A lack of motivation or willpower can do a lot of damage to our lives, but most of us only suffer it in small bouts from time to time.
But what if giving up on life resulted in death?
Sadly, in some cases, it can happen and it’s called ‘psychogenic death’.
As intense as it is, psychogenic death can be prevented as long as people know what signs to look out for.
And, even though it’s been around for a long time, new research has shed some light about how these unexplainable deaths might happen in even healthy people.
In this article, we’re going to find out more about psychogenic death, from the science behind it to the stages that contribute to it.
What is psychogenic death?
Many of us will remember reading stories of old couples who die within hours of each other (from grief), and films often show people dying simply from a broken heart.
It seems that their loved one’s death leaves them with nothing to hold on to, no purpose or reason to live anymore, so they let go and give in to death.
Is it that their experience has such an impact on them that they can’t seem to find an escape, leaving only one fatal option to end their pain?
Unfortunately, there’s no explanation or physical reason for their death – it’s an emotional and mental death which is also called ‘giving-up-itis’ (GUI).
“The term give-up-itis was coined by medical officers during the Korean War (1950-1953). They described it as a condition where a person develops extreme apathy, gives up hope, relinquishes the will to live and dies, despite the lack of an obvious physical cause.”
Dr. John Leach, a senior researcher at the University of Portsmouth, identified the stages that happen during GUI during his research into psychogenic death:
“The study found that people can die in as little as three days in the wake of a traumatic life event if they cannot see a way to overcome it. The term ‘give-up-itis’ was invented during the Korean War, when those being held prisoner ceased to speak, stopped eating and died quickly.”
He also mentions that psychogenic death isn’t considered to be the same as suicide, nor is it linked to depression.
So what causes people to die from giving up on life? If it’s not to do with depression, are there other scientific reasons for them to give up so drastically? Read on to find out the causes of psychogenic death.
What causes psychogenic death?
It’s generally believed that trauma is the main cause of psychogenic death because the sheer amount of stress leads the person to accept death as a way of coping.
Many cases of psychogenic death can be seen in prisoners of war who have faced a lot of physical and psychological damage – accepting death is their way to end the trauma and pain.
It’s also been noted for people who have undergone surgery and believed that it was unsuccessful. In one case, a man still had back pain after surgery and he thoroughly believed that the surgery hadn’t worked.
He died the next day and the toxicology, autopsy, and histopathologic showed no signs as to the cause of death.
What’s the science behind psychogenic death?
According to Dr. Leach, although these types of deaths seem unexplainable, it may be something to do with a change in a frontal-subcortical circuit of the brain, more specifically the anterior cingulate circuit.
This particular circuit is responsible for higher-level cognitive functions which include things like decision making, motivation, and goal-oriented behavior, and Dr. Leach says:
“Severe trauma might trigger some people’s anterior cingulate circuit to malfunction. Motivation is essential for coping with life and if that fails, apathy is almost inevitable.”
This circuit is also associated with dopamine, which is essential for regulating stress reactions and promoting motivation.
Because of this imbalance and the changes in the anterior cingulate, the person can lose the will to even survive because their motivation levels hit an all-time low.
Even basic needs such as eating, bathing, and interacting with others appear to be given up on, and people end up forming a vegetative state of mind and body.
The 5 stages of giving-up-itis
These are the 5 stages that a person goes through when they experience a psychogenic death, and it is important to note that intervention can take place at each stage and potentially save the person from dying.
1) Social withdrawal
The first stage of GUI tends to happen straight after psychological trauma, for example in prisoners of war. Dr. Leach believes that this is a coping mechanism – resisting outward emotional engagement so that the body could focus on its emotional stability.
If left unaddressed, the person will start to experience extreme withdrawal from outside life and may experience the following:
- Reduced emotions
Apathy is a state which happens when a person loses all interest in socializing or having a life. Put simply, they stop caring about everyday things, even their passions, and interests.
Signs of apathy include:
- A lack of energy or motivation to do normal everyday activities
- Having zero interest in experiencing new things or meeting new people
- Little to no emotion
- Not caring about their problems
- Relying on other people to plan their life out
Interestingly, apathy doesn’t fall under the category of depression, even though both have similar effects. In the case of apathy, the person just doesn’t feel anything; their whole motivation towards life is lost.
The third stage in psychogenic death Aboulia which makes a person lose all desire to look after themselves.
“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 behaviour.”
Signs of aboulia include:
- Being emotionally indifferent
- Losing the ability to speak or move
- Not having any goals or plans for the future
- A lack of effort and productivity
- Avoiding socializing with others
4) Psychic akinesia
In this phase, people become in a state of existence but they’re barely holding on. They’re completely apathetic by this point and may even lose the ability to feel intense pain.
