In recent American history there's been a big push for equality. Gay marriage, women's rights, people of color's representation, class issues and the morality of law have all been adduced in the hopes of securing issue-wide equality. With all the debate and discourse surrounding these issues, I can't help but notice that we've left an equally important issue behind, and aren't we all for equality?
The issue in particular? Mental health and illness. Mental health refers to successful performance of mental function resulting in productive activities, being able to function in society and adapt to what's happening in one's respective world. Mental illness refers to a wide range of mental disorders that affect your thinking, behavior and worldly functionality. 
Mental illness and its accompanying stigmas are a hidden epidemic. Sure, the elections are coming up and that's important, but I consider this issue to be more important. Probably because my political knowledge is on par with that of a newborn child. The shame and embarrassment associated with these problems discourage people from acknowledging or talking about them.
And mental health care is far behind the progress made on other social issues, focusing more on genetics and neurological conditions rather than on social and environmental conditions. A number of stigmas surrounding mental health are prevalent partly due to misconceptions about their causes, with misdiagnosis not helping one bit either.
Our reactions to those who are ill are systemically unequal, alleging a pattern of discrimination that runs so deep it's ingrained in societal structure. And on that note, I bring you to the topic at hand, a crowning example of misunderstanding mental illnes. Literally. The "madness" of King George III.
No sickness has had such an everlasting impact on a country and its establishments like that of the “madness” of King George III. No other illness has received as much attention from scientists, researchers, philosophers, and psychiatrists alike. And If you think as long as I have about it, you might just begin to see this social issue in action a century ago.
According to L. J. Witts, author of "Porphyria and George III," King George III is described as “psychiatry’s most famous patient.” The first signs of George’s illness came about only a week after his fiftieth birthday, the year 1765, when physician diagnosed him with “mental imbalance.” This diagnosis subdued George in what he himself described as a “pretty smart bilious attack.” These attacks gave way many symptoms, most notable including: weakness and pain in the limbs, incoherent speech, insomnia, nightly delirium. And the list goes on and on. Physicians at the time, being paid a hefty 30 guineas ($31.50) per visit, suspected an organic infection or toxin, as the king was repeatedly lucid and also completely aware of the sufferings he experienced. His first attack took place during June of 1788. During October of 1788, mental imbalance was confirmed as George tried to strangle his son.
Six months and seven physicians later, the ailing king experienced no improvement. He experienced weakness, stiffness, cramps, confusion, incessant talking, all with increased severity. Rather miraculously, he was completely healthy until his second attack during the year 1801. He suffered through a third attack during the year 1804, and was permanently disabled by blindness, senility, and mental disturbances on account of his fourth attack in 1811. With all the money spent and all the examinations suffered, physicians never fully agreed on a diagnosis. Even at the time of George III’s death (January 29, 1820) no clear explanation could be given for what happened to the king, only that His Majesty went “mad” in 1788, and was never the same.
Though “mad” and unable to function on his own, King George III was not unintelligible, a fact lost in translation. His love of literature, language, and music allowed him to cope with his illness. He was often found occupying his time reading Shakespeare, learning to play the flute, practicing his Latin, perfecting his gardens, and spending time with the royal family. George loved literature, compiling many books into his royal library totaling to 65,000 books and 450 manuscripts, of which eventually became the British National Library.
While suffering, George found music comforting. The King took pleasure in Baroque music, a declining style of music of which the King was an avid supporter of until his death. Specifically, the King took pleasure in Handel, his most favorite artist. His love for Handel and his general musical knowledge was well known throughout his kingdom. Authors such as Charles Burney and Samuel Johnson noted in their writing how the King attended many musical performances and would refuse to hear anything other than his dear Handel. John Jesse wrote that, “His Majesty’s partiality for Handel’s music was so generally spoken of, but I believe it was not universally known what an excellent and accurate judge he was of its merit.”
Yet apparently insane, George was not thought of as incompetent by his subjects, in fact quite the opposite. He was viewed as a man of the people, loved and respected by all, not necessarily a helpless dimwit.
However loved and respected King George III was, the fact that something was seriously wrong with him physically and mentally could not be ignored. George’s illness was, at the time, described as “flying gout” (no, not arthritis) in that it had flown from the King’s legs to his head and stayed there and was later diagnosed as a “mental imbalance”. Physicians at the time believed the King’s illness was insanity as a form of manic-depression caused by an underlying conflict, shown by violent frustration and emotion.
