About the Author:
JOSHUA WOLF SHENK is a curator, essayist, and the author of Lincoln's Melancholy, a New York Times Notable Book. A contributor to The Atlantic, Harper's, The New Yorker, and other publications, he directs the Arts in Mind series on creativity and serves on the general council of The Moth. He lives in Los Angeles.
Excerpt. © Reprinted by permission. All rights reserved.:
CHAPTER 1 The Community Said He Was Crazy
In three key criteria —the factors that produce depression, the symptoms of
what psychiatrists call major depression, and the typical age of onset—the
case of Abraham Lincoln is perfect. It could be used in a psychiatry textbook
to illustrate a typical depression. Yet Lincoln's case is perfect, too, in a very
different sense: it forces us to reckon with the limits of diagnostic categories
and raises fundamental questions about the nature of illness and health.
Though great resources in research and clinical science have
been devoted to depression in the past few decades, we can neither cure it
nor fully explain it.What we can do is describe its general characteristics.
The perverse benefit of so much suffering is that we know a great deal about
what the sufferers have in common. To start, the principal factors behind
depression are biological predisposition and environmental influences. Some
people are more susceptible to depression simply by virtue of being born.
Depression and other mood disorders run in families, not only because of
what happens in those families, but because of the genetic material families
share. A person who has one parent or sibling with major depression is one
and a half to three times more likely than the general population to
experience it.
The standard way to investigate biological predisposition is simply
to list the cases of mental illness—or mental characteristics suggestive of
potential illness—in a family. With Lincoln, such a family history suggests
that he came by his depression, at least in part, by old-fashioned inheritance.
His parents, Thomas and Nancy Lincoln, came from Virginia families that
crossed the Appalachian Mountains into Kentucky in the late eighteenth
century. They married in 1806 and had three children: Sarah, born February
10, 1807; Abraham, born February 12, 1809; and Thomas, born about 1811.
Though our information is imperfect, to say the least, both parents had
characteristics suggestive of melancholy. Nearly all the descriptions of
Nancy Lincoln have her as sad. For example, her cousin John Hanks said
her nature "was kindness, mildness, tenderness, sadness." And Lincoln
himself described his mother as "intellectual, sensitive and somewhat sad."
Tom Lincoln, a farmer and carpenter, was a social man with a talent for jokes
and stories, but he, too, had a somber streak. "He seemed to me," said his
stepgrandson, "to border on the serious—reflective." This seriousness could
tip into gloom. According to a neighbor in Kentucky, he "often got the 'blues,'
and had some strange sort of spells, and wanted to be alone all he could
when he had them." During these spells he would spend as much as half a
day alone in the fields or the woods. His behavior was strange enough to
make people wonder if Tom Lincoln was losing his mind.
Perhaps the most striking evidence of mental trouble in Abraham
Lincoln's family comes from his paternal relations. His great-uncle once told
a court of law that he had "a deranged mind." His uncle Mordecai Lincoln had
broad mood swings, which were probably intensified by his heavy drinking.
And Mordecai's family was thick with mental disease. All three of his sons—
who bore a strong physical resemblance to their first cousin Abraham—were
considered melancholy men. One settler who knew both the future president
and his cousins spoke of the two "Lincoln characteristics": "their moody
spells and great sense of humor." One of these Lincoln cousins swung wildly
between melancholia and mania and at times had a tenuous grip on reality,
writing letters and notes that suggest madness. Another first cousin of
Lincoln's had a daughter committed to the Illinois State Hospital for the
Insane. After a trial, a jury in Hancock County committed thirty-nine-year-old
Mary Jane Lincoln to the hospital, noting that "her disease is of thirteen years
duration." At the hospital, an attendant observed, "Her father was cousin to
Abraham Lincoln, and she has features much like his."
What is striking about the case of Mary Jane Lincoln is that the
jury, charged with answering the question of whether insanity ran in her
family, concluded that "the disease is with her hereditary." According to a
family historian who grew up in the late nineteenth century, the descendants
of Mordecai Lincoln "suffered from all the nervous disorders known. Some
were on the ragged edge." One family member who had frequent spells of
intense mental trouble referred to his condition as "the Lincoln horrors."
