William Shakespeare’s Macbeth is not only a classic revenge tragedy but a powerful exploration of psychological trauma and the unraveling of the human mind. Set in Scotland, the play follows Macbeth, who, in the beginning, was a loyal soldier and nobleman, but ends up descending into paranoia and guilt after murdering King Duncan to gain the throne. At first, Macbeth is praised for his courage. Yet, as the play progresses, this once loyal soldier becomes consumed by himself and haunted by the consequences of his actions. This transformation is not only a moral analysis but also a psychological one.
Although Macbeth predates the modern understanding of mental health and psychology, Shakespeare portrays Macbeth’s pathway into madness through symptoms that align with the modern diagnosis of post-traumatic stress disorder (PTSD), insomnia, and paranoia. Through Macbeth’s unraveling, Shakespeare shows the readers how violence and guilt can trigger the human psyche, revealing the psychological costs of ambition and trauma.
To better understand the creation of Macbeth in relation to mental health, there has to be an understanding of how mental health was viewed when Macbeth was written in 1606. In the 16th and early 17th centuries, mental illness was viewed as a supernatural event; it was believed to be a demon that took over an individual’s body or was linked to sin and not seen as an illness (Mental Illness in the 16th and 17th Centuries | Historic England, n.d.).
When filtered through the modern psychological lens, Macbeth’s descent seems quite similar to what we now call post-traumatic stress disorder. PTSD is a mental health condition that is caused by an extremely stressful or terrifying event that one either experiences or witnesses. Potential symptoms are flashbacks, nightmares, severe anxiety, and uncontrollable thoughts about the event, as defined by the Mayo Clinic (Post-Traumatic Stress Disorder (PTSD), 2024). For a better understanding of post-traumatic stress disorder, refer to this video, Understanding PTSD.
A quote that suggests that Macbeth may suffer from the diagnosis of posttraumatic stress is as follows, “For brave Macbeth – well, he deserves that name-/ Disdaining fortune, with his brandish steel / Which smoked with bloody execution, / Like valour’s minion carved out his passage / Till he faced the slave” (Shakespeare, 2024.1.2.16-20). This quote particularly stands out in the idea of the modern concept of post-traumatic stress disorder, as it suggests that Macbeth had already potentially been affected by trauma caused by battle. The line “which smoked with bloody execution” implies that Macbeth had already been accustomed to death and bloodshed, which helps set the parameters of Macbeth’s inevitable mental downfall.
Due to the repeated exposure to violence and death he saw as a soldier, he is left vulnerable to intrusive thoughts and paranoia. From the story’s beginning, Macbeth is presented as a superior warrior, previously labeled as “brave Macbeth-well deserves that name” (Shakespeare, 2024, 1.2.16). This title foreshadows Macbeth’s identity and strong connection to violence, as he believes that his sole purpose and masculinity are intertwined by his ability to kill for honor, creating a disturbingly seamless transition from an honorable soldier to a murderer. As a man who has spent years in bloody environments, Macbeth’s psyche is pre-conditioned to justify death as his civil duty.
In Act One alone, the readers can see a transition from a loyal soldier to his darker side. “My thought, whose murder yet is but fantastical, / Shakes so my single state of man” (Shakespeare, 2024, 1.3,139-140). In this quote, Shakespeare reveals the first pillar of Macbeth’s psychological deterioration and collapse. At this point, there has yet to be any physical act of violence, but the readers can see how the thought of murder is enough to destabilize Macbeth. The word “fantastical” suggests that the thought is both imaginary and intrusive and out of his control. As Bockaj notes, the imaged dagger and other intrusive thoughts and visions act as “manifestations of a traumatized mind unable to distinguish between reality and the violent memories that haunt it” (Barbara Bockaj, n.d.).
This aligns closely with the experiences of those with post-traumatic stress disorders as well as obsessive disorders, where violent and unwanted images force themselves into the conscious mind. His “single state of man” being “shaken” seems to show a fragmentation of the way he views himself. Specifically, the soldier’s purpose, which was once defined by loyalty and discipline, has now been taken over by a psychological conflict that he cannot get under control. This specific quote seems to mark Macbeth’s descent into obsessiveness. This suggests that his downfall doesn’t begin with Duncan’s death but when he realizes he has no control over the obsessive-compulsive thoughts that are inside his head.
