Issue 25 Understanding Science

Van Gogh’s Disorder

🕒 5 min

Vincent Willem Van Gogh was a Dutch painter who lived in the late 19th century and is generally considered to be the greatest artist after Rembrandt van Rijn. In one decade of his short life, he created about 2,100 artworks, mostly landscapes, still life, portraits and self-portraits. His most famous painting called “Starry night” very well represents his unique artistic style, characterized by bold colours put together with dramatic brush work that greatly paved the way to modern art.

Unfortunately, Van Gogh was not that successful in his career, selling only one artwork during his life, which burdened the artist mentally and caused him severe depression. His mental health was very unstable as the time passed and he suffered severe psychotic episodes with delusions which led to many hospitalisations, but without any improvement because of the limited therapeutic options. Van Gogh´s mental health also affected his physical health, he starved himself and drank heavily most of the time. As mental disorders were even more stigmatized in the past as they are today, he was considered a madman and a failure. His depression took its toll at the very end of his life and he committed suicide at only 37 years old. After his death, he came to be seen as a misunderstood genius in the public eye and finally received well needed recognition.

Numerous debates have been held after Vincent Van Gogh´s death, mostly about the nature of his illness, since the field of psychiatry hasn´t been acknowledged with such mental disorder at the time.  Experts agreed on a conclusion that the painter had an episodic condition with periods of normal functioning. The Van Gogh´s disorder is today known as bipolar disorder, formerly called manic depression. Basically, the disorder is characterized by extreme mood swings that include emotional highs (called mania or hypomania) and the very lows (periods of depression). As the first episode patients usually experience depression followed by a manic or hypomanic episode, but it can also occur the other way around. When patients experience the “low” (or depression), they mostly feel sad or hopeless and lose interest in everyday activities. When their mood shifts to “high” (mania or hypomania) patients feel euphoric, full of energy and are easily irritated. People with bipolar disorder usually experience these extremes at different times, although the episodes can also occur together in a so-called “mixed state”. The mood swings affect sleep, energy level, activity, capability of judgment and can completely change person´s behaviour and the ability to think clearly. Episodes may occur rarely or multiple times a year. Most patients will experience some emotional changes between the episodes, but some also don´t experience any. Although bipolar disorder can occur at any age, it is typically diagnosed in the teenage years or early twenties. There are also several types of bipolar and related disorders, but they all have in common the “repeating” character of the disorder and psychiatrists usually need more time to diagnose, as they need to be sure that the episodes repeat themselves. Although bipolar disorder is a lifelong condition, it can be easily managed by a treatment plan, which usually includes medication and psychological counselling (psychotherapy).

Medications used in the treatment of bipolar disorder are called mood stabilizers, as the drugs can help reduce mood swings and prevent manic or depressive episodes. How these drugs work is still not fully understood, but their main mechanism of action is explained through stabilisation and prevention of overstimulated areas in the brain. The oldest and most studied mood stabilizer is lithium, ingredient of some mineral waters but also in small amounts present in the human body. Lithium is often used to treat mania and to prevent manic or depressive episodes. It is very effective, but it also has many side effects, such as increased thirst, nausea, weight gain and trembling of the limbs. Thyroid and kidney function can be affected by lithium, so it is always recommended to monitor those functions regularly or even stop the treatment if needed. Lithium is also very easy to overdose, so therapeutic drug monitoring (or measuring lithium concentrations in the blood) is often used at the start of therapy. Interestingly, many drugs that were first developed to treat epilepsy can also act as mood stabilizing medications, as for example valproic acid or valproate, carbamazepine and lamotrigine. Whereas valproic acid, valproate and carbamazepine work as effective stabilizers of manic or hypomanic episodes, lamotrigine is more effective in stabilizing depressive episodes. The mood stabilizing medication needs around two weeks to start working and around four to six weeks to reach its full potential. It is very important to take the medication every day and give it some time to work, but when side effects occur and the medicine hasn´t properly worked yet, the therapy could be easily adapted according to patient’s needs. Mood stabilizers are generally considered as cornerstone of treatment for bipolar disorder, however combining them with other types of therapy can greatly contribute to the patients’ well-being. Different forms of talk therapy have been shown as effective in treatment of bipolar disorder, such as cognitive-behavioural therapy, interpersonal and social rhythm therapy. A great role in the treatment also has the education of patients´ family and friends, mostly about how to easily notice different mood swings. Lifestyle changes like exercising regularly, eating a nutritious diet, minimizing the use of alcohol and getting enough sleep are not less important.

The bipolar awareness ribbon (black and white represent mood variation)

World Bipolar Day is celebrated each year on March 30th, the day when the painting genius Vincent Van Gogh was born. It is estimated that around 2,4% of people around the world have had a diagnosis of the disorder at some point in their lifetime. The main goal of a World Bipolar Day is to raise awareness and educate more people about bipolar disorders and to eliminate all present social stigma. To sum up, bipolar disorder is a treatable mental health condition, not a character flaw or a sign of personal weakness. The starting point in the treatment of every mental disorder is understanding, whether of the patient for his condition or his surroundings for the disorder itself. Rethink mental illness and stop the stigma!

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.