Nero Tyrannus: The Physiological and Psychosomatic Causes of His Tyrannical Legacy

Gold coin showing facing busts of Nero and Agrippina / Wikimedia Commons

By Amanda Gardner / 11.02.2015
University of Colorado, Boulder

Undergraduate thesis defended Fall 2015

Evidence from the Rubble

Tiberius Claudius Nero Caesar was born Lucius Domitius Ahenobarbus in 37 AD. He was the adopted son of Claudius and biological son of Agrippina. Many Christians considered him to be the Antichrist because he persecuted and blamed them for starting the Great Fire in 64, which burned for six days in the heart of the city. The fire destroyed three districts and damaged seven more, devastating the Roman capitol. One of the most commonly recounted details of his legacy today is his asserted “fiddling” while Rome burned. Sources disagree concerning his responsibility for the fire, some claiming he was the incendiary himself, others claiming he was entirely free of blame.[1] (Heinz-Jurgen Beste 2013) He would ultimately rebuild the portions of Rome that were burned in the fire, increasing the buildings’ safety and provide a better quality of life for the people, thereby revolutionizing city planning and architecture. (Heinz-Jurgen Beste 2013) He reimagined the insulae by having them constructed with firebreaks between each home and running water guaranteed in each unit. During the largest scale reconstruction that Rome had undergone, Nero also insisted that the buildings be primarily concrete rather than wood to provide protection against the recurrence of such massive conflagration. In place of the ruins, he designed a new palace for himself, more elaborate and sprawling than any Roman palace previously built. It revolutionized architecture in its own right and was an inspiration to Leonardo DaVinci, Michelangelo and many of the painters who contributed to the Sistine Chapel. Before Nero’s Domus Aurea (Golden House), there is no evidence that domed ceilings adorned with such capacious fresco panels ever existed. His palace was even rumored to have been named the Domus Aurea on account of it being entirely overlaid with gold.

The creation of several public events including the juvenalia was a laudable addition to Nero’s otherwise disreputable legacy. Instituting such events was a noble cause undertaken by many emperors, but none personally participated in the games as Nero did. He relished participating in acting contests, charioteer races and various other “plebeian” events considered improbus for a Roman emperor. Ancient historians allege that his churlish conduct extended into his personal life, that he kicked his pregnant wife to death and later turned a young boy into a eunuch in order to present the boy as his wife. The same historians claim that he engaged in an incestuous affair with his mother before he ordered her death just four years after his accession.

Nero is remembered in the popular imagination as a tyrant and a glutton for his indulgence in lavish excesses. He often hosted banquets and parties that offered the most exotic foods and entertainment, even performances of his own. It is due in part to his performances that he is often referred to as a philhellene; his love of participating in artistic competitions and his inclination towards Greek fashion also propagated this label. (Fantham 2013) His affinity for Greek virtues was spurned by the Roman people, and cited as offensive to their patriotic values. On account of these transgressions and others, the Roman populus condemned Nero to memoria damnata, whereby they would systematically attempt to remove someone from history. This attempt was rather successful in the case of Nero, being that only a few historical accounts survive which reflect remarkable negative bias. His accomplishments in architectural endeavors and public works are not typically recognized in modern mainstream culture, and his memory is often relegated to a monstrous caricature. The historians who wrote about Nero and the sources they used for their works are of great importance in understanding how and why his legacy has suffered in such a way.

Modern scholars rely on three major sources for information about Nero. The surviving accounts are primarily Cassius Dio’s Historia Romana, Gaius Suetonius Tranquillus’s De Vita Neronis from his larger work The Twelve Caesars, and Tacitus’s Annales. Dio lived 155-235, and therefore would have had indirect knowledge of Nero that was based only on information he had gathered. Nevertheless, I rely on Dio as an important source for two primary reasons; foremost, Dio would have likely had access to texts from other authors that scholars no longer have. This is a critical point, considering the surviving sources are so few. Because multiple ancient historians would have read the same text, and interpreted it differently, all available sources should be considered when attempting to discern what perspectives the lost sources might have provided. Dio’s account is also valuable because his histories were written in a broader context than Suetonius’s, or Tacitus’s, and they covered events occurring both inside and outside of the Roman Empire. This difference in focal point would likely lead to him selecting more details relevant events and people outside of the Roman Empire from the original sources.

Tacitus was a Roman senator and historian who lived from 56 to approximately 117. He presumably possessed a great deal of personal knowledge about Nero, given that he was born in the early years of Nero’s reign. Although Tacitus was only a small child at the time of Nero’s death, as a boy raised in the senatorial class, he would have had some personal knowledge about the state of Rome and its government at that time. He would have had access to several of Nero’s coetaneous historians and all of the lost texts that would act as sources for later histories. He claims that he based his history on the narratives of three contemporaries of Nero: Fabius Ruisticus, Rufus Cluvius and Pliny the Elder. Tacitus is credited with providing remarkable insight into the psychology of politics and remains so influential in the field that he is frequently a primary source in political theory studies. A man so invested in his own convictions would likely have some rather tenacious opinions on the matter himself, which would invariably lead to subjective historical accounts. His historical accounts concerning Nero clearly evince this bias, as he is notably critical of Nero and seems to substantiate his reputed transgressions throughout his prose. Though some of his lending validity to conjecture in Nero’s lifetime may be due to Tacitus’s succinct nature, it cannot account for the extent of his vicious assumptions. Tacitus maintains a traditional Roman perspective of history in his book by relating only the information that was pertinent to Rome itself at the time. In this way, his work is more focused than Dio’s, but permits a tremendous amount of prejudice, given the patriotism of his time.

