22 ms·

People can die from giving up the fight

335 points by dnetesn 8y ago

fierro 8y ago
this is the saddest article I've ever read
lordnacho 8y ago
Related might be some articles about people dying when they retire. Not working and not having a purpose was, according to some of these articles I read, causal of death. Not sure how well supported.
nprateem 8y ago
As documented decades ago in "Man's Search for Meaning" by Frankl.
- fsloth 8y ago
  Which is an excellent book. In dire cirmustances - how and why can you go on. I really recommend it to everyone. In the book Victor Frankl - as a trained doctor and therapist - documents and - this should be interesting to HN crowd - analyzes his own experience as a nazi concentration camp survivor. The 'lit a cigarette' example in the article is probably borrowed from the book.
  - amelius 8y ago
    Does this book make one feel better or more depressed? The article has not a very good vibe to it, tbh.
    - martin-adams 8y ago
      I read this book a few weeks ago. It was such a surprise for what I expected. Make no mistake, it objectively talks about horrific events, but I felt humbled and appreciative of the life I have and how to deal with challenging times.
    - gerbilly 8y ago
      The book as I remember it made you feel hopeful. It is a very persuasive argument about how one can deal with even the most 'hopeless' situation. It is also a brilliant description of the psychological effects of camp life. The way he described the odd dislocated feeling they got when the allies set them free was particularly memorable for me.
      - Buttons840 8y ago
        Things like Nazi gas chambers are interesting in a horrific sort of way, but this book did not concentrate on those types of things. The book focused on things which I found to be subtly more disturbing, like the ability of an overweight Nazi guard to curse a death camp prisoner for being "swine, who doesn't know how to work!" while the prisoner is literally working themselves to death in front of the guard to just stands around being fat and worthless. Does the guard not see the irony? How is it possible that he does not? Do I myself hold any absurd views like that Nazi guard? Ultimately the book showed me that there are decent and indecent people in any group, and made me want to be a decent person. I wouldn't say the book is depressing.
    - piyh 8y ago
      It's a rational analysis of some of the worst experiences a person can go through. It wasn't written to wrench your soul like Sophie's Choice and gives a great look at the human psyche pushed to its limits.
      - amelius 8y ago
        Okay. Is it written from the point of view of the (almost) dying person, or of the bystanders?
        Boulth 8y ago
        It's written by a person that did not give up, survived and analyzed the experience. I read it previously and I highly recommend it, don't worry you won't be depressed after that. On the contrary.
    - fsloth 8y ago
      Does going to a therapist and discussing about things frankly as they are make one feel better or worse? Viktor has a very objective tone of voice. He never paints himself as a saint, a martyr or a superman. This creates a certain feeling of detachment that shields from the full emotional impact of what he actually went through. Overall, however, the book is about survival and the strength of human spirit. Especially since Mr. Frankl personally went through hell, retained his sanity and will to live, and wrote the book. It's a book that gave me hope and strength in dark times.
    - mettamage 8y ago
      For me it felt a bit like a science book with fascinating insights. Yes, what happened in those places was awful but that wasn't the focal point of the book IMO. The focal point is an analyzed account of how people have a higher (or lower) chance of survival in such a dire setting. Also his book are secretly 2 books for which this part is the first part. The second part is about Logotherapy, something he developed after WWII based on the insights he gained from people in concentration camps.
- sigvirt 8y ago
  Anne Applebaum's book Gulag describes similar psychology and social dynamics. It's an epic work of scholorship that examines the surrounding society as well as the camps and the prisoners. A wide range of inmate experience shows through because of varying lethality of camps and some longer resulting timelines, in contrast for example to Kiernan and Cambodia where the end was often more prompt.
nostromo 8y ago
How on earth do you separate causation from correlation in such cases? To actually know this you'd need a group of random patients to "give up the fight" and compare them to a control group. And you'd need the caregivers to not know which group is which. A coach tells the team: "you lost because you gave up" -- to which they respond, "we gave up because we lost."
- diminoten 8y ago
  The point is the team didn't lose until the game was over, but they stopped trying before the game was over, and perceived the outcome as inevitable. The coach is trying to tell the team that giving up before the outcome is actually certain is what caused the loss, and the team is incorrect to claim that they had lost before they actually had.
- gowld 8y ago
  You can tease it apart by carefull measuring the order in which events occur. In medicine, you can measure various biological entities as well as psychological profile, and see to what extent psychologcal changes can affect biological changes. (Of course, psychology itself is in large part its own biological process.) But you can do experiments like psychological interventions (counseling, inspirational/depressing media content) and see if some tend to cause statistically significant biological changes. There are some obvious cases like if you hurt yourself and don't care enough to clean up or seek care, you risk infection or permanent injury.
- deleted 8y ago
  [deleted]
- tonyedgecombe 8y ago
  Atul Gawande's book mentions a study that showed people who received hospice care lived longer than those who got chemotherapy.
  - cyberpunk0 8y ago
    Well yeah... Chemo is incredibly difficult on the body, not surprising it would significantly shorten your lifespan.
eezurr 8y ago
This reminds me of a short novel I had to read back in elementary school. I think it was called "Thunder Rolling in the Mountains" (yes). The Native Americans were fleeing the colonials all the way up to the Canadian boarder. Later on, during the treaty process, they are given a relatively small parcel of land to rebuild their home. The book ends with Chief Joseph of the Nez Perce dieing from a "broken heart". I thought that was bullshit and that the author was using a euphemism for a heart attack. ~20 years later I guess I am proven wrong.
- nostromo 8y ago
  He died of heart failure. The "broken heart" line was poetic license from his caregiver.
  - MisterTea 8y ago
    I mean it still perfectly describes what happened. His heart done broke.
johnchristopher 8y ago
I don't really get why the article leaves out how malnutrition is certainly an essential factor in that process, especially since it offers examples from people dying in concentration camps.
kazinator 8y ago
