
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Nassir Ghaemi MD MPH is an academic psychiatrist specializing in mood illnesses, depression and bipolar illness, and Editor of a monthly newsletter, The Psychiatry Letter (

He is Professor of Psychiatry at Tufts Medical Center in Boston, where he directs the Mood Disorders Program. He is a also a Clinical Lecturer at Harvard Medical School, and teaches at the Cambridge Hea

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