Suetonius’s work perhaps furnished a more amiable account of Nero than Tacitus’s or Dio’s. He was a Roman historian in the equestrian order born around 69 and died sometime after 122, making him strictly a secondary historical source. He claims to have drawn largely from sources that were Nero’s coevals and official empirical documents to formulate his historical characterization of Nero. While Dio and Tacitus were both senators, Suetonius was solely a historian. This may be an important distinction, given Nero’s penchant for insulting the senate. Any archival offenses to the senate were apt to negatively influence senatorial historians, even decades later. Suetonius may also be considered a valuable source because rather than writing histories pertinent to nature or Rome, he more closely wrote biographies. His book on the life of Nero, when compared with the other books in The Twelve Caesars, appears to be rather typical of the biographical details he finds worthy of recording. This could demonstrate that Nero’s condemnation by the senate did not entirely sway Suetonius’s perspective. His biographies of Nero and other Caesars provide details on any peculiar habits, some physical descriptions, remarks on the health of the emperors and notable events during their lifetimes. This work offers the greatest detail of Nero, and is considered by many to be the most forgiving account.

Pliny the Elder’s historical work was decidedly more prejudicial against Nero than Suetonius’s was; nevertheless, he offered some constructive insight into Nero’s reign. Gaius Plinius Secundus was born in either 23 or 24 and died while aiding victims of the Mount Vesuvius eruption on August 24, 79. (Pliny the Younger, 1.6.16) His most extensive surviving work, Naturalis Historia, was an encyclopedic text that detailed many aspects of his own life and experiences, especially while he was living in Rome. While he lived and wrote in Rome during Nero’s reign, it is clear that he did not have extended personal contact with Nero and only published instructional works on grammar and teaching during that period. Some believed that he avoided writing opinionated works in order to avoid gaining Nero’s attention, which his nephew would later confirm, saying that it had been a dangerous time to write any elevated works. (Pliny the Younger, 1.24.2) Pliny certainly would have had reason to fear the wrath of the emperor since his later works reflected his adverse opinions. At one time he described Nero as hated by all mankind, then continued to indicate his extravagances and failures throughout his Naturalis Historia.(Pliny, 7.45, 34.45) Since Pliny lived during Nero’s reign and was actively writing during that time, his accounts should be especially valuable, but he tends to focus less on Nero in his work than other authors did. For this reason, I do not rely on his texts heavily for information, but I cite his observations when relevant. Pliny’s nephew, Pliny the Younger, kept a record of Pliny’s works and listed one entitled Historia a fine Aufidi Bassi, which likely would have been written within about ten years of Nero acceding to the throne. (Pliny the Younger, 1.24; Champlin 2005) While it is not entirely clear what the attitudes of Pliny would have been towards Nero in this work, it is possible that he did not particularly agree with Nero, given his attitudes throughout his Naturalis Historia. Tacitus is thought to have relied on Pliny’s lost text for a portion of his Annales.

Finally, there are several accounts of Nero that certainly existed, evinced by references to their content by ancient authors, but they no longer survive. Agrippina’s memoirs, the history by Fabius Rusticus and the writings of Cluvius Rufus are all entirely missing from the Classical collections of today. Agrippina’s lost autobiographical work is thought to have contained detailed information about Nero and the unfortunate nature of her family. Although Pliny and Tacitus both cite her memoirs, modern readers have a very few clues regarding the nature of the work. Cluvius Rufus did not pen any surviving texts, but he is known to have been a primary source on Nero. It is thought that he did not cast Nero in a particularly negative light, but that he provided a remarkably accurate account. Because there is not record of his texts surviving, the quotes within Suetonius’s biography of Nero, which were written in Greek, are thought to be from Cluvius Rufus himself. These quotes present new details, but do not tend to slander Nero in any way. Cluvius is mentioned by Tacitus, who claims that he accused Agrippina of initiating the incestuous affair with her son, and that Nero was merely complicit in the matter. Tacitus goes on to claim that all of the other sources agreed with Cluvius’s version of events. This supports the theory that Cluvius was likely a more accurate, and possibly slightly more sympathetic source than Pliny.

Fabius Rusticus was not so kind to Nero’s memory. Surviving fragments are considered anti-Neronian, and Tacitus’s use of his information suggests the same. He was the protégé of Seneca and was reportedly present at Seneca’s forced suicide. Since he maintained such a close relationship with one of Nero’s most trusted advisors, he would have likely been rather biased. Once Nero had ordered the death of Fabius’s mentor, it is thought that Fabius did not endeavor to write histories, but that he likely wrote a biography of Seneca, given the nature of the fragments. It is unlikely that Fabius’s account of Nero would have been all that kind, considering the pain he endured at Nero’s behest. He is the primary source that claimed that Nero initiated the unwholesome relationship with his mother, according to Tacitus, which suggests that he was more inclined to blame Nero for egregious acts than others.

Nero’s Imagery

Emperors routinely had sculptures of themselves commissioned for a multitude of purposes. For instance, they might have commissioned sculptures or busts throughout their reigns to reflect any noticeable changes in their desired or personal appearance. They had many sculptures of themselves displayed throughout the city to remind the public of their power and to project the image of their magnanimous natures. (Bergmann 2013) Augustus had a series of relief panels on the Ara Pacis which reflected him as the true leader of Rome with ties to its most ancient beginnings, thereby reinforcing his position with the Roman populus. (Rose 1997) An emperor often made use of opportunities for celebration by having new portraits of himself created. He also would have his official image distributed throughout the empire to appear on coins in several provinces and the city of Rome itself. Busts and sculptures of Nero were all either destroyed or repurposed after he was posthumously condemned to memoria damnata, which has left scholars with few three-dimensional renderings of Nero’s face. Although the Roman people virtually razed all of Nero’s simulacra, the monetary value of his numismatic portraiture could not be abnegated. (Hiesinger 1975)

Minters in ancient Rome would have been given an official image that was to be copied on the official coins. Different regions would likely have preferred to accentuate different features, and therefore would produce a wide variety of imperial images on coins. (Rose 1997) It was left to the discretion of the minter as to whether or not he would etch the emperor’s beard into the coins, or leave it out entirely. The sculptors were not given this option, and the beard was often painted on statues and busts if it was particularly thin; therefore, Nero’s beard would have often been omitted on coins. Details such as these can place limitations on what scholars are able to discern about Nero’s appearance, but they also provide insight into the disparities between the images.

