‘Sblood, do you think I am
easier to be played on than a pipe? Call me what
instrument you will, though you can fret me, yet you
cannot play upon me. (Hamlet, Act III Scene 2)
These lines, from what is often referred to as the greatest play ever written, depict a seemingly acute episode of mania experienced by Hamlet, the Prince of Denmark. From the beginning of the play, symptoms indicating the onset of a serious psychological disturbance are visible in Hamlet, and as the play progresses, a distinct clinical condition marked by acute psychotic symptoms becomes plainly discernible.
Shakespeare’s remarkable ability to discern and apprehend psychological illnesses, especially in an age when there was very limited knowledge regarding mental health, does not fail to amaze his readers. From Lady Macbeth’s OCD to King Lear’s Paranoia, and from Hamlet’s mania to Ophelia’s Psychosis, the bard’s diligent eye managed to capture clinical conditions perhaps just as accurately as the physicians of his time would have been capable of.
It is certainly astounding how a writer and poet could pay close attention to such minute details in describing mental disorders. Each word and action of the disordered individual so meticulously describes a specific clinical condition that it may as well have been documented by a clinician himself. It is for this reason that Shakespeare has been extensively quoted by famous psychiatrists of the 19th century and to this day his accuracy in understanding mental illness does not fail to impress clinicians and therapists.
Mental Illness in Elizabethan Era
Before we plunge into the fascinating depictions of different psychiatric illnesses within his characters, let us have a look at the status of mental illness in 16th century England and the theories that prevailed in Elizabethan England regarding mental illness.
In 16th century England, the condition of the mentally ill remained dire. Mentally ill individuals were institutionalised in insane asylums. One of the most well known amongst these institutions was St Mary of Bethlehem in London, which was established in 1247, known at that time as Bedlam. (Kendall, 1995)
Mental illness at that time was thought to be of the following types:
• Melancholia, or depression.
• Delirium, which was considered to be abnormal behaviour often accompanied by fever.
• Amentia, the loss of mental ability.
• Epilepsy, which was considered to be a mental disorder and treated as such. (Hanson, 2015).
The Source of Shakespeare’s Medical Information
There can be no doubt that Shakespeare was fascinated by psychiatric illness. Curiously enough, his writings not only contain characters infested with mental disorders but also depict a knowledge of physical illness and disease the accuracy of which does not fail to impress upon his readers. It can only be inferred that he had access to some credible and authentic first-hand information on the subject, the source of which is widely considered to be his son in law John Hall. (Morris, 2012).
John Hall, a physician and a herbalist, earned his master’s degree from Cambridge in 1597, and later went on to settle in Stratford-Upon-Avon, Shakespeare’s hometown. However, on the doctor being the source of Shakespeare’s medical knowledge, the opinion seems divided. As John Hall married Shakespeare’s eldest daughter Suzanna in 1607, and by that time the bard had written many of his plays, it can well be assumed that he obtained most of his medical knowledge on his own.
London, A City of Disease
Some historians are of the opinion that Shakespeare may have acquired knowledge of common physical and psychological disorders by merely observing the sickness and disease around him, especially during the years he spent living in London. 16th century London could truly be considered a nest for all sorts of disease and infection due to the unhygienic conditions that prevailed in the city. Overpopulated and littered, it was infested with flies and rodents that transported bacteria and infection throughout the city. Such conditions could provide someone with a keen eye with an ample opportunity for observation and study of disease and suffering, both physical and mental, especially during the plague which hit the city from 1592 to 1603. (Cummings, 2003).
Madness depicted in Shakespeare’s works
Following are a few examples of some characters, where the symptoms have been described by the bard in such detail that to the professional clinician and therapist, they may not be difficult to diagnose:
Lady Macbeth’s condition emerges as a Psychotic Disorder marked by hallucinations, delusions and Obsessive Compulsive symptoms, apparently induced by extreme guilt. Guilt is a very prominent symptom and contributing factor in different types of psychosis, including major depression and schizophrenia, and Lady Macbeth appears to have developed psychotic symptoms following the murder of King Duncan committed by her husband and herself in cold blood.
An individual’s premorbid personality, that is, personality before the onset of a disorder, also plays a major role in later development of psychological disorders, and Lady Macbeth’s premorbid personality appears not only to be marked by delusions of grandeur but by psychopathic traits as well.
I have given suck, and know
How tender ’tis to love the babe that milks me.
I would, while it was smiling in my face,
Have plucked my nipple from his boneless gums
And dashed the brains out, (Macbeth, Act 1, Scene 7)
Nowhere, however, has Shakespeare’s accuracy in describing mental illness made itself so evident as in the timeless tragedy of Hamlet, in the character of Hamlet himself. The onset of the disorder occurs with the symptoms of bereavement and then exacerbates into a full-fledged bipolar disorder marked by episodes of depression, as well as mania:
To be or not to be,
That is the question (Hamlet, Act 3, Scene 1)
Driven out of his mind with the grief and shock of his father’s untimely death followed by his mother’s hasty marriage, Hamlet from the very beginning manifests signs of psychosis. His first encounter with his father’s spirit may have been “real,” however, in later scenes, Hamlet clearly experiences auditory and visual hallucinations, repeatedly hearing his father’s voice in his head, and again ‘encountering’ his father’s ghost, in the bedroom scene.
As his symptoms worsen, the depressive episode gives way to mania, which becomes manifest in sudden outbursts of anger, violence, and over-excitability, making him a threat to anyone he encounters.
A study of Ophelia’s character reveals a very weak, timid and suggestible young woman, an epitome of the common young woman of the Elizabethan era. Her premorbid personality defines her to be dependent and easily manipulated; she readily accepts her father’s verdict on Hamlet’s character and agrees to have no further interaction with him, despite having strong feelings for him.
I shall obey, my lord. (Hamlet, Act 1, Scene 3)
This quiet submission, however, takes its toll on Ophelia and results in an onset of depression, causing her to lose whatever little judgement and decision making power she possessed, to begin with. In such a state of mind, she is apparently manipulated by the king and her own father into having a confrontation with Hamlet, driving him into a violent episode of mania.
Ophelia’s condition further deteriorates following her father’s death at the hands of Hamlet, her incoherent speech and delirium plainly depicting her heightened level of psychosis. This depression most tragically culminates in her throwing herself off the castle wall, and killing herself. Again, the bard’s apprehension of clinical depression does not fail to astound the modern day reader; his account of her depression, as it gradually takes hold of her and then engulfs her completely, is both accurate and riveting.
It is certainly impressive how Shakespeare’s understanding of mental disorders even extended
to a cognizance of the behavioural repertoire of individuals suffering from different disorders.
Lady Macbeth’s excessive handwashing was a classic example of Obsessive Compulsive symptoms brought on by endless guilt, Hamlet’s mania caused him to turn into a dangerous individual, a threat to others rather than to himself, while Ophelia’s depression drove her towards suicide, all in keeping with the textbook definitions of the disorders. The tragic end of each of his mentally disturbed characters, thus, is thoroughly in accordance with the type of disorder they suffered from.