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With her bizarre behavior, First Lady Mary Todd Lincoln arguably did little to impress the American public. It’s said, for instance, that she spent money wildly; not only that, but she also suffered from moody episodes that sometimes ended in public outbursts. But Expertscape CEO and scholar Dr. George Sotos believes that he understands why Mary was so eccentric in this way – and according to him, it had nothing to do with a bad attitude.

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During Mary’s time, no one could quite understand why she behaved in the manner that she did. Sadly, she suffered from depressive episodes and violent mood swings, with these bouts of ill-health apparently leading some historians to deem her as having been insane. Indeed, Mary’s eldest son, Robert, even had her institutionalized later in life.

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Since then, however, experts have weighed up a series of potential causes for Mary’s unhappy state of mind. In particular, they have wondered if her physical symptoms – including notably pale skin and intense headaches – had something to do with it all. But as we’ll discover later, Soros thinks he has the answer. And his theory links all of the First Lady’s ailments to a single diagnosis.

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While in her native Lexington, Kentucky, Mary had an idyllic childhood – at least, at first. Her mother, Eliza, loved her children dearly, while her father, Robert, provided well for the family by running a local shop. But the birth of sixth child George took a huge toll on Eliza’s body. And while doctors came to the Todd household, they unfortunately couldn’t do anything to help. Ultimately, then, Mary’s mother died in 1825 at just 31 years old.

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Even though she was just six years old at the time, Mary felt completely devastated by the loss of her beloved mother. Making matters worse, her father became engaged to a woman named Elizabeth “Betsey” Humphreys within six months of Eliza’s death. And sadly, Betsey seemingly had no interest in helping to raise Mary and the other kids.

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Instead, people noticed how cruelly Betsey treated her stepchildren and that she relied on shame and embarrassment to discipline. And while Mary’s older sister Elizabeth eventually stepped in to nurture her younger siblings, the Todd children still had to live with their stepmother’s obvious dislike for them. She apparently wasn’t all that fond of the nine kids that she would go on to have with Robert, either.

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Throughout it all, Robert kept emotionally distant from his children. Despite this, though, he wanted all of his offspring – even his daughters – to receive good educations. So, he enrolled Mary at the Shelby Female Academy, where she studied a host of subjects including French, natural science, arithmetic and geography. Of course, back then, female students learned less in school than their male peers, as it was believed that over-educated women would scare away potential suitors.

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Yet despite the limitations placed on her at the time, Mary was undeterred. And when she completed her schooling at Shelby in 1832, she didn’t want to stop learning. Her next stop, then, was Mentelle’s for Young Ladies, which was a boarding school run by a 62-year-old woman from France. Furthermore, although the institution sat close to the Todd family residence, Mary successfully petitioned to board onsite.

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Fortunately, Mary flourished at Mentelle’s – especially in theater and plays. Here, too, she finally got some attention after growing up as one of 15 children in the Todd household. By the time she finished her time at school, then, the young woman was a noted beauty, a wonderful conversationalist and ambitious about her future. And like her older sisters before her, Mary therefore decided that she had to leave Lexington.

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Mary’s siblings Elizabeth and Francis had previously moved from Kentucky to Springfield, Illinois, and she decided to follow suit. Around the same time that Mary arrived in the state capital, though, a new member of the Illinois assembly named Abraham Lincoln was also settling in the city. And in spite of his political appointment, he had a much different reputation in Springfield than Mary did.

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You see, Mary was known for her wonderful ability to chat and converse, and that didn’t stop in Springfield. Indeed, she welcomed plenty of visitors to her sister Elizabeth’s house, where she lodged over the summer of 1837. By contrast, Abraham was often considered to be awkward and a loner.

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Abraham also came from a very different background to Mary. The future president had spent his childhood as a farmer’s son, and he would go on to work as a farmhand, a carpenter and a ferry employee before he started to practice law. As such, people often called him “humble Abraham Lincoln” – a nickname that helped him win his seat in the state assembly.

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Mary didn’t meet Abraham during her first summer in Springfield, though, and at first it appeared as though she may never have the chance to do so. At the end of the season, you see, Elizabeth had to send Mary home, as she and her husband couldn’t afford to support both of the younger sisters who had come to stay. So, Mary regretfully returned to Lexington, where she found a job as an apprentice teacher.

