The Most Beautiful Thoughts Are Always Beside the Darkest

On the social construction of mental illness

Photo by Taylor Hill/Getty Images

NNever have I ever had a friend who isn’t psychotropic-ly medicated. I’m joking, kind of. But not really. When I think of the people close to me, in my age range, they’re all either medicated, have been medicated, or have been encouraged to be medicated. Most popular are the SSRIs: Lexapro, Prozac, Celexa. I’m on an SNRI, which I like to think is fancier, but it’s really just newer, which makes imagining the potential long-term effects extra terrifying. I’ve heard rave reviews about Wellbutrin, an NDRI. My bipolar friends take Lithium or Seroquel. My ADD friends, Adderall or Vyvanse; the insomniacs, Ambien or Lunesta. I’ve had a Benzo prescription for panic since I was 14, and a good friend once assured me he’ll take Klonopin “every day for the rest of his life.”

Thousands of Americans are diagnosed with a mental illness each day. In the past few decades, antipsychotics have replaced cholesterol-lowering medications as the top-selling drugs in the U.S. But many wonder: Is our current trend of rampant diagnosis and loose prescription necessary, or even helpful? In Anatomy of an Epidemic, science writer Robert Whitaker examines whether psychiatric medications fix chemical imbalances in the brain, or whether they, rather, create them.

Recently, when visiting my psychiatrist for routine medication management, I told him I didn’t think my SNRI was really doing anything. He said I might try Lamictal. “It was designed as an anti-seizure medication, but every bipolar medication is discovered that way,” he told me, “also, I don’t think you’re bipolar, but people love it.”

The Wikipedia article on Lamictal declares: “How it works is not exactly clear.”

TThis May, Kanye had what appeared to be a manic episode on TMZ Live. At one point, he turned away from his interviewers and began speaking to the audience of cubicle-workers, his de facto pulpit, screaming about the amount of pills he was prescribed following his 2016 psychiatric hold. In a recent interview with The New York Times, Kanye told Jon Caramanica that he was “learning how to not be on meds,” boasting, “I took one pill in the last seven days.”

Kanye first publicly admitted to mental health struggles in 2010, at a screening for his film Runaway, when he told the audience he had considered suicide. Then, on his 2016 song “FML,” he rapped about how there is “nothing crazier” than when he’s “off his Lexapro.” Later that year, his Life of Pablo tour was cut short due to Ye’s “temporary psychosis.” Shortly after his release from UCLA Medical Center, Ye visited the Trump White House to discuss “multicultural issues.” Things were fairly quiet in Kanye-land until his return to Twitter this Spring, during which his rapid-fire tweets about “free thought,” to me, screamed mania. Then came the infamous TMZ Live interview, after which Kanye told radio host Big Boy he felt privileged to be able to release an album given what had transpired: “Think about somebody who does exactly what I did on TMZ [….] Tuesday morning they come in and lost their job.” On his subsequent album, Ye, he officially announced being bipolar for the first time, deeming it not a disability, but a “superpower.

I watched all 42 minutes of Kanye’s TMZ interview in a state of rapture. There was something magnetic about the performance — and, yes, I’m calling it a performance — in which Kanye floated unpredictably between subjects, rejecting almost every convention known to man. After the previously-mentioned pill-rant, he debated a random TMZ producer about police violence, then insisted he be permitted to hug the producer (for “free love”) — right then, on camera. The final segment brought conservative commentator Candace Owens into the conversation, during which Kanye mostly fidgeted with his phone and whispered conspicuously to Harvey Levin. He seemed annoyed with the formal turn the interview had taken.


Kanye’s musical style is not unlike his rhetoric. It pulls us in, then pushes us away. We think it’s going one way, then it jerks us in another direction. He cuts off samples mid-word, just like he’ll stop a live performance mid-song to rant about some CEO failing to give him due respect. With Yeezus, Kanye traded the smooth maximalist choruses of Dark Twisted for raucous, industrial minimalism. On Pablo, he continued to tweak the album for months following its release, forcing Ye’s label to deem it a “living, evolving art project.” Kanye has no patience for predictability or expectation: He invents styles rather than copies them. He’d rather be a dick than a swallower.

