The Madness of Mary Lincoln

Epilogue

Epilogue The mental illness of Mary Lincoln is a fascinating historical study that has rarely been explored from a psychiatric viewpoint. Despite a historiography of some eighty years, most historians and writers have eschewed the medical perspective, focusing instead on historical, moral, legal, political, and social viewpoints. A true understanding of her illness cannot be understood, however, without determining what her mental aberrations consisted of. The historical evidence shows that Mary Lincoln most likely suffered from Manic-Depressive Illness, now called Bipolar Disorder. She suffered intense mood swings during her youth and early adulthood, which increasingly transformed into periods of depression and, during acutely traumatic episodes such as the death of a loved one, severe depression that went beyond the bounds of what psychiatrists would call a normal grief reaction. Numerous sources offer evidence that during Mary’s marriage to Abraham Lincoln her symptoms escalated to include delusions and hallucinations (such as her constant fear of fires and burglars) and the compulsive spending that so characterized her later life. This continued during the White House years, along with the emergence of delusions of persecution and poverty. The assassination of her husband clearly unhinged Mary, and her mood swings and depressive episodes became more intense and more frequent. Her delusions and hallucinations became more pronounced, as did her spending, until her commitment to Bellevue Place Sanitarium. Her symptoms then turned to violence, first with her 1875 suicide attempt, and then in the form of threats against Robert’s life and her acquisition of a pistol. What little is known about her years in Europe seem to show a lessening in the severity of her condition, but her mood swings, depressive episodes, and senseless spending continued. (For a professional psychiatrist’s viewpoint on Mary Lincoln’s condition, see appendix 3.) The first attempt to psychiatrically examine Mary Lincoln’s mental state was Dr. W. A. Evans’s, Mrs. Abraham Lincoln: A Study of Her Personality and Her Influence on Abraham Lincoln, published in 1932. Evans, a physician and medical school professor who also consulted other specialists in mental diseases, sought to examine and diagnose Mary’s mental 151 152 . Epilogue state through her psychology. His belief was that to truly understand Mary’s life and actions one must understand her personality, which included her mentality and even her physical health. Evans did not limit himself to the actual instances of Mary’s “insanity” but also examined her family background, life history, life traumas, and physical health, to explain what he concluded to be an emotional, but not mental, insanity. Mary had a “mild, emotional insanity which caused her to act as does a case of schizophrenia—living alone, apart, and letting the world take care of itself,” Evans wrote.1 Yet, because she was a victim of her emotions, she was not responsible for what she said or did or for what people said about her, he concluded. Evans’s conclusions for Mary’s insanity were weakened, however, by his defense of her. In fact, Evans nearly contradicted himself and unwittingly gave ammunition to later Mary defenders as his conclusions about the degree of her mental instability were marred by caveats, rationalizations, and nuances that grew as the book moved toward its end. He stated that her mania for money, extravagance, and miserliness were “well known” to psychiatrists and “present in many people who are accepted as normal.” And while not denying her mental condition, Evans also stated that Mary’s belief in Spiritualism, thought at that time by some doctors to be both a cause and a manifestation of insanity, “militated” against her at the time of her trial.2 In January 1941, Lieut. James A. Brussel, U.S. Army Medical Corps, the chief psychiatrist at Fort Dix, New Jersey, published a psychiatric study of Mary Lincoln in the Psychiatric Quarterly.3 Brussel studied Mary’s life from childhood to death and stated that her case was difficult to diagnose, as it was “replete with etiological factors, running the gamut from congenital defects to adverse living conditions and complicating trauma.”4 Brussel found psychotic symptoms of hallucinations, delusions, terror, depression, suicidal intentions and attempts, ideas of persecution, and outbursts of irritability, rage, and overactivity. His diagnosis was that Mary was a victim of migraine, although he stated that epilepsy, “or at least an ‘epileptic equivalent,’” was possible. He ruled out psychoneurosis, Manic-Depressive psychosis, and schizophrenia.5 Twenty-five years later, another psychiatrist, John M. Suarez...