Richard Schain


Sometime during the last week of December 1888, Friedrich Nietzsche apparently fell into complete insanity. Many causes have been put forth as to the origin of his mental breakdown. The thesis advanced in this article is that Nietzsche himself deliberately decided to pass over into ‘madness.’ The evidence for this statement has been derived from his published works, his correspondence, and his personal circumstances. Like the fate of the mad Mr. Hyde in Robert Louis Stevenson’s novel The Strange Case of Dr. Jekyll and Mr. Hyde, there was no road back to normality for him.


            Since the previous mid-November, Nietzsche’s letters were revealing suggestive breaks with reality and a grandiosity that was excessive even for him. But the complete break did not seem to occur until December 31, when he sent a letter to August Strindberg stating he meant to have the young Emperor [of Germany] shot and that Strindberg and he must divorce. He signed the letter Nietzsche Caesar (KSB 8:1229, p. 567). Subsequently, during the first week of January 1889, he sent at least a dozen, and probably more, brief notes to friends, former colleagues, and the king of Italy that had the effect of announcing his madness. A last long letter on January 6th to Jacob Burckhardt in Basel (KSB 8:1256, p. 577-579) caused consternation in Burckhardt and in Nietzsche’s longtime friend Franz Overbeck who had also received a ‘mad’ note. An eminent psychiatrist in Basel, Professor Dr. Ludwig Wille, was consulted. It was decided that Overbeck should immediately travel to Turin to rescue Nietzsche.


            When Overbeck arrived at Nietzsche’s room on January 8th, he described the condition in which he found Nietzsche in a letter to Peter Gast [a.k.a. Heinrich Köselitz]:

I saw Nietzsche in a sofa corner crouched down and reading—as it turned out, the last proof of N contra Wagner—he looked horribly decrepit; recognizing me, he threw himself upon me and embraced me violently, breaking into a torrent of tears, then sinking back on the sofa, twitching and quivering. I too could hardly stand upright from the shock. Did the abyss open before him at that moment or was he plunged in it already? The entire Fino family was present [his landlords]. Scarcely had he started moaning and quivering again when he was given some bromine water that stood on the table. In a moment, he was calm again and smiling; he began to speak of the great reception that was prepared for the evening. So he was in the grip of delusional ideas that never left while I was with him. He broke forth into loud singing and frenzied piano playing, fragments from the mental world in which he had been recently living and interspersed with indescribably uttered expressions, sublime, wonderfully insightful and unspeakably horrible things about himself as a successor to a dead God, all punctuated by chords from the piano after which convulsions and outbursts of unspeakable suffering followed… . (Verrecchia 1986, 255)

            There were a few details Overbeck left out of his letter to Peter Gast. It appears that Nietzsche danced naked in the room, evoking the antique customs of holy sexual frenzies (Verrecchia 1986, 265). It left no doubt in Overbeck’s mind that his friend had suffered a complete mental breakdown. He arranged to have him brought back to Basel immediately. In Basel, Nietzsche was quickly admitted to the Basel Psychiatric Clinic headed by Dr. Wille. The diagnosis made was ‘Progressive paralysis’ (general paresis), a common diagnosis of that era in mental institutions. In 1888, there was already a suspicion that Progressive paralysis was a late manifestation of syphilis. In 1902, when Nietzsche had become famous (he died in 1900), a monograph was published by the noted neurologist Paul Möbius in which was revealed for the first time to the public that Nietzsche suffered with general paresis, a syphilitic disease of the brain resulting in insanity. From that point on, general medical opinion was that Nietzsche had suffered with late onset syphilis, a brain degeneration associated with agitation alternating with euphoria and emotional instability, symptoms that Nietzsche had frequently exhibited. The only question was whether or not his disease had affected his philosophical activity. Opinions varied on this subject.


            However, there were doubts often expressed about the validity of the diagnosis (Schain 2001, chapt. 10). The course of Nietzsche’s illness was not typical with the usual course of general paresis. This diagnosis had become in the nineteenth century a common ‘wastepaper basket’ diagnosis applied to many individuals with uncertain neuropsychiatric disease. With the advent of the laboratory diagnosis of syphilis, the number of diagnosed cases dropped precipitously. Other causes have been offered to explain Nietzsche’s breakdown—drugs (his sister’s explanation), cerebrovascular disease with occult strokes, schizophrenia, manic-depressive psychosis, fronto-temporal (brain) degeneration, and even Lyme’s disease. None of these proposals have had enough evidence to receive general acceptance.