Signs of psychic akinesia include:
- A lack of thought
- Motor deficit (the inability to move)
- Insensitivity to extreme pain
- Reduced emotional concern
In this state, people can be found lying in their waste, or not even reacting when being physically abused – they basically become a shell of a person.
5) Psychogenic death
The final stage in GUI is death itself and it normally happens 3-4 days after psychic akinesia kicks in.
Dr. Leach uses the example of cigarettes smoked by prisoners in concentration camps. Cigarettes were very valuable, often used to barter for food or other essentials, so when a prisoner smoked their cigarette, it was a sign that death was closing in.
“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.”
He goes on to explain that even though it seems like there’s a little spark of life left in the smoking of the cigarette, it’s actually the opposite:
“It appears briefly as if the ’empty mind’ stage has passed and has been replaced by what could be described as goal-directed behaviour. But the paradox is that while a flicker of goal-directed behavior often takes place, the goal itself appears to have become relinquishing life.”
The prisoner achieved their goal, and could then go on to die. This stage includes the complete disintegration of the person, and very little can be done to pull them back to life.
Different types of psychogenic death
Psychogenic death isn’t a one size fits all situation. There are many reasons why people might start giving up the will to live, and what affects one person might affect another in a much more harmful way.
Also, trauma isn’t the only cause of psychogenic deaths – things such as strong beliefs in black magic or deprivation of affection can also make people give up on life.
Let’s look into this in a bit more detail:
One of the reasons why voodoo deaths can be classed as psychogenic deaths is because, for some people, the belief in black magic is extremely strong.
So strong that they can become fixated on it if they believe they’ve been cursed, and in time this can cause death because the person expects it to come true.
In the case of voodoo deaths, people who feel that they’re cursed often experience incredible levels of fear (anyone who has played the ouija board will know what I’m talking about) but also curses that come out of hatred and jealousy from others.
In 1942, physiologist Walter B. Cannon published his finding on voodoo related deaths:
“In it, he relays the concept of psychogenic death some scientists have come to refer to as the Hound of Baskerville effect whereby individuals convinced of some bad omen or curse, literally stress their bodies to the point of death.”
And, whilst not everyone believes in black magic, there are still many countries where it’s seen as a serious subject – and one to fear. This belief then makes it all the more real, and the person begins to shut down out of fear or stress.
The term hospitalism was mainly used in the 1930s as an explanation for children who died after spending long periods in the hospital.
Pediatricians believed that the children passed away, not through being malnourished or sick, but from a lack of attachment to their mother, and as a result very little affection.
The intense separation and feeling of abandonment from their family had such a profound effect on the children that they began to resist basic needs such as eating or drinking – basically giving up on life.
Can it be cured?
Although it sounds pretty hopeless, psychogenic death can be prevented as long as intervention happens as quickly as possible.
One of the most important factors in prevention is to give the person reasons to live, as well as helping them gain back their perception of having full control over their life.
And, of course, whatever trauma they experienced in the past needs to be dealt with professionally so that the person can begin to heal their wounds and put the past firmly behind them.
Dr. Leach says:
“Reversing the give-up-itis slide towards death tends to come when a survivor finds or recovers a sense of choice, of having some control, and tends to be accompanied by that person licking their wounds and taking a renewed interest in life.”
Other things that might help someone who is experiencing psychogenic death include:
- Having a social life
- Increasing healthy habits
- Having future goals
- The use of medication in some cases
- Addressing dysfunctional beliefs
As Ideapod’s founder, Justin Brown, explains in his article on 7 powerful reasons to live:
“You have incredible value just for being you. You don’t need to achieve anything to have value. You don’t need to be in a relationship to have value. You don’t need to be successful, make more money, or be what you may judge as a good parent. You just have to keep on living.”
For people suffering from psychogenic death, sometimes the most important thing is to remember their self-worth and their value in this world.
Their past experiences will have affected them greatly, but with love, support, and a lot of encouragement, they can be brought back to life (quite literally).
Psychogenic death still needs more research into how many people it affects around the world, and if there are any other changes in the brain’s functioning that can cause people to give up on life.
But, one thing is for sure, our brains have an incredible amount of power, so much so that it can create mechanisms for survival which actually lead to our demise instead.
With more understanding of psychogenic deaths, and with the work of Dr. Leach on GUI, psychologists and doctors alike may be able to identify what’s going on sooner rather than mistakenly terming people as depressed.
With this, there is the hope that unnecessary deaths could be prevented and people suffering from the condition will be able to regain their spark and motivation for life again.