Presidential depression and Abraham Lincoln’s struggle with ‘melancholy’: What historians know

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 struggled with severe depression during his lifetime.

Dr. Chris Tuell, a clinical psychiatrist and chemical and behavioral addiction expert at the University of Cincinnati College of Medicine, has studied Lincoln's mental health struggles extensively.

"Although history books play an important role in our perception and understanding of Illinois' 'Rail Splitter,' it is often easy for us to forget that Abraham Lincoln was very much human," Tuell told Fox News Digital.

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"Lincoln led this country out of its worst crisis, while at the same time battling its own internal war of chronic depression."

Here's what to know. 

Symptoms of Lincoln's Depression

At the age of 32, in a letter to John Stuart in 1841, Lincoln wrote, "I am now the most unhappy man living. If what I feel were equally distributed throughout the whole human family, There is not a single happy face on earth. Whether I will ever get better I cannot tell; I had dreadfully predicted that I would not; it is impossible to remain as I am."

Tuell said Lincoln scholars have "clear evidence" that he suffered from depressive episodes by the age of 20.

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"Lincoln's school teacher, Mentor Graham, said, 'Lincoln told me he often felt suicidal,'" Tuell said.

"Law partner and biographer William Herndon said, 'He was a sad-looking man, sad and sad. His sadness dripped from him when he walked.'"

Factors Contributing to Lincoln's Depression

According to the book "Lincoln Melancholy" by Joshua Wolf Schenk, the president's mental health condition can be attributed to both genetics and traumatic experiences.

It is said that Lincoln had a family history of depression.

"Historical records show that Lincoln's mother and father suffered from depression and that one side of the family suffered from mental illness," Tuell said.

"Bereavement in childhood may be one of the most important factors in the development of depressive illness in later life."

As a child, Lincoln lost several close members of his family.

After his brother died in his childhood, Lincoln's mother, aunt, and uncle all died when he was only 9 years old. A decade later, his sister died while giving birth to a stillborn infant.

Later, Lincoln experienced the death of his first love, Ann Rutledge, in 1835.

Placeholder As a father, he experienced the death of two young sons, Eddie and Willie.

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"According to mental health professionals, childhood bereavement may be one of the most important factors in the development of depressive illness in later life," Tuell said.

Dr. Mark Siegel, a clinical professor of medicine at NYU Langone Medical Center and a Fox News medical contributor, said Lincoln's sadness may be linked to his "intellectual skills and his tendency to see and feel things deeply."

How did Lincoln deal with depression?

Before the era of psychotherapy and antidepressants, Tuell said, Lincoln had learned to live with his depressive nature.

"He often used humor and storytelling to improve his mood and distract from his depression," the psychologist told Fox News Digital.

"Only his closest friends had any knowledge of his condition."

Placeholder In a time period when mental health treatment was not available, Tuell said learning to manage his life with his depression was Lincoln's only choice.

"The only option for them would have been to succumb to these adversities," he said.

"By most people's estimation, he overcame that and the Civil War to become our greatest president."

"It does not seem that the personality of the 16th president included acquiescence. Lincoln acted steadfastly and served this country eloquently."

Siegel said that in Lincoln's time, depression was called "melancholy" and was usually treated with opium, a highly addictive narcotic extracted from the poppy plant.

Historians have noted that Lincoln's sons brought him happiness despite his ongoing depression.

"We have become so accustomed to seeing Abraham Lincoln sad and sad that we forget - and the historical record is clear on this - that he laughed when he played with his boys or watched the riots they created, " Raymond Arroyo, a Fox News contributor and bestselling author, previously told Fox News Digital.

He is the author of the book "The Magnificent Mischief of Tad Lincoln", part of his Turnabout Tales series of books.

What to know about depression

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According to the National Institute of Mental Health, depressive disorders affect approximately 18.8 million American adults, or about 9.5% of the US population ages 18 and older.

According to Tuell, there are different types of depressive disorders.

These may include major depression, dysthymia (a persistent, low-grade depression) and bipolar (mood swings between depression and mania).

"Depression can affect every aspect of someone's life — physical health, sleep [habits], eating habits, job, and your relationships with friends and family," Tuell said. "It affects thoughts, feelings and behaviors."

While depression is one of the most serious mental health problems facing people today, Tuell said it is also one of the most treatable.

Tuell and Siegel agreed that Lincoln's perseverance despite severe depression should be admired.

Tuell said, "We can only speculate about what Lincoln would say or do about our current state of political affairs, or what his thoughts might be about the new millennium's understanding of depression and mental health."

"But now, nearly 159 years later, Lincoln's historic personality remains for the ages."

Tuell said Lincoln believed in the human spirit and talked about the role of people toward each other.

"This was never expressed more clearly than Lincoln's own words, 'With malice toward none, with charity toward all,'" he said.

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Lincoln's battle with depression, Siegel said, "can be considered an inspiration to all who suffer from or feel stigmatized by this dangerous disease."

"By most people's estimation, he overcame that and the Civil War to become our greatest president."