PART ONE
CHAPTER 1
The Community Said He Was Crazy
IN THREE KEY CRITERIAâthe factors that produce depression, the symptoms of what psychiatrists call major depression, and the typical age of onsetâthe case of Abraham Lincoln is perfect. It could be used in a psychiatry textbook to illustrate a typical depression. Yet Lincolnâs 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 illnessâor mental characteristics suggestive of potential illnessâin 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 âwas kindness, mildness, tenderness, sadness.â And Lincoln himself described his mother as âintellectual, sensitive and somewhat sad.â Tom Lincoln, a farmer and carpenter, was a social man with a talent for jokes and stories, but he, too, had a somber streak. âHe seemed to me,â said his stepgrandson, âto border on the seriousâreflective.â This seriousness could tip into gloom. According to a neighbor in Kentucky, he âoften got the âblues,â and had some strange sort of spells, and wanted to be alone all he could when he had them.â 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 Lincolnâs family comes from his paternal relations. His great-uncle once told a court of law that he had âa deranged mind.â His uncle Mordecai Lincoln had broad mood swings, which were probably intensified by his heavy drinking. And Mordecaiâs family was thick with mental disease. All three of his sonsâwho bore a strong physical resemblance to their first cousin Abrahamâwere considered melancholy men. One settler who knew both the future president and his cousins spoke of the two âLincoln characteristicsâ: âtheir moody spells and great sense of humor.â 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 Lincolnâs 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 âher disease is of thirteen years duration.â At the hospital, an attendant observed, âHer father was cousin to Abraham Lincoln, and she has features much like his.â
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 âthe disease is with her hereditary.â According to a family historian who grew up in the late nineteenth century, the descendants of Mordecai Lincoln âsuffered from all the nervous disorders known. Some were on the ragged edge.â One family member who had frequent spells of intense mental trouble referred to his condition as âthe Lincoln horrors.â
Three elements of Lincolnâs historyâthe 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 cousinsâsuggest the likelihood of a biological predisposition toward depression. âPredispositionâ means an increased risk of developing an illness. As opposed to traditional Mendelian inheritanceâin which one dominant gene or two recessive genes lead to an illness or traitâgenetic factors in psychiatric illnesses are additive and not categorical. âThe genes confer only susceptibility in many cases,â explains the psychiatrist S. Nassir Ghaemi, in The Concepts of Psychiatry, ânot 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 diseaserelated genes.â
What tips a person from tendency to actuality? For centuries, philosophers and physicians emphasized climate and diet. Todayâs experts focus on harsh life events and conditions, especially in early childhood. Lincolnâs early life certainly had its harsh elements. His only brother died in infancy in Kentucky. In 1816, Abrahamâs 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 Lincolnâs 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 âpuking feverâ to âriver sicknessâ to âfall poison.â Later, it became known as the âmilk sick.â âNo announcement strikes the members of a western community with so much dread as the report of a case,â said a newspaper of the time. A physician described the course of the illness: âWhen 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.â Nausea soon follows, then âa feeling of depression and burning at the pit of the stomach,â then retching, twitching, and tossing side to side. Before long, the patient becomes âdeathly pale and shrunk up,â listless and indifferent, and lies, between fits of retching, in a âmild coma.â First the Sparrowsâwith whom the Lincolns were closeâtook 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 âsad, if not pitiful.â
The one constant in Abrahamâs 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. âWe went out and told Abe,â recalled a neighbor. âI 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.â
In the emotional development of a child, pervasive tension can be just as influential as loss. Lincolnâs relationship with his fatherâthe only other member of his nuclear family who survivedâwas 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. âAbe read all the books he could lay his hands on,â said his stepmother. âAnd when he came across a passage that struck him he would write it down . . . then he would re-write itâlook at itârepeat it.â But at some point Tom Lincoln began to oppose the extent of his sonâs 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 Bible (for his moral life) and legal documents (for his work life). Writing could help, too, as could basic arithmetic. Anything more was a luxury, and for working folks seemed frivolous. For generations, Lincoln men had cleared land, raised crops, and worked a trade. So when this boy slipped away from feeding livestock and splitting logs to write poetry and read stories, people thought him lazy. âLincoln was lazyâa very lazy man,â remembered his cousin Dennis Hanks. âHe was always readingâscribblingâwritingâcipheringâwriting poetry &c. &c.â
Later, Lincolnâs self-education would become the stuff of legend. Many parents have cited Lincolnâs long walks to school and ferocious self-discipline to their children. But Lincoln pursued his interests in defiance of established norms. Far from being praised, he was consistently admonished. He may well have paid an emotional toll. Many studies have linked adult mental health to parental support in childhood. Lower levels of support correlate with increased levels of depressive symptoms, among other health problems, in adulthood. After Lincoln left home in his early twenties, his contact with his father was impersonal and infrequent.
