Pyotr Ilyich Tchaikovsky (1840–1893) composed wonderful symphonies, operas, and ballets, but suffered greatly during his life from an array of medical and psychological issues. His letters and diaries reveal a lifelong struggle with emotional problems that modern medicine would likely classify as depressive or bipolar disorder. He went through frequent periods of melancholy, social withdrawal, extreme self-doubt, and suicidal ideation, as well as episodes of anxiety, agitation, and feelings of worthlessness.
Tchaikovsky suffered from a pathological fear of conducting, which eventually forced him to limit his conducting career. His hypersensitivity to criticism often triggered depressive episodes lasting weeks or months. His homosexuality created enormous psychological pressures at a time when this was not only stigmatized but criminalized, causing him to live in constant fear of public exposure. It undoubtedly contributed to his chronic anxiety and depression and rendered him psychologically vulnerable.
His disastrous marriage, undertaken in 1877 to appear heterosexual, triggered what seems to have been a severe nervous breakdown. The constant fear of exposure and social ostracism in such a repressive society likely contributed to his chronic psychological distress and distress, often manifested by somatization and physical symptoms, headaches, insomnia, heart palpitations, digestive disturbances, and chronic fatigue. These episodes, during which he was unable to compose, required extended periods of rest and recuperation at health spas across Europe. He also suffered from a heightened awareness of physical discomfort, leading to frequent consultations with physicians.
Alcohol played a complex role in Tchaikovsky’s life. He consumed it intermittently to cope with stress and depression, oscillating between periods of abstinence and excessive drinking. His intense emotional sensitivity may have fueled his genius but also rendered him psychologically vulnerable.
Tchaikovsky’s sudden death at age fifty-three remains one of the most controversial aspects of his life. The official given cause was death from cholera, contracted during an epidemic in St. Petersburg. This diagnosis is medically plausible because cholera was a serious threat in 19th-century Russia. Alternative theories, however, persist. He was a heavy smoker and drinker and may well have died from of a heart attack.
Another story indicates that in 1893, a nobleman wrote a letter to Tsar Alexander III complaining that Tchaikovsky was paying improper attention to a student at the College of Law in St. Petersburg. This led to eight of Tchaikovsky’s former schoolmates setting up a “court of honor” meeting to discuss the charges. The meeting lasted five hours, after which Tchaikovsky, looking frightened, ran out of the room to his lodgings and committed suicide by taking arsenic. This story has never been confirmed, so that the cause of the death of one of the greatest composers of all time remains undetermined.