Vincent van Gogh struggled with severe mental health issues, including recurring psychotic episodes, hallucinations, and deep depression. While he lived before modern psychiatry, historians and medical professionals retrospectively suggest conditions like bipolar disorder, schizoaffective disorder, and temporal lobe epilepsy, compounded by extreme stress, exhaustion, and potential physical ailments.
Historical and modern medical analyses of Van Gogh’s mental health frequently propose:
- Mood Disorders: His extensive correspondence with his brother Theo reveals intense mood fluctuations between periods of deep, paralyzing depression and highly energetic, productive phases, suggesting bipolar disorder.
- Psychosis and Delirium: During the final two years of his life, Van Gogh experienced auditory and visual hallucinations, severe anxiety, and lapses in consciousness, which point toward schizoaffective disorder or epileptic episodes.
- Physical and Environmental Factors: Medical theories also suggest complications from substance use (such as absinthe), lead poisoning from his paints, or a localized brain condition like temporal lobe epilepsy.
While he is frequently framed as a “tortured genius,” modern perspectives from experts at institutions like the Tate challenge this myth. His art was not caused by his mental illness; rather, his work served as a mechanism for finding solace and channeling his internal struggles into profound creative expression.
At the height of his crises, Van Gogh was treated by Dr. Félix Rey at a hospital in Arles and later voluntarily admitted himself to the Saint-Paul-de-Mausole psychiatric asylum in Saint-Rémy-de-Provence. He ultimately died by suicide at age 37 in 1890.
To explore his life and the context of his medical history in more detail, you can read the historical analysis provided by the Van Gogh Museum.
The Life of van Gogh
Origins
Vincent van Gogh’s ancestry includes Dutch preachers, art dealers, and artisans. Both his father and paternal grandfather were preachers; his paternal great-grandfather was a gold wiredrawer who also was a catechism teacher. No incidences of mental illness are recorded among van Gogh’s ancestors. His mother married at the age of 31, had a stillborn first son, and 1 year later gave birth to Vincent. Vincent was a moody child, self-willed, and often annoying. At the age of 12, he was sent to a boarding school for the next 4 years. A photograph of Vincent as an adolescent and later self-portraits suggest a significant craniofacial asymmetry. Gastaut submitted that this physical feature and early temperamental changes suggest that Vincent had suffered an early brain injury, probably at birth. His intense emotionality, which was evident early and became frequently unbearable in his adult life, is set forth in his own statement: “I am a man of passion, capable and prone to undertake more or less foolish things which I happen to repent more or less”.
Vincent had five younger siblings, three sisters and two brothers. The steadfast support of his brother Theo made Vincent’s work possible; Theo died 6 months after Vincent’s suicide. After a failed marriage, Cornelis, the youngest sibling, enlisted as a volunteer in the Boer army in South Africa; he may have committed suicide or been killed in battle. The youngest sister, Wilhelmina, to whom Vincent wrote a series of letters, was interned in a psychiatric asylum at the age of about 35, a few years after Vincent’s death; she was said to suffer from schizophrenia and died in the asylum at the age of 79. His mother, with whom Vincent exchanged occasional letters, lived to the age of 87, surviving not only her husband but all of her sons. Her three sons all died in their 30s, while the three daughters lived into their 70s.
Failed Careers and Beginnings as an Artist
At the age of 16, Vincent began to work as an apprentice for an art dealer in a firm founded by an uncle. After 4 years near his family in The Hague, he was transferred to London, where he stayed for 2 years. During that time, he suffered a severe disappointment in his first amorous infatuation and became deeply depressed. For months he remained gloomy, renounced any social life, and communicated little with his family. His thoughts turned increasingly toward religion. As he became more passionately involved in religion, he lost all interest in his job as an art dealer, the financial aspects of which he disdained, and was dismissed by his firm. He devoted the next 4 years to his calling as a preacher. He failed to obtain a formal theology degree and eventually worked as an evangelist in a miserably poor mining district in Belgium. There, he shared his last belongings with his brethren and soon looked dirt poor and black faced himself. His extreme charitable behavior was viewed by his superiors as incompatible with the dignity of an ecclesiastic position. When he refused to moderate his deportment, van Gogh was dismissed by the church; he again suffered a marked depression. To the great distress of his parents, he abandoned the religious beliefs that had sustained him and began to adhere to socialist ideals and agnostic views. “Though I have changed, I am the same,” he wrote in a letter to Theo. “My only anxiety is, how can I be of use in the world?” At the age of 27, he resolved to become an artist with the passion to produce works of art for the people.