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But fortunately for Mary, fate would quickly bring her back to Springfield. Francis got married and moved out of Elizabeth’s home, which meant there was room for the fledgling instructor to move in again. And with that, Mary rushed back to Illinois and kicked off her active social life once more. Yet while Elizabeth threw plenty of parties to help Mary meet the city’s eligible bachelors, the young woman had one stipulation: she wanted to marry for love.

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Interestingly, when Mary first met Abraham, she didn’t seem to think that he’d be the one she’d marry. Indeed, while the two became friends, the Lexington native saw the politician as unimpressive and a bad dancer. In 1840, though, their relationship transformed from platonic to romantic. That was despite the fact that Elizabeth didn’t approve of her sister’s choice in partner – given how differently Mary and Abraham had grown up.

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Abraham feared he couldn’t provide Mary with the life she wanted, either, and their differences came to a head on the first day of 1841. That evening, the state politician was supposed to escort his girlfriend to a party, but he arrived late. Mary therefore went ahead to the soiree on her own, where her beau ultimately found her flirting with someone else. And with that, Abraham cut ties – although the breakup didn’t last long.

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A year after their blow-up, Abraham and Mary mended their relationship. First, the two resumed a friendship, which once again became a romantic bond. This time, they made it to the finish line and gave their family and friends just one day’s notice prior to their wedding on November 4, 1842. Touchingly, the couple exchanged bands etched with the reminder “Love is Eternal.”

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Then, soon enough, the newly minted family would add a new member. In 1843 the pair welcomed their first son, Robert Todd Lincoln, who was named after Mary’s father; their second, Edward, arrived three years later. As the Lincoln clan grew, though, Abraham’s political career progressed. This often left Mary at home alone with her children, and she started experiencing anxiety as a result.

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Mary’s behavior also made her a polarizing figure, even as Abraham’s political star rose. She spoke her mind, for instance, and didn’t hold back – which was precisely the opposite of how women at the time were expected to comport themselves. At home, by contrast, Mary excelled at creating a loving environment for her children and husband. Even so, she needed to carve out quiet corners in order to deal with her migraines and the depressive episodes that she’d experienced since losing her mother.

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And things got worse for Mary when she suffered a string of debilitating losses. First, her father died in the summer of 1849 after a battle with cholera. Then, in February of the following year, she and her husband witnessed Edward succumb to tuberculosis. Apparently, Mary believed in destiny, and she therefore felt that her son’s death was fate working directly against her.

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But Mary’s fortune changed with the births of two more sons: William in late 1850 and Thomas three years later. And during the same decade, Abraham’s political career reached the highest possible level when the Republican Party tapped him as their nominee for president. As history shows, of course, he subsequently went on to win the election and assume office in 1860.

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Yet while the Lincolns were in the White House, Mary’s mental and physical health seemed to decline further. For one thing, she injured her head in a carriage accident, with this having the effect of making her headaches even worse. And along with bouts of depression, the mother of four experienced erratic mood swings and a violent temper. She would even have outbursts in public, which was not the behavior expected of a president’s wife at the time.

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Plus, as we mentioned earlier, Mary had a bad reputation for spending wildly while in the White House, transforming the presidential residence into a regal estate with all-new decor. And at some point, her reckless dealings with money enraged her husband, who warned her that she’d burn through his presidential salary before he even left his post. The press also highlighted Mary’s extravagant lifestyle, and this did little to ingratiate her with the masses.

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Mary’s family ties brought her negative press, too. You see, while her husband led the Union into the Civil War, three of her half-brothers actually fought on the Confederacy’s side. For her part, though, Mary had long held the same views as Abraham; even as a teenager, she had been anti-slavery.

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But it was Mary’s state of mind that was her most pressing issue, and this would only worsen in 1862. That year, her third-born and favorite son, William, contracted typhoid fever and swiftly passed away. Losing William then pushed Mary into a dark depression, and she stayed in bed for a multi-week stretch. After that, the First Lady experienced insomnia and nightmares, leaving her barely able to take care of her youngest son, Tad. Ultimately, then, the president hired a nurse to care for Mary.

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That said, the day would come when Abraham couldn’t look after Mary, either. After his re-election in 1964 and the end of the Civil War, he and his wife thought that they had survived the worst. But, of course, Mary and Abraham’s April 1865 trip to see a show at Ford’s Theater would prove them both wrong. Famously, on that occasion, actor and Confederate sympathizer John Wilkes Booth snuck up behind the president and shot him. Mary had been holding her husband’s hand at the time and screamed in horror when he slumped beside her.

