Can You Die From Losing The Will To Live?
This has been a hell of a holiday season, with celebrity deaths popping up every other day to make our spirits less than bright. But with the death of Golden Age of Hollywood star Debbie Reynolds, a mere day after the passing of her daughter Carrie Fisher, there's another angle to be examined (beyond simply "2016 is horrible and claims everything we love.") Reynolds passed away from what's reported to be a stroke, but her son Todd Fisher told TMZ that it ensued after she broke down planning Fisher's funeral, saying that she "wanted to be with Carrie." Can wanting to give up on life actually cause our bodies to do the same?
Science is increasingly discovering that our mental states hold more influence over our bodies and health than has traditionally been believed. For centuries, doctors believed that there was an intricate relationship between our moods and physical states, with the Galenic medicine of the Greeks dictating that fluctuations in mental state were due to imbalances in the level of our "humors" (bile, phlegm, blood). But we're now learning that things actually work the other way, and that our feelings and thoughts about the world ahead and our own ability to survive in it can have genuine effects on our health and bodily resilience.
How We Lose The Will To Go On
The BBC reports that Reynolds' death may have had something to do with the phenomenon of takotsubo cardiomyopathy, or "broken heart syndrome," in which a massive sudden shock effectively prevents the heart's effective working. Discovered initially in Japan, the syndrome involves a weakening of the heart's left ventricle in a rapid series of events, but it's far different from a standard heart attack. Harvard Health, for instance, notes that "more than 90 percent of reported cases are in women ages 58 to 75", and that it may be caused by a massive spike in the stress hormones of the body with knock-on effects on the heart. The interesting thing about takotsubo cardiomyopathy, according to a landmark study in 2014, is that, compared to people who died of more conventional heart attacks, patients who passed away from the condition were twice as likely to have "a neurological or psychological condition," indicating that there may be a link between emotional states and the condition of the heart. It's an old movie trope that a "weak heart" can bring on a heart attack, or that somebody can "die of a broken heart;" this condition shows that the idea carries a bit more weight than we may have thought.
But what about the idea that Reynolds was "willing" herself to die in order to be with her daughter? The desire to die is a well-known part of medical practice; a lot of thought and legal wrangling has been done over how it's expressed in the terminally ill, and whether they have the right to determine the manner of their own deaths. Massive studies have tried to provide insight into figuring out what drives people with terminal or serious illnesses to desire death; one published in 2014 focused on interviews with 30 different patients in hospice, their caregivers and families, and found that the wish to die in this context is a highly individual thing, stemming from ideas about the body's continuing function, quality of life, the wish not to be a burden, fear, and other important aspects. Doctors have also pointed out that there is a lot of wriggle room in expressing "desire to die statements" (DTDS), from wanting to let the disease take its natural course to hastening death with euthanasia. It's rarely the case that the DTDS is inexplicable or unreasonable; but does a desire to die actually bring on death faster, beyond simply refusing to eat or asking for a morphine overdose?
How Optimism May Increase Our Lifespans
Two landmark studies published in the '90s found an apparent link between our state of mind (our willingness to fight, if you like, or our optimism about the future) and our survival rates for certain illnesses. The body and the mind, according to these hypotheses, are not distinct things running on concurrent tracks; one influences the other, and the will to live or die may alter the track of an ill person's life.
The two studies, according to a review of the science of optimism published in 2014, found that "resignation to illness may actually hasten death." One study focused on gay men with AIDS, the other on women with breast cancer, and a common thread was found: those people who resigned themselves to the outcome and refused to view their future as anything except doomed had lower survival rates and less time alive after their diagnosis. According to the breast cancer study, which took place over 15 years after initial diagnosis, "Recurrence-free survival was significantly common among patients who had initially reacted to cancer by denial or who had a fighting spirit than among patients who had responded with stoic acceptance or feelings of helplessness and hopelessness." It's a pattern that's since been found with other diseases; a study of pessimism among Finns with coronary heart disease released in 2016, for instance, found that the most pessimistic ones were 2.2 times more likely to die than the rest of the cohort.
The quality of optimism that drives people to survive is called, in psychological and medical terminology, "resilience." As a personal quality, it appears to help people survive trauma, develop longer survival rates from various diseases, and weather both shocks and serious bodily challenges. Resilience, according to a 2011 study on how we measure it, "could be the key to explaining resistance to risk across the lifespan and how people 'bounce back' and deal with various challenges presented from childhood to older age, such as ill-health." That study found that we're still trying to figure out precisely how to measure resilience in people: one of the most common at the moment is the Connor-Davidson Resilience Scale, developed in 2003 as a 25-point list that includes such things as the ability to adapt to change, to focus and think clearly under pressure, and to take pride in accomplishments.
What precisely happened to Debbie Reynolds we may never know. Science, however, is gradually realizing that there's more to the intersection between the wish to die, the body's strength, and the fate of our health than just poetry or metaphor.