The murder of Duncan is the last pillar that triggers Macbeth’s full psychological break. This event is marked by hallucinations, guilt, and insomnia, key symptoms of post-traumatic stress disorder and a destabilized mind. In the moments leading up to the murder of Duncan, Macbeth imagines a floating dagger, and this becomes the first clear sign of his mental health downfall. He asks, “Is this dagger which I see before me, / The handle toward my hand?” (Shakespeare, 2024, 2.1.33-34). The imagined weapon blurs the boundary between reality and hallucination, highlighting both the intrusive thoughts and violent images that fill his mind.
Much like trauma survivors who experience flashbacks, Macbeth is unable to distinguish between his own thoughts and reality. The dagger, which is pointing towards Duncan’s chamber, shows Macbeth’s underlying thoughts and the psychological pressure he feels. This moment in the story highlights how Macbeth’s previous exposure and history as a soldier has become the perfect breeding ground for further mental health issues, as his brain begins to work against him.
Following the death of Duncan, Macbeth’s psychological state further deteriorates as he begins to hallucinate and shows symptoms of profound anxiety. At one point, hearing a voice cry out, “Macbeth does murder sleep” (Shakespeare, 2024, 2.2.36). This line intertwines both guilt and insomnia. Sleep, which is often associated with peace and restoration, becomes impossible for Macbeth. He remains trapped in a state of hypervigilance as he is unable to sleep, both symptoms being closely related to PTSD. The voice represents his own subconscious and the internal torment of his “sin”. The inability to sleep is an underlying issue and a sign of how the trauma that he endured cracks his psyche, leaving him in a cycle of anxiety and sleepless nights that mirrors the same symptoms of trauma-induced insomnia. Bockaj links this sleeplessness to “hyperarousal and obsessive rumination,” Psychological responses that are typical among individuals suffering from combat-related trauma (Barbara Bockaj, n.d.).
His psyche unravels more with the restless nights and culminates in an obsessive guilt. At one point, this is portrayed within the quote “Will all great Neptune’s Ocean wash this blood / Clean from my hand?” (Shakespeare, 2024, 2.2.60 – 61). The imagery Shakespeare has written of this unremovable stain symbolizes moral corruption and the persistent memory that will not go away. These obsessive-compulsive thoughts are characteristic of trauma responses, where individuals relive traumatic events through intrusive, consistent thoughts and memories. For a simple explanation of obsessive-compulsive disorder, please click this link.
Macbeth’s fixation on his “bloody hands” can also be seen through the modern diagnosis of trauma-induced obsessive-compulsive behavior. This is a psychological disorder that is often linked to post-traumatic stress disorder. The repeated attempts to cleanse himself may relate to the overwhelming feelings of guilt and contamination that some trauma survivors feel. His desperate attempts to remove the imagined blood can be seen as a compulsive behavior, like individuals with OCD, he seeks a temporary relief from the intrusive thoughts through these repetitive actions.
Macbeth’s “madness” is not only a theatrical exaggeration but a psychologically grounded portrayal of the natural trauma of nature. Macbeth’s obsession with cleanliness, insomnia, and hallucinations demonstrates how post-traumatic stress can evolve into obsessive-compulsive disorder when the guilt becomes too much to handle and becomes all-consuming. Throughout the storyline, Shakespeare creates an image of a man who is unraveling through psychological trauma and obsessive fixation. Macbeth’s hallucination and guilt reflect an individual who is unable to handle and cope with traumatic experiences.
As Macbeth’s mental decline continues, his guilt transforms into paranoia and delusion, and these symptoms seem to get stronger. In Act Three, Scene Four, the ghost of Banquo appears when Macbeth is at a dinner party; previously, his hallucinations only occurred when he was alone, making it evident that Macbeth’s hallucinations are getting stronger and he is beginning to lose all control of his mental deterioration. Macbeth begins to project his guilt onto the hallucinated Banquo in the line “Thou canst not say I did it: never shake/ Thy gory locks at me” (Shakespeare, 2024, 3.4.50-51).