Although the use of different minters could create a vastly varying collection of imperial imagery, I have determined that Nero’s numismatic images are the most helpful in evaluating his physical changes. Due to his memoria damnata, the bulk of his simulacrum was destroyed, making his coinage the most consistently available medium for evaluating how gradually or suddenly his appearance changed. There are at least one if not several different examples of Roman imperial coinage available for each year of Nero’s reign, which gives a more precise method for investigating his weight gain. I have also determined that the coins minted in Rome were likely to be more accurate than those minted in outlying provinces.[2] (Sutherland and Carson 1984) For these reasons, I chose only Neronian coinage minted in Rome. I will often provide more than one image of a coin as an example of a particular year because it is occasionally necessary to do so in order to convey a representative sample of the variations in that year. In other cases, I will select just one coin to represent a given year. I made these choices by evaluating the available images and attempting to select a portrait that appears to have the most features in common with all other available coins of that year. By this process, I have provided a sample set of coins from Nero’s earliest mint until his last that accurately represent Nero’s changing features.

Nero’s Imperial Imagery

As the last emperor of the Julio-Claudian line, Nero left a noteworthy legacy, but he typically is remembered most for his alleged heinous actions, as memorialized by Roman historical writers such as Tacitus and Suetonius. While modern perceptions of Nero likely are influenced by heavily biased accounts reported through ancient historians, his surviving numismatic iconography presents evidence that is central to any responsible and informed excogitation on Nero as a historical figure. Specifically, certain aspects of his appearance seem to change suddenly from a typically-Augustan young emperor to a corpulent brute of a man. The first confirmed imagery of Nero is his image on imperial coins minted in 51 (fig.1).[3] This portrays Nero as a young man having recently obtained legal majority and donning the toga virilis for the first time. This was roughly one year after his great uncle and then emperor, Claudius I, adopted him. On this coin, he wears his military cloak and has rather plain hair, falling on his forehead, as was common for a young Roman boy. His image is overall vague and displays little more than what is congruent with a youthful countenance.


His aureus in 54 (fig. 2)[4] was minted shortly after he had become emperor and included his mother’s portrait facing his own on the obverse of the coin, with her inscriptions displayed prominently around their heads. Nero’s image appears still somewhat generic in nature here, but obviously that of a much older boy. It seems that the boyish coiffure may have been intended to project some aspect of boyhood onto the young man with decidedly more adult features. It was not until 55 that Nero was finally depicted as an adult with individualized features that are distinctly recognizable. The aureus of 55 A.D. (fig. 3)[5] is shared with his mother again, but he occupies the foreground with a larger portrait, while his mother’s face is overlapped behind his own, rather than facing him.


While the coiffeur is more elaborate, his image remains relatively standard. Although this represents the changing of his imagery with his mother, it shows little change in his adult appearance. The true transition to undeniable individual does not occur until the following series issued 55-56 (fig. 4).[6] when Nero is first pictured without his mother. It is this image that not only sets his portraits apart as his own, but also lends itself to more thorough analysis. His facial features begin to emerge more prominently, especially his slender and steep-angled nose and bulbous chin. His deeply set eyes appear on all later coins and become more pronounced throughout his reign. For the sake of clarity, a denarius minted in 56-57 (fig. 5)[7] is featured in place of an aureus, which thus far has been the standard.


For this period, the denarius is in much better condition than any aurei currently available. His profile changes from slender, typical Julio-Claudian to a more oafish figure with a growing neck girth and rounding cheeks. The sudden change is surprising when viewed chronologically in line with his previous coins. He dons a more elaborate hairstyle in this series, complete with careful curls falling low on the back of his dramatically larger neck. The aureus from 57-58 (fig. 6)[8] features an even more robust representation of Nero, complete with a sagging under-chin area, fleshy cheeks and an excessively protruding chin which begin to bulge around his smallish features. Aurei from 58-59 (fig. 7)[9] are exceedingly similar and show, most notably, an enlarged neck. Special attention should be given to the small bulge that seems to appear on the back of his neck, just below the hairline.

This is atypical of weight gain, and is a cause for these images presenting such a problem to historians. The imperial aurei of 59-60 (fig. 8)[10] finally begin to show the truly unusual nature of Nero’s rapid expansion; it was not so odd that he was gaining weight so rapidly in and of itself; after all, he was the emperor of the entire Roman world. Rather, it was perplexing that he began to carry the excess weight where he did. While many historians have offered theories on his weight gain, some even having a laugh at Nero’s expense, none has been able viably to develop causality from anything other than gluttony and greed. However, the fat deposit on the back of his neck paired with protruding cheeks and a small fatty area just above the bridge of his nose point to something far weightier than simple lack of restraint. It is not difficult to track the progression of these signs, but I have included in this series of pictures an example of every imperial Roman aureus on which he appeared for comparison’s sake.

The trend continues in the subsequent eight year span; a selection of those minted between 60 -62 is represented above (fig. 9-11).[11] This selection evidences the unusual appearance of Nero’s increasingly thick neck, and his facial features seem to shrink back into his head while his rotund cheeks and chin begin to seem as though they are dominating his entire face. Next, I have furnished the images of two coins that are broadly representative of the Neronian coins minted in 61-62. Two images are used for this single year because I found it noteworthy that there are considerable variations in these coins, presumably minted from the same image. Despite the fact that Nero’s face appears more austere in fig. 11, both coins clearly show a double chin, what is called a buffalo hump where his neck and back meet, and the aforementioned protruding fat deposit just above his nose. Also noteworthy are the conspicuous striations across Nero’s face in fig. 11. These most likely were intentional and created by citizens after Nero was condemned to memoria damnata while the coins were still in circulation after his death. (Zedelius 1979) The coins minted earlier in his reign rarely suffered the same fate, as Romans purportedly recognized the early part of his rule as the better portion.