> 'give-up-itis', a term used to describe what is known medically as psychogenic death. I have found my new metal band name, and feel freshly inspired to write some new tunes. Ladies and gentlemen, give it up for Give-up-Itis!
- TuringTest 8y ago
  Just to be clear: Psychogenic Death is the name of the band and Give-up-Itis is the tune, or is it the other way around?
daphneokeefe 8y ago
I know of two cases in my own family where one elderly spouse died, and the other announced that they did not want to go on, and they died within about a week.
- phkahler 8y ago
  A friend of my mom died and his wife died sitting in her car just as they were about to begin the procession. Nice couple, married for a long time, shared some of the same odd characteristics. I don't recall what he died of or if there was indication it was coming, so it's not clear how far down this progression she was or how fast it hit. It was sad but also the thought of a couple meaning that much to each other is rather touching.
  - paublyrne 8y ago
    It could also be a coincidence.
- agumonkey 8y ago
  I had this, I was in very good shape (15s~ for 100m sprint sets for fun) and nearly died of grief. If you're old and your system is frail, I can easily see how your emotional state could disrupt it. These bonds root deep in us.
  - agumonkey 8y ago
    ps: to add some details, here are a few hypothesis (AFAIcan understand) - tako tsubo syndrom, emotional shock => hormone cascade => myocard deformation to the point of uselesness - arteries constrictions, nearly all your arteries (even micro capillaries) have tiny valve-rings, since fear can induce vasoconstriction to ensure high blood supply, I think high anxiety can force your system in that state for prolonged amount of time which will lead to blood flow disruption (tiny clots, mild hypoxia) and derail organs on the way.
- macintux 8y ago
  My grandmother has not wanted to go on for 15+ years now after my grandfather died, yet she's still here, and doing relatively well for a 95-year-old. I definitely think there's a correlation between your mental and physical health, but it's definitely not a simple one.
nathanvanfleet 8y ago
Using the term "give-up-itis" discredits this article. It's like describing it as a "case of the mondays" when you die.
- gph 8y ago
  No it doesn't. They use the proper medical term in the very same sentence, and continue to use psychogenic death except in a direct quotation from a doctor. You have to be pretty damn anal to think using a colloquial term suddenly discredits all the other information in that article.
  - felipemnoa 8y ago
    >>You have to be pretty damn anal to think using a colloquial term suddenly discredits all the other information in that article. There is some validity to his point though. Every time I read the word "give-up-itis" I reflexively feel negative feelings towards the article. It feels as if they are trying to be funny but not in a good way.
    - waterhouse 8y ago
      I actually think "give-up-itis" is a more specific term than "psychogenic death", and is a better descriptor for what they're talking about. First, "psychogenic death" just means a death caused by the mind, without any specifics about how the mind caused it—e.g. if you think about something really scary and make your heart rate jump up and manage to give yourself a heart attack, it seems like that might qualify as a "psychogenic death" (I imagine there'd have to be other things wrong with your heart for that to tip you over the edge, but I'm not an expert); whereas this is about a mechanism involving some kind of apathetic mindset. Second, "psychogenic death" can only apply after the person is dead; it doesn't describe someone suffering from the same mechanism that hasn't killed them yet. Maybe "psychogenic decay"? (But again, that doesn't specify the mindset involved; perhaps someone who spends all their time experiencing pain, or anger, or something else would decay in a different way.) If they had to come up with a "medical" term for "give-up-itis", I might guess it'd be "apathetic psychogenic decay", or else some Latinized phrase. https://translate.google.com/#auto/la/disease%20of%20giving%20up https://translate.google.com/#auto/la/disease%20of%20giving%... yields "De morbo dare sursum", who knows. I also suspect this research is early enough that it doesn't make sense to choose an official term and commit to it yet. I am in favor of people not polluting the namespace of terms with things that, upon closer examination, should have been named something else.
innocentoldguy 8y ago
I experienced going down this path. I was recently in an accident and shattered my spine. If it hadn’t been for the support of my family, I don’t think I’d still be here. Life seemed to be a pointless and miserable dead end and I was ready to go. Fortunately, my family helped me work through it and I survived.
- barking 8y ago
  Well done yourself as well as your family.
- throwaway413 8y ago
  I’m glad you’re here.
- photik 8y ago
  Yeah, bravo. It's good to hear that other people aren't giving up.
amelius 8y ago
Is this related to "depersonalization" as experienced e.g. by people with extreme anxiety?
- WalterSear 8y ago
  This is driven by depressive, anhedonic mechanisms, rather than anxious or dissociative ones.
- randyrand 8y ago
  I definitely noticed a similarity to DP. Resonated with me.
srinivgp 8y ago
People can also suffer greatly from not giving up the fight.
typetehcodez 8y ago
In it's most basic premise, life is perplexingly defined as "not death". And what is life other than a struggle to fight entropy? Sisyphus is happy, and I would argue - alive! https://medium.com/@mustaphahitani/camus-suicide-and-imagining-sisyphus-happy-bec124dad750 https://medium.com/@mustaphahitani/camus-suicide-and-imagini...
jrlocke 8y ago
Wet streets cause rain.
- coldtea 8y ago
  Superficial readings cause facile dismissals.
harveywi 8y ago
I can relate, I die a little inside each time I read a post on HN.
- dmarlow 8y ago
  How about when you come across a comment like yours?
  - fb03 8y ago
    He then dies a lot harder than 'a little', probably.
- kvartz 8y ago
  Why are you even here?
woop-throwaway 8y ago
I smell bullshit. After my own trauma I went to sleep with a prayer “please god don’t wake me up the next day”, for a year. Thankfully one can’t get a gun easily in Europe, otherwise I won’t probably be writing this... and I haven’t experienced even an appetite loss, not saying about social etc. After SSRIs I’m not that anymore, but I’m still ready to give up at first chance, just I know at worst I lose a job and a house. But death.. for good or bad, it doesn’t work that way.
- andrewmcwatters 8y ago
  I don't mean to dismiss your experience, but this is such a super-tunnel vision point of view there's nothing here to gain. Your sample-size is one person, and for some reason you bring up gun control laws, which changes the course of discussion. Of course many people with depression don't just die of being depressed. That's not what this article is describing. Depression isn't severe trauma. Severe trauma can cause depression, and what's explained here, is that it can cause death by psychosomatic cause.
  - aaron695 8y ago
