Caligula the Madman

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1: Psychopathy?

This is a list of the 20 traits assessed by a diagnostic tool for psychopathy, known as
the Hare Psychopathy Checklist, PCL-R:

      glib and superficial charm
      grandiose (exaggeratedly high) estimation of self
      need for stimulation
      pathological lying
      cunning and manipulativeness
      lack of remorse or guilt
      shallow affect (superficial emotional responsiveness)
      callousness and lack of empathy
      parasitic lifestyle
      poor behavioural controls
      sexual promiscuity
      early behaviour problems
      lack of realistic long-term goals
      impulsivity
      irresponsibility
      failure to accept responsibility for own actions
      many short-term marital relationships
      juvenile delinquency
      revocation of conditional release
      criminal versatility

2: Thyrotoxicosis (Hyperthyroidism, Graves' Disease)?

The thyroid gland, which is in the front of the neck, controls the rate of at which the
body's cells work (the metabolic rate). In thyrotoxicosis, the rate of metabolism is
increased, and this results in most of the symptoms:

      weight loss in spite of increased appetite
      Increased or decreased appetite
      Irritability
      Weakness and fatigue
      rapid heart rate
      a fine tremor
      increased nervousness and emotional instability
      mental illness: may range from anxiety to psychosis
      loss of libido
      intolerance of heat, and excessive sweating
      staring, bulging eyes
      enlargement of the thyroid gland, which is at the front of the neck, at the level
       of the voice box

3: Anxiety

The symptoms of general anxiety disorder (GAD) often develop slowly and can vary
in severity from person to person. Anxiety can affect you physically and
psychologically (mentally).

Psychological symptoms of GAD

      restlessness
      a sense of dread
      feeling constantly 'on edge'
      difficulty concentrating
      irritability
      impatience
      being easily distracted

Your symptoms may cause you to withdraw from social contact (seeing your family
and friends) to avoid feelings of worry and dread. These actions can make you worry
even more about yourself and increase your lack of self-esteem.

Physical symptoms of GAD

      dizziness
      drowsiness and tiredness
      pins and needles
      irregular heartbeat (palpitations)
      muscle aches and tension
      dry mouth
      excessive sweating
      shortness of breath
      stomach ache
      nausea
      diarrhoea
      headache
      excessive thirst
      frequent urinating
      painful or missed periods
      difficulty falling or staying asleep (insomnia)
4: Schizophrenia

Changes in thinking and behaviour are the most obvious symptoms of schizophrenia.
The symptoms of schizophrenia are usually classified into one of two categories:
positive or negative. The illness may develop slowly. The first signs of schizophrenia,
such as becoming socially withdrawn and unresponsive or experiencing changes in
sleeping patterns, can be hard to identify. Because the first symptoms often develop
during adolescence, the changes can be mistaken for an adolescent 'phase'. People
often have episodes of acute schizophrenia, during which their positive symptoms are
particularly severe, followed by periods where they experience few or no positive

Positive symptoms of schizophrenia

A hallucination can involve any of the senses, but the most common is hearing voices.
These seem real to the person experiencing them. Some people describe the voices
they hear as friendly and pleasant, but more often they are rude, critical, abusive or
just annoying.

A delusion is a belief that is held with complete conviction, even though it is based on
a mistaken, strange or unrealistic view. Someone experiencing a paranoid delusion
may believe that they are being harassed or persecuted. They may believe they are
being watched, plotted against or poisoned, often by a family member or friend.

Confused thoughts (thought disorder)
People experiencing psychosis often have trouble keeping track of their thoughts and
conversations. Some find it hard to concentrate and will drift from one idea to

Changes in behaviour and thoughts
Behaviour may become more disorganised and unpredictable, and appearance or dress
may seem unusual to other people. People with schizophrenia may behave
inappropriately or become extremely agitated and shout or swear for no reason.

Negative symptoms of schizophrenia

The negative symptoms of schizophrenia can often appear several years before
somebody experiences their first acute schizophrenic episode. These initial negative
symptoms are often referred to as the prodromal period of schizophrenia. Symptoms
during the prodromal period usually begin gradually and then slowly get worse.
Negative symptoms experienced by people living with schizophrenia include:
      losing interest and motivation in life and activities, including relationships and
      lack of concentration, not wanting to leave the house and changes in sleeping
      being less likely to initiate conversations and feeling uncomfortable with
       people, or feeling that there is nothing to say

The negative symptoms of schizophrenia can sometimes be mistaken for deliberate
laziness or rudeness.

5: Bipolar disorder

Bipolar disorder is characterised by extreme mood swings. The mood swings can
range from extreme highs (mania) to extreme lows (depression). Episodes of mania
and depression can often last for several weeks or more.


   During a period of depression, your symptoms may include:

      feeling sad and hopeless
      lacking energy
      difficulty concentrating and remembering things
      loss of interest in everyday activities
      feelings of emptiness or worthlessness
      feelings of guilt and despair
      feeling pessimistic about everything
      self-doubt
      being delusional, having hallucinations and disturbed or illogical thinking
      lack of appetite
      difficulty sleeping
      waking up early
      suicidal thoughts


   The manic phase of bipolar disorder may include:

      feeling very happy, elated or overjoyed
      talking very quickly
      feeling full of energy
      feeling self-important
      feeling full of great new ideas and having important plans
      being easily distracted
      being easily irritated or agitated
      being delusional, having hallucinations and disturbed or illogical thinking
      not feeling like sleeping
      not eating
      doing things that often have disastrous consequences, such as spending large
       sums of money on expensive and sometimes unaffordable items
      making decisions or saying things that are out of character and that others see
       as being risky or harmful

Rapid cycling

Between episodes of depression and mania, you may sometimes have periods of
"normal" mood. However, some people with bipolar disorder can repeatedly swing
from a high to low phase quickly without having a "normal" period in between. This
is known as rapid cycling.

Living with bipolar disorder

Bipolar disorder is a condition of extremes. A person with bipolar disorder may be
unaware of being in the manic phase of the condition. After the episode is over, they
may be shocked at their behaviour. However, at the time, they may think that other
people are being negative or unhelpful.

During episodes of mania and depression, someone with bipolar disorder may
experience strange sensations, such as seeing, hearing or smelling things that are not
there (hallucinations). They may also believe things that seem irrational to other
people (delusions). These types of symptoms are known as psychosis or a psychotic

Weighing up the Evidence

So… having looked at the symptoms of a number of conditions which various
scholars have suggested might be apposite to the emperor Gaius ‘Caligula’, do you
think he suffered from psychopathy, thyrotoxicosis, anxiety, schizophrenia, or bipolar
disorder? Or is it just too difficult to try to diagnose a ‘patient’ at a distance of two
millennia? Or should we distrust the sources, and seek explanations elsewhere?

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