The years 6264 (fig. 12 &13)[12] bring marked weight gain at an incredible pace, and his mouth nearly disappears between his enlarged chin and cheeks. He hardly resembles the young man presented in coins earlier in his reign, a condition exacerbated by the unusual allocation of adipose tissue. While his change in appearance is unquestionable in these images, it becomes more severe in later years. It should be noted that Nero would likely have been under an enormous amount of pressure after 64, having endured and secretly blamed for the Great Fire of Rome in 64, which he supposedly watched from his roof while singing of the fall of Troy (Dio, Hist. LXII 18.1). After this stress and the tides of the popular favor turning against Nero, it would stand to reason that he may gain some amount of weight, but again, the extent of his weight gain is unprecedented among Julio-Claudian emperors. (Bergmann 2013) Nero finally becomes the monstrosity described by Suetonius on the imperial coins minted 64-68. He not only displays the characteristics continuously noted on the coinage prior to this range, but he also displays an overly ornate hairstyle, which is often described as ostentatious and befitting the Roman lower classes.

I elected to represent mint year 64-65 in a series of three coins because there is a great deal of extant coinage minted in that year that is available for study and these three images do represent a wide array of variables in his facial profile. (Fig. 15-17) had become creased as it folded over under the weight of his fleshy brow.

It should be noted that Nero appears on these coins both with and without a sparse beard. As noted by Bergmann, this likely was due to the fact that he had only a wispy, thin beard, which would have been painted onto statues, but would have been optional for die makers to include. Some busts of Nero may also include a carved beard, which was a stylistic choice that could be made by sculptors when they rendered the image. (Bergmann 2013) His images on coins minted between 65 and 68 are nearly identical and feature a new crown style.[13] (Figs. 18, 19 and 20) On these coins Nero’s semblance of Apollo is arguably purposeful, evidenced by his wearing a radiate crown, which was symbolic of the sun. The addition of this feature may indicate his burgeoning belief that he deserved deification before his death. Additionally, the fat deposits both on his face and between his shoulders have grown to epic proportions at this late point in his reign. His beard appears still to be an optional addition, and rather sparse when included, which is remarkable only for the fact that he was between twenty-nine and thirty years of age when these images were struck. The denarius from 65-66 (fig. 18) was used for its dramatic representation of his full cheeks. Perhaps, this was an anomaly for this series, but given the surviving coins from that year, it is unlikely. His final image to be struck on Roman coinage gives an impression of a slovenly glutton, which is precisely how Romans and future scholars would remember him.

Nero’s numismatic portraiture offers a greater level of diversity than his statuary imagery does; however, I have chosen for inclusion in this study just one, which brings to light the true distension of Nero’s face exceptionally well, considering the few recognizable sculptures. (fig. 21)[14] Given a glimpse from a lower perspective, it is possible to see the fullness of Nero’s face, and the adiposity of his chin and neck.

The preceding imagery illustrates the more common problems that have troubled modern historians. These issues have prompted a multitude of conjecture and theoretical scholarship in search of an explanation. I will argue in chapter three that his weight gain likely was caused by a medical disorder given its presentation and the other risk factors that Nero displayed. This diagnosis can possibly resolve the concerns that scholars have had concerning the dramatic change in Nero’s appearance over a considerably short period.

Nero through a Modern Lens

Nero’s iconography presents a wide array of problems for modern scholars, but these problems have yet to be linked to any viable common source. While the observation about his portly face seems self-evident, explaining it in historical terms may be rather daunting. The ancients had no term to identify his collection of symptoms. All of the surviving ancient literary sources agree that Nero was notorious for his overindulgence in food and [alcoholic] drink alike. One may initially assume that the food is to blame for the excessive weight gain in a relatively short span of time, but perhaps the drink played its fair part as well. The most likely cause of Nero’s physical symptoms may be a modern syndrome Cushing’s syndrome (CS). CS differs from the more commonly known Cushing’s disease in that the disease itself is typically hereditary (something which cannot be substantiated in Nero’s ancestry) and is distinguished by a set of symptoms typical to the disease. Cushing’s syndrome may best explain Nero’s collection of symptoms since surviving accounts from Tacitus, Dio, and Suetonius along with surviving records of his actions correlate strongly to this diagnosis when combined with his sudden onset obesity. While both diagnoses are caused by hypercortisolism, (excessive cortisol) Cushing’s syndrome is merely a syndrome, rather than a disease, meaning that it only represents a set of symptoms that would be typical of Cushing’s. The symptoms or indications of Cushing’s disease and syndrome are the same, save for genetic and biological factors, which are specific to Cushing’s disease. Individuals may experience or display symptoms differently, but the most common symptoms of CS are relatively consistent. Physically, patients typically present with upper body obesity, a very round or “moon face,” proportionally thin extremities, fat deposits around the neck or face, a fatty hump between the shoulders, severe stretch marks, wounds and infections which are slow to heal, acne, fatigue and muscle weakness, glucose intolerance, increased thirst and urination, bone loss, high blood pressure and headaches. These physical symptoms are the body’s outwardly visible reaction to an excess of the cortisol hormone in the body.[15] In addition to the array of physical symptoms, someone suffering from Cushing’s should also expect to experience some mental and behavioral symptoms such as cognitive dysfunction, anxiety, irritability and depression.