    Most gun deaths are sucide. It's very high for men (I assume OP is male cause of this) USA is very unusual that gun sucides are only double other guns deaths. Europe is much different. You could argue removing sucide by gun just means sucide moves to other methods but I'd say the data doesn't show this and OP thinks this as well for them. No one is strongly arguing this here, it was just an off the cuff point. Their story is one of the better comments here. ( The article is bullshit as others have pointed out, it's possible dangerous as it almost is saying depression and death is a choice )
- coldtea 8y ago
  >After my own trauma I went to sleep with a prayer “please god don’t wake me up the next day”, for a year. Well, what one consciously expresses is not always a match for their inner state. Second, it's another thing to say "oh god, take me now" than to consider yourself as nearing death. One is a kind of negative wish, while the other is how you view yourself objectively to be going to. Besides, biological processes are not physical laws. They are statistical phenomena, and people can differ. It's what happens in the aggregate and for most that's examined. In that sense, a counter-example is not enough to take down the phenomenon. In any case, glad it worked out for you.
drakonka 8y ago
This has also been known to happen among African cichlids, a type of fish. I'm sure it's likely other animals are affected as well but I have cichlids myself, so I have more context with them specifically. Cichlids tend to be highly territorial and socially competitive. They're constantly vying for some rock or hole to "own". Usually it is recommended to overstock a cichlid tank slightly in order to disperse aggression. With three fish it's easy for the most aggressive alpha to pick on and injure the weakest link. With twelve fish the most aggressive alpha will have that many more others to compete with/take out his aggression on. Sometimes, however, the weakest link still emerges. When this happens multiple fish might pick on the weakling and chase him/her around, disallowing them from entering any kind of territory among the rocks (they like rocks). They drive this weaker fish to stay toward the top reaches of the tank. Eventually the fish just starts hanging out there naturally because it knows it'll get bullied if it comes down. Then, after some time of giving up on fighting for its own territory and competing with the other fish, the weakling just...gives up. Even if the other fish have left them alone by then, and the fish isn't physically injured or lacking food or anything, the fish doesn't even try to reenter "society" anymore and just...dies. I got my cichlids a couple of years ago and have since decided that while I will continue to care for these fish as best I can as I took on that responsibility, I'm not going to be getting any more fish for ethical reasons.
- dcow 8y ago
  What are the ethical reasons? Do you find it unethical to foster a species that behaves in such a way? Strictly curious.
  - deleted 8y ago
    [deleted]
  - drakonka 8y ago
    After getting fish and seeing them in captivity first hand I've decided that I don't think it's ethical to keep fish in captivity in general. As good a home as I try to give them, they're still wild animals in a little box. I think no matter the size of my aquarium or the effort I put into water maintenance, providing suitable rocks, etc, all of my effort and good intentions will never compare to the home they are meant to have in the wild. I just feel bad for them and bad about myself for contributing to an industry that puts animals in these kinds of conditions.
petercooper 8y ago
There's an entire, and fascinating, book on psychosomatic illnesses that goes into this topic called It's All in Your Head by Suzanne O'Sullivan, an Irish neurologist. Most people seem to write off psychosomatic illnesses as they don't fit into their models of how the world should work, but their existence and ways to resolve them are well documented and doctors frequently find psychological or neurological ways to resolve or alleviate them (e.g. prescribing antidepressants to chronic pain sufferers). The book also goes into how cancer can, in some circumstances, be hugely affected by the mental outlook of the patient, but for some reason this continues to be controversial in a way that 'dying of a broken heart' is not.
- agumonkey 8y ago
  I have negative feelings toward oncology protocols because they're not capable of explaining things to patients, so they start hopeless and pick many wrong choices after diagnosis. It's .. somehow criminal to me.
- arountheworld 8y ago
  Psychosomatic is the bucket where lands everything lazy doctors don't want to investigate.
  - olliej 8y ago
    Psychosomatic is actually an interesting one -- it's not just "lazy doctors" -- there's plenty of evidence to show that the brain is totally capable of causing a range of side effects all on its own (Placebo and nocebo trials have made this clear). If you want annoying go for "Idiopathic". For example I have idiopathic optic nerve hypoplasia. The last three words mean my optic nerve is narrow than it should be - I have a gap in one quadrant of my peripheral vision - the "idiopathic" bit means they don't know why.
    - taneq 8y ago
      > the "idiopathic" bit means they don't know why. Oooh, sort of like "not otherwise specified" meaning "dunno what's going on".
706f6f70 8y ago
Head's up on the publication's goal: > Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. [. . .] Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations. Not saying it's completely without merit, but this should not be interpreted as a scientific study of any type.
- shawn 8y ago
  this should not be interpreted as a scientific study of any type. Feynman was intensely interested in the paranormal, and said that it was important for any physicist to be. Because if it were true, that's exactly where you'd find the truth. Now, I'm not standing up for alternative medicine. But the subject is beside the point. You said "This isn't science," but didn't point to any examples of why. Anyone who follows the scientific method is doing science. Science isn't an exclusive clique; everyone can do it.
- resu_nimda 8y ago
  Pretty unnecessary FUD. Did you have any objection to the actual content? How did you determine that the work was "not a scientific study of any type"? Seems un-scientific to dismiss the whole thing based on that paragraph.
  - duxup 8y ago
    I didn't read his comment as "dismiss the whole thing".
  - scott_s 8y ago
    Looking at the abstract (there are several links in the comments), I think it's accurate to say it's not a scientific study because it's not a study. That is, to me, a "study" implies some systematic examination of some observable thing. But this paper is more a formal hypothesis: the author is proposing that a particular phenomenon exists, with some anecdotal support. That means that the story title is not accurate, as it declares the thing exists, when the entire point of the paper is that it may exist.
Footkerchief 8y ago
