John Adams and mental health

Why are some people able to face life with all its storms and woes, and then go on to some degree of happiness and achievement, while others never seem to pick themselves up or be able to avoid a tragic personal slide into failure?  John Adams, in the Pulitzer Prize presidential biography by David McCullough on which the HBO Films miniseries was based, dealt with that question and came up with his own answers, partly from the world he lived in and partly from his own insights.

Death loomed large in American society in the late 18th century.  Several illnesses, including smallpox and yellow fever, killed many thousands.  In the city of Philadelphia, which had a yellow fever epidemic every summer, in just one such summer lost over 5,000 residents to that plague.  And certainly there were other tragedies in people’s families and personal lives. John Adams escaped from Philadelphia to his pleasant farm outside Boston where he and his wife Abigail were able to nurse their very considerable anxiety over their “tumult of grief,” as she called her deep struggle.

Both John and Abigail wrote numerous letters and kept “diaries,” personal journals in which they searched for understanding and ways to overcome. Journaling has more recently become a widely-accepted means of helping people through their challenges. John counseled his children and grandchildren to take up the practice.  Without it, he wrote, our travels would “be no better than a flight of birds through the air,” leaving no trace. It was an expression of his belief that “Everything in life should be done with reflection,” and of the view that “We must learn to know ourselves, to esteem ourselves, to respect ourselves.”  He also advocated going on frequent long walks along woods and open fields for much the same reason, and to strive for “independence,” personally, financially, and nationally.

The down-side of all this was that John, and many of the people of his times, could not accept within their own families those who failed in life, nor understand the fact that good habits and right thoughts are not sufficient to conquer the kinds of personal challenges that some people face.  One of the close friends of John Adams was a great help here, and indeed famous for his theories on mental illness and addiction.  This was Benjamin Rush, a signer of the American Constitution and a notable doctor who wrote Medical Inquiries and Observations upon the Diseases of the Mind, a book that became required reading in medical schools, earning Rush the title of “father of American psychiatry.”

Rush linked the mind with the body to show that there are common causes to physical and mental illnesses.  He opposed the general use of restraints and coercion in dealing with insanity and advocated for separate mental health wards and humane treatment. Rush also began to change the view that alcoholism was nothing more than sin and character failure, noting that the chemical properties of alcohol itself are “causal agents” in alcoholism.  He suggested that addicts be shown harm-reducing therapies such as “weaning them off” by access to “less potent substances.”  How modern many of his views now appear to be.




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