Mary Todd Lincoln and the Double Standard of Mental Illness
· Time
American history has long applied a gendered double standard to mental illness, granting men empathy and dignity while branding women unstable and unworthy.
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When men displayed sorrow or temper, it was often excused as external stress rather than a failure of character or impairment. When women did the same, they were more likely to be labeled as intrinsically flawed, weak, and unfit.
The most famous example of this bias can be found in the lives of Abraham and Mary Lincoln. The Lincolns were considered an unlikely pair. They came from starkly different worlds; she was highly educated, wealthy, and socially at ease, while he was self-taught, poor, and introverted. Yet in one essential respect, they were remarkably alike—both were brilliant, complex figures who grappled with mental illness. Mood swings and depression marked their lives, and they helped each other through the difficult spells.
History, however, treated those struggles unevenly, extending understanding and even a sense of gravitas to his, while reducing hers to a character flaw. Their intertwined experiences show how gender, power, and public perception can shape reactions to mental illness with profound historical consequences.
Lincoln’s well-known depression did not define his presidency or his legacy. Historians such as Pulitzer Prize-winning biographer David Herbert Donald portrayed his deep melancholy as integral to his moral authority and central to his contemplative leadership style. Scholar Allen C. Guelzo argued that Lincoln’s depression deepened his compassion and understanding of human suffering. Presidential historian Doris Kearns Goodwin wrote that Lincoln’s melancholy sharpened his “extraordinary empathy.”
In the 1840s and 1850s, Lincoln was so depressed that he routinely ingested “blue pills,” which contained dangerous levels of mercury. He had, at one point, a complete nervous collapse that many Springfield politicians were well aware of. And, even when his behavior panicked his friends to the point that they feared he would harm himself, Lincoln was not stigmatized. When his career hit bumps, his friends later reported he would sink into a trance-like gloom. Still, historians never suggested his depression was disqualifying.
By contrast, Mary Lincoln’s emotional struggles—amid grief, suffocating public scrutiny, and unspeakable personal loss—were not merely misunderstood; they were judged. She lost three children (one died in the White House), yet she was afforded little grace. Her prolonged grief was viewed as female “hysteria” and an irredeemable character flaw.
Her anxiety shaped her reputation and unfairly tarnished her legacy. She is remembered not as an effective first lady, which she was, or as a smart political partner, but as a burden on Lincoln. This one-dimensional judgment reveals both a profound misunderstanding of mental illness and the ease with which it was wielded against women.
The Lincolns are far from the only example of this gendered double standard in America. Ernest Hemingway suffered from severe depression and was an alcoholic, but his emotional issues were often framed as a rugged masculine struggle. By comparison, the English writer Virginia Woolf’s severe depression and likely bipolar disorder caused her and her work to be viewed through the lens of fragility or impairment, rather than through the power of her raw literary talent and brilliance.
Conditions such as postpartum depression and acute anxiety were misunderstood or ignored. The Diagnostic and Statistical Manual of Mental Disorders did not include the postpartum onset of depression as a medically defined diagnosis until 1994. Women were expected to find fulfillment in motherhood, and failure to do so was often treated as a deficiency. There was no male equivalent scrutiny.
The institutionalization of Mary Lincoln in 1875 exemplifies how legal mechanisms could be abused to silence women under the guise of care. While Mary was exhibiting troublesome behavior at the time, some contemporary medical professionals now surmise she was likely experiencing post-traumatic stress disorder (PTSD), not understood at the time. A decade after her husband was assassinated in front of her, reminders were everywhere, a classic triggering event for PTSD.
She became irrationally convinced her only living son was dying and rushed back from Florida to Chicago. While back in Chicago, she shopped excessively and found solace in harmless interactions with spiritualists. But Robert was embarrassed by her eccentric behavior and felt people were judging him because she would not allow him to direct her life and finances. Her behavior and his own Victorian expectations drove him to rid himself of the problem. He ambushed her with an incompetency trial.
The jury relied on testimony from her son and doctors chosen by her son, as well as from a hotel staff prepped by Robert’s lawyers. Seven physicians pronounced her insane; only one had treated her. The all-male jury came back in 10 minutes to declare her insane and a “fit person to be institutionalized.” Ironically, this same son suffered a “nervous breakdown” (his words) at around the same age he had committed his mother, and was forced to take an extended leave from his job. But no one ever tried to institutionalize him.
Mary was smart and resourceful and got herself out of Bellevue Place in just under four months. But her legacy as a politically savvy spouse—who advised her husband and navigated wartime Washington—was erased.
The stigma surrounding mental illness in women has unquestionably decreased in recent decades, as psychiatry has moved toward evidence instead of moral judgment. In 1980, the American Psychiatric Association finally deleted “hysteria” as a viable diagnosis for women. By 1990, women were being included in health care research, and men started talking openly about depression.
If Mary Todd Lincoln were evaluated today, her behavior would not be lumped into a single catch-all diagnosis. It would be broken down into treatable conditions. Instead of being dismissed as erratic, she would be offered mood stabilizers, therapy, and informed care. Most importantly, her suffering would be interpreted not as a failure of character, but as the cumulative effect of grief, pressure, and genetics.
Still, the double standards remain deeply embedded in cultural attitudes toward women’s health. Women’s symptoms are more likely to be dismissed, while men frequently avoid seeking help. A 2024 study found that older women are far more likely to be diagnosed with depression than men, suggesting that men still avoid being diagnosed for fear of seeming weak.
A shift from judgment to diagnosis, from stigma to treatment, would likely have changed not only how Mary Lincoln was regarded during her lifetime, but how she was remembered.