Here's a link to the study: https://researchportal.port.ac.uk/portal/en/publications/giveupitis-revisited-neuropathology-of-extremis(1ba3ff20-86a2-4701-b6fd-776061f3191e).html https://researchportal.port.ac.uk/portal/en/publications/giv... > The term ‘give-up-itis’ describes people who respond to traumatic stress by developing extreme apathy, give up hope, relinquish the will to live and die, despite no obvious organic cause. This paper discusses the nature of give-up-itis, with progressive demotivation and executive dysfunction that have clinical analogues suggesting frontal-subcortical circuit dysfunction particularly within the dorsolateral prefrontal and anterior cingulate circuits. It is hypothesised that progressive give-up-itis is consequent upon dopamine disequilibrium in these circuits, and a general theory for the cause and progression of give-up-itis is presented in which it is proposed that give-up-itis is the clinical expression of mental defeat; in particular, it is a pathology of a normal, passive coping response. "It is hypothesized" is the closest it gets to evidence. This level of research seems to be that journal's specialty: https://en.wikipedia.org/wiki/Medical_Hypotheses#Peer_review_debate https://en.wikipedia.org/wiki/Medical_Hypotheses#Peer_review... This article is a press release that drastically overstates the already weak claims of the paper itself.
- ColanR 8y ago
  As an aside, reading the wikipedia link, it seems like that journal does fulfil a very useful function. Not that it's a publisher of accurate articles, but that it can help the medical field escape local maxima. "There are ideas that may seem implausible but which are very important if true. This is the only place you can get them published."
- dropit_sphere 8y ago
  I am actually personally acquainted with Dr. Charlton, former editor of MH. He has some legit concerns about the epistemic effects of peer review (as well as the "business" of science---obtaining grants, etc.). I'm torn, because on the one hand I wish everything from MH came with a giant "UNPROVEN AND DOES NOT FIT YOUR SCHEMA OF AN ACADEMIC PAPER" disclaimer, and that that would pass through when adapted to other media (like, say, this press release). On the other hand I basically share concerns about the peer review process and the stranglehold it can have on research.
xhrpost 8y ago
> Dr. Leach said one prisoner of war who was also a medical officer described being in this stage as waking each morning but being unable to summon the energy to do anything. Others describe it as a severe melancholy, where even the smallest task feels like the mightiest effort. I would have just assumed this to be depression or a part of it. However, the article is claiming this symptom is something different?
fokinsean 8y ago
Reminds me of how concentration camp life is described Man's Search for Meaning[0]. The prisoner's could tell when someone was about to die if they noticed them refuse to get up for work for the day or smoke their cigarettes (which were used for currency rather than smoking). This reflected them giving up hope and they would usually pass within a few days. https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning
pontifier 8y ago
This hits close to home. I've had many diverse failures in the past 2 years. Every attempt I've made to create, or build has been thwarted by corruption, power struggles, and lying theives who seem to be getting on just fine. It is totally demoralizing to feel that there is no possibility of success. Vivid thoughts of violent revenge are the only sparks of life I feel anymore.
- techsin101 8y ago
  Wow.. feel bad man
- x220 8y ago
  You should move to a different place. That's a sign that your culture (be that your acquaintances, neighborhood, city, state, country, or civilization) does not maintain an environment where you can be reasonably sure that your sacrifices will pay off, and it's easier to get by through stealing and corruption. If this is accurate, your culture will fester and die. Best to leave as soon as possible.
- throwaway5250 8y ago
  Yeah, can relate. Wish the article had more ideas on how to deal with it, rather than just describing it.
- darkerside 8y ago
  Revenge? Against whom? Please get help if you need it. I mean that sincerely.
- throwaway010718 8y ago
  It is a pity the human mind can become a dark abyss. Be careful indulging thoughts of revenge. They will subside with time, but then decades later you find yourself in a dark place again and all those re-enforced feelings will bubble up again. Thoughts of revenge are detrimental to success. You aren't guaranteed to be successful no matter how hard you try, but you certainly can't be successful if you ruminate on revenge. Please if you own a gun, then find a friend with a safe and give it to them. Liquidate all your cryptocurrency so you don't hire a hitman. Don't let this brief period destroy your entire future. There are people whose children were murdered in front of them by a Nazi soldier and never got "violent revenge" and went on to live fulfilling honorable lives. Is your injustice anywhere near as bad ? Please find the strength to find a way to get through this without resorting to violence.
deleted 8y ago
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arountheworld 8y ago
When people say medicinal cannabis doesn't "cure", they should read this. It helps people eat, sleep and be in a good mood and that provides foundation for willingness to fight. My view is that people who deny this medicine are criminals and should be brought to justice.
hi41 8y ago
Few months back I read that an article about children of refugees in Europe going into a coma like state. Could this be related?
- photik 8y ago
  Impossible to tell without directly interfacing with them, but more likely what they're talking about is a dissociative mechanism to deal with situational trauma.
deleted 8y ago
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known 8y ago
aka https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy
manmal 8y ago
This is what happened to my grandmother. She had had a hard life full of catastrophes (20+ of her relatives died in Auschwitz and Dachau), being stifled (grandfather forbid her to take a job), and resulting depression and alcoholism. She had had an essential tremor for 20 years, but apart from that, she was fine according to doctors. She told anybody she‘d just did not want to continue anymore. She developed a sore area of skin on her foot which eventually landed her in hospital, lost almost all her weight, and never returned home. She never talked about the cruelties she and her family had to endure from the Nazis. And in the end, she didn’t seem to even remember. It was simply too much for her to ever cope. Just an n=1, but personally I am convinced that you can die from giving up (or a broken heart, on another matter).
- thrav 8y ago
  I’m honestly most surprised that this isn’t just common sense. Anyone who pays attention for a minute can see it play out all around them.
SZJX 8y ago
So it seems from the summary that eventually the direct cause of death is the person not eating anything. However there are more than one way why a person might have reached that state. Anorexia is another such example. The title is a bit sensationalist IMO. It's just a case of severe depression/psychological disorder where the person doesn't even eat, which has been known since eternity and documented in countless legends/fables. It isn't some sort of magical/previously unknown process where a person suddenly dies if they give up, etc.

