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"I am now the most miserable man living," Abraham Lincoln once wrote to a friend. "If what I feel were equally distributed to the whole human family, there would not be one cheerful face on the earth…. To remain what I am is impossible; I must die or be better, it appears to me."

May is National Mental Health Awareness Month, a time to remember that millions of Americans, at some point in their lives, experience mental health challenges. Our greatest president was no different.

Lincoln was famous for his "melancholy" nature, marked by spells of deep sadness and gloom. "His melancholy dripped from him as he walked," his law partner William Herndon observed. "No element of Mr. Lincoln’s character was so marked, obvious and ingrained as his mysterious and profound melancholy," another fellow attorney wrote.

Vintage engraving of Abraham Lincoln, after a photograph made in early 1865. Stains and age spots are authentic and add to the character of the portrait. Published in an 1872 book, the image is now in the public domain. Digital restoration by Steven Wynn Photography.

Vintage engraving of Abraham Lincoln, after a photograph made in early 1865. Stains and age spots are authentic and add to the character of the portrait. Published in an 1872 book, the image is now in the public domain. Digital restoration by Steven Wynn Photography.

It is impossible to know the exact source of Lincoln’s melancholy, but surely the loss he experienced had much to do with it. His mother died while he was a boy, and his sister died in childbirth along with her baby. When he was a young man, his sweetheart, Ann Rutledge, died suddenly of a fever.

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Lincoln lost two sons, Eddie in Springfield, Illinois, and then Willie in the White House. The Civil War cost the Lincolns close friends and family members. The horrific casualty reports from the front preyed on Lincoln’s mind.

Twice in life, when he was a young man, he seems to have spiraled out of control in depression. In 1835, when Ann Rutledge died, he spoke of committing suicide and wandered the Illinois countryside, senseless with grief, until friends nursed him back to health. In 1841, after breaking off an engagement to Mary Todd, his future wife, he grew so despondent, friends made sure to keep razors and knives away from him.

Effective medical therapies for such conditions were almost nonexistent. Doctors often resorted to treatments like drawing blood, inducing diarrhea and vomiting, and prescribing quinine.

Abraham Lincoln

Abraham Lincoln (whitehouse.gov)

But Lincoln was nothing if not perseverant, and as I depict in my novel, "Old Abe," he was able to bring his melancholy under control with an arsenal of techniques.

Fellowship helped. Lincoln counteracted his solitary, brooding side by deliberately putting himself in contact with others, whether by shooting the breeze around a potbelly stove in a general store or pressing the flesh with voters. He knew that the human touch is medicine for the mind and soul.

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He used laughter to drive away "the blues." Lincoln was a famous joke teller. He often started a meeting by reading from a joke book or humorous sketch in a newspaper. "With the fearful strain that is upon me night and day, if I did not laugh I should die, and you need this medicine as much as I do," he told his cabinet.

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A man of great compassion, he found solace in helping others. He jumped at the chance to pardon young soldiers sentenced to be shot for going home without leave or running away in battle. "It makes me rested, after a day’s hard work, if I can find some good excuse for saving a man’s life," he said.

Work brought relief. It gave him something to throw his emotions into. Lincoln was a great believer in work.

"Work, work, work is the main thing," he once advised. Despite the war’s horrors, the presidency gave Lincoln the chance to lift his sights and work for a cause much greater than himself.

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Lincoln drew on his faith. The precise nature of his faith has been debated over the years. He loved reading the Bible and went to church quite a bit, but he was never baptized and never formally joined a church.

Regardless, his faith deepened during his White House years. It became a refuge as well as a source of strength and wisdom. "I have been driven many times upon my knees by the overwhelming conviction that I had nowhere else to go," he told a friend.

All these strategies allowed Lincoln to cope with his melancholy side, and in coping he forged a life of extraordinary achievement.

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Some mental conditions are, of course, much more serious than Lincoln’s melancholy and require much different kinds of care. Thankfully, treatments have come a long way from the days of bloodletting and mustard rubs.

Yet for all of us, especially when the COVID-19 pandemic and lockdowns have affected the mental well-being of so many Americans, Lincoln’s story offers inspiration. His journey reminds us of the resilience of the human spirit as well as the respect we owe those who, like Lincoln, face mental health challenges.

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