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I just finished reading this letter from David Hume to a doctor. The first question I had was regarding the authenticity of the document. I assume that John Hill Burton's sources were vetted since 1846. The dates seemed about right from what I know of Hume's life, i.e., the Bristol trip was around 1736. The comment about college ending in Scotland typically around 14 or 15 years of age seems somewhat odd considering Hume reportedly have attended college there at the unusually young age of 10 - 12 years.

In any case, it seems to me the intent of Ms Cyckowski and Mr. Grobstein (in posting this letter) was to offer it as an example of depression of other mental health problems. I do not believe the letter or Hume's history are compatible with a mental health etiology for his health problems. Hume did confuse his mental fatigue (which sounds very much like CFS/ME symptoms, i.e., "brain fog", but without the numbing physical exhaustion of that disease constellation) with descriptions by mystics of what St. John of the Cross called "the long night of the soul." Mystics often suffer tremendously seeking the direct communication with the divine, particularly when that has occurred and is then denied them (see the suffering of Mother Teresa which came to light only after her death). Hume being an atheist, that is obviously not something he would be familiar with.

One might suggest that brain fog is a symptom of depression, but clinical depression is much more than problems focusing, e.g., doing high level academic work. There would be general retardation, depressed mood, difficulty doing the normal activities of life. Hume did not seem to display any of those symptoms. His mood was good and he easily resorted to activitity in an attempt to regain his mental capability.

I have only taken a quick look at his case, but it appears likely Hume was suffering from metabolic or endocrine problems, e.g, hypothyroidism perhaps brought on by insufficient iodine in the diet. His diet was probably poor, in light of his necessary frugality in his early years. He worked long hours and did not eat well. Poor electrolye intake (sodium, potassium) would predispose to heart palpitations as he reports. It is also likely he was exposed to various parasites, which might explain the morbid progression of his disease in his last year, where chronic diarhea further depleted his stock of absorbed nutrients. He seems to mention some arthropathy, some joint pain along with skin spots and likely signs of vitamin c deficiency (scurvy). The abrupt obesity transition is not surprising in the context of hypothyroidism, where his metabolic rate is low but may still have enough food intake to cause weight gain (I notice images of him in later life to show a portly fellow, with a fairly enlarge neck area, another possible sign of a hypothryoid type disorder, e.g., Hashimoto's).

If David Hume had mental health issues, he certainly coped with them in a positive manner, seeming to pave the way for current CBT (cognitive behavior therapy) where he attempted to talk his way out of his problems with positive mental processing.