Content Warning: This section of the guide describes and discusses the novel’s portrayal of mental illness and death by suicide. 

Much of the conflict surrounding Johanna stems from her brother-in-law’s and her husband’s mental illness. Before marrying Theo, Johanna is aware that Vincent suffers from bouts of melancholy. Mental illness is not well understood in the setting of late 19th century, so Theo worries deeply when Vincent suffers such bouts because little can be done to bring him out of these moods. At other times, Vincent’s illness causes him to harm himself physically, such as when he cuts off his ear. This and similar actions cause Vincent to be deemed “mad”—a condition that brought with it a deep stigma in the 19th century. Those who were labeled as such were frequently regarded as beyond help or even dangerous. Theo, however, wants desperately to help his brother because he believes that the illness masks Vincent’s true goodness. Ironically, the novel portrays Vincent’s mental illness as potentially instrumental in his art, providing not only a means to access his creativity but also an outlet to express whatever inner demons may have plagued him. This portrayal employs an established trope that connects mental illness with creative genius, relying on poetic (i.