335 points by dnetesn 8y ago

this is the saddest article I've ever read

Related might be some articles about people dying when they retire. Not working and not having a purpose was, according to some of these articles I read, causal of death. Not sure how well supported.

nprateem 8y ago

As documented decades ago in "Man's Search for Meaning" by Frankl.

fsloth 8y ago
Which is an excellent book. In dire cirmustances - how and why can you go on. I really recommend it to everyone. In the book Victor Frankl - as a trained doctor and therapist - documents and - this should be interesting to HN crowd - analyzes his own experience as a nazi concentration camp survivor. The 'lit a cigarette' example in the article is probably borrowed from the book.
- amelius 8y ago
  Does this book make one feel better or more depressed? The article has not a very good vibe to it, tbh.
  - martin-adams 8y ago
    I read this book a few weeks ago. It was such a surprise for what I expected. Make no mistake, it objectively talks about horrific events, but I felt humbled and appreciative of the life I have and how to deal with challenging times.
  - gerbilly 8y ago
    The book as I remember it made you feel hopeful. It is a very persuasive argument about how one can deal with even the most 'hopeless' situation. It is also a brilliant description of the psychological effects of camp life. The way he described the odd dislocated feeling they got when the allies set them free was particularly memorable for me.
    - Buttons840 8y ago
      Things like Nazi gas chambers are interesting in a horrific sort of way, but this book did not concentrate on those types of things. The book focused on things which I found to be subtly more disturbing, like the ability of an overweight Nazi guard to curse a death camp prisoner for being "swine, who doesn't know how to work!" while the prisoner is literally working themselves to death in front of the guard to just stands around being fat and worthless. Does the guard not see the irony? How is it possible that he does not? Do I myself hold any absurd views like that Nazi guard? Ultimately the book showed me that there are decent and indecent people in any group, and made me want to be a decent person. I wouldn't say the book is depressing.
  - piyh 8y ago
    It's a rational analysis of some of the worst experiences a person can go through. It wasn't written to wrench your soul like Sophie's Choice and gives a great look at the human psyche pushed to its limits.
    - amelius 8y ago
      Okay. Is it written from the point of view of the (almost) dying person, or of the bystanders?
      - Boulth 8y ago
        It's written by a person that did not give up, survived and analyzed the experience. I read it previously and I highly recommend it, don't worry you won't be depressed after that. On the contrary.
  - fsloth 8y ago
    Does going to a therapist and discussing about things frankly as they are make one feel better or worse? Viktor has a very objective tone of voice. He never paints himself as a saint, a martyr or a superman. This creates a certain feeling of detachment that shields from the full emotional impact of what he actually went through. Overall, however, the book is about survival and the strength of human spirit. Especially since Mr. Frankl personally went through hell, retained his sanity and will to live, and wrote the book. It's a book that gave me hope and strength in dark times.
  - mettamage 8y ago
    For me it felt a bit like a science book with fascinating insights. Yes, what happened in those places was awful but that wasn't the focal point of the book IMO. The focal point is an analyzed account of how people have a higher (or lower) chance of survival in such a dire setting. Also his book are secretly 2 books for which this part is the first part. The second part is about Logotherapy, something he developed after WWII based on the insights he gained from people in concentration camps.
sigvirt 8y ago
Anne Applebaum's book Gulag describes similar psychology and social dynamics. It's an epic work of scholorship that examines the surrounding society as well as the camps and the prisoners. A wide range of inmate experience shows through because of varying lethality of camps and some longer resulting timelines, in contrast for example to Kiernan and Cambodia where the end was often more prompt.

nostromo 8y ago

How on earth do you separate causation from correlation in such cases? To actually know this you'd need a group of random patients to "give up the fight" and compare them to a control group. And you'd need the caregivers to not know which group is which. A coach tells the team: "you lost because you gave up" -- to which they respond, "we gave up because we lost."

diminoten 8y ago
The point is the team didn't lose until the game was over, but they stopped trying before the game was over, and perceived the outcome as inevitable. The coach is trying to tell the team that giving up before the outcome is actually certain is what caused the loss, and the team is incorrect to claim that they had lost before they actually had.
gowld 8y ago
You can tease it apart by carefull measuring the order in which events occur. In medicine, you can measure various biological entities as well as psychological profile, and see to what extent psychologcal changes can affect biological changes. (Of course, psychology itself is in large part its own biological process.) But you can do experiments like psychological interventions (counseling, inspirational/depressing media content) and see if some tend to cause statistically significant biological changes. There are some obvious cases like if you hurt yourself and don't care enough to clean up or seek care, you risk infection or permanent injury.
deleted 8y ago
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tonyedgecombe 8y ago
Atul Gawande's book mentions a study that showed people who received hospice care lived longer than those who got chemotherapy.
- cyberpunk0 8y ago
  Well yeah... Chemo is incredibly difficult on the body, not surprising it would significantly shorten your lifespan.

eezurr 8y ago

This reminds me of a short novel I had to read back in elementary school. I think it was called "Thunder Rolling in the Mountains" (yes). The Native Americans were fleeing the colonials all the way up to the Canadian boarder. Later on, during the treaty process, they are given a relatively small parcel of land to rebuild their home. The book ends with Chief Joseph of the Nez Perce dieing from a "broken heart". I thought that was bullshit and that the author was using a euphemism for a heart attack. ~20 years later I guess I am proven wrong.

nostromo 8y ago
He died of heart failure. The "broken heart" line was poetic license from his caregiver.
- MisterTea 8y ago
  I mean it still perfectly describes what happened. His heart done broke.

johnchristopher 8y ago

I don't really get why the article leaves out how malnutrition is certainly an essential factor in that process, especially since it offers examples from people dying in concentration camps.

kazinator 8y ago

> 'give-up-itis', a term used to describe what is known medically as psychogenic death. I have found my new metal band name, and feel freshly inspired to write some new tunes. Ladies and gentlemen, give it up for Give-up-Itis!

