There are only a few artists of any kind that possess as much mystery, illusion, and complexity of form and composition as Vincent van Gogh. When people hear of van Gogh, two facts usually come to mind: 1) he cut off his own ear, and 2) he painted “The Starry Night.” Both of these facts have given van Gogh a dramatic, and very often stereotypical, identity as “the tortured, psychotic, misunderstood artist” whose only true freedom and medicine was the creation of his art.

However understandable this idea may sound, it has falsely simplified the artist’s condition and attempted to feed a list of creators and artists who all seemed to have suffered from a similar psychotic fate, some of whom include: Ludwig van Beethoven, Virginia Woolf, Ernest Hemingway, and Robert Schuman.

But the numerous art historians, medical historians, neuropsychiatrists, and neurophysiologists brave enough to investigate van Gogh’s mental illness have discovered not only how mysterious and unconventional his psychosis was, and still is today, but also how it informed and transformed his work in the last two years of his life. In order to respect the uniqueness of van Gogh’s mind we must search deeper into the artist’s family, his lifestyle, his relationships, his letters, and his colors.

Since his death on July 29, 1890, well over 150 art and science professionals from various fields have attempted to accurately describe van Gogh’s mental illness. Among the first physicians to have written reports about van Gogh’s condition were Felix Rey, Theophile Peyron, and Paul Gachet — all of whom attended directly to van Gogh throughout the course of his psychosis. Even though they wrote extensive reports regarding both his symptomatology and prognosis, the best sources of information which have survived over the 126 years since van Gogh’s suicide are his letters written to his brother Theo, with whom he had a long, complicated yet intimate, relationship throughout his short life.

In his letters, van Gogh describes suffering from frequent gastrointestinal problems, at least one bout of constipation that required medical attention, as well as auditory and visual hallucinations, partial seizures, fever, and sexual impotence. His condition was further exacerbated by malnutrition and fasting, excessive ingestion of alcoholic beverages (mainly absinthe), overwork, and a liking toward camphor and other terpenes.

In a letter to Theo on March 7, 1877, Vincent writes about his depression: “But I am so angry with myself now because I cannot do what I should like to do, and at such a moment one feels as if they were lying bound hand and foot at the bottom of a deep, dark well, utterly helpless.”

The last two years of van Gogh’s life included six documented medical crises. Mysteriously, each of these crises had an abrupt onset, followed by a period of days or weeks of insomnia, hallucinations, aphasia, fever, and stupor, and then a swift resolution described by van Gogh as: “One day fine — the next day, down with sickness … yesterday I was too sick to write — today I pick up the pen … We’re all mortal and subject to all possible illnesses, what can we do about it when the latter aren’t precisely of a pleasant kind. The best thing is to try to recover from them.”

From the above characteristics described by van Gogh, historians and researchers have argued over possible diagnoses, only some of which include: epilepsy, bipolar disorder, sunstroke, acute intermittent porphyria, lead poisoning, absinthe intoxication, Meniere’s disease, and digitalis toxicity.

Rey and Peyron both thought that van Gogh suffered from epilepsy. Epilepsy is a paroxysmal (sudden and recurring) transient disturbance in brain function manifested by episodic impairment or loss of consciousness, abnormal motor phenomena, psychic, or sensory disturbances, or perturbation of the autonomic nervous system.

In a letter from January 29, 1889, addressed to van Gogh’s brother Theo, Peyron writes: “I am writing to you on behalf of M. Vincent, who is the victim of another attack. M. Vincent was getting on very well and was completely himself when last week he wanted to go to Arles to see some people, and two days after he made the journey the attack took place. At present he is unable to do any work at all and only replies incoherently to any question put to him. I trust that this will pass again as it has done before.”

Edgar Leroy and Victor Doiteau, van Gogh’s biographers, supported the diagnosis of temporal lobe epilepsy in 1928, but others, such as Wilfred Niels Arnold of the University of Kansas Medical Center, disagree, pointing out that the nature of his seizures, as well as the time and duration of the episodes, do not follow the typical pattern of the classical complex partial seizure.