What are Psychotic Symptoms and how do they Manifest in Kanye West?
The majority of the public discourse about Kanye West’s recent comments praising Trump are missing one vital piece of information: Kanye has repeatedly displayed symptoms of mental illness. He has talked somewhat openly about a mental “breakdown” which he refers to as a “breakthrough”.
Kanye can explain rationally that he identifies with the grandiosity of Trump (which he refers to as “superman confidence”) and the fact that a reality TV star who spits nothing but BS can and did achieve what generally no one believed he could and become POTUS. Now Kanye believes he can be president too. Cannot we all now imagine Kim Kardashian as first lady thanks to this drunken shit-show of an administration? And the term “president” to Kanye seems to mean very little about government and policy. Kanye generally describes feeling emboldened when being told that he cannot or should not do something and uses that as motivation to do whatever that is.
That’s just the part that makes sense. The rest is quite familiar to those of us in the mental health field.
This morning, rapper TI was on The Breakfast Club talking about a recent 4hour conversation between he and Kanye about this very issue. He said that he has never before talked at such length about the same thing over and over again, and noticed that Kanye doesn’t understand any of the politics or actual policies of the Trump Admin. He had never heard of the travel ban. TI said Kanye “needs a translator” and that he “talks in riddles”. This is actually a psychotic symptom that falls into a category called Disorganized Thought Process or Thought Disorder. TI also said that Kanye talked about his ‘conscience talk[ing] to his subconscious’ which sounds a lot like how an articulate patient might describe auditory hallucinations.
Disordered Thinking: A failure to be able to “think straight.” Thoughts may come and go rapidly. The person may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention. The person may be unable to connect thoughts into logical sequences, with thoughts becoming disorganized and fragmented.
I will never forget Kanye’s 2016 MTV VMA awards speech (video above). At the time I had been working in a NYC CPEP (aka psychiatric emergency room) for a few years and was honestly shocked to see one of my people on stage.
But if you think about last week, there were 22 people murdered in Chicago. You know, like, people come up to me like, ‘yeah, that’s right! Take Taylor!’ But bro, like, I love you all y’all. That’s why I called her.
This speech clearly displays disorganized thought process. Of the patterns of thought disorder I recognize tangentiality, loosening of associations, and derailment and/or flight of ideas.
In January 2017 Kanye reportedly made another disorganized rant on stage at a concert in Sacramento. He then checked himself into UCLA’s neuropsych unit for a week.
I cannot fully assess for hallucinations or symptoms of paranoia and other delusions, but in my experience, I noticed that “the illuminati” was a popular theme with my patients exhibiting symptoms of paranoia in the Bronx. Other themes mentioned frequently are: feeling that you’re being watched and/or followed, feeling that “everyone” is against you or talking about you, feeling that someone is stealing your personal property, only eating certain things and/or self-prepared and/or packaged goods due to the feeling that food is contaminated or someone is trying to poison you.
Its hard to say definitively whether Kanye is exhibiting symptoms of paranoia from this distance, but he did seem inexplicably upset about Kim’s fur coat being stolen, and he continues to site this event as a major life stressor. I suspect that for him this event was confirmation that people are trying to harm him and his family.
“My Ego is My Drug”
Kanye, in his own mind, has been special for most of his life. The rules do not apply to him. He also seems to have a bit of an OJ complex. I don’t think anyone really knows where the Narcissism ends and Delusional Grandiosity begins. Kanye’s above average narcissistic traits were present before his behavior and language stopped making sense.. And arguably he would not have become so successful without that extra touch of narcissism and eccentricity. Of course, he is obviously Extremely talented in addition to having ‘Superman confidence’.
I am leaving all this as self evident. Just listen to a few Kanye songs or google “kanye ego” if in doubt.
“George Bush Doesn’t Care About Black People”
In my eyes the most glaringly contradictory piece of the whole puzzle is seen when we juxtapose Kanye’s public comments about president Bush in 2006 to where he is today. Let me refresh everyone’s memory: “George Bush Doesn’t Care About Black People”. It’s possible that his symptoms had not yet manifested at that time and his behavior actually appeared quite brave and sensical when considering what was going on with hurricane Katrina and New Orleans at the time. GWB has spoken about that moment and admitted he was quite hurt by the comments. However, when that 2006 declaration is contrasted with his current praise of Trump and criticism of Obama, it doesn’t objectively make much sense. I think a lot of people are now thinking “Kanye West Doesn’t Care About Black People”.
