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People can die from giving up the fight (medicalxpress.com)
335 points by dnetesn on Sept 27, 2018 | hide | past | favorite | 124 comments



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.


As a former owner of African Cichlids I can confirm that Darwin plays a key role in Cichlid society. The strong murdered the weak and buried their body under the castle until there were only a few left. They also manipulated the gravel in the tank creating hills and valleys to their liking.


Sounds like human society. Makes you wonder whether or not we are just play things in a 'fish tank'?


You could argue that's exactly what we are, unless you're rich enough to be the ones who control the conditions the rest are kept in.


That sounds like “learned helplessness”. I suspect (but lack time and skill to properly test this hypothesis) that this mechanism is also long term depression-in-the-everyday-sense can lead to depression-in-the-clinical-sense.

This study explicitly says this is different from clinical depression. From the examples they chose in the article, I hypothesise the difference is between acute/imposed and chronic/natural psychological states.


I am by no means an expert on learned helplessness, but I'm not sure that's what this is. I could see it if the fish was prevented from eating by the other fish, and even when it is no longer being prevented from eating it chooses not to eat and dies because it doesn't know any better. However, this does not seem to be the case. The fish is not prevented from eating when food is dropped into the tank. In fact it is often one of the first to get a chance at food because it is hanging out at the top of the tank, where the food is dropped. Instead it is prevented from assimilating into the territory and rocky habitat, and gets kicked out of the main social hierarchy of the tank. After enough time it stops trying to assimilate and stops eating as well, even though access to food was never the issue.

There are a few ways to try to try and fix such a situation, including quarantine. One example is rearranging the rockscape in the tank to force the rest of the fish to re-establish the territories amongst themselves and take focus off of the weakling for long enough for him to maybe take a spot back.


What are the ethical reasons? Do you find it unethical to foster a species that behaves in such a way? Strictly curious.


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.


Do you worry about his sense of purpose or something? Unlimited food, no predators, might not be so bad for a fish.


I worry about a lot of things, including but not limited to the expression of all the instinctive behaviours that a fish would have in its natural habitat that living in a glass box prevents (no matter how enriching we try to make the captive environment). I could write a lot about this, but I've dwelled on it enough as it is. Suffice to say I have just decided on a personal level after keeping fish that I do not think they are a suitable species for "ethical" captivity in the home.


Legitimate question, how do you feel about dogs?

I find your ethics intriguing (in a positive way, to be clear).


First I'd like to iterate that I am not trying to convince anyone to share or understand my views on this, I'm only posting this because you asked the question. I have some conflicting and sometimes contradictory feelings on animals in captivity in general and tend to lean against captivity in the majority of cases.

Personally I feel better about keeping dogs in captivity than fish. Dogs are domesticated and want to be around us. Not only that but they can be around us fully, as opposed to sitting in a box for their entire life. They love and care for us in their own way, are very in tune with our emotions (and we with theirs), and have evolved to live alongside us (if one chooses the appropriate kind of dog for them). Where I live the laws on keeping dogs are more strict than some countries, and dogs enjoy a lot of access with their owners. They can't be left alone for more than a few hours at a time, so if a person is to keep a dog they either take it (almost) everywhere with them or sign up for dog daycare where the dog gets to spend the work day playing with other dogs and humans. I think dogs are in tune with us enough to be legitimately happy, and life alongside humans has become the "natural habitat" for many types of dogs (again assuming one chooses the appropriate dog).


I'm curious, do you consume animal products? I appreciate you answering these personal questions, no stress if you're not interested in continuing the barrage of questions. :~)


I'm ashamed to say yes. I cut meat out years ago but do still consume dairy and eggs. More recently the vegan alternatives at local grocery stores seem to be getting better and better, so I'm starting to consume less of those as well. Hopefully in the near future I will be able to honestly answer "no" to this question :)


I feel the same about keeping pets. The vegan options overall have gotten so much better in the last 5-10 years. It's easier now than it's ever been!


As a newish vegan, I think I’m having an inflection point where being a vegan seems much easier than I thought. Low sodium canned beans really made this last week at work easier, for instance.


> Where I live the laws on keeping dogs are more strict than some countries, and dogs enjoy a lot of access with their owners.

This sounds amazing! Where is this if I may ask? My experience in Australia is that there are a lot of dogs and dog owners, but overall it is not very dog friendly at all. For example you can't take pets on trains and it is uncommon to take them to work.


Thankfully that's slowly starting to change here.

https://www.vic.gov.au/rentfair/pets-are-welcome.html

I've also noticed more workplaces allowing pets to be brought in occasionally, and a significant number of cafes and shops allowing pets in and even supplying water bowls and an area for them to tie up and rest while you shop/eat.