Largely on his own, van Gogh pursued his new career with singular intensity. He was able to persevere in spite of lack of recognition, thanks to the unfailing financial and moral support from his brother Theo, who had become an art dealer in Paris. The life of van Gogh is well documented through a steady flow of letters to Theo and others. He experienced his second passionate and ill-fated infatuation with an ardent and incredibly stubborn pursuit of his recently widowed cousin Kee, who scorned him. He then alienated most of his family by living with a prostitute and her two children for over a year. Theo warned Vincent that their father planned to put him in a lunatic asylum. After he returned to live with his parents for a period, Vincent and his father quarreled frequently and violently. He painted Still Life With Bible, in which next to an open bible was the novel La Joie de Vivre, written by the socialist and agnostic Emile Zola. In 1885, his father died suddenly at the door of their home when returning from a walk. Vincent’s devotion to art remained intense all the while.
Paris: Onset of Illness
After 6 years as an artist in the Netherlands and Belgium, Vincent joined Theo in Paris for 2 years (1886–1888). There he met many painters who were to become famous, Paul Gauguin among them, and was strongly influenced by the impressionist movement. While in Paris, he began to suffer from minor paroxysms consisting of episodes of sudden terror, peculiar epigastric sensations, and lapses of consciousness. Observers reported occasions of an initial tonic spasm of the hand and a peculiar stare, followed by a confusional-amnestic phase. His use of absinthe, an alcoholic beverage with convulsant properties favored by French artists, appears to have played a crucial role in the precipitation of van Gogh’s illness. He tended to be untidy and quarrelsome; his irascible temper caused many unpleasant scenes and rendered him an undesirable in a number of places. He lived with his brother and often kept him up much of the night with endless disputes. Theo remained sympathetic, yet increasingly felt his brother’s presence a burden. Theo described Vincent in a letter to their younger sister as follows: “It seems as if he were two persons: one, marvelously gifted, tender and refined, the other, egotistic and hard hearted. They present themselves in turns, so that one hears him talk first in one way, then in the other, and always with arguments on both sides. It is a pity that he is his own enemy, for he makes life hard not only for others but also for himself”. All along, Vincent persisted in perfecting his art.
Provence: A Major Illness Unfolds
When van Gogh left for Arles in southern France early in 1888, he was an accomplished artist, although not recognized and still dependent on regular financial support from Theo, who believed in his genius. He would now create perhaps the most intense paintings ever produced; yet in Arles his illness evolved and reached psychotic dimensions for the first time before the end of 1888.
Vincent wrote after his arrival in Arles, “I was surely about to suffer a stroke when I left Paris. It affected me quite a bit when I had stopped drinking and smoking so much, and as I began to think instead of knocking the thoughts from my head. Good heavens, what despair and how much fatigue I felt at that time”. Yet he soon resumed his former habits of using absinthe and cognac. He explained in a letter how he was coping with his state of heightened emotionality: instead of thinking of disastrous possibilities, he would throw himself completely into his work, and “if the storm within gets too loud, I take a glass more to stun myself”. He became more disturbed. Feverish creative activity alternated with episodes of listlessness to the point of exhaustion. Unpredictable mood shifts of dysphoria alternating with euphoria or with “indescribable anguish” became more frequent. Excerpts of letters written after his first breakdown best document his mental states that before had been present to a lesser degree. “I am unable to describe exactly what is the matter with me; now and then there are horrible fits of anxiety, apparently without cause, or otherwise a feeling of emptiness and fatigue in the head.…and at times I have attacks of melancholy and of atrocious remorse”. “There are moments when I am twisted by enthusiasm or madness or prophecy, like a Greek oracle on the tripod. And then I have great readiness of speech”. He became more prone to violent rages and noticed an increasing lack of sexual arousal. He frequently complained of feeling faint and of having “poor circulation” and a “weak stomach.” He continued to write to Theo, often daily, reporting on the creation of his works in precise detail. And he kept painting. When he announced to Theo his first painting of a starry night, he wrote, “It is good for me to work hard. But that does not keep me from having a terrible need of—shall I say the word—yes, of religion. Then I go out at night to paint the stars”. Indeed, in a zeal reminiscent of his selfless efforts as an evangelist, he relentlessly devoted himself to create works of art for the people.