Many of the outward signs of Cushing’s can be noted in the photos of a patient from a clinical case study; photos A and B depict a patient with Cushing’s syndrome and typical presentation. (Fig. 22) The following photos in frames C and D show the same patient eighteen months after having a surgery to remove a pituitary tumor (which was the cause of the symptoms in his case). This illustration gives a remarkable view of how an individual’s appearance changes when affected by Cushing’s syndrome. By examining these photos in comparison to the imagery on Nero’s coinage, a definite correlation emerges. From Nero’s imagery, his developing moon face is notably parallel to the patient photos in fig. 22, along with the fatty hump behind his neck and the smaller fat deposit between his eyebrows. While the subject in these images may not have fully recovered from the effects of Cushing’s syndrome in frames C and D, the drastic change is still quite notable. Nero had a similar appearance to frames C and D early on in his reign, but rapidly expanded to resemble the patient in frames A and B. Special attention should be given to the man’s facial features; notice that in the after photos, he has prominent chin, mouth, nose and eyes, but in the earlier photos, those features were distorted beneath a layer of swollen adipose tissue. Not only does the face swell with fat deposits when one suffers from this syndrome, but due to the hormone imbalances, one will also have swollen hands and face from edema, a concentration of fluid. Many studies have found that men suffering from Cushing’s are very likely to have a lack of facial hair and possibly impotence, caused by a testosterone deficiency. (Ambrogio, et al. 2014; Chentli, et al. 2004; Vierhapper, Nowotny and Waldhäusl 2009) Given Nero’s reputation, one may first assume that this is an unlikely symptom for him to have suffered. If he did have difficulty producing an erection, he would not necessarily have been unable to engage in sexual intercourse at all times. It is reasonable to assume that he would have been able to achieve an erection at least a portion of the time. Champlin discusses the likelihood that Nero actually may not have been very promiscuous, especially when compared to such predecessors as Augustus, Tiberius and Caligula. (Champlin 2005, 161-62) This also could explain certain examples of his sexual behaviors, such as his unusual obsession with Sporus and his affinity for choosing concubinae who resembled previous lovers; he may have been forced to seek more exciting and unusual stimuli than the average man does in order to fully engage in sexual interactions. We have no surviving evidence that his daily interactions with others consisted of overtly sexual behavior. While Tacitus does claim that Nero abused Britannicus (Annals 13.17), there is not enough evidence of consistent sexual lewdness to classify this as a symptom. After all, he did not possess the lengthy list of lovers and sexual exploits confirmed by multiple sources that Caligula and Tiberius had. It should also be noted that, as Champlin astutely points out (p.163), the violent sexual accusations were all made concerning the earlier part of Nero’s reign, no later than 56, indicating that, if they did occur at all, they were likely singular occurrences rather than habitual. Nero’s lack of a thick beard well into adulthood could also be explained by this deficiency. In addition, the extreme thirst common to Cushing’s could explain why the emperor’s condition continued to worsen throughout his lifetime; it is very likely that when Nero was thirsty, there was often wine easily at hand, which he would partake in to quench his insatiable thirst. However, we are also given indications by Pliny the elder that perhaps he also took a particular interest in his water quality. (Natural Histories 31.40) This indicates that he would have likely drunk water often enough to regulate its quality, but Woods points out that this could be linked to the ancients’ belief that certain types of water, or water consumed at extreme temperatures had healing qualities. (Woods 2009)

The historians, though potentially quite biased against the emperor whom they might consider a mad tyrant, also provide evidence that Nero did in fact exhibit several symptoms of CS. Suetonius describes nearly all of the possible physical symptoms in his description of the reportedly slovenly emperor.[16] While Suetonius’s account is disputable due to the undeniable bias that many historians harbor against Nero after he was subject to memoria damnata, it is not the description that holds up the theory, but rather the theory that serves to support Suetonius’s description. Because he seems to have exhibited many of the symptoms common to Cushing’s syndrome, it is far more likely that he was as Suetonius described, probably brought on by his insatiable thirst for wine. This likely contributed to his symptoms, and only made him more ill. Although Suetonius claims that Nero was ill only three times in his lifetime, Tacitus claims that he was less healthy than Suetonius suggests, and even recounts one of his illnesses in greater detail. (Suetonius Nero 51, Tacitus Annals 14.22) Nero hardly would have been the picture of health if he suffered from Cushing’s, but his illnesses would likely not have been severe enough to interfere with his official duties. As Suetonius put it, “atque ita ut neque vino neque consuetudine reliqua abstineret”[17] “and he was never so [ill] that he would abstain either from wine or old habits”. He would have likely sought a cure for his ailments, however privately he may have done so. Woods suggests that he may have bathed in and drank extremely cold water as a hopeful remedy. (Woods 2009)

His symptoms seem to have begun manifesting themselves a few years after acceding as emperor, which would coincide with Nero distancing himself from his mother, as can be noted from coinage of his minted between 54 and 56. (Fig. 2-4 p.1-2) It stands to reason that when he took power over the empire at seventeen his mother was heavily influential, probably made problematic by the usual rebellious spirit of adolescence. The historians tell us that Agrippina herself assigned Seneca to be Nero’s advisor and speechwriter, and appointed his advisor, Burrus. (Suetonius, Nero, 9; Dio LXI) Burrus and Seneca initially served Agrippina well by keeping Nero’s licentious nature in check. Though he was somewhat controlled, he already showed signs of his future insurrection by his affinity for being a charioteer and his deep interest in artistic expressions. Though these were small rebellions, Agrippina seemed determined to keep them that way when she demanded to be honored as his co-regent before the public. Both Tacitus and Suetonius substantiate these claims in their biographical accounts of Nero, claiming that on the first day of his reign, he made the watchword of the Praetorian Guard mater optima.(Tacitus, Annals 13.2.11, Suetonius, Nero 9) Besides so much evidence to his inevitable rebellion against his mother, he reportedly ordered her death in 59, less than a full five years from the time she aided him in securing the throne. (Suetonius Nero 35) Having only five years between the time he rose to power and when he had his mother murdered speaks volumes about how he must have truly felt about her. He even ordered Burrus’s death and replaced him with the far more bloodthirsty Tigellinus. He certainly was not faint of heart, and seemed more than willing to go to great lengths for a desired result. It is precisely that brashness that likely links Nero to another indication of CS: irritability. Accounts of Nero’s fiery temper are present among all historians. It seems, in fact, that Nero’s moody outbursts are one of the few facts on which they all can agree. Suetonius alleges that he kicked his pregnant wife, Poppaea, to death, poisoned his mother and stepbrother, Brittanicus, and that spectators were frightened to leave the theater during Nero’s performances. (Nero 34.2, 35, 23) He may also have suffered from impaired cognitive abilities associated with CS, which he would have dutifully hidden from the public eye (as would any Roman emperor). Suetonius also tells us that Nero would hear legal cases, he would withdraw and have his counselors each prepare his own opinion in writing, for Nero to review in private, and based on these opinions he would then make a judgment in the case. (Nero 15.1) This could suggest that he was not as proficient at hearing and fully comprehending the cases as they were argued, but that he may have required additional input from his advisors and ample time to process and comprehend the complexities of the cases before making a judgment.

