The marriage of Patrick Henry and Sarah Shelton in 1754 certainly got off to a good start. Her parents provided them both with a fine dowry including a 600-acre tobacco farm in Virginia called Pine Slash, a house, and six slaves. Patrick's early attempt at becoming a gentleman farmer ended due to a disastrous drought in Virginia and a fire in 1757 that destroyed their house. Patrick sold the slaves and used the profits to open a store which also failed. Despite these setbacks, his self-taught law skills and talent for oratory earned him public attention and launched him on a political career. Patrick later purchased a new plantation and all seemed to be well, except...
By 1771 and after the birth of her sixth child, Sarah's mental health had deteriorated rapidly. Diagnosis on the basis of historical accounts is always a tricky business and the exact nature of her illness is open to debate (post-partum depression is one possibility) What is not in debate is that Sarah was no longer able to care for herself or her children. For families with mentally ill members, there were few options in those days. While the colony of Virginia had a lunatic asylum in operation, the standard of care for inmates left much to be desired. Treatment was nonexistent and it was primarily a place where the mentally ill could be held against their will (and out of sight). Placing Sarah in such an institution was not an option for Sarah's family and she would spend the rest of her life being cared for on the family plantation. For her own protection, she was confined to a large cellar room which, no doubt, worsened her condition although her family ensured that it was as comfortable as possible.
Sarah eventually died in 1775 without ever having recovered her sanity and she was buried in an unmarked grave on the plantation. Her death hit her husband hard and when he made his famous "Give me liberty or give me death" one month later, it was likely that the memory of his dead wife made it especially poignant. He would later remarry and his stature as a politician would ensure him a permanent place in U.S. history but there is little to mark Sarah's life except as a footnote in her husband's biography.
For generations after Sarah's death, families with mentally ill members would be forced to make the same harsh choices that her family did. Spontaneous recovery from mental illness rarely occurred, especially in the cramped, underserved hospital settings that most mental patients were forced to endure. It wasn't until the late twentieth century that effective treatment would make hospitals into something more than a place to warehouse those considered too insane to be accommodated in society. While the stigma of mental illness continues and downsizing of psychiatric services means that too many of the mentally ill are wandering the streets,we've hopefully moved somewhat beyond the era of madwomen locked in cellars. At least, in this part of the world.