1.
Sometimes, when something happens, I spend some time in disbelief. Because my memory tells me it did happen, and my mind tries to convince me it couldn’t have. Usually, when this happens, it’s because a person has acted in a way so incongruent with what is supposed to be “normal” (maybe it’s more apt to say “ideal”) human conduct.
It’s easy to catch me declaring my preference for engaging reality without the rose tint, but I do have some unintentionally idealistic ways of viewing the world. I accept it for its absurdity. But I also cannot understand many of them, so much so that attempting to sometimes causes me mental distress.
So when someone acts in a way so divergent from what I consider rational, I wonder for a fleeting moment if they are in some form or another, a bit mental. Although I think it unlikely, I imagine they can’t possibly be whole in their minds and act as they have. It’s why I struggle to understand aggressive online trolls [with nothing to gain from it], or people who wank in public, or people who enjoy inflicting senseless harm.
No matter how exposed I am to such stimuli, they scarcely fail to confound me.
Every now and then, I find myself thinking: What the hell is going on in this person’s head? And are they normal? Is the human experience so varied and absurd that even this, somehow—without any bug in the code—is normal, rationalisable human behaviour?
Naturally, or tangentially, this often makes me wonder how people go mad.1 Raving, walking-dirty-on-the-streets mad, yes. But also quiet, well-put-together-in-every-other-aspect mad. Is it sudden or slow, and are people aware they’re slipping into a mental cesspit? Is madness compartmentalised—as in, could you be going bonkers, absolutely batshit crazy in one room while the other rooms in your brain operate fine enough to convince you there's nothing crazy about your very unusual conducts? And perhaps most importantly, can it happen to anyone?
2.
Recently, I went Googling to find out.
Because it’s a curiosity I’ve had for a long time (I spent a few of my teenage years frequently scrolling the pages of the DSM-5—I might explain why some other day).
But also because something happened sometime last year that put me in a state of faux denial for a week or so. I knew it happened, and it wasn’t all that surprising that it did. But it shocked me all the same.
I was in my lab, early in the morning, and this man, all of a sudden, after saying hi to everyone and doing some writing, whips out his penis and starts furiously jerking off. Three of us were in the lab besides him—two ladies and me. I didn’t realise what he was doing immediately (because a desk initially shielded his lower body from my view), but by the time I did, I just couldn’t understand it. I was in utter shock.
In the weeks leading up to this, I could tell he was not stable at least. It was not immediately obvious until you talked to him for a bit and his conversation slipped from normal, intelligent even, to slightly absurd. But I had spoken to him before, and barring his segues into what struck me as delusional religious talk, he seemed mostly under control. He had offered me unsolicited but sound advice about how to write my research proposal and seemed generally all right even if sometimes overly enthusiastic in offering advice.
My obliviousness to how dire his instability was or that he even had such inclinations added to the shock I felt seeing him suddenly unravel.
After this strange encounter and the adrenaline in my body had dissipated and I went home and pulled up his LinkedIn as I tried to make sense of his person, I was only further discombobulated. Well-accomplished and well-educated. (I am aware that mental illness does not care about your history or status. My bewilderment was because the last position he held was so recent and I still couldn’t tell if his behaviour was driven by recent mental illness or if it was a demonstration of his long-term perverse proclivities.) From his profile, you would scarcely suspect he was roaming the university, clean and responsible-looking on some days; haggard, with the mien of someone minutes from jumping into the streets on others.
It was unsettling. And it bothered me that reporting him did nothing to ensure he was prevented from coming back. They said he couldn’t do any harm and couldn’t have done what he did intentionally. Because he wasn’t in his right mind.
(You see, I didn’t and still don’t know how to feel. Ask me how many times I’ve looked up why people wank in public between then and now, and I can only sigh. The discourses travel in several directions. There’s validity to the argument that his mental instability drove his actions, but his LinkedIn also had some recent posts of seemingly lucidly written albeit perverse thoughts. This doesn’t mean much since an unstable mind can produce lucid thoughts. However, I’m still uncertain how much of his thoughts/behaviour is attributable to his slipping sanity and how much is his unadulterated personality. I often wonder where the lines between what may be explained by mental illness and what is simply a peculiar or perverse iteration of normal blur.)
It would be unfair, their argument was, to have him arrested [since his behaviour was because of his shaky sanity].
It is at this point I note that it is sad that Nigeria doesn’t have a fantastic supply of good, fully state-funded institutions to care for the mentally ill, not anyone you would willingly put someone you cared about [which is why I wasn’t even sure what it was I wanted them to do with him when I complained]2. This is unfortunate because unless you’re willing to foot the bill for someone’s care at a decent mental institution, you are lost for ways to resolve these things. Even if you decided to be heavy-handed and arrest them to prevent them from acting in potentially harmful ways again, you would have to spend money you likely had little of to keep them away—while battling the moral dilemma birthed by your decision—unless the line you’re trying to stop them from crossing has been crossed.