Pretty much everything Ye did and said during the TMZ interview was overshadowed by his declaration that slavery “sounds like a choice.” On the heels of his MAGA-related Tweets, this comment left the public enraged. Fans felt betrayed that the man who famously said “George Bush doesn’t care about black people” now appeared to be aligning himself with the alt-right. But I wasn’t shocked. In 2005, Ye told the crowd at the Live 8 benefit concert that AIDS was a “man-made disease”; in 2011, at a British music festival, he compared himself to Hitler. Anyone paying attention knows there is nothing Kanye hates more than the neoliberal establishment, and Trump is the face of the opposition. (Oh, they also share “dragon energy.”)

Last Spring, a year before Kanye’s epic return to Twitter, I interviewed Gender Studies Professor Jeffrey McCune, who is writing a book called On Kanye: A Philosophy of Black Genius. Regarding the public’s reaction to Kanye, McCune told me: “[b]ecause of the dismissal of his heightened performances, often we miss the significance and meaning of some really valuable statements and proclamations made by West.” In recent months, McCune told Pitchfork: “I think Kanye needs a much more nuanced analysis. He needs to have someone provide for him a much deeper context for his comments.” In his April interview with Charlamagne tha God, Kanye echoed: “People will take something that’s enlightened, put it in a different context and call it crazy to diminish the impact of what I’m saying.”

Following the TMZ interview, a reddit user deemed it “ironic” how the press fixated on Kanye’s slavery soundbite. “In the context of the full interview,” he wrote, “the slavery comment was an analogy to how people are manipulated to think a certain way [….].” The press “did exactly what he said they would do.” Ye “claimed the media would condition people to hate and not listen to his actual ideas and the actual point he is trying to make.” He concluded: “I’d like to take a second and say that I’m not a Trump supporter.”


“In Kanye’s songs,” Vox’s Constance Grady wrote last year after a platinum-haired Kanye met with Trump just after being released from the mental hospital, “Trump is a symbol of the kind of wealth and power that American culture generally withholds from black men.” Kanye reiterated on TMZ Live: “Trump is one of rap’s favorite people.” A search of “Trump” on Genius reveals countless lyrical matches. Despite his inherited wealth, there is something decidedly New Money — in the American Dream-y way rappers loves — about Trump. He’s lavish. He loves gold. And unlike most of our presidents, he didn’t go to Harvard or Yale.

Rejecting the chorus deeming Kanye an irritating contrarian, McCune retorted that Ye is rather “trying to disrupt the institutions that we have come to know as trusted institutions.” As Kanye said of his debut album College Dropout’s title in 2004: “All that’s saying is make your own decisions. Don’t let society tell you.” Through and between his numerous provocative declarations, McCune believes Kanye insists on the “deprogramming of American society.”

When asked about his controversial take on slavery, Kanye told the New York Times, “If you look at that clip you see the way my mind works.”

Throughout history, philosophers and scientists have grappled with whether those we dismiss as “crazy” are actually more closely in touch with reality.

Foucault’s 1964 opus Madness and Civilization explains that during the Renaissance, the “mad” were seen as possessing a kind of wisdom. They could see the world for what it was rather than what it pretended to be. By the mid-17th century, we began to cast away and medicate the mentally ill. Foucault argued that the supposed scientific neutrality of modern psychiatry is mostly an attempt to preserve conventional bourgeois morality. Likewise, in 1972, French philosophers Deleuze and Guattari argued that the schizophrenic “will not be trapped by the power-laden and despotic webs of signifiers that saturate society and the psychoanalytic practice.”

Dead French philosophers aren’t the only ones who believe mental “illness” is mostly about social control. Contemporary sociology professor Allan V. Horwitz has argued that most conditions we currently consider mental illness are social constructions, normal reactions to stressful circumstances, or just regular forms of deviance.

Likewise, psychology student Michael Sendrow recently wrote that America’s relationship towards mental illness is “based in fear and bent toward eradication.” He believes that in diagnosing and medicating “non-normative behavior,” we ultimately “tranquilize these behaviors at the expense of understanding them.”

Schizophrenia has a poorer prognosis for people in the West than for those in less urbanized societies, where people are less likely to be medicated. Accordingly, a long-term NMH study of schizophrenic patients found that unmedicated patients were more likely to recover than the medicated patients. At the 15-year follow-up, more individuals in the medicated group were actively psychotic.

