George III is one of the more famous British monarchs in history, but not for reasons he would have liked. He is known, first and foremost, for being the king that lost America. He is also known for being “mad.” If you are somewhat more familiar with his reign or the time period, then perhaps you also associate his many children with him – he and his wife, Charlotte of Mecklenburg-Strelitz, would have 15 in all between the years 1762 and 1783.

It’s unfortunate, too, because George had all the makings of a great king. He ascended the throne in 1760 at the age of 22 when his grandfather, George II, died after a 23-year reign. He was the third monarch in the House of Hanover, a house that existed in England because the Stuarts died out (not counting, of course, its Catholic members) and the country was forced to reach far up the family tree to find this German offshoot, descended from James I through his daughter, Elizabeth. Reviews of the Hanoverians were mixed and so, too, were the Hanoverians’ opinions of the English.

But George was well-positioned to change that: The first generation to be born in England and not Hanover, he was young, healthy, conscientious and followed a strict moral code. Had the ball bounced another way, his reign could very well have unfolded as a success. For while popular culture might remember him first for his mental illness, the general consensus among scholars has been that, whether his fault or not, the monarchy steadily lost power over the course of his reign, and its close relationship with national morality and values became even more intertwined – a fact his descendants could likely have done without.

Our understanding of George’s illness – what it was, when it started, how it manifested itself – is hazy at best. The traditional theory is that the king suffered from porphyria, first presented in a 1966 scholarly paper titled, “The Insanity of King George III: A Classic Case of Porphyria.” Unfortunately, this theory has become so closely associated with George and the Royal Family that it has overshadowed other working theories, which are equally compelling. One of them is that George suffered from bipolar disorder: The symptoms that he displayed throughout bouts of “insanity” are consistent with how a manic episode would present itself.

BBC published an interesting rundown of this theory in 2013, noting:

Using the evidence of thousands of George III’s own handwritten letters, Dr Peter Garrard and Dr Vassiliki Rentoumi have been analysing his use of language. They have discovered that during his episodes of illness, his sentences were much longer than when he was well.

A sentence containing 400 words and eight verbs was not unusual. George III, when ill, often repeated himself, and at the same time his vocabulary became much more complex, creative and colourful.

These are features that can be seen today in the writing and speech of patients experiencing the manic phase of psychiatric illnesses such as bipolar disorder.

Mania, or harmful euphoria, is at one end of a spectrum of mood disorders, with sadness, or depression, at the other. George’s being in a manic state would also match contemporary descriptions of his illness by witnesses.

They spoke of his “incessant loquacity” and his habit of talking until the foam ran out of his mouth. Sometimes he suffered from convulsions, and his pages had to sit on him to keep him safe on the floor.

The researchers have even thrown doubt on one of the key planks in the case for porphyria, the blue urine. George III’s medical records show that the king was given medicine based on gentian. This plant, with its deep blue flowers, is still used today as a mild tonic, but may turn the urine blue.

These bouts could have begun as early in George’s reign as 1765, but the first significant record of his illness occurred in the summer of 1788. On the first night his symptoms manifested themselves and he collapsed, Queen Charlotte was apparently so terrified that she insisted on being given her own bedroom and was heard lamenting, “What will become of me? What will become of me?” over and over again.

By November George had fully lost his senses, with accounts claiming that he frequently foamed at the mouth, spoke without stopping for hours at a time and believed himself to be the King of Prussia.

Charlotte was not kept updated on the development of her husband’s health, but her eldest son, the Prince of Wales, was. She accompanied George to Kew Palace of her own volition, but kept her and her daughters separated from him. During visits, he was reported to hug them and refuse to let go. The entire fiasco, which continued until the spring of 1789, permanently damaged George and Charlotte’s marriage, which had been, by all accounts, blissfully happy for almost 30 years.

The situation also led to friction between Charlotte and the Prince of Wales by calling into question what a Regency would look like. Both parties suspected the other of wanting to have the King declared insane and assuming power themselves, a fact that, in the case of Charlotte, is difficult to find credible given that she had zero history of meddling in British politics. Though it’s possible she sought the Regency simply because she mistrusted her son’s intentions.

In any event, the Regency Bill of 1789, introduced on February 3 of that year, empowered the Prince of Wales as Regent if George didn’t recover, but his guardianship, and that of his court and minor children, was granted to Charlotte. The bill  passed the House of Commons, however before it could pass the House of Lords, George appeared to recover. Though under its terms, Charlotte was able to successfully bar the Prince from seeing his father, a practice that continued even after the King regained health. Mother and son would eventually reconcile in 1791.

George’s health remained permanently more fragile, particularly during times of stress. In 1801, the “Catholic question” was put before him after William Pitt the Younger suggested that certain legal restrictions imposed on Catholics be removed. The King believed that to do so would violate the oaths he had made at his coronation as Head of the Church of England. He suffered a relapse, though luckily (well, for George, not the Catholics) Pitt’s successor as Speaker of the House of Commons was equally as opposed to Catholic emancipation.

He suffered another relapse in 1804 from which he recovered, but another recurrence in 1810 would set him over the edge. What prompted it may have been the health of Princess Amelia, George’s youngest and favorite in child. In 1808, at the age of 25, Amelia fell ill with the measles, permanently weakening her. She fell ill again in the summer of 1810, and by October suffered from St. Anthony’s fire, a skin disease, which confined her to her bed. In her last days, Amelia had a “mourning ring” made for her father, consisting of a lock of her hair set with diamonds – upon receiving it, he reportedly broke into sobs. Universally beloved by her family, her death on November 2 was a blow to them all, but especially the King.

The effects of his mental health, combined with the symptoms of old age, were too much for George and he agreed to the necessity of a Regency.

The Lords Commissioners granted the Royal Assent in George’s name to the “Care of the King During his Illness, etc. Act 1811.” Within the bill, the Prince of Wales was named Regent and from February 5, 1811 until George’s death, he would act as sovereign in his father’s name.

On November 17, 1818 Charlotte died at Kew Palace with the Prince Regent by her side. It is worth noting that, after Philip, Duke of Edinburgh, Charlotte is the longest-serving British consort, having been queen for a total of 57 years.

Her husband, George, outlived her by 14 months. During the Christmas holiday in 1819 he reportedly spoke gibberish for 58 hours straight, and on January 29, at Windsor Castle, he died in the company of his second son, Frederick, Duke of York. He was buried alongside his wife in St. George’s Chapel at Windsor.

His death brought to an end a reign that, at the time, was the longest in British history, running over 59 years. It also ended a nine-year Regency that was the first of its kind and, to-date, has never had to be replicated. The Prince Regent would be crowned George IV in July 1821 and rule until June 1830, at which point his younger brother, William, Duke of Clarence, would succeed him and reign until June 1837. One of his few legitimate grandchildren, Queen Victoria, would eventually take over, reigning for 63 years and overseeing the British Empire at its most powerful. Indeed, the legacy of George and Charlotte could be seen throughout the reign of their granddaughter, from her personality and customs, to many of the domestic and political issues she faced as queen.

Perhaps the most powerfu aspect of their legacy is the very concept of the Royal Family itself. For it was under George and Charlotte, and their 15 children, that the monarchy solidified its evolution from a position of power for one individual, to that of an endeavor shared and maintained by the entire family.

To learn more, see From Normandy to Windsor.