At the time, I could only think about how his presence around the department was a safety risk (I was told he had harassed and/or been inappropriate towards a few people outside of what I witnessed and I could only think about the potential for extreme scenarios given that what I had witnessed was unprecedented).
Part of me wondered if I was acting in ways bereft of empathy by insisting on the risk he posed. I could hear why those I reported to were reluctant to take action (they knew him in his better days), and I could understand it, but I was also wondering if it made sense to let only empathy take the front seat.
How much grace should we give to people whose mental instabilities make them a potential harm to others, and how culpable are they if they indeed are acting the way they are because of a bug in the code?
I know, from various distances, people who have slipped into madness; and they are, at their lowest, incredibly sad to watch. You see how much they could be, and how their life is gradually slipping away without them in the driver’s seat. But for those who pose a risk to others’ safety, how much empathy is enough before it becomes acceptable to make hard choices?3
What do we do with people who, possibly through no fault of theirs, have an elevated potential to cause harm?
I don’t know.
A lot of the discourse I see regarding the treatment of people with the type of overt mental illness characterisable as madness in Nigeria focuses on certain types of ideal cases, such as those where the concerns of those around the troubled person are, at worst, the social stigma or embarrassment that the person’s behaviour could bring them. These are cases which, although difficult too, are easier to manage in ideal ways (not that a lot of people do so).
Sometimes the concerns are more material, such as when a person’s delusions lead them to physically harm or abuse others. This, I do not see discussed as often.
Even in cases where the potential for harm is real, some are easier/harder to deal with than others. For example, humane institutionalisation [a luxury in an institutionally decrepit country like Nigeria] may seem a justifiable recourse for people who are violent and too far gone (i.e., whose loss of touch with reality and the threat they pose to others are constant and palpable).
But for people who suddenly slip in and out of violent psychotic episodes, how do you justify restricting them for the weeks or even months when they are nothing but normal and reasonable? And how do you ensure, if you simply let them be, that there are no casualties in the wake of their next episode?
I don’t know of many easy answers that maximise everyone’s interests. Perhaps that is why it is often glossed over.
I should note that while my tone has been mostly bleak (this isn’t a topic that makes me happy), insanity is not necessarily damning. While surfing the interwebs, I came across a number of approved drugs for managing various psychosis-related conditions. While they may not work for everyone, they are life-saving to those for whom they work.
It’s a curious thing that the next time I saw that man after that day was the afternoon just after I wrote most of this letter. He entered into an office I was in and I felt all the hairs on my body rise while my hands quivered from the sudden adrenaline rush. He looked worse than before, leaner, more mercurial, body squirming in his seat and eyes frequently making long, unbroken contact. While he maintained what seemed to be normal conversation with my supervisor, it was clear now that all wasn’t well with him. To be honest, I thought he might lunge out of his seat at any time and attack.
3.
My original question was about why people go mad.
As with nearly every question I ask here, I don't know the answer. But it is unsurprising that people go mad for many reasons—reasons which evade experts as well.
But that is what it is.
I did confirm something else though.
Apparently, almost anyone, at any time, can go mad.
There is some research showing that the brains of some people who go on to develop schizophrenia later in life show unusually high levels of grey matter loss (amongst other things outside of my bandwidth to discuss) years before any behavioural change occurs.
Outside covert brain changes, among the complex forces that can launch someone into madness or temporary psychosis are traumatic life experiences, depression, extreme stress, blows to one’s self-image, etc.—experiences so rattling that the mind retreats into itself and loses touch with reality.
Some people are definitely more predisposed to developing the types of mental illness characterised as madness than others, but it can happen to anyone.
One’s sanity, even when well-cared for, is at best a carefully constructed tower of dominoes—and one ridiculously well-aimed hit can send all the chips crashing down. At least that’s a theory with which the Psychologist Zimbardo concurs.
When I first started writing this, I watched a lot of videos and interviews about experiences describable as insanity.
In many of the interviews I watched with people who had experienced bouts of (violent or non-violent) psychosis, whether brought on by schizophrenia or otherwise, I was struck by how frequently they described the suddenness of the onset of their delusions.
One day, without prior warning or a clear predisposition, it simply came on them.
The experience is definitely not the same for everyone. Some people recall the events of their psychosis. Some don’t. Some could tell they were losing their grasp on reality. Some couldn’t.
It’s a bit terrifying, to be in those shoes. And sometimes it is also terrifying to be a witness.
When I say mad here, I do not use it as a term for describing people I simply do not understand or for mental illness in general. I strictly mean insanity, whether subtle or full-blown. I understand it’s not the most palatable word choice, but I don’t know what else collectively describes the type of mental illness discussed here without watering it down.
The linked document is a detailed discussion of the state of mental healthcare in Nigeria. Among its many findings is that public mental health institutions engage in many inhumane treatments of patients, particularly those with insanity.
I am still unsure what “hard choices” means. But I imagine even the most humane, empathetic, and ethical solution in such cases is not an easy or perfectly ideal one.