Fun fact of life....a lot of processes have basically two ways they can go. Someone can play a hand of limit hold 'em and look like st1ckman, mostly because he had two options and just happened to flip heads. The st1ck rides again. Next hand he aborts every street and you stop wondering what you were thinking. The st1ck is dead; long live the st1ck!
Going insane is no different. You can go insane in two basic ways. The first one is just what everyone accepts as going insane. It's not as clean as they show on TV (nothing is....the white house...a court room...being a cop....saving the universe from a guy with a big chin), but it happens roughly the same way. One day you wake up and your brain simply can no longer process and handle the world it is currently occupying. You cannot cope with your environment, it's all fucking madness, and to the outside world you look like a stone lunatic. You effectively cease to function. I've done that one and let me tell you it's no fucking bueno. Nothing makes sense, you can't solve the simplest of problems, everything is insurmountable, and waking up in the morning becomes a herculean effort that, once achieved, you literally question the point of.
The second way, unfortunately, walks the first path, but continues on to a more interesting place. You wake up one day and realize that your brain can no longer function in the world you've built for it. That's the same. But there isn't a sense a panic, loss, or failure. You aren't incapacitated. You don't cease to function. You realize that that the problem isn't necessarily with your mind, with you, but rather with the world you've carefully constructed around yourself. That's the source of the madness. In effect you're going insane, but what you're actually doing is leaving behind your past (insane) choices and moving on to a different (scary) place. To the outside world, and to all but your closest friends, you probably look the same as you would in the first method. And that make sense, as you have to basically go through there to get to this place. But it's very different.
I suspect that many extremely successful people have gone insane in just this way. They wake up one day and simply decide that their world is bullshit and that they no longer respect its norms and customs. Elon Musk, as much as I hate him, is extremely successful and probably didn't want to flip the world on its ass at age 7. The same argument could be made for Donald Trump. It's entirely possible that the ability survive going insane could be a driving force in human evolution.