有嚴重心理創傷的人或將放棄生命，在三天內死亡

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

一項研究稱，僅僅因為人們放棄了求生的意志，他們就會死去，而且這一切可能發生在幾天內。

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

普次茅斯大學的約翰.利奇博士表示，他的研究顯示，就這麼放棄自己的心態，或心因性死亡是一種真正的疾病。

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.

他的研究發現，在遭遇嚴重的心理創傷後，如果人們無法自行排解，只消三天時間他們就可能死去。

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

就這樣放棄的心態最早出現在朝鮮戰爭時的戰俘身上，他們會停止說話、失去進食的意願，然後在幾天的時間內死去。

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.

利奇博士相信，當一個人感覺自己已向生活屈服時，負責照看自己的大腦區域的活動就會發生改變。

Commenting on his study published in the journal Medical Hypotheses, he said: Psychogenic death is real.

在對自己發表在「醫學假說」雜誌上的研究進行評論時，利奇博士說：「心因性死亡是真實存在的。」

It isnt suicide, it isnt 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.

「這不是一種自殺，而是一種和抑鬱有關的疾病，不過在幾天內放棄生命的行為是一種和嚴重創傷有關的、真正的疾病。」

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

作為他研究的一個部分，他解釋了病人們如何會在幾周內就會死去，以及他們將經歷的五個階段。

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

利奇博士稱，在第一個階段他們會放棄社交，第二階段他們甚至會失去照顧自己的興趣。

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.

第三個階段是放棄主動和決定權，在四個階段中他們會出現大小便失禁，整天坐以待斃的癥狀。

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

心因性死亡發生在第五個階段，據稱這是完全放棄求生意志的狀態。

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.

就這樣放棄自己的過程可能來源於從大腦額葉-皮質下一個改變，這是管理人的目標導向行為的區域。

Dr Leach said: Severe trauma might trigger some peoples anterior cingulate circuit to malfunction.

利奇博士說：「嚴重的創傷可能會讓大腦額葉-皮質的功能失常。」

Motivation is essential for coping with life and if that fails, apathy is almost inevitable.

「目標是人們應對生活的一個重要部分，如果失去了它，人們變得漠不關心也就在所難免。」

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.

利奇博士稱，最平常的干預方式是體力活動，或者能識別當前的情況，這證明他們還有自我控制能力。

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

他說，這兩種方式都能觸發感覺良好的多巴胺化學物質的釋放。

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.

利奇博士還說：「轉機往往會出現在以下幾種情況中：求生者發現或重新找會自我決定意識，能夠控制自己，這時往往會有一個人的陪伴，這個人會幫他們走出陰影，重新點燃他們對生活的熱情。」

擴展閱讀：

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

就這麼放棄自己的五個階段

Social withdrawal

離群索居

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

在遭遇心理創傷後，很多人都會避免和外界接觸。

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

如我們在戰俘身上見到的一樣，他們可能會變得詞不達意，對別人的苦難不管不問。

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.

利奇博士表示，這可能也是他們應對生活的一種方式，因為這能讓他們不去想自己的遭遇，從而讓情緒更加的穩定。

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

但是，如果任由這個情況發展下去，他們可能會很難找回對事物的熱情和興趣。

Apathy

冷漠

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

在某人不再對照顧自己的生活起居感興趣時，這個情況就會發生，這時他們甚至連洗澡的動力都會消失，利奇博士說道。

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

在大屠殺中幸免於難的義大利化學家普里莫·萊維說：「在監獄只待了一個星期， 我的清潔本能就完全都丟失了。」

For some, the smallest task begins to feel like the mightiest e?ort,』 according to an Englishman who was held in a Russian prison between 2003 and 2005.

某位在2003-2005年曾被囚禁於俄羅斯監獄的英國人說：「最小的任務開始變成最難的任務。」

Aboulia

意志喪失

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

如果任由冷漠的態度發展下去，可能會導致意志喪失，也就是沒有主動和決定能力。

Many inmates ceased to wash. This was the ?rst step to the grave, a concentration camp victim said.

「很多的囚犯都會停止洗澡。這是他們進入墳墓的第一步，」一個集中營的的受害說道。

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

「這幾乎是一條鐵的定律：這些不再天天洗澡的人馬上就死了。」

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

意志喪失的人可能會變得更加冷淡，而且連話都說不上幾句。

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

處於這個階段的人通常會繼續照顧小孩和他人，但是他們照顧自己的動力會一點點的消失。

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

利奇博士說：「意志喪失一個有趣的地方是，它看上去像是沒有思想的頭腦或缺乏內容的意識。」

People at this stage who have recovered describe it as having a mind like mush, or of having no thought whatsoever.

在這個階段的人恢復的人會將其描述為頭腦不清晰，或者沒有了任何思想。

In aboulia, the mind is on stand-by and a person has lost the drive for goal directed behaviour.

「在這個階段，大腦處於處於「旁觀者」的狀態，人失去了目標導向行為的動力。」

Psychic akinesia

心理上喪失運動能力

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

心理上喪失運動能力在一個人沒有動力的時就會出現，這時他們甚至會出現大小便失禁，坐以待斃的情況。

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

而且，在這個階段，很多的戰俘都不再感覺到疼痛，在被打的時候沒有了畏懼感。

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

在利奇博士的研究的中，他將19歲的女子診斷為心理上喪失運動能力，後者曾在海灘上遭遇二度燒傷。

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

雖然她看上去經歷或巨大的疼痛，但她連遮掩的動力都沒有。

Psychogenic death

心因性死亡

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

利奇博士稱，就這樣放棄的最後階段是放棄生存意志的心因性死亡階段。

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.

「他們可能會躺在他們的排泄物中，任何的警告、鞭打和懇求都不能讓他們回歸正常生活，」奧地利精神病學家、大屠殺倖存者維克多·弗蘭克說道。

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

當在集中營的人們達到這個階段時，他們經常被稱做臨死的人，這時他們會開始吸煙。

Cigarettes were highly valuable in camps and could be traded for food.

集中營的煙是極為珍貴的，因為它可以用來換取食物。

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.

利奇博士說：「當一個囚犯拿出一根香煙並點燃的時，他們集中營夥伴們就知道他真正地放棄生命、失去了求生的信念。」

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

在死亡前，有的人甚至會表現得突然活躍，如突然吸上一根煙。

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.

「這看上去就像「空白的頭腦」階段之後，並被被成為目標導向行為所替代一樣，」利奇博士說道。

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

「但這是個自相矛盾的事情，在目標導向行為若隱若現的同時，目標本身看上去已經變成了放棄生命。」

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

但是當人們保持了就這樣放棄的心態時，死亡看上去就離他們不遠了。

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.

利奇博士表示，鍛煉和意識到你的確還有控制自己生命的意識能觸發感覺良好多巴胺的意識的釋放。

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.

「轉機往往會出現在以下幾種情況中：求生者發現或重新找會自我決定意識，能夠控制自己，往往這時會有一個人的陪伴，這個人會幫他們走出陰影，重新點燃他們對生活的熱情。」

We all knew that if we didn』t get our minds o? dying that any one of us would be next, a prisoner-of-war added.

「所有人都知道，如果我們自己沒有放棄死亡的念頭，那麼我們中的任何人的想法都改變不了你，」一位戰俘補充說道。

source：You can die from give-up-itis, doctor warns