            There are cogent reasons to believe that Nietzsche’s ‘madness’ was not due to any exogenous agent nor to any intrinsic mental disorder, but was a willed act on his part. Many indications in his history and writings suggest that this is what happened. In one of his earliest published books, Morgenröte (1881), written after resigning his professorship at Basel, the following passages can be found under the label Significance of madness in the history of morality:

Nevertheless, when I say new and deviant ideas, values, desires again and again broke out, these occurred with a fearful accompaniment: almost everywhere it was madness that paved the way for the new ideas, that broke the spell of honored usage and superstition.


Later in the same passage,

Ach, so give me madness, you heavenly powers! Madness, so that I can finally believe in myself! Give delirium and convulsions, sudden lights and darkness, terrify me with frost and heat, as no mortal has ever felt, with roars and prowling forms, let me howl and whimper and creep like an animal; so only that I may find faith in myself! Doubt consumes me, I have killed the Law; the Law frightens me as a corpse does a living person: if I am not more than the Law, then I am the most depraved of all. (KSA 3:14)

One wonders if this is a script for what followed seven years later in Nietzsche’s life.


Nietzsche’s next book, Die Fröhliche Wissenschaft (1882), has a passage in the same vein but more depressing, in spite of the title of the book:

Homo poeta—I myself, having made this tragedy of tragedies entirely on my own; I who have first tied up the knot of morality so tightly that only a God could loosen it—as Horace demanded!—I myself have murdered all the Gods in the fourth act—from Morality! What is now to become of the fifth? Where to get the tragic solution? Must I begin to think about a comic solution? (KSA 3:153)


Podach (1931, 157) suggests that Nietzsche found this solution in a passage from Beyond Good and Evil:

—In any case, with such a wish, it is necessary to be clear what one will get to see: only a satyr’s game, only a farcical epilogue, only the ongoing proof that the long real tragedy is at an end: assuming that every philosophy in its development was a long tragedy. (KSA 5:25)


The final passage I shall quote from Nietzsche’s published works—although there are others—is from Jenseits von Gut und Böse (1886) and exhibits his mood of extreme pessimism:

The depravity, the destruction of higher men, of alienated souls is the rule; it is frightening to have such a rule always before one’s eyes. The many-sided torment of the psychologist who has discovered this destruction, the entire inner “hopelessness” of higher men, this eternal ‘too late!’ in every sense, at first and then almost always again discovered throughout history—can one day embitter him, turn him against his own lot and lead him toward his own destruction—so that he himself becomes “depraved.” (KSA 5:269)


One can find other forms of evidence of his inclination toward madness in his correspondence at the end of December and the first week of January. A clue as to his intentions can be found in the letter to Peter Gast on Dec. 16 that is concerned with his publications. In the middle of the letter, he abruptly remarks: “Every so often I think why should I accelerate too much the tragic catastrophe of my life, which begins with Ecce” (KSB: 1192). But Nietzsche must have changed his mind because in a letter to Gast dated Dec. 31, Nietzsche wrote, “Ah friend! What a moment—when your card arrived, what had I done then…It was the famous Rubicon—I don’t know my address any longer: we can assume that it should be the Palazzo del Quirinale” [Italian official residence in Rome] (KSB:1228).


            This is a most significant statement. The Rubicon was the fateful river in Italy across which Julius Caesar led his legion to eventually become Emperor. It has come to signify a point of no return for the one who crosses it. Nietzsche identified with Caesar and signed a letter to Strindberg, “Nietzsche Caesar.” We are entitled to assume that the Rubicon for Nietzsche meant the crossing over into madness, into a break with reality as societies of human beings consider it to be. Nietzsche never wrote anything that was without meaning for his own life.


            August Strindberg was the individual in Europe perhaps most capable of understanding Nietzsche at this time. Like Nietzsche, he was a brilliant and multifaceted writer. He had just gone through a severe episode of mental illness himself, which he had utilized to write two of his most interesting books. The two admired each other’s works and Nietzsche had asked him to translate Ecce Homo into French—which Strindberg declined, citing financial needs that Nietzsche could not possibly meet.