In Anatomy of an Epidemic, Whitaker wrote that the main reason Americans don’t know know about the severe chronic problems created by long-term psychiatric drug use is because mainstream American journalism and government agencies have conspired to keep that information hidden. The tangled relationship between American psychiatry and the pharmaceutical industry, Whitaker argues, has rendered mental illness a “profit center.” On TMZ Live, Kanye lamented that Americans are over-prescribed to suppress “free thought.”

Numerous studies link mental “illness” with enhanced cognitive abilities.

Last year, Canadian researchers found that anxiety disorders are linked with higher IQ. Another study concluded that former straight-A students were four times more likely to be bipolar than their peers. Research from Washington University found that connectivity within the brain correlates to the person’s overall intelligence. This connectivity is important. As Steve Jobs said, “creativity is just connecting things.”

Mania fosters rapid connection-making. A manic episode is typically categorized by loud and swift speech, and something psychologists call “clanging.” This refers to speech characterized by seemingly irrational associations, which may include “compulsive rhyming or alliteration” with no logical connection between the words. And when you’re uber-famous, on live television, discussing sensitive topics in a state where you can’t follow the logic the rest of us have subscribed to, it becomes particularly easy to offend people.

In response to Kanye’s recent antics, a spokesman for the Depression and Bipolar Support Alliance suggested that rather than an illness, bipolar disorder could be considered “a suite of traits and perspectives that, while sometimes problematic and unusual, can also — if understood, managed, harnessed, and directed — be assets in many areas of life and even specific lines of work, including creative pursuits and entrepreneurship?”

Consistent with the idea that not every non-normative mental process is an “illness” that needs to be medicated, the educational non-profit the Icarus Project was founded to “tap into the true potential that lies between brilliance and madness,” in turn recognizing that “breakdown can be the entrance to breakthrough.” (Ye likewise told Charlamagne tha God: “I think I’m at a stronger place than I ever was, after the breakdown — or I like to say, the breakthrough.”)

Do you remember the first time you heard My Beautiful, Dark Twisted Fantasy?

I do.

When my friend told me he couldn’t “get through” Kanye’s TMZ interview, I told him I watched it like I watched the 1975 cult documentary, Grey Gardens. During both, I felt like I was watching something profound I couldn’t quite access. Both left me with a sense of awe, inspiration, and unease. Was I championing mad geniuses, or participating in their exploitation?

I am not a rap superstar. I am a white woman who has never made six figures. But I also heavily relate to Kanye West. His distrust of group-think. His twin desires to be popular and to alienate everyone. His tendency to become heated about an idea, be dismissed as crazy, and then promptly become crazier. His desperate desire to shatter the narratives our nation holds sacred. His wild vacillation between egomania and self-loathing. His perpetual struggle regarding whether and to what degree he should medicate, and whom he can trust in that arena. His being punished for existing inside the very box we’ve shoved him into.

Pointing to TMZ’s staff during the interview, Kanye announced that his opiate addiction began following a surgery: “I had plastic surgery because I was trying to look good for y’all.”

“I got liposuction because I didn’t want y’all to call me fat like y’all called Rob [Kardashian] at the wedding and made him fly home before me and Kim got married,” Kanye continued. “I didn’t want y’all to call me fat so I got liposuction, right? And they gave me opioids, right?” (The confession was extra-haunting in light of how Kanye’s beloved mother Donda passed away: a botched liposuction procedure funded by Mr. West.)

Michael Sendrow wrote that we “project our worst impulses onto [the] sick mind.” He continued: “We see this sick mind not as a condition of any collective illness but instead the cause. This sick mind is the source and expression of society’s faults and failures.”

In an interview at Ye’s listening party, Kanye explained the album title: “I believe ‘ye’ is the most commonly used word in the Bible, and in the Bible it means ‘you,’” he continued. “So I’m you, I’m us, it’s us. It went from Kanye, which means ‘the only one,’ to just Ye — just being a reflection of our good, our bad, our confused, everything. The album is more of a reflection of who we are.”

So before we dismiss Kanye, or anyone else, as “crazy,” maybe we should realize that he is all of us.

Me, you, Ye.

vagablonde (unnamed press, may 2020); bad lawyer (hachette books, spring 2021)

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