Though acceptable at the time, this belief has since been debunked as it neglects his physical symptoms, of which were a major part of the King’s suffering. Historians and researchers consider these past diagnoses and beliefs with “a grain of salt,” as everything that physicians recorded concerning George and his attacks were not always reliable. Any opinion a doctor may have had would have contributed to the decision of whether George was healthy enough to be king. Doctors were suspected of political bias.
The language of these documents is also particularly hard to understand, as Doctors MacAlpine and Hunter put it, “The language is that of a passing age.” Medical technology was not anything superb either. Diagnoses were made on the assessment of physical symptoms and appearances such as pulse, tongue color, etc. To top it all off, doctors were often restrained from completing a full examination as they had to respect royal protocol.
Physicians were troubled with whether the illness was a mania or a delirium. Mania versus delirium, hopefulness versus despair, no one was really sure. Many years later, Doctors Ida MacAlpine and Richard Hunter suggested that King George III did not suffer from a mental breakdown, but from Acute Intermittent Porphyria (AIP). Rare Diseases Network defines AIP as an enzyme deficiency (formed from genetic mutation) that has major effects on the nervous system, with attacks ranging from weeks to months and recovery being generally slow.
Geoffrey Dean, a notable expert on porphyria, does not entirely agree. In his book "The Porphyrias," Dean explains that porphyria is not a common cause for insanity and is rarely found in mental hospitals. The only way to prove this generally accepted diagnosis, Dean says, is to show that George’s descendants had a higher chance of developing porphyria than other people, and that the genetic mutation causing AIP traveled down his ancestral line. To Dean, the generally accepted diagnosis of hereditary porphyria would be kept for a long while, but should not be trusted entirely unless supported with factual evidence.
Well the doctors did their homework, as they found that the mutation originated in Mary Queen of Scots and traveled all the way down to George III himself. Four of George’ sons and his granddaughter suffered from AIP as well. This new diagnosis challenged many historians to change their perspective on George and his troubles and allowed other to sympathetically depict his affliction, namely Alan Bennet and Peter Davies’ theatrical production “The Madness of George III.”
The thing is, the debate on whether the doctors’ diagnosis was correct isn't even the most prominent one to surface. Ironically, the biggest debate about George’s illness had nothing to do with his physical symptoms at all. The “high point” of controversy concerning George III’s illness came in the year 1788 when the king went apparently full-blown “mad”. This attack became the center of political controversy rather than of medical, as the king’s mental state alone determined whether he was fit to rule or not. His physical symptoms never came up in the discussion at all. Hence the importance of doctors’ opinions: their opinions, in essence, determined the fate of the King, and of what was to become of his kingdom.The doctors’ diagnosis changed, however, with the publication of their book "George III and the Mad Business."
Taking into account physical symptoms, genetic transfer, and the improvements of treating mental diseases during the 20th century, the doctors concluded that George III suffered from Porphyria Variegata (VP). Rare Diseases Network defines VP as an enzyme mutation (formed from metabolic gene discrepancies) which causes major physical symptoms to show on account of the impairment of the nerves controlling the muscles. Thus, taking into account all historical evidence and present research, modern medicine finally had an explanation for King George III’s “insanity,” pain, and ruined reputation: Porphyria Variegata.
But King George III was neither mad nor insane. Rather, he was simply misunderstood. And that is what I believe to be the real problem concerning mental health and its corresponding illnesses and stigmas: misunderstanding. George was a highly educated man who enjoyed the arts, and proved to be a capable leader up until his 50th birthday in which the first signs of his apparent “madness” came to light. Had physicians of the time had better medical technology, more understandable language, and a lack of royal protocol they might have been able to figure out the cause of this mysterious illness on their own. But in an age of finding rational explanations for irrational phenomena, “insanity” had to suffice.
In our age, with such incredible medical technology and personnel we've gotten better at identifying problems, but lack some progress in helping, treating and accepting those with mental health issues. It all roots back to a lack of understanding. We need to realize that people cannot control their symptoms with sheer willpower. People are not defined by their illnesses. Bad parenting is not the go-to cause of mental illnesses. Medication isn't the only solution for mental illness. Mental illness affects everyone in some way or another, and those who understand the issue shouldn't lower their standards.
Educating others about the real issue and working together to combat these problems are at least two of the steps people should take as a whole to start rectifying this issue. It's a tall order, and I know it won't happen immediately, but there isn't an excuse as to why we shouldn't start.
I hope reading about King George III has inspired you to at least educate yourself on the issues we face concerning mental health. As Dr. Carl Sagan says:
