You can die from 'give-up-itis', doctor warns

You can die from ‘give-up-itis’: People often pass away because they’ve simply ‘given up’, doctor warns as he gives five tell-tale signs to look out for

Person can die in as little as three days after a traumatic life event
‘Give-up-itis’ was coined in the Korean war to describe prisoners-of-war
Changes activity in the brain region that motivates people to care for themselves

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People can die simply because they have given up on life – and it can happen within days, according to research.

Dr John Leach, from Portsmouth University, said his study showed ‘give-up-itis’ – or psychogenic death – is a real medical condition.

His research found people can pass away in as little as three days after a traumatic life event, if they believe they cannot overcome it.

Give-up-itis was coined during the Korean war, when prisoners would stop speaking, lose the will to eat and perish within days.

People can die simply because they have given up on life, a doctor has warned (stock)

Dr Leach believes when a person feels beaten by life it changes the activity in the region of the brain that motivates them to take care of themselves.

Commenting on his study published in the journal Medical Hypotheses, he said: ‘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.’

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As part of his research, he has unveiled the five stages of the condition and explained how patients progress over a matter of weeks.

It starts with social withdrawal, Dr Leach revealed, before they quickly lose interest in even looking after themselves.

The third step is the inability to take initiative or make decisions, and the fourth can see patients become incontinent and lie in their own waste.

Psychogenic death is the fifth stage and is described as someone totally losing the will to live.

Give-up-itis could stem from a change in a frontal-subcortical circuit of the brain that governs how a person maintains goal-directed behaviour.

Dr Leach said: ‘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.’

Dr Leach said the most common interventions are physical activity and/or a person being able to see a situation is at least partially within their control.

He said both of which can trigger the release of the feel-good chemical dopamine.

Dr Leach added: ‘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.’

WHAT ARE THE 5 STAGES OF GIVE-UP-ITIS?

Social withdrawal

After a life trauma many people avoid the contact of others.

As seen in prisoners-of-war, they may also struggle to show emotion and become indifferent to other people’s suffering.

This can be a way of coping because it allows them to disengage from their feelings in order to be more emotionally stable, according to Dr Leach.

But, if it persists, they may struggle to gather enthusiasm or interest for anything.

Apathy

This occurs when a person is no longer interested in looking after themselves and may even lack the motivation to shower, Dr Leach said.

The Italian chemist Primo Levi, who survived the Holocaust, said: ‘After only one week of prison, the instinct for cleanliness completely disappeared in me.’

For some, ‘the smallest task begins to feel like the mightiest eﬀort,’ according to an Englishman who was held in a Russian prison between 2003 and 2005.

A person can pass away in as little as three days after a traumatic life event if they believe they cannot overcome it, according to an academic from the University of Portsmouth (stock)

Aboulia

If apathy goes unchecked, it can lead to aboulia – the inability to take initiative or make decisions.

‘Many inmates ceased to wash. This was the ﬁrst step to the grave,’ a concentration camp victim said.

‘It was an almost iron law: Those who failed to wash every day soon died.’

People with aboulia may withdraw deeper with themselves and struggle to even speak.

Often, people at this stage continue to look after others, such as their children, but become less and less motivated to care for themselves.

‘An interesting thing about aboulia is there appears to be an empty mind or a consciousness devoid of content,’ Dr Leach said.

‘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.’

Psychic akinesia

Psychic akinesia can occur when a person’s motivation drops so much they may even become incontinent and lie in their own waste.

Also at this stage, many prisoners-of-war have become unaware of pain and may not even flinch during beatings.

In Dr Leach’s research, he describes a 19-year-old woman diagnosed with psychic akinesia who suffered second-degree burns while on a beach.

Although likely in extreme pain, she was not motivated enough to cover up.

Psychogenic death

The final stage of ‘give-up-itis’, Dr Leach describes psychogenic death as someone totally losing the will to live.

‘They might be lying in their own excreta and nothing – no warning, no beating, no pleading can make them want to live,’ according to Viktor Frankl, an Austrian psychiatrist and survivor of the Holocaust.

In concentration camps, people who reached this stage were often known to be near death when they started smoking cigarettes.

Cigarettes were highly valuable in camps and could be traded for 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,’ Dr Leach said.

Before passing away, someone may even show a flicker of life, such as enjoying a cigarette.

‘It appears briefly as if the “empty mind” stage has passed and has been replaced by what could be described as goal-directed behaviour,’ Dr Leach said.

‘But the paradox is that while a flicker of goal-directed behaviour often takes place, the goal itself appears to have become relinquishing life.’

But death does not have to be inevitable in a person suffering from give-up-itis.

Exercising and realising you do have at least some control over your life both trigger the release of the feel-good hormone dopamine, according to Dr Leach.

‘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,’ he said.

‘We all knew that if we didn’t get our minds oﬀ dying that any one of us would be next,’ a prisoner-of-war added.

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