In the following lines, “Sit, worthy friends: my lord is often thus, / And hath been from his youth: pray you, keep/ seat; / The fit is momentary; upon a thought / He will again be well: if you much note him” (Shakespeare, 2024, 3.4.53-57). The reader can see the historical idea of “madness” as Lady Macbeth admits that Macbeth is unwell and that it will be okay if ignored. She makes sure that nobody suspects that anything is wrong, So they don’t find out about the murder, and so they will not find out about Macbeth’s mental decline.
Lady Macbeth also exhibits some trauma responses within Act Five, Scene 1, “Out damned spot! Out, I say!” Lady Macbeth’s compulsive handwashing creates a psychological representation of repressed guilt, which manifests as an obsessive behavior. Her fixation on the imagined bloodstain symbolizes the intrusive traumatic memories in her consciousness, a symptom associated with PTSD and OCD. As the instigator of Duncan’s murder, her mind is full of constant reminders of the murder and then attempts to cleanse herself of the act, as though she may be able to erase her “sin” if she cleans herself enough.
The statement “Out damned! Out, I say!” suggests both desperation and loss of control, as she externalizes her guilt. Shakespeare’s way of portraying obsessive disorders reflects on how unresolved trauma can ruin the psyche and how something that was once suppressed can resurface as a compulsive habit. Along this idea, her sleepwalking becomes a form of psychological confession. Her mind replays the crime in fragments and reveals her inner torment, which coincides with Macbeth’s own dissociation and numbness. While her psyche turns towards fixation and repetition, Macbeth spirals into violence and paranoia. Together, they create a worrying study of how guilt and trauma manifest in different, yet equally destructive ways.
By the end of the play, Macbeth’s mental state is numb, characteristic of trauma fatigue and psychological exhaustion. Once a loyal soldier with ambition, he is now hollow, unable to feel even his own wife’s death. His response to her death, “She should have died hereafter” (Shakespeare, 2024. 5.5.17), is detached and reveals that, beyond his grief, he has become numb due to his own mental state. He at once cared about the “sins” he made, but now he seems to struggle to find any reason to care. His reflection “Life’s but a walking shadow, a poor player / That struts and frets his hour upon the stage / And then is heard no more. It is a tale / Told by an idiot, full of sound and fury, / Signifying nothing” (Shakespeare, 2024. 5.5.23-28) shows the void that has been created by the psychological trauma that he endured. Macbeth seemingly is unable to find a purpose in life and is filled with emptiness.
At one point, even Macbeth himself confesses, “I have supped full with horrors” (Shakespeare, 2024. 5.5.13), a potential metaphor for his complete desensitization; he has seen and been a part of so much violence in his life that he can no longer see anything else other than violence. Macbeth’s final transformation from an honored soldier to a complete numbness is similar to the final stage of trauma, the disconnection from an individual’s self to the world. His death, both literal and psychological, can be seen as a mind that can no longer bear the weight of its own suffering, and the final release of its own mental torment.
In the end, Macbeth is not only a tragedy but a horrifying portrayal of the mind unraveling under violence and traumatic events. Shakespeare was able to capture and connect the symptoms of post-traumatic stress, with hallucinations, insomnia, obsessive compulsions, and emotional detachment, centuries before there was a diagnosis. The play produces a timeless truth, that the psychological wounds of guilt and violence are often much worse. Deeper than any physical scar.
Reference Page
Barbara Bockaj. (n.d.). Full of scorpions is my mind: Trauma in Macbeth. https://www.scribd.com/document/482077808/16-Bockaj-pdf
Mental Illness in the 16th and 17th Centuries | Historic England. (n.d.). Historic England. https://historicengland.org.uk/research/inclusive-heritage/disability-history/1485-1660/mental-illness-in-the-16th-and-17th-centuries/#:~:text=Mental%20illness%20could%20be%20seen,%2C%20astrologers%20%2D%20who%20offered%20treatments.
Post-traumatic stress disorder (PTSD). (2024, August 16). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
William Shakespeare. (2024). Macbeth
Sprockets and Springes 