Ah yes, I like the sound of that! Of course it is in Victoria. You watch and learn, New South Wales.


not op, but the laws he describes sounds a lot like what we have in Sweden. I'm not sure as to what number of hours a dog are allowed to be left alone though, but I think it's less than a normal working day, I have a bunch of colleagues who occasionally works from home due to their dogsitter being sick or otherwise unavailable.


This isn't your or his decision to make. We don't get to decide if a creature's preference is the cage. There is no way of knowing in the first place.


Sounds like highschool.


And thus like (modern) human society.


are you Foo the Flowerhorn? :)


Afraid not, but now I'm Googling who that is!


Here's a link to the study: 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...

This article is a press release that drastically overstates the already weak claims of the paper itself.


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.


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."


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.


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.


Not to presume to know her mental state, but it strikes me as probable that she says "I don't want to go on" because she feels it's expected of her as a widow, even if it's not an accurate expression of her true mental state.


You mean, not a 100% guaranteed one.

It's pretty simple, actually. The body cannot live (thrive) without the mind.


Fake news. See: braindead people.


I think he was quoting The Matrix...


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.


It could also be a coincidence.


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.


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.


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."


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.


>How on earth do you separate causation from correlation in such cases?

You don't always need (or can afford to have) a full control group and 100% separation causation from correlation.

Sometimes you can just draw the obvious conclusions from the events you see and only rationally eliminate other causes.


Atul Gawande's book mentions a study that showed people who received hospice care lived longer than those who got chemotherapy.


Was hospice vs chemotherapy randomly distributed to the control group, with no patient or doctor choice on the matter?

Because otherwise, there's a million statistical biases that can creep into that outcome.


I can't remember the exact details now but that was how I interpreted it at the time I read it.


How on earth did they get ethical approval to run this study?

"So, do you want to enter into a 50/50 lottery, where we will either try to treat you, or let you die in peace? You don't get a choice of which, by the way."

Even if I was a cancer patient with an extremely poor outlook, I would probably have some pretty strong preference in the question of whether I wanted chemo, or end-of-life care.


I agree, it seems unlikely that you could get an IRB sign off any study that wasn't simply post-death statistic study.

You /could/ try to control that by try to separate the groups into "type of cancer" and "stage", so that you're comparing like-to-like when looking at mortality. But even then there are problems ("stages" are subjective, and there's evidence that they're slowly shifting so that old stage three would now be considered stage four), different Drs may be more aggressive at directing people to chemo, etc.

I think there's also basic issues of what we're comparing, e.g. are you undergoing chemo in an attempt to live a bit longer, or as an attempt to not die. Because at the "you're going to die within 3-6 weeks" you're going to get radically different survival rates for chemo than "you're going to die in 3-6 years". Which makes me wonder how you would deal with "EoL" chemo that does cause the cancer to die back?

I'm having trouble wording it, but what I'm curious about is what happens when you have a patient that

1. Is dying, and given 3 months to live. Can choose between chemo and hospice 2. Chemo successfully pushes the cancer back 3. Cancer comes back 5 years later 4. Patient chooses hospice 5. Patient "dies in hospice" 3 months later.

Which group should the patient be placed in?

This is why I'm glad nothing I do impacts peoples health/safety/etc


>> How on earth do you separate causation from correlation in such cases?

The other responses are better, but I think the stories of the prisoners should be enough to believe it. They watched people around them go through the progression with no apparent illness or other causes of decline. They didn't mention but I don't think they were just talking about old people where life may have just run its course. "This sucks, I'm done" seems to fit better than anything.


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.


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.


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.


A Swedish study found that just a diagnosis of cancer greatly increased a person’s chances of dying in the following weeks

http://www.greenmedinfo.com/blog/research-some-cancer-diagno...


Psychosomatic is the bucket where lands everything lazy doctors don't want to investigate.


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.


> the "idiopathic" bit means they don't know why.

Oooh, sort of like "not otherwise specified" meaning "dunno what's going on".


I agree with you, but if there is no evidence that something is psychosomatic, the doctor shouldn't give the diagnosis that it is. If a doctor is keen on dismissing the patients I think that should be investigated and that person barred from working in the field.


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-imagini...


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


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.


Does this book make one feel better or more depressed?

The article has not a very good vibe to it, tbh.


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.


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.


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.


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.


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.


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.


Okay. Is it written from the point of view of the (almost) dying person, or of the bystanders?


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.


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.


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.


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.


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.


