The concept of care for individuals deemed ‘mad’ is contentious; long associated with passivity, benevolence, coercion and oppression enacted through colonial mental health systems and psy-ways of thinking-feeling. Simultaneously, the materiality of deep distress often necessitates ‘care’. How then, might we think-feel-practice care differently? How might care be co-created? Playful? Disruptive? How might care support us to reconceptualise madness, and madness support us to reconceptualise care? In this chapter I draw on post-humanist and Mad approaches, alongside sharing and collective theorizing with 15 peer support workers, to consider the productive possibilities of Mad care for shaping mental health care otherwise, as well as psy-relations that put peer support at risk of replicating the institutional care that Mad activism has long critiqued.