Nero’s behaviors often were erratic and unpredictable, but perhaps most surprising was his anxiety. A man who displayed such rebellion and arrogance seems irreconcilable with one so self-conscious and concerned with the public’s opinion of him, as described by Suetonius.[18] While it is debatable whether he was remarkably talented in any of his artistic pursuits, it is agreed that those particular interests were not acceptable preoccupations for a man of his social status in ancient Rome. (Fantham 2013) Suetonius did praise Nero for his performances and skill, but mostly for bringing spectacula to the Roman people. Although these games seem congruous with an emperor functioning for the best interest of the masses, it is also recognized as a bid at another form of self-aggrandizement. For a philhellenistic emperor captivated by all forms of the performing arts and literature, the creation of the Neronia (with his name prominent above all), could likely have been another opportunity to be seen by his subjects and admired by them all. He likely would have relished in the ferment of applause he would create after a performance. Though he did not have reason to agonize over winning, Nero was said to have been quite nervous entering competitions (Dio, 61.21.2; Fantham, 2013, 24). For, who would proudly wear the crown, declaring himself victor over the emperor? Suetonius tells us that he also felt that the only people knowledgeable enough in the arts to truly appreciate his performances were the Greeks (Suetonius, Nero 22.3-4). This was not just a major insult to the Roman pride, but also to the actors and competitors whom he often accompanied on stage. Dio discussed this point as well, saying that Nero was awarded the crown for lyre-playing at the Neronia and was afterwards granted the crowns for those contests by default, even those which he did not compete in. (Dio, 61.21.2; Champlin, 2013).

Nero’s Mental State

Accounts of Nero’s unusual behaviors combine to paint the portrait of a tyrannical ruler who evidently suffered from many psychological infirmities. The stories about his commitment to his ability to perform, such as placing lead weights on his chest, abstaining from acidic drinks and not speaking for long periods before a public performance depict Nero as quite eccentric by contemporary standards and social norms; however, his relationships and documented actions indicate something much more grim. It is widely accepted that he did order the death of his mother, and that he did try to kill her at least once. The simple act of killing (or ordering the murder of) one’s own mother represents some very sinister sociopathic tendencies alone. The fact that Nero also ordered the suicide of Seneca and lacked surprise at the sudden death of his step-brother, Brittanicus, points to the conclusion that perhaps he was not an entirely balanced individual. He created controversy on a regular basis with no visible efforts to disguise his rebellious behaviors. This type of ostentatious display of disregard for social norms is often linked to several mental health disorders. While it may seem unlikely that Nero could have had an undiagnosed physiological disorder and mental health disorders, this conclusion is based in science. CS and Bi-polar disorder (BPD) and depression have a very high rate of comorbidity. (Krishnan 2005) Several of the impulsive and erratic actions displayed during Nero’s reign point to some degree of BPD.

Multiple mental disorders regularly occur with CS, most notably major depressive disorder. Second to depression, BPD is diagnosed in approximately 30% of patients with CS. (Haskett 1985) This is a striking relativity and suggests that, compared to the 1% of the general population diagnosed with BPD, those diagnosed with CS are exponentially more likely to suffer from BPD. (Sonino, Fallo and Fava 2010) This striking statistic supports my theory that Nero may have effectively caused his own BPD. Alcoholism frequently occurs alongside both BPD and CS, but each can be created or exacerbated by heavy alcohol use. (Besemer, Pereira and Smit 2011) This creates a compounded cyclical effect, where one leads to the other and simultaneously stimulates an increase in the other.

BPD is characterized by periods of extreme highs and lows, called depressive states and manic states, respectively. This constant shifting of moods is typically not within moments or hours, but rather occurs over periods of days or weeks. (American Psychiatric Association 2013) A typical patient with BPD will have extended periods of depression which occur often without environmental cause, and last for at least three days at a time. Those periods of depression are often followed by a manic state, in which the patient displays erratic and uncontrolled behaviors. Some patients can have what is commonly referred to as “rapid cycling” or increased lability between cycles but this is typically only evident during times of unusually high stress. The Diagnostic and Statistical Manual for Diagnosing Mental Disorders, 5th edition, details some aspects of a manic state:

“Mood in a manic episode is often described as euphoric, excessively cheerful, high, or ‘feeling on top of the world.’ In some cases, the mood is of such a highly infectious quality that it is easily recognized as excessive and may be characterized by unlimited and haphazard enthusiasm for interpersonal, sexual, or occupational interactions. For example, the individual may spontaneously start extensive conversations with strangers in public. Often the predominant mood is irritable rather than elevated, particularly when the individual’s wishes are denied or if the individual has been using substances.”

-American Psychiatric Association, DSM V

The preceding description clearly outlines some of the major notable problems from surviving accounts of Nero. Many scholars agree that Nero did likely indulge in alcohol excessively, which would qualify as substance abuse. From this substance abuse, it is likely that Nero suffered from CS, which has an irregularly high comorbidity with BPD. While it is rather difficult to pinpoint any direct depressive symptoms exhibited by Nero, this problem is largely due to a lack of evidence. Our problem does not lie in the fact that he simply did not exhibit depressive symptoms, but that historical accounts of any such behavior do not survive. Historical accounts, both modern and ancient, may not include details which could indicate depression, since it is not particularly salacious in its presentation. Bearing this in mind, scholars are limited in their evaluation of Nero’s predisposition for depression or depressive attributes, based on documented experiences throughout his life.