TuringTest 8y ago
Just to be clear: Psychogenic Death is the name of the band and Give-up-Itis is the tune, or is it the other way around?

daphneokeefe 8y ago

I know of two cases in my own family where one elderly spouse died, and the other announced that they did not want to go on, and they died within about a week.

phkahler 8y ago
A friend of my mom died and his wife died sitting in her car just as they were about to begin the procession. Nice couple, married for a long time, shared some of the same odd characteristics. I don't recall what he died of or if there was indication it was coming, so it's not clear how far down this progression she was or how fast it hit. It was sad but also the thought of a couple meaning that much to each other is rather touching.
- paublyrne 8y ago
  It could also be a coincidence.
agumonkey 8y ago
I had this, I was in very good shape (15s~ for 100m sprint sets for fun) and nearly died of grief. If you're old and your system is frail, I can easily see how your emotional state could disrupt it. These bonds root deep in us.
- agumonkey 8y ago
  ps: to add some details, here are a few hypothesis (AFAIcan understand) - tako tsubo syndrom, emotional shock => hormone cascade => myocard deformation to the point of uselesness - arteries constrictions, nearly all your arteries (even micro capillaries) have tiny valve-rings, since fear can induce vasoconstriction to ensure high blood supply, I think high anxiety can force your system in that state for prolonged amount of time which will lead to blood flow disruption (tiny clots, mild hypoxia) and derail organs on the way.
macintux 8y ago
My grandmother has not wanted to go on for 15+ years now after my grandfather died, yet she's still here, and doing relatively well for a 95-year-old. I definitely think there's a correlation between your mental and physical health, but it's definitely not a simple one.

nathanvanfleet 8y ago

Using the term "give-up-itis" discredits this article. It's like describing it as a "case of the mondays" when you die.

gph 8y ago
No it doesn't. They use the proper medical term in the very same sentence, and continue to use psychogenic death except in a direct quotation from a doctor. You have to be pretty damn anal to think using a colloquial term suddenly discredits all the other information in that article.
- felipemnoa 8y ago
  >>You have to be pretty damn anal to think using a colloquial term suddenly discredits all the other information in that article. There is some validity to his point though. Every time I read the word "give-up-itis" I reflexively feel negative feelings towards the article. It feels as if they are trying to be funny but not in a good way.
  - waterhouse 8y ago
    I actually think "give-up-itis" is a more specific term than "psychogenic death", and is a better descriptor for what they're talking about. First, "psychogenic death" just means a death caused by the mind, without any specifics about how the mind caused it—e.g. if you think about something really scary and make your heart rate jump up and manage to give yourself a heart attack, it seems like that might qualify as a "psychogenic death" (I imagine there'd have to be other things wrong with your heart for that to tip you over the edge, but I'm not an expert); whereas this is about a mechanism involving some kind of apathetic mindset. Second, "psychogenic death" can only apply after the person is dead; it doesn't describe someone suffering from the same mechanism that hasn't killed them yet. Maybe "psychogenic decay"? (But again, that doesn't specify the mindset involved; perhaps someone who spends all their time experiencing pain, or anger, or something else would decay in a different way.) If they had to come up with a "medical" term for "give-up-itis", I might guess it'd be "apathetic psychogenic decay", or else some Latinized phrase. https://translate.google.com/#auto/la/disease%20of%20giving%20up https://translate.google.com/#auto/la/disease%20of%20giving%... yields "De morbo dare sursum", who knows. I also suspect this research is early enough that it doesn't make sense to choose an official term and commit to it yet. I am in favor of people not polluting the namespace of terms with things that, upon closer examination, should have been named something else.

innocentoldguy 8y ago

I experienced going down this path. I was recently in an accident and shattered my spine. If it hadn’t been for the support of my family, I don’t think I’d still be here. Life seemed to be a pointless and miserable dead end and I was ready to go. Fortunately, my family helped me work through it and I survived.

barking 8y ago
Well done yourself as well as your family.
throwaway413 8y ago
I’m glad you’re here.
photik 8y ago
Yeah, bravo. It's good to hear that other people aren't giving up.

amelius 8y ago

Is this related to "depersonalization" as experienced e.g. by people with extreme anxiety?

WalterSear 8y ago
This is driven by depressive, anhedonic mechanisms, rather than anxious or dissociative ones.
randyrand 8y ago
I definitely noticed a similarity to DP. Resonated with me.

srinivgp 8y ago

People can also suffer greatly from not giving up the fight.

typetehcodez 8y ago

In it's most basic premise, life is perplexingly defined as "not death". And what is life other than a struggle to fight entropy? Sisyphus is happy, and I would argue - alive! https://medium.com/@mustaphahitani/camus-suicide-and-imagining-sisyphus-happy-bec124dad750 https://medium.com/@mustaphahitani/camus-suicide-and-imagini...

jrlocke 8y ago

Wet streets cause rain.

coldtea 8y ago
Superficial readings cause facile dismissals.

harveywi 8y ago

I can relate, I die a little inside each time I read a post on HN.

dmarlow 8y ago
How about when you come across a comment like yours?
- fb03 8y ago
  He then dies a lot harder than 'a little', probably.
kvartz 8y ago
Why are you even here?

woop-throwaway 8y ago

I smell bullshit. After my own trauma I went to sleep with a prayer “please god don’t wake me up the next day”, for a year. Thankfully one can’t get a gun easily in Europe, otherwise I won’t probably be writing this... and I haven’t experienced even an appetite loss, not saying about social etc. After SSRIs I’m not that anymore, but I’m still ready to give up at first chance, just I know at worst I lose a job and a house. But death.. for good or bad, it doesn’t work that way.

