So either she just likes to pretend to be nuts to have interesting lyrics to sing, or she's slowly trying to tell is she's really nuts and that we shouldn't be surprised when she goes serial?
She's actually having fun with her public image in this song/video. When she sings "Got a long list of ex-lovers/they'll tell you i'm insane", the "they" can/should(?) be interpreted to mean "the media", not the lovers.
See, I have a decent phone, but why do all my pictures come out blurry or grainy? I see pics like this and I think they are faked by a professional photographer...
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