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Go to New York City area and North Jersey and you will see the meaning of these words.
You don't have to go to a mental institution to see urban insanity. Just go to New York City and North Jersey and how they behave. They always give you an attitude from reasons only them could know.
Someone or something being so amazing that it surpasses sicko mode, reaching near divinity.
"I just went 80 in a school zone!"
"That's actually insane-o mode"
Random recruit: "Yo bro how would you define Astoria?"
Me, who's seen how fucking stupid the server is: "Derangement, insanity, and utter hellholery."