andrewmcwatters 8y ago
I don't mean to dismiss your experience, but this is such a super-tunnel vision point of view there's nothing here to gain. Your sample-size is one person, and for some reason you bring up gun control laws, which changes the course of discussion. Of course many people with depression don't just die of being depressed. That's not what this article is describing. Depression isn't severe trauma. Severe trauma can cause depression, and what's explained here, is that it can cause death by psychosomatic cause.
- aaron695 8y ago
  Most gun deaths are sucide. It's very high for men (I assume OP is male cause of this) USA is very unusual that gun sucides are only double other guns deaths. Europe is much different. You could argue removing sucide by gun just means sucide moves to other methods but I'd say the data doesn't show this and OP thinks this as well for them. No one is strongly arguing this here, it was just an off the cuff point. Their story is one of the better comments here. ( The article is bullshit as others have pointed out, it's possible dangerous as it almost is saying depression and death is a choice )
coldtea 8y ago
>After my own trauma I went to sleep with a prayer “please god don’t wake me up the next day”, for a year. Well, what one consciously expresses is not always a match for their inner state. Second, it's another thing to say "oh god, take me now" than to consider yourself as nearing death. One is a kind of negative wish, while the other is how you view yourself objectively to be going to. Besides, biological processes are not physical laws. They are statistical phenomena, and people can differ. It's what happens in the aggregate and for most that's examined. In that sense, a counter-example is not enough to take down the phenomenon. In any case, glad it worked out for you.

drakonka 8y ago

This has also been known to happen among African cichlids, a type of fish. I'm sure it's likely other animals are affected as well but I have cichlids myself, so I have more context with them specifically. Cichlids tend to be highly territorial and socially competitive. They're constantly vying for some rock or hole to "own". Usually it is recommended to overstock a cichlid tank slightly in order to disperse aggression. With three fish it's easy for the most aggressive alpha to pick on and injure the weakest link. With twelve fish the most aggressive alpha will have that many more others to compete with/take out his aggression on. Sometimes, however, the weakest link still emerges. When this happens multiple fish might pick on the weakling and chase him/her around, disallowing them from entering any kind of territory among the rocks (they like rocks). They drive this weaker fish to stay toward the top reaches of the tank. Eventually the fish just starts hanging out there naturally because it knows it'll get bullied if it comes down. Then, after some time of giving up on fighting for its own territory and competing with the other fish, the weakling just...gives up. Even if the other fish have left them alone by then, and the fish isn't physically injured or lacking food or anything, the fish doesn't even try to reenter "society" anymore and just...dies. I got my cichlids a couple of years ago and have since decided that while I will continue to care for these fish as best I can as I took on that responsibility, I'm not going to be getting any more fish for ethical reasons.

dcow 8y ago
What are the ethical reasons? Do you find it unethical to foster a species that behaves in such a way? Strictly curious.
- deleted 8y ago
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- drakonka 8y ago
  After getting fish and seeing them in captivity first hand I've decided that I don't think it's ethical to keep fish in captivity in general. As good a home as I try to give them, they're still wild animals in a little box. I think no matter the size of my aquarium or the effort I put into water maintenance, providing suitable rocks, etc, all of my effort and good intentions will never compare to the home they are meant to have in the wild. I just feel bad for them and bad about myself for contributing to an industry that puts animals in these kinds of conditions.

petercooper 8y ago

There's an entire, and fascinating, book on psychosomatic illnesses that goes into this topic called It's All in Your Head by Suzanne O'Sullivan, an Irish neurologist. Most people seem to write off psychosomatic illnesses as they don't fit into their models of how the world should work, but their existence and ways to resolve them are well documented and doctors frequently find psychological or neurological ways to resolve or alleviate them (e.g. prescribing antidepressants to chronic pain sufferers). The book also goes into how cancer can, in some circumstances, be hugely affected by the mental outlook of the patient, but for some reason this continues to be controversial in a way that 'dying of a broken heart' is not.

agumonkey 8y ago
I have negative feelings toward oncology protocols because they're not capable of explaining things to patients, so they start hopeless and pick many wrong choices after diagnosis. It's .. somehow criminal to me.
arountheworld 8y ago
Psychosomatic is the bucket where lands everything lazy doctors don't want to investigate.
- olliej 8y ago
  Psychosomatic is actually an interesting one -- it's not just "lazy doctors" -- there's plenty of evidence to show that the brain is totally capable of causing a range of side effects all on its own (Placebo and nocebo trials have made this clear). If you want annoying go for "Idiopathic". For example I have idiopathic optic nerve hypoplasia. The last three words mean my optic nerve is narrow than it should be - I have a gap in one quadrant of my peripheral vision - the "idiopathic" bit means they don't know why.
  - taneq 8y ago
    > the "idiopathic" bit means they don't know why. Oooh, sort of like "not otherwise specified" meaning "dunno what's going on".

706f6f70 8y ago

Head's up on the publication's goal: > Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. [. . .] Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations. Not saying it's completely without merit, but this should not be interpreted as a scientific study of any type.

shawn 8y ago
this should not be interpreted as a scientific study of any type. Feynman was intensely interested in the paranormal, and said that it was important for any physicist to be. Because if it were true, that's exactly where you'd find the truth. Now, I'm not standing up for alternative medicine. But the subject is beside the point. You said "This isn't science," but didn't point to any examples of why. Anyone who follows the scientific method is doing science. Science isn't an exclusive clique; everyone can do it.
resu_nimda 8y ago
Pretty unnecessary FUD. Did you have any objection to the actual content? How did you determine that the work was "not a scientific study of any type"? Seems un-scientific to dismiss the whole thing based on that paragraph.
- duxup 8y ago
  I didn't read his comment as "dismiss the whole thing".
- scott_s 8y ago
  Looking at the abstract (there are several links in the comments), I think it's accurate to say it's not a scientific study because it's not a study. That is, to me, a "study" implies some systematic examination of some observable thing. But this paper is more a formal hypothesis: the author is proposing that a particular phenomenon exists, with some anecdotal support. That means that the story title is not accurate, as it declares the thing exists, when the entire point of the paper is that it may exist.

