As I stared at the small frame hanging from the walls of my friend’s bedroom, I found myself entranced. I remember standing in awe as I took in the dark swirls of the painting’s dark blue sky; the bright yellow dots that represented the stars; and the calming landscape of the town in the background. The way that these aspects seemed to move and churn drew me in, unlike any other painting that I had previously encountered.
The painting that saw that day was Vincent Van Gogh’s The Starry Night, to this day, one of my favorite paintings of all time. When I stared at that painting for the first time, I initially appreciated the visual beauty of the work, taking it just as a simple piece of art. However, I recently had the opportunity to visit the mental asylum where he is said to have painted many of his most prolific pieces. While I was there, my individual perception of the painting began to change. Rather than a simple piece of art, Van Gogh’s style and painting began to reflect a deeper meaning, a look into his deteriorating madness.
Starry Night: One of Van Gogh’s most prolific paintings. Said to describe the view of a village from the east window of his mental asylum.
While Van Gogh is still remembered today by the many beautiful pieces of work, there is another aspect of Van Gogh himself that remains a hot topic of discussion, his mental instability. Throughout his life, Van Gogh had suffered through many psychotic symptoms. He was noted to have suffered from multitudes of mood swings between major depression and extreme highs, incoherent speech, and lapses of consciousness (Blumer, 2002). He was also noted to have suffered from visual and auditory hallucinations, although these were only within short durations (Strik, 1997). While there is a multitude of diagnoses surrounding the actual nature behind Van Gogh’s mental instability, the most prevalent of these is the diagnosis of bipolar disorder (Blumer, 2002). While understanding the nature of Van Gogh’s illness offers up an interesting line of discussion in itself, I believe this discussion is simply a platform for a greater line of questioning. That question is whether Van Gogh could be effectively treated with the techniques of today.
Since the time of Van Gogh, modern psychiatric treatments have developed far beyond what we could have imagined. With the development of mood stabilizers and antipsychotic medication, the effective treatment of these major mental disorders has increased dramatically (Lopez-Munoz et.al, 2018). However, one of the most effective treatments for the most popular diagnosis of Van Gogh, bipolar disorder, may not lie within the development of these modern antipsychotic medications but rather something rather shocking, electroconvulsive therapy.
Electroconvulsive therapy, otherwise known as ECT, is a form of treatment within patients with severe depressive or bipolar disorder. The technique relies on administering a brief electrical stimulation of the brain while the patient is under anesthesia. This brief electrical stimulation forces the patient into a brief seizure (McDonald, 2016). Though the exact mechanisms underlying the effectiveness of electroconvulsive therapy are unknown, there are still a variety of theories that are used to explain the phenomenon. One of the most common of these theories deals with ECT’s influence on the release of neurotransmitters. One study conducted in 2014 by Baldinger, found that after the implementation of ECT on patients suffering from bipolar disorder there was an overall increase in the release and binding of the neurotransmitters serotonin and dopamine, which are associated with the stability of one’s mood and the brain’s reward system respectively (Baldinger, 2014).
A picture of a patient going through electroconvulsive therapy. Unlike electroshock therapy, electroconvulsive therapy is generally very safe with few side effects.
While this particular treatment gets a horrible reputation by the press, often being cited as unethical and invasive, modern neuroscientific research seems to show a different story. In a recent study conducted in 2017, Perugi et.al aimed to investigate the influence that ECT had on the response rates of patients who suffered from Bipolar Disorder. By conducting an observational study on 522 patients who suffered from Bipolar Disorder before and after they had gone through ECT, Perugi found that around 344 (approximately 68.8%) of participating patients responded positively to the treatment. These results reflected Perugi, the greater effectiveness that ECT seemed to have with the response of the patients. He notes how with the improved rate of response along with the unlikelihood of future mood destabilization within his patients, that ECT should not be limited towards a finite amount of patients but used within a greater context (Perugi, 2017).
With the greater percentage of improvement that we see in modern-day patients with bipolar disorder, it can be easily inferred how the implementation of this treatment could have influenced the treatment of Van Gogh during his time. Techniques like ECT have pioneered a modern wave of mental illness treatment that allows for those suffering to live the best lives that they can possibly achieve. Who knows, if only this type of treatment were readily available to Van Gogh’s personal physicians, maybe there would have been greater amounts of Van Gogh’s work to fill the halls of museums all around the world.
Citations:
Baldinger P, Lotan A, Frey R, Kasper S, Lerer B, Lanzenberger R. Neurotransmitters and electroconvulsive therapy. J ECT. 2014;30:116–121.
Blanco C., Laje G., Olfson M., Marcus S.C., Pincus H.A. 2002; Trends in the treatment of bipolar disorder by outpatient psychiatrists. Am. J. Psychiatry.159(6):1005–1010.
Blumer D. The illness of Vincent van Gogh. Am. J. Psychiatry. 2002;159:519–526. doi: 10.1176/appi.ajp.159.4.519.
López-Muñoz, F., Shen, W. W., D’Ocon, P., Romero, A., & Álamo, C. (2018). A History of the Pharmacological Treatment of Bipolar Disorder. International journal of molecular sciences, 19(7), 2143.
McDonald, W., & Fochtmann, L. (n.d.). 2016; What is Electroconvulsive therapy (ECT)? Retrieved from https://www.psychiatry.org/patients-families/ect
Perugi, G., Medda, P., Toni, C., Mariani, M. G., Socci, C., & Mauri, M. (2017). The Role of Electroconvulsive Therapy (ECT) in Bipolar Disorder: Effectiveness in 522 Patients with Bipolar Depression, Mixed-state, Mania and Catatonic Features. Current neuropharmacology, 15(3), 359–371.
Strik, Werner. (1997). [The psychiatric illness of Vincent van Gogh].. Der Nervenarzt. 68. 401-9.
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