Book SummaryA First Rate Madness, by Nassir Ghaemi

1-Page Summary1-Page Book Summary of A First Rate Madness

Many of us consider good mental health to be an important quality for leaders, whether they’re a nation’s president, a military general, or a CEO. However, in A First-Rate Madness, Nassir Ghaemi writes that while this may be true in times of peace and stability, leaders with mental illness are often better fit to lead during a crisis. He argues that mental illness contributed to the successes of historical leaders such as Winston Churchill and Franklin D. Roosevelt. According to Ghaemi, if we better understand how conditions like depression and bipolar disorder can enhance leadership, we can lessen the cultural stigma surrounding mental illness.

Nassir Ghaemi is a psychiatrist and director of the Mood Disorder Program at Tufts Medical Center. He has published numerous books as well as over 100 scientific articles on mental illness, with his research focusing on depression and bipolar disorder.

In this guide,...

A First Rate Madness Summary Mental Illness and Leadership

According to Ghaemi, some of the greatest leaders throughout history succeeded not in spite of, but because of their experiences with mental illness. Although conditions such as depression and bipolar disorder can be harmful and exhausting to those who suffer from them, Ghaemi argues that these same disorders can also cultivate powerful leadership qualities.

(Shortform note: While Ghaemi only reviews a few United States presidents, one study found that out of the first 37 presidents, 49% of them likely suffered from mental illness at some point in their lives. Based on biological records and the Diagnostic and Statistical Manual of Mental Disorders, psychiatrists suggested that 24% suffered from depression and 8% from bipolar disorder. The researchers further concluded that presidential mental illness resulted in no national disasters, which supports Ghaemi’s argument that mental illness isn’t always deleterious when it comes to leadership.)

Defining Mental Health and Mental Illness

Before we can discuss how mental illness can...

A First Rate Madness Summary How Depression Improves Perspective and Understanding

In this section, we’ll first look at how depression can strengthen a leader’s sense of perspective and understanding, providing them with the right insights to handle critical moments. According to Ghaemi, depression does this in two ways.

1) Depression Gives You a Realistic Perspective

In Ghaemi’s eyes, leaders who either suffer from depression or have dysthymic personalities are better at realistically assessing critical situations, while mentally healthy leaders are too optimistic. To illustrate this, Ghaemi points to experiments showing that mentally healthy people tend to overestimate how much control they have over situations—for example, they overestimate their ability to predict the results of coin tosses or to control random events.

This phenomenon is called an “illusion of control.” The experiments Ghaemi discusses showed that people with depression have a more realistic perception of control over their environment, more accurately judging their ability to predict chance events or to influence those events.

(Shortform note: The illusion of control is what’s known as a positive illusion, which is an unrealistically pleasant belief we hold [to maintain...

A First Rate Madness Summary How Mania Prepares Leaders for Unprecedented Challenges

Now that we’ve examined how depression enhances leadership, let’s discuss how mania can help leaders not only understand critical situations, but also overcome them. According to Ghaemi, mania and hyperthymia can make a leader uniquely prepared to tackle unprecedented challenges by boosting their resilience to adversity and encouraging innovative thinking.

1) Mania Enhances Your Ability to Overcome Adversity

Ghaemi contends that mania can enhance your ability to overcome adversity because it naturally elevates your mood and energy while decreasing anxiousness and self-doubt. This also applies to people with hyperthymic personalities who naturally have positive traits such as a sense of humor, enthusiasm, and open-mindedness, all of which combine to make a leader more capable of handling trying circumstances.

(Shortform note: While Ghaemi believes mania can help you overcome adversity and thus become more resilient, others have found that people with bipolar disorder often have lower levels of resilience. Whether or not you struggle with mental health issues, Brené Brown offers suggestions on how to...

A First Rate Madness Summary How Mental Wellness and Treatment Affect Leadership

Ghaemi not only explains how mental illness can foster positive leadership traits, but he also details the specific ways that mental health can contribute to leadership failures. In addition, he argues that the manner in which you treat mental illness can affect leadership abilities—proper treatment can enhance positive traits while improper treatment can impair crisis decision-making.

Good Mental Health Is Bad During Crises

According to Ghaemi, mentally healthy leaders often make bad decisions during crises—they tend to be overly optimistic, less empathetic, unchallenged by struggles, and inflexible when compared to mentally ill leaders. He argues that while such leaders can be effective during peacetime, they often lack the right instincts during times of conflict. To make his point, he examines how mental health negatively affected the leadership of Neville Chamberlain, George McClellan, George W. Bush, and Tony Blair.

Emotions, Memory, and Decision-Making During Crises

Ghaemi describes several reasons why mentally healthy people make bad decisions in crises. However, everyone, regardless of their mental health, can fall prey to poor...

Shortform Exercise: Apply the Four Leadership Traits to a Personal Crisis

According to Ghaemi, depression and manic depression enhance four traits that are crucial for leadership during crisis situations. However, you don’t have to struggle with mental illness to develop a realistic perspective, empathy, resilience, or creativity. Consider how you can apply these traits to your own life.

Describe a crisis or a challenge that occurred recently in your life. What made it a challenging situation? How did you handle it?