            When Strindberg received one of Nietzsche’s ‘madness’ notes, he immediately understood its significance. He replied in kind with both a Greek and a Latin quotation: “Carissime doctor! qelw, qelw manhnai!” (Anacreon), meaning “I will, I will be mad!” A quote from the Latin poet Horace follows: “Better wilt thou live, Licinus, by neither always pressing out to sea nor too closely hugging the dangerous shore in cautious fear of storms.” A phrase from Strindberg in Latin follows: “Meanwhile it is a joy to be mad!” Strindberg’s reply and translations from the Latin are found in Middleton (1969, 344-45). But Nietzsche did not follow Horace’s (and Strindberg’s) advice. What may have been initially ‘simulation’ of madness eventually became a fixed condition in which there was no way back to ‘normal’ life.


            It is revealing to note that during the first week of January 1889 when Nietzsche was sending out his madness notes, he sent several notes to his publisher C. G. Naumann in Leipzig (KSB, 8:1233,1236,1237). These are brief, to the point, and without any trace of madness. They give directions to publish Ecce Homo immediately, prior to Nietzsche contra Wagner, and to return the two poems that were to end it. “Forward with Ecce!” Nietzsche wrote. Herr Gast was to be notified of the change of plans. Tellingly, he ends the last note, “Address as usual, Turin.” Two days before, in his letter to Peter Gast about crossing the Rubicon, he had said he no longer knew his address, it might be the Palazzo del Quirinale. In the midst of sending out his ‘mad’ notes, Nietzsche was obviously at this point capable of writing a perfectly sane one if he wished to do so.


            Soon after his arrival in Basel, Nietzsche was transferred to the Psychiatric Clinic in Jena in order to be near his mother’s home (although she was allowed to see him only occasionally). He was under the care of Otto Binswanger, a prominent neuropsychiatrist and specialist in the pathology of neurosyphilis. He remained in the Clinic [hospital] for fourteen months. During this period the hospital records, given in detail by Podach (1931, chapts. 5, 6), indicate he was noisy, often violent, incoherent, apparently in a fully delusional state.


            Shortly after admission to the Jena Clinic, Nietzsche was visited by Peter Gast who did not think he looked too bad. In a letter to their mutual friend Carl Fuchs, he wrote he had seen Nietzsche in a state that “seemed to him—horrible to say—as though he were only pretending to be insane, as though he were glad to have ended this way.” He believed Nietzsche “would be just about as grateful to his rescuers as somebody who has jumped into the water to drown himself and has been pulled out by some fool of a coastguard” (Podach 1931, 214). Overbeck expressed a similar view in a later publication, “I cannot escape the horrible suspicion that arises within me at certain definite periods of observation, or at least at certain moments, namely, that his madness is simulated. This impression can only be explained by the general experience which I have had of Nietzsche’s self-concealment, of his spiritual masks. But here, too, I have bowed to facts which over-rule all personal thoughts and speculations” (Podach 1931, 215). But what Overbeck thought were facts are questionable.


            Nietzsche was released to the care of his mother in March 1890. He lived for ten more years. Initially, he was able to take long walks with his mother but at times exhibited outbursts of rage. One thing he was able to do from his former life is to improvise on the piano. But gradually he sunk into apathy and became bed-ridden. Some visitors who saw Nietzsche commented on the strange ‘aura’ that seemed to surround him. In August 1900 he developed a cold that progressed into pneumonia. He died August 25, 1900 six weeks short of his 56th birthday. Strangely, no autopsy was performed in spite of the many questions about the cause of his breakdown—and even though his physician Dr. Binswanger was an authority on pathology of the brain.


            Elizabeth Nietzsche, his sister, staged an elaborate funeral. Many pretentious ‘unNietzschean’ things were said at the ceremonies, which were long drawn-out affairs (Peters 1977, 171-74; Janz 1995, vol. 3, 352-358). A more appropriate, brief epitaph would have been that given for Hamlet by Horatio in Shakespeare’s play. Hamlet was Nietzsche’s favorite literary character, who by his resort to masks, buffoonery, and suicide might be considered the later Nietzsche’s alter ego:

            “Now cracks a noble heart. Goodnight, sweet prince,

             And flights of angels sing thee to thy rest!”