Footkerchief 8y ago

Here's a link to the study: https://researchportal.port.ac.uk/portal/en/publications/giveupitis-revisited-neuropathology-of-extremis(1ba3ff20-86a2-4701-b6fd-776061f3191e).html https://researchportal.port.ac.uk/portal/en/publications/giv... > The term ‘give-up-itis’ describes people who respond to traumatic stress by developing extreme apathy, give up hope, relinquish the will to live and die, despite no obvious organic cause. This paper discusses the nature of give-up-itis, with progressive demotivation and executive dysfunction that have clinical analogues suggesting frontal-subcortical circuit dysfunction particularly within the dorsolateral prefrontal and anterior cingulate circuits. It is hypothesised that progressive give-up-itis is consequent upon dopamine disequilibrium in these circuits, and a general theory for the cause and progression of give-up-itis is presented in which it is proposed that give-up-itis is the clinical expression of mental defeat; in particular, it is a pathology of a normal, passive coping response. "It is hypothesized" is the closest it gets to evidence. This level of research seems to be that journal's specialty: https://en.wikipedia.org/wiki/Medical_Hypotheses#Peer_review_debate https://en.wikipedia.org/wiki/Medical_Hypotheses#Peer_review... This article is a press release that drastically overstates the already weak claims of the paper itself.

ColanR 8y ago
As an aside, reading the wikipedia link, it seems like that journal does fulfil a very useful function. Not that it's a publisher of accurate articles, but that it can help the medical field escape local maxima. "There are ideas that may seem implausible but which are very important if true. This is the only place you can get them published."
dropit_sphere 8y ago
I am actually personally acquainted with Dr. Charlton, former editor of MH. He has some legit concerns about the epistemic effects of peer review (as well as the "business" of science---obtaining grants, etc.). I'm torn, because on the one hand I wish everything from MH came with a giant "UNPROVEN AND DOES NOT FIT YOUR SCHEMA OF AN ACADEMIC PAPER" disclaimer, and that that would pass through when adapted to other media (like, say, this press release). On the other hand I basically share concerns about the peer review process and the stranglehold it can have on research.

xhrpost 8y ago

> Dr. Leach said one prisoner of war who was also a medical officer described being in this stage as waking each morning but being unable to summon the energy to do anything. Others describe it as a severe melancholy, where even the smallest task feels like the mightiest effort. I would have just assumed this to be depression or a part of it. However, the article is claiming this symptom is something different?

fokinsean 8y ago

Reminds me of how concentration camp life is described Man's Search for Meaning[0]. The prisoner's could tell when someone was about to die if they noticed them refuse to get up for work for the day or smoke their cigarettes (which were used for currency rather than smoking). This reflected them giving up hope and they would usually pass within a few days. https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning https://en.wikipedia.org/wiki/Man%27s_Search_for_Meaning

pontifier 8y ago

This hits close to home. I've had many diverse failures in the past 2 years. Every attempt I've made to create, or build has been thwarted by corruption, power struggles, and lying theives who seem to be getting on just fine. It is totally demoralizing to feel that there is no possibility of success. Vivid thoughts of violent revenge are the only sparks of life I feel anymore.

techsin101 8y ago
Wow.. feel bad man
x220 8y ago
You should move to a different place. That's a sign that your culture (be that your acquaintances, neighborhood, city, state, country, or civilization) does not maintain an environment where you can be reasonably sure that your sacrifices will pay off, and it's easier to get by through stealing and corruption. If this is accurate, your culture will fester and die. Best to leave as soon as possible.
throwaway5250 8y ago
Yeah, can relate. Wish the article had more ideas on how to deal with it, rather than just describing it.
darkerside 8y ago
Revenge? Against whom? Please get help if you need it. I mean that sincerely.
throwaway010718 8y ago
It is a pity the human mind can become a dark abyss. Be careful indulging thoughts of revenge. They will subside with time, but then decades later you find yourself in a dark place again and all those re-enforced feelings will bubble up again. Thoughts of revenge are detrimental to success. You aren't guaranteed to be successful no matter how hard you try, but you certainly can't be successful if you ruminate on revenge. Please if you own a gun, then find a friend with a safe and give it to them. Liquidate all your cryptocurrency so you don't hire a hitman. Don't let this brief period destroy your entire future. There are people whose children were murdered in front of them by a Nazi soldier and never got "violent revenge" and went on to live fulfilling honorable lives. Is your injustice anywhere near as bad ? Please find the strength to find a way to get through this without resorting to violence.

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arountheworld 8y ago

When people say medicinal cannabis doesn't "cure", they should read this. It helps people eat, sleep and be in a good mood and that provides foundation for willingness to fight. My view is that people who deny this medicine are criminals and should be brought to justice.

hi41 8y ago

Few months back I read that an article about children of refugees in Europe going into a coma like state. Could this be related?

photik 8y ago
Impossible to tell without directly interfacing with them, but more likely what they're talking about is a dissociative mechanism to deal with situational trauma.

deleted 8y ago

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known 8y ago

aka https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy https://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy

manmal 8y ago

This is what happened to my grandmother. She had had a hard life full of catastrophes (20+ of her relatives died in Auschwitz and Dachau), being stifled (grandfather forbid her to take a job), and resulting depression and alcoholism. She had had an essential tremor for 20 years, but apart from that, she was fine according to doctors. She told anybody she‘d just did not want to continue anymore. She developed a sore area of skin on her foot which eventually landed her in hospital, lost almost all her weight, and never returned home. She never talked about the cruelties she and her family had to endure from the Nazis. And in the end, she didn’t seem to even remember. It was simply too much for her to ever cope. Just an n=1, but personally I am convinced that you can die from giving up (or a broken heart, on another matter).

thrav 8y ago
I’m honestly most surprised that this isn’t just common sense. Anyone who pays attention for a minute can see it play out all around them.

SZJX 8y ago

So it seems from the summary that eventually the direct cause of death is the person not eating anything. However there are more than one way why a person might have reached that state. Anorexia is another such example. The title is a bit sensationalist IMO. It's just a case of severe depression/psychological disorder where the person doesn't even eat, which has been known since eternity and documented in countless legends/fables. It isn't some sort of magical/previously unknown process where a person suddenly dies if they give up, etc.