The world would be better off without some people. That being said, there's a big difference between the call of the void and true intent to act.

I can't imagine that any parent who saw their child murdered wouldn't at least entertain the thought of revenge. But I also see a profound power imbalance in your story. The powerful can act with impunity. Give the parent the power of reprisal and things start to look different. The child might have lived.

Perhaps there would be a bit less corruption and dishonesty in this world if there was a bit more fear of real consequences for ones actions.


Yeah, can relate. Wish the article had more ideas on how to deal with it, rather than just describing it.


Revenge? Against whom? Please get help if you need it. I mean that sincerely.


Wow.. feel bad man


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


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.


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.


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.


>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.


You are drawing a general conclusion based on a single anecdote.


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.


Well done yourself as well as your family.


Yeah, bravo. It's good to hear that other people aren't giving up.


I’m glad you’re here.


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.


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


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.


>>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.


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%... 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.


Not to mention the fact that "-itis" refers to swelling so it's not even a medically correct use of the suffix! ;)


A small nitpick of your nitpick. Our obsession with 'proper sounding' language is likely counter productive. When you translate many of the formal phrases we use into their original language, it's not far up from give-up-itis. hypothermia = underheated, brontosaurus = thunder lizard, cardiac arrhythmia = heart lacking rhythm, hematoma = blood mass, etc.

Choosing to continue the tradition of naming things in a way such that only a relatively small chunk of society would immediately understand their meaning is something that I've never understood.


If you aren't functional with Greek and Latin prefixes, you're basically not an English speaker.

A lot of the words with these roots are international, or nearly so:

Polish: brontozaur; Spanish: brontosaurio, Slovak: brontosaurus; French: brontosaure; German: Brontosaurus.

These kinds of words actually make English easier to learn for people coming from numerous other languages.

Sure, let's be the laughing stock and replace that with "thunder lizard" and "underheating".


> Choosing to continue the tradition of naming things in a way such that only a relatively small chunk of society would immediately understand their meaning is something that I've never understood.

Jargon has its place. In regards to medical jargon, it serves as both a signal knowledge of medicine and pointing to a specific idea. Using plain language may or may not refer to the specific idea at hand and it definitely signals a lack of knowledge.

It's the same reason people who use computers say "cursor" instead of "pointy thing".


I don't think one signals knowledge by choice of vocabulary, but rather by what is said. If you've ever been pitched something in a field you're an expert in by an imposter, they're more than capable of talking the talk. It's the content of what is actually said where their fraud is exposed. It's not for a lack of knowledge of vernacular or even its misuse, but for lack of understanding the topic which they are discussing. By contrast if you translate e.g. Socrates to pidgin, I'm certain the wisdom would no doubt still resonate simply because of what is said and the logic behind it, regardless of how it is said.

The precision is certainly a reasonable argument, yet that may be begging the question. The reason these words are more precise than alternatives is because these words are the ones chosen to associate with whatever 'thing' we might be referencing. Blue berry is hardly precise in terms of the words used, yet you know exactly what I am referencing with those words. Had we adopted such a tradition there we might find ourselves calling them vaccinium cyanococcus in a parallel dimension, and certainly there they would likely find the notion of blueberry to be an insufficiently precise alternative.


The article insinuates that there exists such a term that is in use; if that is the case, I wouldn't malign it for conveying that situation.

Still I can't see how someone in the medical profession would stick the -itis suffix on something that isn't any sort of inflammation, even out of jest.

Even, say, "give-up-osis" would be an improvement; an "osis" is just a condition (neurosis, psychosis, ...).

"itis" is used in the vernacular for making up words for obsessive preoccupations or imaginary illnesses and such; that formation style is not fitting in a serious medical setting at all.


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


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.


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).


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.


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.


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.


He died of heart failure. The "broken heart" line was poetic license from his caregiver.


I mean it still perfectly describes what happened. His heart done broke.


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.


this is the saddest article I've ever read


> 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?


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


This is driven by depressive, anhedonic mechanisms, rather than anxious or dissociative ones.


I definitely noticed a similarity to DP. Resonated with me.


> '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!


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?


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.


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.


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.


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.

To be fair that is on par with a lot of science journalism (though I do realize this article was published by the journal itself). But I take the point and on a closer read I understand the original comment a bit better, the journal isn't actually purporting to put forth scientific studies, just hypotheses.


I didn't read his comment as "dismiss the whole thing".


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



[flagged]


How about when you come across a comment like yours?


He then dies a lot harder than 'a little', probably.


Why are you even here?


Wet streets cause rain.


Superficial readings cause facile dismissals.




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