            Nietzsche was a virtual unknown at the time of his breakdown, except to a few individuals outside of Germany. But soon after his admission to the mental institutions, the German press reported about a philosopher who had gone mad and was institutionalized. Interest in Nietzsche and his writings began to develop. Like a match applied to a woodpile, Nietzsche’s fame began to blaze up in Germany and then elsewhere in Europe. The adroit publicity generated by his sister who acquired his literary estate no doubt hastened the process. By the time of his death, he was a celebrity figure. It has been reported that German soldiers during the First World War carried copies of Thus Spoke Zarathustra in their knapsacks. All this happened while Nietzsche himself sunk into deepening apathy and was incapable of becoming aware of his fame. This perhaps was the most poignant tragedy of his life.


            Over a century after his death, it is impossible to state with absolute certainty the cause of Nietzsche’s mental breakdown. Perhaps it is not even that important since it is his writings, not his persona, that have had a profound effect on world letters. But people want to know about the lives of writers who have stimulated them to new dimensions of thought. Without Nietzsche’s madness, it is very possible that Nietzsche and his writings would have sunk into oblivion or been reduced to a few footnotes in scholarly tracts. There were certainly contributory factors to his breakdown, whatever the primary cause might have been. At that time, Nietzsche lived alone in cramped circumstances (one rented room), he had no friends or relatives nearby, he had a very imperfect knowledge of the language of the country in which he lived. His Basel pension was being reduced and his books did not sell; he had to pay to have his writings published. He was probably, as he said of himself, three-quarters blind. All these factors must have weighed on him (in spite of his protestations to the contrary) and must have contributed to the temptation to drop out from the ‘normal’ world, although he may not have been fully aware how destructive the long-term consequences were to be for him.


            Perhaps even more relevant was the presence of an unconscious awareness that he, the preacher of the Übermensch, of the will to power, of the dominance of the instincts, was, after all, just a meek little near-blind German philosopher to whom nobody paid any attention. His few clumsy attempts at sexual relationships had been dismal failures. What if he was a unique prose stylist with the German language? What if he had a few isolated readers far away? The German intellectuals had ignored or made fun of him. He had rejected metaphysics so that no God could help him. Zarathustra was a figment of his imagination, not a reality. As a classical philologist, he had long known of Plato’s belief that madness for philosophers was superior to a normal mind (Phaedrus) and Nietzsche repeatedly dwelled on the subject in his books. The desire to assert himself through madness must have been very great. For all these reasons and the ones discussed above, it is the judgment of this writer that Nietzsche deliberately willed himself into a state of madness. He finally crossed his Rubicon.


            The question may arise whether any person is able to will himself into a state of permanent madness, not merely into a transient frenzy or temporary loss of contact with the ‘real’ world. The conventional current psychiatric view is that unknown origin chronic psychoses (‘madness’) such as schizophrenia or bipolar disease are due to an abnormal brain physiology that involuntarily affects a person’s mind. Just ‘willing’ oneself into lifelong madness is not ordinarily regarded as a possible clinical phenomenon. However, Nietzsche was not an ordinary person. The psychiatrist-philosopher Karl Jaspers who published a thick tome about him (Nietzsche: Introduction to the Understanding of his Philosophical Activity) commented there was only one Nietzsche and there will never be another like him. Anything could be possible for the unique individual that was Friedrich Nietzsche.


The translations into English in this essay, if not otherwise stated, are by the author.



Janz, Curt Paul. Friedrich Nietzsche Biographie. Munich: Carl Hanser, 1993.

Middleton, Christopher. Selected Letters of Friedrich Nietzsche. Indianapolis: Hackett, 1969.

Peters, Heinz F. Zarathustra’s Sister. New York: Markus Wiener, 1977.

Podach, Erich. F. (1931): The Madness of Nietzsche. London: Putnam, 1931. (Translated by F.A.Voigt from Nietzsche’s Zusammenbruch. Heidelberg: Kampmann, 1930.) The copious references and notes in the original German edition unfortunately were left out of the English translation.)

Schain, Richard. The Legend of Nietzsche’s Syphilis. Westport: Greenwood Press, 2001.

Verrecchia, Anacleto. Zarathustra’s Ende. Vienna: Böhlaus, 1986. (German translation of La Catastrofe di Nietzsche a Torino, 1976)


Published in: The Agonist: A Nietzsche Circle Journal, Vol. XII, 2019.