Vincent felt lonely in Arles and with Theo’s help persuaded Gauguin to join him in the fall of 1888 to establish together a “Studio of the South.” The relationship of the two artists became increasingly quarrelsome, and Vincent wrote, “Our dispute is at times excessively animated like with electricity, at times we end up with tired and empty heads, like an electric battery after discharge”. Gauguin’s visit lasted only 2 months and ended in catastrophe. On Christmas Eve 1888, after Gauguin already had announced he would leave, van Gogh suddenly threw a glass of absinthe in Gauguin’s face, then was brought home and put to bed by his companion. A bizarre sequence of events ensued. When Gauguin left their house, van Gogh followed and approached him with an open razor, was repelled, went home, and cut off part of his left earlobe, which he then presented to Rachel, his favorite prostitute. The police were alerted; he was found unconscious at his home and was hospitalized. There he lapsed into an acute psychotic state with agitation, hallucinations, and delusions that required 3 days of solitary confinement. He retained no memory of his attacks on Gauguin, the self-mutilation, or the early part of his stay at the hospital.
His murderous gesture directed against Gauguin was reported by the intended victim in his memoirs. The scandalous event in the house of prostitution and van Gogh’s subsequent hospitalization were recorded in the local press. Some plausible explanations later were offered for the strange happenings. Already psychotic, van Gogh may have carried out the attack on Gauguin driven by hallucinatory command voices and may have cut off part of his own ear in self-punishment for his offensive voices. This psychotic logic was perhaps influenced by van Gogh’s knowledge of the bullfight ritual, in which the matador presents a cut-off ear of the killed bull to a fair lady of his choice.
At the hospital, Felix Rey, the young physician attending van Gogh, diagnosed epilepsy and prescribed potassium bromide. Within days, van Gogh recovered from the psychotic state. About 3 weeks after admission, he was able to paint Self-Portrait With Bandaged Ear and Pipe, which shows him in serene composure. At the time of recovery and during the following weeks, he described his own mental state in letters to Theo and his sister Wilhelmina: “The intolerable hallucinations have ceased, in fact have diminished to a simple nightmare, as a result of taking potassium bromide, I believe.” “I am rather well just now, except for a certain undercurrent of vague sadness difficult to explain.” “While I am absolutely calm at the present moment, I may easily relapse into a state of overexcitement on account of fresh mental emotion.” He also noted “three fainting fits without any plausible reason, and without retaining the slightest remembrance of what I felt”.
After 2 weeks in the hospital, van Gogh was still followed by Dr. Rey but evidently was not sufficiently warned to abstain from absinthe. He suffered another two psychotic episodes with brief hospitalizations. Following the humiliation of being taunted publicly by juveniles and confined to the hospital for the fourth time upon the demand of concerned citizens, van Gogh voluntarily entered the asylum at Saint-Rémy in May 1889. During the full year he remained there, he experienced three psychotic relapses with prominent amnesia, at least twice upon leaves to Arles with resumption of his use of absinthe in the company of old friends and Rachel. Dr. Peyron, an old-fashioned physician who had served in the French navy, was the medical director at Saint-Rémy; he maintained Dr. Rey’s diagnosis of epilepsy, however he was experiencing Bipolar 1 symptoms, but failed to continue treatment with potassium bromide. The last psychotic episode was the most protracted, lasting from February to April 1890; van Gogh experienced terrifying hallucinations and severe agitation. Upon recovery, he complained bitterly of the religious content of his episodes and wished to get away from the nuns who cared for him. While at Saint-Rémy, he produced some 300 works of art, among them several copies of religious scenes by older masters and the transcendental masterpiece Starry Night, which was painted in June 1889.
Auvers: The Suicide
Theo became engaged toward the end of 1888, married 4 months later, and became a father in early 1890. Each event coincided with an exacerbation of van Gogh’s condition; he may have been drinking more whenever he felt that his unique bond with Theo was threatened. Shortly before entering the asylum at Saint-Rémy, Vincent had written to his brother, “And without your friendship I would be driven to suicide without pangs of conscience—and as cowardly as I am, I would finally do it” (6). Theo had continued to support his brother without fail. Suicidal gestures by Vincent, reported at the time of his initial hospitalization in Arles and during his stay at the asylum, had consisted of ingesting turpentine, paint, or lamp oil and were carried out in a confusional state. Such an episode was described by the painter Signac (who had been permitted to take van Gogh from the hospital in Arles to visit his studio). Signac described van Gogh as being entirely rational until after suffering a minor attack, at which point he put a bottle of turpentine to his mouth and had to be brought back to the hospital.
