In a recent post I investigated Andy Warhol’s medical history, concentrating on the story of the heroic Dr Guiseppe Rossi’s lifesaving treatment of the seriously wounded Andy Warhol and on his gallbladder disease and final operation and his unnecessary death in 1987. Since that post, I have been researching Andy’s medical history in more depth using several biographical sources. Finding Andy’s medical history was relatively easy. Using several sources, probably every illness can be identified. However, none of the sources I have thus far read have even begun to discuss Andy’s mental health.

Reading Victor Bockris’s and Bob Colacello’s biographies gives some insights, but neither tries to discuss Andy’s psychological health. There are other books that do look at aspects of Warhol’s mental health. Claudia Kalb discusses Andy’s hoarding while Brian Dillon examines his hypochondria.

Reading Bockris’s and Collacello’s biographies one gets the feeling that Andy couldn’t have been a particularly ‘nice’ person. The biographies show that Andy was born in Pittsburgh in relative poverty. He was his parents’ third son, but the couple had had a daughter, born in Miková, then in the Austro-Hungarian empire, but now in Slovakia, near the Polish border. The girl died after only six weeks. Ondrej, Andy’s father (after whom he was named) was a hard worker and often had to travel away to work. So the three boys would be brought up mainly by their mother, Julia. The family was poor and Julia worked cleaning houses and making toys out of tin cans which she sold for 25 cents. Ondrej was thrifty and saved money to be able to send his youngest son to college. He hadn’t been able to afford to send his two elder sons — they started working early in life. Ondrej had recurrent jaundice that improved after his gallbladder was removed in 1939. However, his liver later began to fail and he was housebound for the last year of his life, dying in 1942 at the age of 55, when his son Andrew was only 14 year old.

Julia’s English wasn’t good. The family lived in cramped conditions and had a poor diet. Soups were often what they ate. Andy’s childhood illnesses made him closer to his mother. Remember, she had already lost her first born child. At the age of two, Andy had swollen inflamed eyes, which necessitated bathing them with boric acid solution. When he was four he fell and broke his arm. He didn’t tell his mother and it was several months before it was noted that his arm was crooked and he went to a doctor. It was necessary to re-break his arm to straighten it. In 1936, when Andy was six, he caught scarlet fever and developed Sydenham’s chorea, tremor and muscular weakness. He was confined to bed for several weeks and when he had apparently recovered he had a relapse and was again sent back to bed. A further consequence of the illness was that it left his skin blotchy and it would be a problem for him for the rest of his life. He also had problems with pimples and is nose was lumpy and ugly. He became very concerned about his appearance. And in addition, in his twenties, he began losing his hair and took to wearing wigs.

Andy began using various cosmetics to hide his blotchy skin and pimples and visited dermatologists at first searching for a cure, but later for collagen injections to fill out his sunken cheeks, the result of his inadequate diet because of his gallbladder disease. In the mid 1950s he had a procedure to sandpaper down his bulbous and swollen nose, but the treatment provided only a temporary result and he felt his nose was worse afterwards. He took courses of tetracycline for his pimples.

Warhol always maintained that he did not take drugs, though his associates witnessed him dipping his finger in cocaine and smearing it on his gums while saying the he didn’t take it. However, as part of weight loss treatment he was prescribed Obetrol®, a mixture of four amphetamine preparations (a 10 mg capsule contained 2.5 mg methamphetamine saccharate, 2.5 mg methamphetamine hydrochloride, 2.5 mg racemic amphetamine sulphate, 2.5 mg dextroamphetamine sulphate, while the 20 mg capsule contained twice the amount of each constituent). Andy would continue to take these capsules twice daily for the rest of his life.

Andy’s mental health:
Andy Warhol was inordinately attached to his mother, taking her to live with him in New York. He was homosexual but had difficulty in forming longterm relationships. He was vain and deeply insecure, always seeking approbation and affirmation. He had a twofold aim in life, to be the most famous artist of the twentieth century and to become very rich. He lacked empathy, discarding friends and associates, often delegating uncomfortable decisions to others. He was stingy and underpaid his Factory employees. He even failed to pay the $3,000 bill from the surgeon who, in 1968, saved his life after Andy was shot and seriously wounded. The bill was found when one of WArhol’s Time Capsules was opened almost 30 years after Warhol’s death. Warhol also suffered periods of depression. In summary, he appears to have been a classic case of Narcissistic Personality Disorder. The DSM-V states:

The most important characteristics of Narcissistic Personality Disorder (NPD) are grandiosity, seeking excessive admiration, and a lack of empathy. These identifying features can result in a negative impact on an individual’s interpersonal affairs and life general. In most cases, on the exterior, these patients act with an air of right and control, dismissing others, and frequently showcasing condescending or denigrating attitudes. Nevertheless, internally, these patients battle with strong feelings of low self esteem issues and inadequacy. Even though the typical NPD patient may achieve great achievements, ultimately their functioning in society can be affected as these characteristics interfere with both personal and professional relationships. A large part of this is as result of the NPD patient being incapable of receiving disapproval or rebuff of any kind, in addition to the fact that the NPD patient typically exhibits lack of empathy and overall disrespect for others.

