“For my part I know nothing with any certainty, but the sight of the stars makes me dream.” This quote by Vincent Van Gogh sums himself up perfectly. It is known that he had various psychotic symptoms, such as auditory and visual hallucinations, and it is still disputed whether some of his works are accurate portrayals of reality, or simply representations of his “dreams.” Fortunately, our class had the opportunity to visit Arles this past weekend, the small town in Provence where Van Gogh famously stationed himself and painted many of his most famous pieces. We were able to witness many of the things we had previously seen only in his paintings. For example, we saw the river painted in “Starry Night over the Rhone” and the garden portrayed in “Garden of the Hospital in Arles.” Van Gogh certainly had no trouble capturing the full beauty of these places with his paintings, but was his abstract and unique style just an artistic twist, or was it really how he perceived these locations?
“Garden of the Hospital in Arles” by Van Gogh
A photo from our visit to the garden of the hospital, which is much less yellow in real life
There have been many retroperspective diagnoses of Vincent Van Gogh. It is most commonly believed that he suffered from bipolar disorder. However, he was known to have been an avid absinthe drinker, a drink reported to cause hallucinations. Thus, my first inclination was that Van Gogh’s psychotic symptoms must have been due to his absinthe abuse. When in Arles, some friends and I went to “Le Cafe Van Gogh”, the cafe where Van Gogh spent most of his time drinking. We noticed the menu had a cocktail called “Le Van Gogh” which contained some absinthe, so, as any good scientist would, we ordered some. Surprisingly, the absinthe didn’t have much effect, and certainly didn’t cause any hallucinations. Possibly, I was wrong and it wasn’t the absinthe that caused Van Gogh’s psychosis.
The famous Cafe Van Gogh
It is widely believed that the active hallucinogen in absinthe was thujone, which comes from the wormwood oil included in the beverage. Studies have even shown that thujone is a neurotoxic compound, with the ability to inhibit GABA receptor activity (Hold et al., 2000). GABA is an inhibitory neurotransmitter and is involved in calming the body, such as relieving anxiety. Inhibition of GABA receptors, as caused by thujone, may produce mood elevation (Olsen, 2000).
Another recent study found that thujone has inhibitory effects on serotonin receptors too (Deiml et al., 2004). Serotonin is an excitatory neurotransmitter that has been shown to play a role in various psychiatric conditions, such as depression, anxiety, and obsessive-compulsive disorder (Dayan and Huys, 2008). Inhibition of GABA and serotonin on their own hasn’t shown any signs of causing hallucinations, but recent evidence shows that together, they could have. A study suggests that an imbalance of excitatory and inhibitory influences on the brain could cause be the cause of hallucinations (Jardri et al., 2016). Perhaps, the mixture of serotonin and GABA inhibition by thujone, causing simultaneous excitatory and inhibitory signals, was the culprit in Van Gogh’s insanity.
However, contrary to this, recent studies also suggest that absinthe has never contained enough thujone to actually cause psychiatric symptoms; rather, the amount of thujone required to cause hallucinations would poison us to death before causing this phenomenon (Padosch et al., 2006). This doesn’t mean that Van Gogh’s absinthe abuse didn’t account for any of his symptoms, though, as new research presents evidence that alcohol on its own can cause psychosis in some individuals (Salen and Stankewicz, 2018). Alcohol-induced psychosis is a recently defined disorder in which certain individuals experience hallucinations, paranoia, and fear during or shortly after alcohol consumption (Salen and Stankewicz, 2018). Although this is an extremely rare condition, possibly Van Gogh was one of the few unlucky (or lucky) individuals to suffer its consequences. If this were the case, absinthe would have only exacerbated the symptoms of the condition due to its extremely high levels of alcohol, rather than its thujone content.
Regardless of the cause of Vincent Van Gogh’s insanity, one thing’s for sure: it led to the creation of some of the greatest, most unique artwork of history which he will always be remembered for.
Location of Arles
Sources:
Höld KM, Sirisoma NS, Ikeda T, Narahashi T, Casida JE. (2000). Alpha-thujone (the active component of absinthe): gamma-aminobutyric acid type A receptor modulation and metabolic detoxification, Proc. Natl. Acad. Sci. USA, 97(8):3826-31
Olsen R, (2000). Absinthe and γ-aminobutyric acid receptors, Proc. Natl. Acad. Sci. USA, 97(9): 4417–4418
Deiml, R. Haseneder, W. Zieglgänsberger, G. Rammes, B. Eisensamer, R. Rupprecht, G. Hapfelmeier, (2004). α-Thujone reduces 5-HT3 receptor activity by an effect on the agonist-induced desensitization, Neuropharmacology 46(2): 192-201
Peter Dayan and Quentin J. M Huys, (2008). Serotonin, Inhibition, and Negative Mood, PloS. Comput. Biol. 4(2): e4
Renaud Jardri, Kenneth Hugdahl, Matthew Hughes, Jérôme Brunelin, Flavie Waters, Ben Alderson-Day, Dave Smailes, Philipp Sterzer, Philip R. Corlett, Pantelis Leptourgos, Martin Debbané, Arnaud Cachia, Sophie Denève, (2016). Are Hallucinations Due to an Imbalance Between Excitatory and Inhibitory Influences on the Brain?, Schizophr. Bull. 42(5): 1124–1134
Stephan A Padosch, Dirk W Lachenmeier, and Lars U Kröner, (2006). Absinthism: a fictitious 19th century syndrome with present impact, Subst. Abuse. Treat. Prev. Policy. 1:14
Holly A. Stankewicz and Philip Salen, (2018). Alcohol Related Psychosis, StatPearls [Internet]
Image:
https://en.wikipedia.org/wiki/Hospital_in_Arles#/media/File:Van_Gogh_-_Garten_des_Hospitals_in_Arles1.jpeg