Trump to Biden–many US Presidents were mentally ill. It’s the elite who deal with the problem

A third of US Presidents between 1776 to 1974 demonstrated symptoms of clinically significant depression, bipolar disorder and alcohol abuse while they were in office.

US President Donald Trump (c) Copyright Thomson Reuters 2024

History records the fires burning inside Ludwig II’s mind, a rage so strong that it washed over the memory of his long-dead father, Maximillian II. “Get his skull from the sarcophagus and box his ears,” the king ordered. There was also a time when a table was set outdoors for the king to dine in the snow with the ghost of Jeanne Antoinette Poisson, mistress to King Louis XV, and the reforming noblewoman Françoise d’Aubigné.

Comima Wagner, sister to the composer Richard Wagner, wrote: “He ordered a dinner for twelve people near Partenkirchen, came alone, greeted the empty seats and sat down.” “He also never exited his castles through the doors, but through the windows.”

And there were endless rumours of young men drawn from the ranks of the army draping themselves around Ludwig II, as he pretended to be a Turkish sultan, Alison Rattle and Allison Vale write.

For weeks now, as US President Donald Trump takes the hammer to his country’s institutions, economy and élite, his former National Security Advisor John Bolton has reignited old questions about the state of the President’s mental health. Twenty-seven mental health professionals led by Brandy Lee had, in 2017, issued a controversial assessment suggesting the President was unfit to rule. 

There were also serious questions—well known, in fact—about the mental health of former President Joe Biden, which his staff is known to have made considerable efforts to cover up. 

Less well known is that a third of US Presidents who served from 1776 to 1974 demonstrated symptoms of clinically significant depression, bipolar disorder and alcohol abuse while they were in office, according to the medical scholars Jonathan Davidson, Kathryn Connor and Marwin Swartz. These illnesses would, obviously, have impaired their ability to work—though what moments of history were significantly coloured remains unknown.

The point isn’t that madness and power are closely entwined, though they might indeed be. The real test of the competence of nation-states, the stories of mad rulers show, is the ability of courtiers and the élite they represent to make the problem disappear.

The tragedy of the swan king

From the work of medical historians like Reinhard Steinberg and Peter Falkai, it seems probable that Ludwig II likely suffered from schizophrenia—the disease that also afflicted his younger brother, Prince Otto. The psychiatrist who treated Ludwig II, Bernhard von Gudden of the Ludwig Maximilians University in Munich and director of the city’s asylum, diagnosed him with “paranoia”. Later, Steinberg and Falkai recorded that an autopsy would suggest damage from childhood meningitis and frontotemporal atrophy as possible causes of delusional psychosis.

This did not mean, however, that the Bavarian state under Ludwig II was dysfunctional. Following the Austria-Prussian War of 1866, in which Bavaria picked the wrong side, Ludwig II was compelled to sign a mutual defence treaty. Like many other German kingdoms, Bavaria lost its independence in 1870 and joined the North German Confederation. The king’s diplomats, though, were able to secure a high degree of autonomy for Bavaria.

For his contemporaries, Ludwig II’s interests in the arts, and his construction of extravagant palaces, marked him out from other rulers. The fairyland castle of Neuschwanstein—the inspiration for the Disney Cinderella castle—remains a major tourist attraction. King’s House was decorated with Eastern-style kitsch, including a replica of the famous Peacock Throne. Ludwig II was careful, though, to pay for the work with his personal fortune, not State funds.

True, his mind became entwined in Richard Wagner’s often toxic racial fantasies, which, as Julian Young notes, laid the foundations for a welter of fascist movements. Among other things, Ludwig II’s fascination with Wagner would lead him to believe Bavaria needed an absolutist monarchy. Ludwig II fantasised that he would become the Moon King, a kind of romantic shadow of the French Sun King, Louis XIV, but there was little effort to turn his regime into a tyranny.

Fourteen million marks in debt, and demanding loans from Europe’s other courts, time finally ran out for Ludwig II in 1888. The king responded to his ministers’ austerity demands by sacking them. The ministers, in turn, responded by having Ludwig II declared insane, based on a report from four psychiatrists, only one of whom had ever met the king. Ludwig II died by suicide.

The limits of power

Evidence that large numbers of other rulers suffered from similar problems—often with more painful outcomes for their nations—isn’t hard to come by.  King George III, who led the United Kingdom into its disastrous war in America, is remembered by history as an arrogant authoritarian who sought to reverse constitutional progress in limiting the monarchy’s powers. The truth, however, is more complex. As historian PDG Thomas argues, George III often had no views at all on complex issues, relying on his courtiers and ministers to form one. As important, any monarch would have had to raise high, harsh taxes to garrison the new American territories.

George III’s courtiers engaged his first bouts of bipolar disorder with skilled shows of sycophancy—famously mimicking his delusions and seizures to make it appear that they were just some charming royal idiosyncrasy. However, the king’s illness became hard to hide, sometimes expressing itself in texts with highly-florid sentences made up of more than 400 words.

Later, the king was subjected to the less-than-tender ministrations of the psychiatrist Francis Willis. Like most of his contemporaries, Willis thought madness had to be beaten out of the patient. This meant a liberal use of the gag, restraints, torture by blistering the skin, and threats. George III did appear to improve—or at least learned to hide his illness better—earning Willis a staggering £271,000 in fees, and a growing practice among the élite. 

Talented politicians like William Pitt the Younger and Charles Fox—as well as an élite in Parliament well-tuned to its own interests—kept the country running. Economists have noted that the loss of the American colonies freed up resources to fund the Industrial Revolution and speeded up the search for profits in Asia. The price of George III’s madness was not great.

Large numbers of similar examples litter 19th-century Europe. Even though Charles VI of France believed—quite literally—that his body was made of glass, his uncles and advisors ruthlessly upheld royal power. An uprising by the workers of Ghent was crushed in 1832, and the young king’s armies forcefully dealt with unrest in Paris and Rouen. The psychopathic behaviours of Ivan IV Vasilyevich did not diminish his contributions to laying the foundations for the modern Russian state.

The responsibilities of elites

This isn’t to say, of course, that madness doesn’t matter: Leaders who understand the uses of nuclear deterrence, the consequences of economic policies, or the social consequences of their actions are preferable to those who don’t or cannot. The deranged leader can have hideous consequences for millions of lives. The Soviet Union’s Josef Stalin was almost certainly not clinically mad, scholars Francois Retief and André Wessels note, but his psychopathic personality drove the Gulags. Adolf Hitler’s drug addiction may well have contributed to crazed decision-making.

However, history also demonstrates that élites can and have often exercised the responsibility of containing kings’ madness. Even if they cannot always contain the consequences of bad decision-making, rulers’ worst impulses can often be reined in. In some cases, of course, evil rulers were simply removed from the scene.

The lesson for electorates, of course, is a more complex one. Too often, the public is reluctant to recognise the demagogue or the simply insane for what they are. The temptation to read meaning, even redemption, into crazed ravings is a deep one. The consequence of a bad choice can be profound, self-inflicted suffering.

Praveen Swami is contributing editor at ThePrint. His X handle is @praveenswami. Views are personal.

(Edited by Ratan Priya)