psychogenic death

A recent press release discussed the phenomenon of psychogenic death, in which an individual can pass away from giving up.

“Psychogenic death is real”, says Dr. John Leach, a senior research fellow at the University of Portsmouth in England. The phenomena of “give-up-itis” is real enough to cause concern among medical professionals. Once a person feels defeat, gives up on the fight for life, death usually follows within three weeks.

The phenomenon of psychogenic death is not linked to depression, nor is it suicide. It usually follows a trauma, where the person feels that there is no other way out, and “death seems like the only rational outcome”, as stated in a recent press release.

Give-up-itis is believed to be caused by changes in a frontal-subcortical circuit of the brain, which controls goal-directed behavior. Specifically, the anterior cingulate circuit, which initiates this goal-directed behavior and is responsible for motivation, begins to malfunction. Once motivation fades away, apathy arises in the patient.

As reported in a recent press release, Dr. Leach describes five stages for the development of psychogenic death. Throughout these stages, there is still hope to be able to reverse the process of give-up-itis. This is usually done through physical activity or a regained sense of control over one’s situation. These are believed to work through the release of dopamine neurotransmitters.

The five stages of psychogenic death

1. Social withdrawal

Following a trauma, the individual may begin to withdraw, showing a lack of emotions and drive, as well as indifference. This may serve as a coping mechanism. Left untreated, this can escalate to further, more severe stages.

2. Apathy

This can be considered an emotional death, or “a demoralizing melancholy different to anger, sadness or frustration.” The person no longer strives to preserve their life. Some “describe it as a severe melancholy, where even the smallest task feels like the mightiest effort.”

3. Aboulia

A combination of a severe lack of motivation and an inhibited emotional response. The person lacks initiative and is unable to make decisions. At this stage, the patient is likely to not be speaking, washing or eating, and withdraw further from the outer world. Here, the person cannot motivate themselves but is completely dependent on others for motivation. It can be described as a state of inertia.

As Dr. Leach describes it: “An interesting thing about aboulia is there appears to be an empty mind or a consciousness devoid of content. People at this stage who have recovered describe it as having a mind like mush, or of having no thought whatsoever. In aboulia, the mind is on stand-by and a person has lost the drive for goal-directed behavior.”

4. Psychic akinesia

A state of severe apathy, where the person is still conscious yet unaware of even acute pain. The person will not react even if they are hit. Often, they can be incontinent and will continue to lie in their own waste.

5. Psychogenic death

“The disintegration of a person”. Dr. Leach describes cases from concentration camps, where the person reached this stage and was known to be close to their deaths. They will light up a cigarette, a precious commodity which could be used to obtain food. “When a prisoner took out a cigarette and lit it, their campmates knew the person had truly given up, had lost faith in their ability to carry on and would soon be dead.”

This sudden change, the sudden enjoyment of a cigarette, for example, is known to accompany the last stage. There is a sudden surge of goal-directed behavior. However, the goal itself is actually the abandoning of life.

Written by Maor Bernshtein

Reference: People can die from giving up the fight. (2018, September 27). Retrieved October 8, 2018, from https://www.eurekalert.org/pub_releases/2018-09/uop-pcd092018.php

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