When reviewing the facts of Lincolnâs childhood, we should keep in mind some context. For example, in the early nineteenth century, one out of four infants died before their first birthday. And about one fourth of all children lost a mother or father before age fifteen. Of the eighteen American presidents in the nineteenth century, nine lost their mother, father, or both while they were children. None of Lincolnâs contemporaries, nor Lincoln himself, mentioned the deaths of his siblings and mother as factors contributing to his melancholy. The melancholy was unusual, but the deaths were not. In the same vein, while we ought not to ignore Lincolnâs conflict with his father and discount its possible emotional aftereffects, we risk missing more than we gain if we look at it exclusively through the lens of modern psychology. In fact, such a conflict between ambitious young men and their fathers was not uncommon in the early nineteenth century, a time of broad cultural and economic change.
Abraham was not evidently a wounded child, but signs point to his being sensitive. He spent a lot of time alone. He was serious about his studies and reading, and uncommonly eager to explore imaginative realms, which psychologists often observe in sensitive children. He also took up a popular cause among sensitive people, the welfare of animals. Some boys found it fun to set turtles on fire or throw them against trees. âLincoln would Chide usâtell us it was wrongâwould write against it,â remembered one of his neighbors. His stepsister remembered him once âcontending that an ants life was to it, as sweet as ours to us.â
At the same time, Lincoln was a winsome child. Others sought him out, followed him in games, and applauded him when he mounted a stump and performed for them, pretending to be a preacher or a states man. By the time he was a teenager, grown men would flock around him, eager to hear his jokes and stories. He was well liked.
Lincoln was not depressed in his late teens and early twentiesâat least not so far as anyone could see. When he left his family, at age twenty-one, he had no money or connections. His chief assetâperhaps his only real assetâwas his golden character. Settling as a stranger in New Salem, a small village on a river bluff in central Illinois, he soon was among the best-liked men around. A gang of rough boys developed a fierce attachment to him after he made a stellar showing in a wrestling match, displaying not only physical strength but a sense of fairness. Others were impressed with Lincolnâs wit and intelligence, noticing, for example, how when he recited the poetry of Robert Burns, he nailed the Scottish accent, the fierce emotion, and the devilish humor. Though Lincoln looked like a yokelâtall and gangly, he had thick, black, unruly hair and he wore pants that ended above his anklesâhe had good ideas and a good manner. âHe became popular with all classes,â said Jason Duncan, a physician in New Salem.
After less than a year in New Salem, Lincoln declared himself as a candidate for the Illinois General Assembly. He was twenty-three years old. He lost the race but got nearly every vote in his precinct, which, said another candidate, was âmainly due to his personal popularity.â When he volunteered for a state militia campaign against a band of Native Americans under Chief Black Hawk, a part of the bloody Black Hawk War, his company elected Lincoln captain. Nearly three decades laterâas a veteran of Congress and his partyâs nominee for president of the United StatesâLincoln wrote that this was âa success which gave me more pleasure than any I have had since.â
In his first four years in New Salem, Lincoln struck his new friends and neighbors as sunny and indefatigable. âI never saw Mr Lincoln angry or desponding,â said a fellow soldier in the Black Hawk War, âbut always cheerful.â Indeed, âthe whole company, even amid trouble and suffering, received Strength & fortitude, by his bouancy and elasticity.â Once Lincoln stopped at the house of a neighbor, Elizabeth Abell, after working in the fields. He was scratched all over from briar thorns. Abell fussed over him, but Lincoln laughed about it and said it was the poor manâs lot. âCertainly,â she said years later, âhe was the best natured man I ever got acquainted with.â Asked by a biographer whether the Lincoln she knew was a âsad man,â Abell answered, âI never considered him so. He was always social and lively and had great aspirations.â Crucially, his liveliness and sociability served him well in politics. Campaigning again for the state legislature in 1834, he went out to a field where a group of about thirty men were working the harvest. A friend of Lincolnâs, J. R. Herndon, introduced him. The men said that they couldnât vote for a man who didnât know how to do field work. âBoys,â Lincoln said, âif that is all I am sure of your votes.â He picked up a scythe and went to work. âI dont think he Lost a vote in the Croud,â Herndon wrote.