What Not to Do
Don’t Drop the Blunt and Disrespect the Weed
In 2017 Kanye’s insurance company–Lloyd’s of London–refused to continue coverage during a tour, citing the reason as his ongoing cannabis use. His tour was cancelled halfway through following Lloyd’s doctor’s assessment that Kanye’s mental condition was “disabling” enough to prevent him from continuing the tour.
One thing that would certainly help dissipate Kanye’s psychosis is for him to stop smoking weed. Mind you, I am not a hater of marijuana; I think it has a lot of potential both medically and recreationally. But to say that it’s not dangerous is to not know the facts: Some people should not smoke weed. Period. I have seen some serious breakthrough psychosis with frequent marijuana use as the main impetus.
I have a close personal friend who had no history of mental illness in the family or in himself, who made himself psychotic by smoking wax. He spent three plus weeks as an involuntary inpatient at a private hospital in NYC. They gave him a 200mg shot of Haldol Decanoate and discharged him on ~20mg Haldol po a day. The inpatient treatment team could not know whether my friend would be suffering with mental illness for the rest of his life or not. And I don’t think they were informed about how much wax he had been smoking on a daily basis. But, my friend completely recovered, stopped taking the meds after a few days, and has not needed any additional mental health treatment. I was not convinced drug-induced psychosis was a real thing until watching the course of this transformation.
More often, however, the boundaries of whether an episode of psychosis is caused by mental illness or is substance-induced, are not so well defined. Many people prone to psychosis also use THC and exacerbate their symptoms despite medication and treatment compliance. In my opinion, Kanye falls into this more common category–if he does in fact continue to smoke marijuana.
How do we Really Fight the Stigma?
For what it’s worth I have a lot of respect for Kanye’s statements about wanting to take away the stigma of ‘mental health’—on the surface at least. But as a mental health clinician, I calls it as I sees it. Not chalking up to needing/utilizing psychiatric help–aka labeling a reason for inpatient admission “exhaustion”–doesn’t do thecommunity any favors. Kanye recently stated that he isn’t in therapy and talks to friends and family instead—which is to say that he is publically announcing the fact that he’s not in treatment and pretty much negates any positive steps toward decreasing the “stigma” (Likely also indicating that there should be plenty more bizarre statements and behavior to come going forward).
What would actually help minimize stigma is to talk about being in treatment and to admit publicly that one was having psych symptoms or treated for symptoms without shame so as to inspire others to get help and to talk about whatever they are going through. Having psychiatric symptoms does not make anyone a monster, or a less worthy human being, or “other”. Many people are treated for symptoms at some point in their lifetime. I would argue that many MANY more people SHOULD be. I am and have been in treatment for depression and ADHD for over 10 years. My mother was diagnosed with bipolar disorder and was involuntarily admitted to inpatient treatment several times. She’s stayed connected to treatment, takes her medications, and has been stable for over 15 years. Her mother had a mental illness involving psychotic symptoms (in a period of time when much effective treatments were much less available). The stigma is perpetuated by dancing around the subject, making excuses, and by people not being able to talk about mental/behavioral health/illness without shame.
Stigma and the Media
I am noticing a lot of push-back in the media against people who are questioning Kanye’s mental stability. To those people I say: labels really don’t matter in psychiatry as much as lay people may think. I’m not going to diagnose Kanye from a distance. In truth, diagnosis is so subjective that in psychiatry we focus on assessing and treat the symptoms. Suffice it to say that and diagnoses is mainly for billing purposes.
I tried to address only symptoms Kanye has exhibited in public in the above paragraphs. If you are not a mental health clinician and/or lack familiarity with the varying degrees of mood and psychotic symptoms that an individual can display, than you don’t really know what you’re talking about.
If Kanye was not Kanye/Yeezy, i believe his friends and family would be more likely—not less likely—to try to convince him to remain compliant with mental health treatment. Because he is interpreted more as a creative genius than a regular person, he is surrounded by enablers and people who find asinine excuses for him. The fact that Kanye is a rapper and writes lyrics for a living does a lot to obscure the fact that he is walking around talking in riddles. I find the public defensiveness of some people against this very conversation quite telling.
All that being said, even with symptoms of mental illness Kanye is not as petulant as trump. I would take Kanye’s delusional grandiosity over trump’s malignant narcissistic personality disorder any day. After all, personality disorders tend to be nearly impossible to treat. In Trump vs Kanye, Kanye gets my vote fo sho.