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Abraham didn’t die immediately, though, and he was subsequently taken across the street to a private house. Meanwhile, Mary descended into an understandable fit of hysteria – one that the men caring for her husband couldn’t deal with. Instead of trying to calm the First Lady down, then, the helpers removed her from the room and away from her husband. And when Mary saw Abraham again, she fainted; sadly, the president passed away before she came to.

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Naturally, losing Abraham pushed Mary into yet another depressive episode. She didn’t go to his funeral; instead, she spent 40 days in bed. And after that, the widow had to decide where to go next, as she was no longer the nation’s First Lady. Mary couldn’t bear to return to Springfield, however, and instead she and her two living sons, Robert and Tad, moved to Chicago.

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In Chicago, Mary finally began to grieve her husband’s death, but she did so in private – to the point where she became a recluse. Then came one final tragedy: her youngest son, Tad, died from tuberculosis, pneumonia and congestive heart failure. This heartbreak only made Mary behave more erratically, and her depression worsened to boot.

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So, four years later, Mary’s eldest and only living son, Robert, had her committed to an Illinois asylum. And the former First Lady felt so helpless about the decision that she went on to visit multiple pharmacies, hoping to get enough prescription pills to end her life. But, thankfully, an employee at one of these establishments sensed her plan and gave Mary a placebo – thus thwarting her suicide attempt.

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Mary later left the mental health facility and then traveled around Europe for four years. Fate would bring her back to Springfield in the end, though, as the widow ultimately moved in with Elizabeth in the town where she’d met her ill-fated husband. And it was there in 1882 that Mary slipped into a coma and suffered a stroke on the 11th anniversary of Tad’s death. Sadly, she died the next day.

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And in the years since Mary’s passing, psychologists and historians have debated what had caused her to behave in such a strange way. After all, she had once been a well-spoken, charming young lady; as time went on, however, she had become moody, depressed and erratic. But while experts had plenty of theories to explain Mary’s decline, none of these seemed to fit the situation perfectly.

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Immediately after Mary’s death, for instance, her doctor noted how divisive of a personality she had been in life. He warned others, too, against judging someone who had cerebral disease, or mental illness. In a similar vein, other experts have credited her mood swings and erratic spending to bipolar disorder.

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But in 2016 Dr. John Sotos presented an entirely different hypothesis regarding Mary’s behavior. He had perused the former First Lady’s remaining medical records, which had come from her four-month stint in a mental health facility. And according to Sotos, the information was more than enough to diagnose Mary with pernicious anemia.

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Pernicious anemia is arguably not as scary today as it once was. The condition stems from a deficiency in vitamin B12, which the body needs to produce red blood cells and nerves and keep a person’s DNA working as it’s supposed to. Yet before doctors isolated vitamin B12, they had no idea why people were getting sick and suffering from the illness.

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What’s clear is that many of Mary’s noted symptoms match those typical to pernicious anemia. For one, the condition is a degenerative disease – meaning it gets worse over time. And as we explored earlier, both Mary’s behavior and health did indeed decline as the years passed. She suffered from a laundry list of pernicious anemia-related side effects, too, including headaches, pallor and the sensation of needles poking her body.

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Pernicious anemia also comes with psychological side effects, meaning Mary may have dealt with hallucinations and delusions that she considered to be very real. Without B12, the brain additionally shrinks in size – something that can also cause paranoia. And in old age, the former First Lady lost her ability to speak and see as well.

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Unfortunately for Mary, doctors of the period were not aware of pernicious anemia, so they had no way of explaining her decline in mental and physical health. Mary and others who suffered from the condition basically had a death sentence, then, and that wouldn’t change until the mid-1920s.

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In 1926, you see, doctors George Whipple, William Murphy and George Minot found that eating a half-pound of raw liver every day could overcome pernicious anemia. And their discovery was such a huge breakthrough that, in 1934, the trio ultimately won the Nobel Prize – regardless of how unsavory their treatment method was.

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Then in 1948 experts isolated B12 as the cause of pernicious anemia, leading them to develop a shot that could replenish stores of the vitamin. Mary didn’t have that luxury, though, which is why Sotos wants the world to consider that she suffered from the degenerative disease. And in 2016 the doctor told CNN that he hoped his theory would help others to reconsider the former First Lady, whom he labeled as the “notoriously difficult-to-understand partner to one of the most consequential figures in world history.”

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