Lincoln won the election easily. When a mentor in the legislature recommended that he study law, he took the challenge. It would be a good profession to accompany politics, in particular the politics of the Whig party, which drew its strength from the growing number of urban and industrial professionals. In the early nineteenth century, attorneys commanded a kind of awe, embodying the stately Anglo-Saxon tradition of common law and domestic order. Gaining âthe secrets of that science,â explained the poet-author William Allen Butler, would give a person a perpetual glow, for the law, âmore than all other human forces, directs the progress of events.â
It is a mark of Lincolnâs soaring ambition that, four years from the fields, he sought to join such ranks, at a time when all but five percent of the men in his area did manual work for a living. It was a sign of his pluck that he did it virtually all on his own. While other young men learned the law at universitiesâor, more commonly, under the tutelage of an established attorneyâLincoln, as he noted in his memoir, âstudied with nobody.â This was hardly the only mark of his ambition. A lawyer named Lynn McNulty Greene remembered Lincoln telling him that âall his folks seemed to have good sense but none of them had become distinguished, and he believed it was for him to become so.â This language suggests that Lincoln had, more than a personal desire, a sense of calling. âMr. Lincoln,â explained his friend O. H. Browning, âbelieved that there was a predestined work for him in the world . . . Even in his early days he had a strong conviction that he was born for better things than then seemed likely or even possible . . . While I think he was a man of very strong ambition, I think it had its origin in this sentiment, that he was destined for something nobler than he was for the time engaged in.â In his first published political speech, Lincoln wrote, âEvery man is said to have his peculiar ambition. Whether it be true or not, I can say for one that I have no other so great as that of being truly esteemed of my fellow men, by rendering myself worthy of their esteem.â
But there were cracks in Lincolnâs sunny disposition. âIf the good people in their wisdom shall see fit to keep me in the background,â he said in that same speech, âI have been too familiar with disappointments to be very much chagrined.â At times, his faith in personal progress gave way and his familiarity with disappointments shone through. Back from the militia campaign, Lincoln and a partner opened their own store, buying the stock on credit. When the store failed, Lincoln was in serious financial jeopardy. Seeing him despondent, his new friends got him a crucial political appointment, as New Salemâs postmaster. Later, he was made deputy surveyor, too. These jobs, Lincoln noted, âprocured bread, and kept soul and body together.â Nevertheless, his debt soon caught up with him: a creditor seized his surveying equipmentâincluding his horse, his compass, and his chainâand put it up for auction. An older man named James Short saw Lincoln moping about and heard him say he might âlet the whole thing go.â Short tried to cheer him up. Then he went and bought the equipment for $120 (about $2,500 in modern dollars) and returned it to Lincoln.
These streaks of sadness and worry may have been minor depressions. But it wasnât until 1835 that serious concern emerged about Lincolnâs mental health. That summer, remembered the schoolteacher Mentor Graham, Lincoln âsomewhat injured his health and Constitution.â The first sign of trouble came with his intense study of law. He âread hardâday and nightâterribly hard,â remembered Isaac Cogdal, a stonemason. At times, Lincoln seemed oblivious to his friends and surroundings. âHe became emaciated,â said Henry McHenry, a farmer in the area, âand his best friends were afraid that he would craze himselfâmake himself derange.â
Around the same time, an epidemic of what doctors called âbilious feverââtyphoid, probablyâspread through the area. Doctors administered heroic doses of mercury, quinine, and jalap, a powerful purgative. According to one recollection, Lincoln helped tend to the sick, build coffins for the dead, and assist in the burialsâdespite the fact that he was âsuffering himself with the chills and fever on alternate days.â He was probably affected mentally, too, by the waves of death washing across his new homeâreminiscent, perhaps, of the âmilk sickâ that had devastated his family in his youth.
Among the severely afflicted families were Lincolnâs friends the Rutledges. Originally from South Carolina, they had been among the first to settle in New Salem, opening a tavern and boarding house, where Lincoln stayed and took meals when he first arrived. He knew the family well and had become friends with Anna Mayes Rutledge, a bright, pretty young woman with flowing blond hair and large blue eyes. In August 1835, Ann took sick. As she lay in bed in her familyâs cabin, Lincoln visited her often. âIt was very evident that he was much distressed,â remembered a neighbor named John Jones. She died on August 25. Around the time of her funeral, the weather turned cold and wet. Lincoln said he couldnât bear the idea of rain falling on Annâs graveâand this was the first sign people had that he was in the midst of an emotional collapse. âAs to the condition of Lincolnâs Mind after the death of Miss R.,â Henry McHenry recalled, âafter that Event he seemed quite changed, he seemed Retired, & loved Solitude, he seemed wrapped in profound thought, indifferent, to transpiring Events, had but Little to say, but would take his gun and wander off in the woods by him self, away from the association of even those he most esteemed, this gloom seemed to deepen for some time, so as to give anxiety to his friends in regard to his Mind.â
Indeed, the anxiety was widespread, both for Lincolnâs immediate safety and for his long-term mental health. Lincoln âtold Me that he felt...