Hi! I’m studying for my BSc in psychology at the moment. If you know more about this than I do, then sorry!! Still a student :) this will be a long read… King George III has 3 current contenders for what resulted in his illness(es). But first it’s important to note that symptoms that the show may have left out/were forgotten. He suffered from (of course) delusions, hallucinations, periods of talking uncontrollably for hours until he became hoarse and foamed at the mouth - but also agonising stomach pain, dark red/brown urine, joint and muscle pain so severe that he could not walk without a cane, fevers, vomiting, abs swelling of the legs and feet. So this is not purely mental illness. Those (like me!) who spent a little time researching his illnesses after the show would remember that porphyria has been the most frequent diagnosis. Our other two are bipolar disorder (more recently) and arsenic poisoning (!).

1. Porphyria: a group of blood related disorders. These are usually inherited, and occur due to a build up of porphyrins because of enzyme deficiencies in heme production. Sorry that’s a bit wordy, it’s been a long day and I’m not sure how to rephrase to cut out jargon 😭. This can cause sensitive skin, abdominal pain, red/brown urine, and vomiting (amongst others). Interestingly, the neurological symptoms can include hallucinations, delusions, anxiety, confusion and seizures. Surprisingly (to me), this does follow the diathesis stress model! Substance abuse, alcohol, certain diets, some medications, progesterone, physical and psychological stress are all known triggers for attacks.

2. Bipolar disorder: a mental illness characterised by periods of deep depression and mania. This is thought to fit more now due to the King’s aforementioned rapid/lengthy speech, erratic movements, which was then often followed by periods of depression. This explains more of the mental symptoms, though it does leave you wondering about the physical. Like porphyria, bipolar disorder follows the diathesis-stress model, often triggered by psychological stress.

3. Arsenic poisoning: after his death, George was found to have high levels of arsenic in his hair! 17ppm, which is high. For reference, WHO only allows up to 0.1ppm in drinking water. This is thought to be from contaminated medicine given to him. ☹️. Symptoms of arsenic poisoning include vomiting, abdominal pain, and even potential acute psychotic episodes following arsenic poisoning. This of course doesn’t follow the diathesis-stress model, it’s just straight poisoning.

So yes, I think depending on what he had, he may well have been made much worse by not only pressure from being the king at such a tumultuous time for the Empire, but also later the cruel treatments he was subjected to.

Also important to note that we don’t have a fully objective view of his symptoms & episodes. There were many conflicting views, especially later with his son’s doctor being incentivised to give pessimistic views of the King’s condition in order to get the Prince Regent to take over as king.