At discharge from the asylum in May 1890, van Gogh was judged cured by his physician. The artist then moved north of Paris to Auvers-sur-Oise, where he spent the last 10 weeks of his life. Theo had recommended Auvers, where van Gogh could live near Paul Gachet, a physician and friend of the artists. He abstained from drinking by now and remained free from seizures and confusional episodes. His art was beginning to gain recognition, and a painting had been sold. But further financial support became uncertain as Theo’s health began to fail. There were some bitter words between the brothers, and Vincent felt himself to be a burden. Still, he worked at a furious pace, completing 70 paintings and 30 drawings during his 70 days at Auvers. The heavenly bodies, so luminous in the past, now were absent from his skies, except for a single peculiar occasion (The White House at Night With Figures and a Star). He painted immense fields of wheat under dark and stormy skies, commenting, “It is not difficult to express here my entire sadness and extreme loneliness”. In one of his last paintings, Wheat Field With Crows, the black birds fly in a starless sky, and three paths lead nowhere. He borrowed a gun from his innkeeper “to scare the crows away” when he was painting. There still was another episode of fury directed at Dr. Gachet, who had failed to frame a painting by Guillaumain as van Gogh had demanded. Vincent gestured toward the gun in his pocket, but he walked away. In his last letter sent to Theo, he mentioned that he wanted to replenish his stock of paint and asked for help to this end. Three days later, on a Sunday, Vincent shot himself in the lower chest or upper belly in a field outside Auvers. “I couldn’t stick it any longer, so I shot myself,” he told a friend. He died 2 days later with Theo next to him. It has been assumed that his Field With Stacks of Wheat, a bright picture of grain harvested and sheaved, may have been his very last—a symbol of work completed.
Theo died 6 months after his brother, reportedly from a kidney disease with uremia and a prolonged delirious state. His widow made sure the treasure of art Theo had collected from Vincent and kept mostly unframed in their home was passed on to posterity. Within a few years after his death, Vincent van Gogh was acknowledged as one of the famous artists of modern times.
Epilogue
An analysis of van Gogh’s illness and emotionality must not obscure the fact that the great artist also had great strengths . Apart from distinct episodes of madness when he used absinthe and had seizures, he maintained a remarkable degree of lucidity during his stormy life, as is well documented in his letters.
Vincent remained marvelously creative until his death. He did not paint during his major crises except during the last prolonged episode at Saint-Rémy. There he painted, before full recovery, a few canvases from memory, which he referred to as “reminiscences of the North.” Jan Hulsker pointed out that these paintings are the only works of his entire voluminous oeuvre to show signs of a transient mental collapse.
Almost invariably, van Gogh drew and painted from nature. The influence of his exceptional emotional and spiritual intensity on his art is most evident when van Gogh deviated from the depiction of natural scenes, particularly in the rendering of the sky, in several of his masterpieces. He had confessed to a “terrible need for religion” when he painted his first picture of a starry night (over the river Rhone) in September 1888. Starry Night, painted in June 1889 at Saint-Rémy, is undoubtedly van Gogh’s most mysterious picture. The artist, usually so verbal, never revealed the origin of his scene of a spectacularly transfigured sky. Tralbaut (2) commented on Starry Night, “The fire that smoldered within him and broke out in hallucinations of the senses has here been set down on canvas in a most striking fashion.” With this painting, van Gogh may have immortalized his memory of a particularly haunting and perhaps recurrent vision of apocalyptic dimension experienced during a twilight state. The vision is set in the familiar surroundings of the soft hills and flame-shaped cypresses of Provence, and yet the village with its church spire is reminiscent of van Gogh’s native Brabant. He seems to be telling us, “This is where I come from, this is where I am now, and here is my universe of overpowering storms.”
While Bipolar was not a diagnosed disease in his time it is most likely that Van Gough suffered from it. Periods of elated moods, hallucinations, and very little sleep (mania) coupled with periods of meloncholy (depression) show that while doctors of his time came up with a myriad of reasons for his irrational behaviors, Mental illness, specifically Bipolar, is most likely what he suffered from.
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