A pioneering study into Vincent van Gogh’s psychiatric health in the years immediately before his suicide has found that the artist had delirium, in part due to alcohol withdrawal after cutting off his ear and being admitted to hospital.
An article published by researchers in the International Journal of Bipolar Disorders has pointed to evidence that Van Gogh was increasingly heavily dependent on wine and absinthe from 1886 until his death on 29 July 1890 at the age of 37.
The last three years of the artist’s life were some of his most productive, during which the Dutch artist painted more than 30 self-portraits and the series of seven paintings of sunflowers.
As a young man there were signs he had developed a bipolar mood disorder, with traits of a borderline personality disorder, but this “likely worsened through an alcohol use disorder combined with malnutrition, which then led, in combination with rising psychosocial tensions, to a crisis in which he cut off his ear”, said the authors of the study, led by the emeritus professor of psychiatry Willem Nolen from the University of Groningen in the Netherlands.
After handing his ear to a woman in a brothel, Van Gogh was in hospital three consecutive times in Arles, France, between December 1888 and May 1889, and subsequently transferred to the asylum of Saint-Rémy-de-Provence in May 1889.
During two of his hospital stays, Van Gogh wrote that he suffered “unbearable hallucinations”, anxiety and nightmares. He described it as a “mental or nervous fever or madness, I do not know quite what to say or how to name it”.
The researchers suggest the symptoms were linked to an enforced period without alcohol. They add that the two deliriums related to withdrawal were then followed by “severe depressive episodes (of which at least one with psychotic features) from which he did not fully recover, finally leading to his suicide”.
The theory stems from the examination of 902 of Van Gogh’s letters, 820 of which were written to his brother Theo and other relatives, as well as interviews with three historians who have studied the artist in depth.
“Those who consume large amounts of alcohol in combination with malnutrition, run the risk of brain function impairment including mental problems,” the researchers wrote. “Moreover, abrupt stopping with excessive alcohol consumption can lead to withdrawal phenomena, including a delirium.
“Therefore, it is likely that at least the first brief psychosis in Arles on the days after the ear incident during which he likely stopped drinking abruptly, was actually an alcohol withdrawal delirium. Only later on in Saint-Rémy, when he was forced to minimise or even stop drinking, he probably succeeded in it and he also did not have further withdrawal problems.”
The paper deflates a number of other theories relating to Van Gogh’s mental health. One of the first diagnoses after his death was schizophrenia, but the researchers found he did not exhibit any psychotic symptoms before the ear incident at the age of 35, nor during the intervals between his psychotic episodes in the last 15 months of his life. They note a lack of relevant symptoms, such as diminished emotional expression.
The researchers also suggest it is unlikely Van Gogh had syphilis, even though he was treated for gonorrhoea and Theo died six months later from that infection. They found no suggestion of syphilis in the papers of Van Gogh’s doctors.
They also doubt the theory that he sustained carbon monoxide poisoning from gas lamps in his Arles home. “There are no other reports of (possible) carbon monoxide poisoning in Arles”, the study said.
The authors, however, do not discount that he had epilepsy in his final months, “resulting in a highly variable expression of anxiety, delusions and hallucinations”.
The study added: “Despite all these problems which contributed to his illnesses, we however also would like to stress that Van Gogh was not only a great and very influential painter but also an intelligent man with an enormous willpower, resilience and perseverance.”
