The Suffering of Vincent Van Gogh with Bipolar II with Rapid Cycling Features

Vincent Van Gogh is regarded as one of the greatest artists of all time. However, it was well documented that he suffered from some type of mental illness. This illness seemed to fuel his creative drive and genius. No formal diagnosis was ever made, but evidence seems to suggest that he was suffering from Bipolar II with Rapid Cycling features.

The basic criteria for both a Major Depressive Episode and a Hypomanic Episode are met. When it comes to a Major Depressive Episode, six of the nine symptoms to qualify for an MDE are met.

Those symptoms include: "depressed mood, weight loss and lack of appetite, insomnia and hypersomnia, feeling worthless and guilty for no reason at all, psychomotor agitation, and frequent thoughts of death (American Psychiatric Association [DSM-IV-TR], 2000)". The duration of these symptoms appears to span the majority of his life, effectively ruling out a single MDE episode. These periods of emotional lows could be noticeable during his first assignment in the priesthood to a poor coal mining region. The death and poverty surrounding him regularly seemed to contribute to his MDE. He would experience periods of emotional lows followed by periods of emotional highs.

When it comes to a Hypomanic Episode, five out of seven symptoms are met. Those symptoms include: "lack of sleep or need for it, racing ideas, being more talkative and social than usual, an increase in goal-directed activities, and an excessive involvement in pleasurable activities (DSM-IV-TR, 2000)". The "excessive involvement in pleasurable activities" could be observed in how he would buy an overabundance of paint supplies. Van Gogh was also known to be a womanizer and suffered from bouts of STI's throughout his life. These periods were also coupled with excessive energy, as exhibited in how he would produce many pictures during these times. He would work constantly, painting both day and night. Mania can be ruled out due to his depressed episodes that usually preceded or followed his manic-like behavior.

This swapping or cycling in behavior leads to the diagnosis of Bipolar II Disorder with Rapid Cycling features.

To qualify for Bipolar II, one must meet the criteria for Major Depressive Episodes and Hypomanic Episodes. The symptom criteria and length of time these symptoms are present have been met. Rapid Cycling is identified due to the number of episodes of both MDE and Hypomanic Episodes that he suffered from throughout his life. The cycling could also be seen in how he seemed to recover and make progress, only to then switch to an MDE or Hypomanic Episode. The period of cycling appeared to occur in a day-to-day pattern. This pattern caused him to become very exhausted at times, followed by periods of hypersomnia. This cycling caused him extreme distress. Many of his social relationships suffered due to his sometimes erratic behavior. It was documented that his final fallout with his artist friend Gaugin involved Van Gogh threatening him with a razor blade. In the end, Van Gogh stopped himself, but instead cut off his own ear and gave it to a prostitute. This erratic behavior and self-mutilation can be attributed to his rapid cycling features.

Van Gogh met the criteria to be diagnosed with Bipolar II Disorder with Rapid Cycling features. The cycling made him unstable but also contributed to his genius. This cycling can be seen in his paintings and how his strokes and colors changed, which could be correlated with his cycling of episodes. These changes in style that were expressed in his paintings have contributed to his fame and genius.

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.

Minnelli, V. (1956). Lust for Life. [DVD].

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