What we know of Nero’s childhood is rather macabre; Nero’s father died and his mother was exiled by the time that Nero was three years old. From the tender age of three until eleven (or twelve, the sources disagree on this point) years old, Nero was in the care of a dancer and a barber. Many would one day posit that this influence from the lower class had shaped Nero’s entire adult life. Nevertheless, it must be considered that as a young boy in his most formative years, being orphaned and placed in the care of lower-class citizens would have been traumatic. (Fendrich, Warner and Weissman 1990) Additionally, once Agrippina was released from exile and began to vie for the affections of Claudius I, Nero was instantly snatched from his life as an orphan and placed in what would be a royal family. It was this shocking change during his coming-of-age that likely solidified many of the mental disorders that would one day plague the young man. (Fendrich, Warner and Weissman 1990) He was first deserted by his own mother, then left to live a life of relative poverty, then thrust into the limelight as he led a group of youths in the ludus circensis when he was nine years old. For the next several years his mother would parade him in public when it was convenient or beneficial to her. When he was eleven and officially adopted by Claudius, he was finally accepted into his mother’s home permanently. It was not long before Agrippina began plotting the death of Nero’s younger brother, Brittanicus. Because Brittanicus was Claudius’s biological son, he had all rights of accession to the throne, which would leave Nero and Agrippina out in the cold in the event of Claudius’s death. Scholars have speculated that perhaps Nero himself helped to orchestrate the death of his stepbrother, but blame is most often ascribed to Agrippina. Considering that Nero would have been younger than twenty when all of these events occurred, including the death of his step-father, Nero had a great deal of trauma which he was forced to undergo at a considerably young age. This points to several risk factors for depression, which make it ever more likely that he suffered from this aspect of BPD as well.[19] The nature versus nurture argument could reasonably be applied here, which substantiates my theories. Nero likely was predisposed to mental instability, given his family’s history of incest and the erratic behaviors of both his mother and his uncle, Caligula. This natural inclination towards mood or personality disorders may have lied dormant if it were not potentiated by the traumas that Nero later underwent. The combination of the risk factors exponentially increased his likelihood of developing psychiatric abnormalities later in life.

Nero is said to have ordered citizens (and senators) remain in the theater to witness his performances appears to be an arrogant show of his own narcissistic leanings, a theory which is disputed by Gyles. (Gyles 1962) She suggests that perhaps Nero truly did captivate his audience, which led them to be inclined to hear every moment of his performance, and even refusing to relieve themselves. While this is a persuasive theory, it is not widely accepted by scholars, who often characterize Nero’s actions as “histrionic” (e.g. Rudich, 1993, p 41 and 211; B. Baldwin, 1979.) That characterization may reasonably be taken to imply that these scholars would classify him as having suffered from what modern psychiatry calls “histrionic personality disorder”, yet this does not necessarily mean that he did indeed have this disorder. A clinician might understand this to be a casual diagnosis, but this term is used more typically in the English language as an adjective to describe individual actions. Few likely would dispute that Nero exhibited traits popularly and clinically associated with HPD (Histrionic Personality Disorder), but his actions are less diagnostically histrionic. He more closely fits the definitions for Narcissistic Personality Disorder (NPD). The comorbidity of personality and psychiatric disorders is clear in case studies and cross-sectional analyses by Krishnan, Haskett, Swearingen and Tang, as all of them present the likelihood of subjects being diagnosed with psychiatric or personality disorders after CS diagnosis, regardless of etiology of the syndrome, or psychosomatic nature of the psychiatric symptoms. There is an overwhelming amount of scientific evidence to support the theory that someone with CS would not only suffer from either BPD or depression, but that he may also be diagnosed with a personality disorder. This affirmation supports my theory that Nero likely suffered from several ailments, both of the body and of the mind.

The following table (fig. 23) taken from information available in the DSM V (APA, 2013), actively compares NPD and HPD based on modern criteria for diagnosis. Of special importance is Nero’s actions during the death of Brittanicus, at which time he is said to display little emotion. (Tacitus, Annals) He does, however, seem to be somewhat annoyed by the fact that attention was suddenly shifted to Brittanicus at the time, as evidenced by his plea that the dinner guests pay him no mind. This is not consistent with HPD, in that it does not display any discomfort on his part in not being to focus of attention. His emotions were also far from shallowly expressed, considering his alleged willingness to resort to murder when provoked. His speech likely was not lacking in detail, as Suetonius indicated that he was well-read and rather adroit at most of his endeavors. (Jones 2000, Suetonius, Nero) He at the very least could not be considered easily suggestible beyond the time he accessed the throne, since he ordered the death of his advisors, his mother and his tutor. While some aspects of this disorder do seem to correlate to what we know of Nero, the DSM V states that for accurate diagnosis, the subject must display at least five of the listed traits in a variety of contexts.

Click image to enlarge

The table in fig. 23 also shows several attributes of NPD which Nero seems to have demonstrated throughout his life. His sense of self-importance can be noted by Pliny the Elder in his description of the Domus Aurea, when he indicates that the palace was so large that it overshadowed the city.[20] The same symptom, along with his requirement of excessive admiration and sense of entitlement, are evidenced by his predetermined victories at all acting competitions. This same act demonstrates his arrogant and haughty behaviors quite thoroughly. Arguably, he considered himself “special” beyond his role as emperor in that he truly expected the senate to comply with his policies and lifestyle choices without argument. He also endeared himself to the Greek way of life through his theatrical and musical accomplishments far more than the Roman standard. This may have given Romans this impression that he valued the Greeks over them. After all, he was competing when the Great Fire began. He was exploitative of others in so far as they were useful to him. He would frequently rely heavily on others until they no longer had a use for his aggrandizement, as with his mother and Seneca. The very fact that he was so skilled at lyre-playing, singing, and performing alone demonstrates his need for excessive admiration. The allegation that he kicked the pregnant Poppaea to death after she criticized his theatrical performance further demonstrates this point. The list of diagnostic criteria for NPD is parallel to several of Nero’s reported personality traits. While his role as leader of the most powerful empire of his time may have contributed to these factors, his manifestation of these symptoms goes far beyond that of previous emperors. Tiberius and Caligula, for instance, are two of the most notable Julio-Claudian emperors concerning their eccentricities, but even they did not go to the lengths of performing in a theater for personal satisfaction.

