Did Alexander the Great suffer from PTSD?

[cartfc]

I have been doing a bit of reading about Alexander and his campaigns having picked up some figures to build an army and it struck me last night that some at least of his behaviour could be attributed to post traumatic stress disorder. The rages, such as lead to the death of Cleitus, the drunkeness, paranoia and sometimes rash or erratic behaviour would all fit with a diagnosis of PTSD. Of course it would be immpossible to prove either way, but he certainly saw enough death and destruction to have suffered as a result of it.

[Jim Webster]

On a serious note, you wonder just how much post traumatic stress there was in the Ancient world. Some people have said that a sturdy peasant background and greater familiarity with life and death would have hardened them, but experience with the modern equivilent of these people suggests perhaps not

Jim

[Patrick Waterson]

And Alex at the time of Cleitus' death was certainly in a stressful situation: the Scythians were threatening, Spitamenes was revolting and blockheads like Cleitus were threatening to tear apart the fabric of empire by freely insulting the Persians whom Alexander was trying to reconcile with his rule.

I am not surprised that he snapped.  More like Alex is the contrition expressed thereafter.

I think Jim is right: if we look at Pompey's reported behaviour at the time of the battle of Pharsalus, he has been subjected to continuing harassment and abuse by his 'colleagues', accepts battle against his better judgement, tries to convince himself that his hopeful plan will work; when it does not he bemusedly retires to his camp in an apparent daze.  This sort of behaviour is compatible with someone severely overstressed (like Mussolini in 1943 being unable to make decisions, so much so that after being pressed for weeks to decide between two contradictory memoranda he finally signed them both!).

Patrick

[TDF]

I also have to wonder whether such actions are not simply the result of personality to some degree.  I don't think it's that unreasonable to suggest that for such leaders, (those that are so single-minded and forceful, those that believe in their cause to such extreme levels, those that believe their way is the right way etc.), would have personality traits which clash with the heroism and inspirational leadership.  Ego, power, paranoia and the pressure brought through success often reveal the best and the worst in generals.  That's not to say PTST wouldn't be diagnosed today, or wasn't a contributing factor, but I'm more inclined to believe it's just symptomatic of who he was and how he operated.
 

[Jim Webster]

Well there is the argument that stable, well balanced and well adjusted individuals don't attempt to conquer the world 

Jim

[Patrick Waterson]

And then there is the argument that the really neurotic ones desperately want to, get as far as creating a unit called 'the Phalanx of Alexander the Great' or launching a campaign aganst Neptune, but lack the talent to do anything more than parade and boast.

Actually in the 4th century BC everyone from Agesilaus to Isocrates* wanted to conquer the Persian Empire; Alexander was the only one who actually managed it.  I suppose he decided that if life is to be stressful then one might as well be stressed for a sheep as for a lamb.

*Isocrates gave us this meaningful quote about Greek democracy: "Democracy destroys itself because it abuses its right to freedom and equality. Because it teaches its citizens to consider audacity as a right, lawlessness as a freedom, abrasive speech as equality, and anarchy as progress."

Patrick

[Mark G]

there are better psychological explanations for the less than stable bits of Alexander's life than PTSD.

Bi-Polar / Manic depression seems a much better fit.

As does the basic fact that he was an alcoholic and an adventurer.

given he was also convinced he was descended from a God, and therefore himself divine - I think these facts make a much better explanation.

he can reasonable get away with arguing that anyone who disages with him on a battlefield is a coward, and in the council tent is a trator - thats a pretty heady level of power for a twenty something - and when you need only call for a bunch of brutal killers do do your bidding - even thinking about getting drunk is a serious risk.

a drunken rage killing Craterus (aloholic / god complex)
well known sulking in his tent - classic 'black dog' depressive episodes.
etc.

His prestigue itself depended on him leading the charge and never shirking from battle (who rules - the strongest), so I don't think it reasonable to suggest he was seeking death - rather the was demonstrating his suitability to rule.

or simply, he was just a petulant young man who didn't live long enough to discover that the world didn't revolve entirely around him.

[Jim Webster]

The problem is, it was getting to the situation where much of the world did revolve around him

Jim

[aligern]

And we have to remember that it's lonely at the top. Alex could not share the burden with his father's generation and too much time with the graceful Hephaiston made others jealous. I'd go with the thought that Alex was not a well balanced individual, but then the Social-work team is going to be very interested when your mother has your fathermurdered.

Roy

[Mark]

I don't think it's a work of deep historical research but I enjoyed Mary Renault's non-fictional The Nature of Alexander, as a complement to her (excellent) trilogy of historical novels on Alexander. As I remember she sees the experience in Egypt (post deification stress disorder?) and also his near death experience with pneumonia in the Tarsus mountains as turning points in his personality.

I've seen the association of alcohol with a bi-polar diagnosis but Macedonian "on-tour" culture seems to have been pretty alcoholic anyhow, and Cleitus goading a highly effective spearman while drunk is a bit like goading a highly effective, armed gunman while drunk would be now.

I think the key is more likely around his "Achilles complex" and feeling pressure to achieve an incredible amount in a short time, and this being reinforced by what actually happened.

[Patrick Waterson]

Mary Renault seems (at least to me) to understand Alex quite well, with the exception of his sexuality, which he keeps under wraps in order to avoid being unduly influenced - but which comes into the open when he meets Roxane.  He is, as I see it, trying hard to avoid what might later be called 'Antiochus syndrome' (many of us will remember that Antiochus III opened his campaign against the Romans with a good start, capturing Euboea, and then wasted a season paying court to a lady of Chalcis while the Romans prepared).  Hence, although completely smitten with Roxane, once married he packs her off into her own tent and concentrates on his other grand obsession: conquering more than anyone who came before, man or god.

He does seem to believe that he is able and destined to conquer the world.  The priest Menkheperre at Siwa has said so in his capacity as the oracle of Amon.  The same priest has revealed that Alexander is the son of a god - in a world whose predominant cultures associate great achievement with semi-divine birth.  He has a mission to fulfil and standards to live up to.  However, as Plutarch points out, fortune is often working against him - overtime.  Things go wrong, and have to be put right.  He gains an empire, and now has to govern it - and his basic sense of fairness does not allow him to condone wrongs done in his name.  He realises that it is only possible to rule people if you let them keep what they have, which in the case of Persians means their dignity.  Many of his followers, including his best friend Craterus, do not seem to realise this, and short-sightedly press for Macedonian ways at all costs.  Alexander sees that it will cost all if insisted upon - he has no particular love of luxury, oriental or otherwise (several of his sayings and his ready disposal of excess loot and baggage attest to this), but in order to rule orientals he adheres to the principle that Henri IV later encapsulates in his phrase: "Paris vaut une messe" (Paris is worth a mass).  Persian clothing and Persian ceremony help to cement the allegiance of the Persians, and considerate treatment secures the attachment of Sogdians, Bactrians and other key peoples.

One may note that when things are going well Alexander is at his most generous.  When they are not, and certain persons are being world-class annoyances or are engaging in conspiracies (or are believed to be), Alex reacts with terrible effectiveness.  The problem is removed with minimum fuss and as swiftly as possible.  No ruler seems more willing to extend trust, and none reacts quite so sharply to having it betrayed.

Patrick