But this isn’t really enough. Andy was a hoarder, another anxiety-based condition. DSM-V states that the symptoms of the hoarding disorder are:

1. Persistent difficulty or parting with possessions, regardless of their actual value.
2. This difficulty is due to a perceived need to save the items and to distress associated with discarding them.
3. The difficulty discarding possessions results in the accumulation of possessions that congest and clutter active living areas and substantially compromises their intended use. If living areas are uncluttered, it is only because of the interventions of third parties (e.g. Family members, cleaners, authorities).
4. The hoarding causes clinically significant distress or impairment in social, occupational or other important areas of functioning including ( including maintaining a safe environment for self and others).
5. The hoarding is not attributable to another medical condition (eg., brain injury, cerebrovascular disease, Prader-Willis syndrome).
6. The hoarding is not better explained by the symptoms of another mental disorder (eg. Obsessions in obsessive-compulsive disorder, delusions in schizophrenia or another psychotic disorder, cognitive deficits in major neurocognitive disorder, restricted interests in autism spectrum disorder).

The hoarder engages in excessive acquisition, buys items that are unnecessary and they do not have have space for. The hoarder may have good insight and realise that their hoarding is a problem or have poor insight and not recognise their behaviour is unhealthy.
According to (DSM-5) 80-90% of hoarders also engage in excessive shopping and buying unnecessary items.

This describes to a tee Warhol’s shopaholic behaviour. He threw nothing away. Quite apart from filling his house with about 100,000 items that, on his death, many were found not to have been removed from the packaging in which he took them home, he accumulated 610 boxes of “stuff” from his Factory studio that he called “Time Capsules”. These, now in the Warhol Museum, contain invoices, unread letters, used postage stamps, broken toys, gifts, records, decaying pizza slices, and much else.

I have a theory that many artists have a touch of obsessive compulsive related disorder (OCRD). But are OCRD and hoarding related? There are cardinal differences as explained by in a 2014 article:

The disorders in the OCRDs category have both similarities and differences. Although all the disorders in this category have intrusive thoughts, these obsessional thoughts manifest somewhat differently. Some disorders, such as obsessive-compulsive disorder (OCD) are characterized by classic obsessions. Obsessions are repetitive, unwanted, and intrusive thoughts that trigger anxiety. In other disorders, such as body dismorphic disorder (BDD) and hoarding disorder, the intrusive thoughts could be more aptly described as a persistent and unrelenting preoccupation. In the case of BDD, this preoccupation focuses on personal appearance and attractiveness. In the case of hoarding disorder, the preoccupation centers around possessions.

The intrusive thoughts of people with hoarding disorder are associated with their preoccupation regarding their possessions; specifically, parting with, or losing these possessions. Unlike spontaneous OCD obsessions, intrusive hoarding thoughts and resultant anxiety are not usually activated until faced with the prospect of losing or parting with possessions.

Andy’s preoccupation with his appearance–he always considered himself ugly–could perhaps be construed as a symptom of body dysmorphic disorder, BDD.

By all accounts Andy was not loved, more tolerated. There were, however, many sycophantic hangers on who wanted to share Warhol’s fame. His employees at the Factory called him “scrooge” because of his meanness. But Warhol was inordinately generous to people he wanted to impress, giving paintings and prints to potential clients or advertisers.

Over and above these personality disorders, Andy had several phobias. He was afraid of the dark from childhood. He was inordinately afraid if hospitals and doctors, despite having his own personal physician and regularly visiting dermatologists. It is unclear exactly when this fear of hospitals began; it could have been in his teens when his mother, Julia, was operated on for bowel cancer and ended up with a colostomy. Colacello states that it started n earnest after an operation in March 1969 to remove part of a bullet that remained in his body after he was shot by Valerie Solanas on June 3rd 1968. This inordinate fear was to cause him to delay having his gallbladder removed until his physical condition was poor. Unsurprisingly, Warhol became more paranoid after he was shot. Andy professed to a fear of flying. Early in his career choosing to cross America by car rather than fly. However, he seems to have overcome this later in his lie as he journeyed round the world to exhibitions.

I think we can conclude that Andy Warhol was a tortured soul. Biographical descriptions lead me to conclude that he probably suffered from at least three psychological disorders: narcissistic personality disorder, hoarding disorder and possible body dysmorphic disorder. However, his psychological deficiencies did not prevent him from producing amazing art that still influences twenty-first century art.

Sources:
Bockris, V. The Life and Death of Andy Warhol. 1989
Colacello, B. Holy Terror–Andy Warhol Close Up. HarperCollins, 1990.
Kolb, C. Andy Warhol Was a Hoarder- National Geographic, 2016.
Dillon, B. Tormented Hope: Nine Hypochondriac Lives. Penguin Ireland, 2009.