There is a lot of mystery around what ailed the renowned painter Vincent van Gogh.  Some doctors think he had epilepsy, some think he had manic depression or schizophrenia, and others think he had a mix of both conditions.  Personally, I believe van Gogh had temporal lobe epilepsy, which led to manic depression. 

According to Dr. Blumer, a published psychiatrist, van Gogh started abusing absinthe, an alcoholic beverage that was popular in van Gogh’s time, which had detrimental effects later on.  While in Paris, van Gogh began having “minor paroxysms, which consisted of sudden episodes of terror, peculiar epigastric sensations, and lapses in consciousness” (Blumer).  Observers remember van Gogh having hand spasms and staring strangely, followed by confusion of what had just occurred.  These are all signs of a seizure, which means his epilepsy probably started while he was in Paris between 1886 and 1888.  

The reason I believe van Gogh had temporal lobe epilepsy rather than frontal lobe epilepsy is because temporal lobe epilepsy causes long-term memory dysfunction, which is not found to be associated with frontal lobe epilepsy.  As Dr. Blumer describes in his article, van Gogh was hospitalized multiple times for psychotic episodes and seizure-like symptoms before ultimately signing himself into Saint Rémy, a mental asylum, where he received treatment for a year.  Following each psychotic episode, van Gogh had no memory of his actions or why he executed those actions, like cutting off his ear.  This kind of long-term memory dysfunction makes me believe he had temporal lobe epilepsy rather than frontal lobe epilepsy. 

The first time van Gogh had a true psychotic break was after he left Paris.  He had severe mood shifts, became more prone to violent outbursts, and had a greatly diminished sex drive.  Blumer describes van Gogh’s mood swings as “alternating with euphoria or with ‘indescribable anguish.’”  All of these are symptoms of manic depression.  People with manic depression experience very high-highs, very low-lows, and not much in between.  They also have a tendency to be more violent due to lack of impulse control.  Van Gogh experienced all of these symptoms leading up to the night he cut off his own ear.  What sparked this break was his friend and roommate, Paul Gauguin, announcing that he was moving out.  Following this announcement, van Gogh followed and approached Gauguin with a blade, but Gauguin fought him off.  After van Gogh attempted to fight Gauguin, he went back to his home, cut off his left ear, and presented it to his favorite prostitute.  The police were alerted to the incident, found van Gogh unconscious, and hospitalized him.  He was kept in solitary confinement in the hospital for three days.  When he snapped back to reality, he had no recollection of anything, not even cutting off his own ear.  In this incident, van Gogh shows symptoms of both a seizure and a manic episode.  

At the hospital, van Gogh was diagnosed with epilepsy and prescribed potassium bromide.  The potassium bromide did help for a while, but due to the absinthe abuse, he suffered a total of four more psychotic episodes before voluntarily checking himself into Saint Rémy.  While at Saint Rémy, van Gogh experienced three more psychotic relapses and each time had no memory if it.  His last psychotic episode lasted from February to April and he experienced terrifying hallucinations and severe agitation.  These breaks are not simply epilepsy, but the manic depression that developed due to the epilepsy.  I believe that van Gogh abused absinthe in order to cope with his undiagnosed epilepsy; however, by the time he was finally treated, his mind was too far gone.  Van Gogh’s epilepsy probably led him to isolate himself since he didn’t understand what was happening to him, which led to the absinthe abuse, which led to the manic depression.  

If van Gogh was alive currently, he would get much better help and there would be a much better understanding of his conditions.  I feel that if his epilepsy had been diagnosed sooner, his manic depression and alcohol abuse wouldn’t have been so crippling since he would have understood his seizures and why he was having them.  All in all, van Gogh was definitely a mad genius and definitely suffered from mental illness, which was exasperated at times when he felt alone.