I think people can be a bit harsh when assessing Alexandra, particularly when it comes to the issue of her health. Branding her as "insane" is rather cold and doesn't seem to take into account the fact this woman had an extremely tragic life.
Firstly, she loses both of her parents before she is 20. Secondly, she marries into a foreign court with and has to come to terms with a new religion, language, culture and court in a very short space of time. Thirdly, her physical health is generally poor. The speed at which she produced children would wear out most women since pregnancy, as any woman who has had children will tell you, can/is very taxing on the body. Then to put the cherry on the ill-tasting cake, her only son, the one who is supposed to one day rule an empire, has a debilitating illness that could kill him at any moment. The fact she passed it onto him probably made her feel even worse. I'm not surprised at all that Alix had a number of health issues both physically and mentally. I think people can be quite insensitive to her plight at times. I'm not saying Alix was a saint but recently I've come to believe that she was a sick woman who has been unfairly demonised both when she was alive and after her death.