I think that most people have been near an aging or terminally ill loved one and, after they were gone, realized that there was a moment when the person simply decided that they were done living.
The first time I ever heard about this phenomenon among healthy, younger people was when I was researching voodoo for a book I wrote. I learned that a good percentage of people – young, healthy people – hexed by a voodoo master will actually die.
Like, just because they believe with their whole hearts that it’s inevitable.
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The actual scientific term for this is “give-up-itis,” and even though the medical community recognizes that is is a real thing that occurs, they’re still not entirely sure how a person manages to up and die without a single physiological cause.
Doctors and other observers first described the phenomenon among South Korean soldiers dying in POW camps during the war, and it has since been since to other POWs, shipwreck survivors, and even concentration camp inmates, based on firsthand testimony.
Scientists believe that a psychologically traumatic situation that feels inescapable is a hallmark of the condition, and is always present before the patient responds with extreme apathy, withdrawing from social situations, and entirely giving up on living.
While examining historical and modern records, University of Portsmouth research fellow Dr. John Leach concluded that give-up-itis might be more prevalent than previously thought – cases have been noted going back as far as the 1600s – and set out to provide the first-ever description of its clinical markers.
He published an article in Medical Hypotheses in which he listed a pattern of 5 phases and hypothesized on the brain activity that underlies each one.
“Psychogenic death is real. It isn’t suicide, it isn’t linked to depression, but the act of giving up on life and dying, usually within days, is a very real condition often linked to severe trauma,” Leach said in a statement.
He believes that it’s essentially regarded by the sufferer as the best possible coping mechanism – the only real way out of their predicament.
The first phase he’s called social withdrawal, and, unchecked, it will lead directly into the next phase: apathy, which he describes as “shut in profound inertia.” Patients will stop cleaning themselves, and eventually progress to stage three, aboulia, where they cease all daily tasks, including speaking and eating.
“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.”
Next is stage four, which he calls psychic akinesia, where the person stops responding to physical stimuli (even intense pain), and finally, the person just dies.
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“They might be lying in their own excreta and nothing – no warning, no beating, no pleading can make them want to live.”
Leach thinks the phases are linked to a specific brain region, the anterior cingulate circuit. The region is involved in motivation and initiation of goal-directed behavior, and the trauma disrupts dopamine signaling.
Death is not inevitable, according to past observations, and people have recovered from stages one through four when someone or something has given them a reason to engage with reality again.
The farther a human descends down the list of these phases, though, the more difficult it is to pull them back out again.