He is perhaps best known for his honesty — but a lesser-known fact about Abraham Lincoln is that the 16th president of the United States battled severe depression during his lifetime.
Dr. Chris Tuell, a clinical psychotherapist and a chemical and behavioral addiction specialist at the University of Cincinnati College of Medicine, has studied Lincoln’s mental health struggles extensively.
“Though the history books play a significant role in our perception and understanding of the ‘rail splitter’ from Illinois, it often becomes easy for us to forget that Abraham Lincoln was very human,” Tuell told Fox News Digital.
“Lincoln led this nation through its worst crisis, while at the same time battling his own internal war of chronic depression.”
Here’s what to know.
Signs of Lincoln’s depression
At age 32, in a letter to John Stuart in 1841, Lincoln wrote, “I am now the most miserable man living. If what I feel were equally distributed to the whole human family, there would not be one cheerful face on earth. Whether I shall ever be better, I cannot tell; I awfully forebode I shall not; to remain as I am is impossible.”
Lincoln scholars have “clear evidence” that he suffered from depressive episodes beginning in his 20s, Tuell noted.
“Lincoln’s school teacher, Mentor Graham, stated, ‘Lincoln told me that he felt like committing suicide often,’” Tuell said.
“Law partner and biographer William Herndon stated, ‘He was a sad-looking man, gloomy and melancholic. His melancholy dripped from him as he walked.’”
Contributing factors to Lincoln’s depression
The president’s mental health condition can be attributed to both genetics and traumatic experiences, according to the book “Lincoln’s Melancholy” by Joshua Wolf Shenk.
Lincoln is said to have had a family history of depression.
“Historical records indicate that Lincoln’s mother and father were disposed to melancholy and that one side of the family ‘was thick with mental disease,'” said Tuell.
“Bereavement in childhood can be one of the most significant factors in the development of depressive illness in later life.”
As a child, Lincoln lost several close family members.
After his brother died in infancy, Lincoln’s mother, aunt and uncle all died when he was just 9 years old. A decade later, his sister died while delivering a stillborn infant.
Later, Lincoln experienced the loss of his first love, Ann Rutledge, in 1835.
As a father, he experienced the death of two young sons, Eddie and Willie.
“According to mental health professionals, bereavement in childhood can be one of the most significant factors in the development of depressive illness in later life,” Tuell said.
Dr. Marc Siegel, clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said that Lincoln’s melancholy may have been tied to his “intellectual prowess and [his tendency to] see and feel things deeply.”
How Lincoln dealt with depression
Before the age of psychotherapy and antidepressant medications, Lincoln learned to live with his depressive disposition, Tuell said.
“He would frequently use humor and storytelling to elevate his mood and distract himself from his depression,” the psychologist told Fox News Digital.
“Only his closest friends had any insight concerning the extent of his condition.”
In a time period when mental health treatment was not available, Tuell noted that learning how to manage his life with his depression was Lincoln’s only choice.
“The only other option would have been for him to succumb to these adversities,” he said.
“He managed to overcome it and the Civil War to become our greatest president, by most people’s estimation.”