The theater was a place for plebeian performances, something that was degrading for someone of even senatorial class, let alone the emperor himself. (Fantham 2013, Bergmann 2013) The very fact that the emperor was participating in such lowbrow recreations was shocking to Roman citizens and insulting to the senators. Nero did not shy away from his abilities on the stage, and even required that senators participate in his performances. He mocked them by having them make fools of themselves before the audience and in doing so, waged a war against the senate. When he lost the people’s support, he could scarcely believe it. Even as he attempted suicide, he lamented for the people’s loss even more than his own loss of life in his reported final words, “Qualis artifex pereo!” or, “What an artisan I am in my dying”[21] (Suetonius, Nero 49.1) It was so difficult for Nero to reconcile fantasy and reality that he was in certain denial until his death.

He considered himself to be so extraordinary that he believed he could divorce or murder his wives without fear of legal retribution. He married Octavia to secure his succession to the throne, though he had already been legally adopted. After going to such lengths in order to bolster his claim to the throne, he was instantly willing to toss aside the asset in favor of a plebeian maiden. He seems to have thought himself entirely immune to the evil eye of the people; he divorced his first wife by executing her, kicked another to death, and had one turned into a wife by castrating and dressing up a young boy. The people did not turn a blind eye to this, rather he rapidly lost the support of the people, who he had pleased so well with his buildings and juvenalia. The loss of popular support in the Roman Empire does not necessarily spell disaster for an emperor, but losing senatorial support did. Nero had pushed away the senate not only through humiliating them, but also through giving freedmen rights that they were typically denied and parading them before the senate in his praetorian guard. Each convention that he broke brought the senators closer to wrath until it ultimately caused Nero’s demise.

Interpreting Nero in Context

Nero’s numismatic imagery changed so dramatically throughout his reign that it has perplexed scholars for centuries. While his physical changes do represent some extent of his excessive indulgences, the excess is not necessarily entirely to blame for those changes. Nero was not simply overweight, he was ill. His physical illness lead to eventual mental illness, which would ultimately determine his fate. A specific cause of his eccentricities is relatively indiscernible because the causes are so indelibly linked to outcomes. His traumatic history set the stage for depression, which would cause Nero to overindulge in alcohol, whereby, worsening the depression. His overindulgence lead to hypercortisolism, which includes several mental and physical symptoms. This syndrome then created an ideal setting in which he could develop a rather robust personality disorder. Nero is so often remembered for his heinous acts of violence, and even for actions that were alleged by obviously biased sources; however, we know little about the man who made ancient headlines. It was my goal, given the lack of resources, to create a more accurate portrayal of a man who has become mere legend. By humanizing a man whose shadow had outgrown him, I argue that there was a man behind the infamous monster. . The people of ancient times closely resemble the people of today, and therefore we all suffer the same risks of infirmities. Understanding the motivations behind even the most egregious crimes may help us to better separate the man from his illness and discern precisely what did go wrong. This portrait reflects the worst case scenario of what could happen given certain circumstances, and can be used to extrapolate a valuable lesson for today’s world.

Nero cannot be excused from his actions simply due to the involuntary nature of his madness, but he can be better understood. We have unmatched insight into the mind of Caesar, for example, given his surviving texts; however, we have little more than surviving inscriptions and a few Greek letters from Nero. Our knowledge of Caesar’s temperament has helped us to understand his actions. The same level of understanding may never be achieved concerning Nero, but a small amount of introspection is provided through the revelation about his health. The question of how such a promising young emperor strayed from the path of Augustan success may be answered in the most logical of terms. The importance of studying history comes from its ability to make us wiser, its ability to impact today from such a distance. History would not be able to dictate today’s world if modern readers could not comprehend the humanity of those whom they study. Interpreting the past is most effectively done with a great deal more information than what survives about Nero, and even then interpretations often vary dramatically. By gaining a greater understanding of his motivations and struggles, modern scholars can perhaps better interpret the actions of the emperor gone mad.


  1. Tacitus recounts the greatest variety of explanations, whereas Suetonius and Dio have similar claims about Nero’s culpability. All agree that he did play the lyre at some point during the six-day blaze. It is unlikely that Suetonius’s or Dio’s accounts are accurate, given that each was entirely secondary and ignored any other explanations.
  2. This accuracy was due to the caliber of minters, or artists in the area and the pressure placed on the coin makers to create an accurate image. The more talented minters would have likely migrated to the city of Rome from any outlying provinces so that they would gain more recognition for their skills. These coin makers would also have greater responsibility to create accurate images of the emperor since the people of Rome would have likely seen the emperor personally and because the emperor himself would be more likely to see the final work.
  3. Fig. 1: BMC RE1 p.176 no. 86.
  4. Fig. 2: BMC RE1 p.200 no. 2.
  5. Fig. 3: BMC RE1 p.201 no. 7.
  6. Fig. 4: BMC RE1 p. 201 no. 9.
  7. Fig. 5: BMC RE1 p. 202 no. 13.
  8. Fig. 6: BMC RE1 p. 202 no. 15.
  9. Fig. 7: BMC RE1 p. 203 no. 19.
  10. Fig. 8: BMC RE1 p. 203 no. 21.
  11. Fig. 9: RIC1, p. 151 no. 25, Fig. 10: BMC RE1, p. 205 no. 33, Fig. 11: RIC1, p.152 no. 33.
  12. Fig. 12: RIC1 p. 152 no. 38, Fig. 13: RIC1 p. 152 no. 40.
  13. Fig. 18: BMC RE1 p.212 no. 92, Fig. 19: RIC1 p.154 no. 66, Fig. 20: RIC1 p. 154 no. 71.
  14. Rome, Musei Capitolini, Palazzo Nuovo. Inv. MC0427. Hall of the Emperors.
  15. For further reading on Cushing’s, see Swearingen, Biller (2011).
  16. “Nero was about the average height, his body marked with spots and malodorous, his hair light blond, his features regular rather than attractive, his eyes blue and somewhat weak, his neck over thick, his belly prominent, and his legs very slender.” (Nero 51)
  17. Suetonius, Nero 51.
  18. Suetonius, Nero 35.
  19. For further reading on depression risk factors, see: Fendrich, Warner and Weissman (1990) For Nero’s early life see: Geer (1931).
  20. Pliny, Naturalis Historia 33.54.
  21. For this translation, see Champlin (2005). For another popular translation, “What an artist dies in me!” see Gyles (1962).


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