Three elements of Lincoln's history—the deep, pervasive sadness
of his mother, the strange spells of his father, and the striking presence of
mental illness in the family of his uncle and cousins—suggest the likelihood
of a biological predisposition toward depression. "Predisposition" means an
increased risk of developing an illness. As opposed to traditional Mendelian
inheritance—in which one dominant gene or two recessive genes lead to an
illness or trait—genetic factors in psychiatric illnesses are additive and not
categorical. "The genes confer only susceptibility in many cases," explains
the psychiatrist S. Nassir Ghaemi, in The Concepts of Psychiatry, "not the
illness. That is, they only increase the likelihood that fewer or less severe
environmental factors are required for the illness to develop, compared with
someone who has fewer disease-related genes."
What tips a person from tendency to actuality? For centuries,
philosophers and physicians emphasized climate and diet. Today's experts
focus on harsh life events and conditions, especially in early childhood.
Lincoln's early life certainly had its harsh elements. His only brother died in
infancy in Kentucky. In 1816, Abraham's eighth year, the family moved to
southern Indiana. Two years later, in the fall of 1818, an infectious disease
swept through their small rural community. Among those affected were
Lincoln's aunt and uncle, Thomas and Elizabeth Sparrow, and his mother,
Nancy Lincoln. Eventually, the disease would be traced to a poisonous root,
eaten by cattle and then ingested by humans in milk or meat. But when
Abraham watched his mother become ill, the disease was a grim mystery
that went by various names, from "puking fever" to "river sickness" to "fall
poison." Later, it became known as the "milk sick." "No announcement
strikes the members of a western community with so much dread as the
report of a case," said a newspaper of the time. A physician described the
course of the illness: "When the individual is about to be taken down, he feels
weary, trembles more or less under exertion, and often experiences pain,
numbness and slight cramps." Nausea soon follows, then "a feeling of
depression and burning at the pit of the stomach," then retching, twitching,
and tossing side to side. Before long, the patient becomes "deathly pale and
shrunk up," listless and indifferent, and lies, between fits of retching, in
a "mild coma." First the Sparrows— with whom the Lincolns were close—
took sick and died. Then Nancy Lincoln went to bed with the illness. Ill for
about a week, she died on October 5, 1818. She was about thirty-five years
old. Her son was nine.
In addition to the loss of his mother, aunt, and uncle, a year or so
later Abraham faced the long absence of his father, who returned to Kentucky
to court another bride. For two to six months, Tom Lincoln left his children
alone with their twenty-year-old cousin, Dennis Hanks. When he returned,
the children were dirty and poorly clothed. Lincoln later described himself at
this time as "sad, if not pitiful."
The one constant in Abraham's life was his sister, Sarah. She
was a thin, strong woman who resembled her father in stature, with brown
hair and dark eyes. Like her brother, Sarah Lincoln had a sharp mind. She
stayed with the family until 1826, when she married, set up house, and
quickly became pregnant. On January 28, 1828, she gave birth to a stillborn
child and shortly afterward died herself. "We went out and told Abe," recalled
a neighbor. "I never will forget the scene. He sat down in the door of the
smoke house and buried his face in his hands. The tears slowly trickled from
between his bony fingers and his gaunt frame shook with sobs."
In the emotional development of a child, pervasive tension can be just as
influential as loss. Lincoln's relationship with his father—the only other
member of his nuclear family who survived—was so cool that observers
wondered whether there was any love between them. The relationship was
strained by a fundamental conflict. From a young age, Abraham showed a
strong interest in his own education. At first his father helped him along,
paying school fees and procuring books. "Abe read all the books he could lay
his hands on," said his stepmother. "And when he came across a passage
that struck him he would write it down . . . then he would re-write it—look at
it—repeat it." But at some point Tom Lincoln began to oppose the extent of
his son's studies. Abraham sometimes neglected his farm work by reading.
Tom would beat him for this, and for other infractions.
To men who had been born and expected to die on farms, book
learning had limited value. A man ought to be able to read the Bi...
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