This is one of the metaphors for crazy that seems right on. Someone on the crazy train does, in fact, seem gone, as if they went on a trip somewhere and left a copy of their body to carry on in their place.
In some cases, it feels as if the person hasn’t gone so far. You think you could snap your fingers or clap and find them returned to you. But some people are very far gone. They disappeared off to Borneo, or off to (opposite of Borneo) if you lived in Borneo.
And they usually go without a forwarding address or a phone number where they can be reached or even findable on the internet.
Sometimes a person is so far gone, you can only reach them by hiring a plane and flying messages over the mountains in smoke.