Saturday, January 14, 2012

Near Death Euphoria and the Link to Suicide

I was asked by a friend if I ever came across someone who attempted suicide not to escape suffering, but because they knew it would feel good.  Although not suicidal, the person asking the question was curious because he had experienced a near-death situation in which he was injured and felt euphoria.

I thought this was a really thought-provoking question. The link between near-death euphoria and suicide never crossed my mind before.

This was my response:

I have heard of people recounting similar types of experiences, but I had never considered the link between near-death euphoria and the intention to commit suicide.

A brief discussion of Thomas Joiner's theory of suicide is in order. The basic gist is that people may build a tolerance for the negative feelings associated with hurting / killing themselves by engaging in self-injurious or thrill seeking activities. While it is not necessarily intentional, the negative feelings about death may lessen over time.

Let's just say a person regularly sky dives. Then, for whatever reason, they become suicidal. If you're already used to jumping out of planes, the idea is maybe you won't be that scared to jump off of a bridge.

There is another relevant example to this discussion as well. Namely, if a person regularly cuts themselves (without intent to die) when they're upset, they may not be scared to make life-threatening incisions when suicidal urges come up.

While I formerly thought of this concept as similar to "building up the courage" to attempt suicide via repeated episodes of cutting / dare-devil behavior, this question has me thinking differently. Perhaps there is an additional component here that is consistent with Joiner's theory.

When people cut their skin with no intent to die, it is thought that endorphins are released. This would create reduction in the negative feelings that may prompt self-injury, like shame, anxiety, sadness, etc. Perhaps people also feel mild euphoria, or positive feelings, from the endorphins. This might suggest that for some, self-injury has at least two psychological functions - reducing negative feelings and increasing positive feelings - perhaps produced by the same biological mechanism (i.e. endorphin release).

In any event, a link between injuring oneself and feeling good is formed. Maybe this association generalizes to suicide in the sense that injuring yourself is linked with feeling good.

Now, getting more to the point of suicide, endorphins are not only relesaed during self-injury, but during a traumatic / near-death event as well. This is very interesting to me because a link can be formed between feeling good and death, specifically. In the sky diving example used above, an association is formed between feeling good and jumping from a height, but not necessarily death. In the case of a traumatic event, the link is formed between feeling good and specifically being near-death.

While people may not report chasing the feeling of euphoria that comes with being close to death, if they've experienced it, the drive for this positive feeling could theoretically propel future suicidal behavior. Whether or not the person is aware that they are driven to suicide because of past feelings of euphoria when close to death, it could be a biological function maintaining the behavior.

In short, while I had formerly thought of suicide as a behavior maintained by the function of wanting to escape pain, this point raises the question of whether or not people want to commit suicide to actually feel better. Again, while I don't think people would necessarily report wanting to die to feel that euphoria, it could influence their suicidal drive and behavior.

[For people familiar with psychology lingo on this blog, the function may not necessarily just be automatic negative reinforcement, but automatic positive reinforcement as well.]

Truly, a fascinating point. Thank you so much for asking.

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2 comments:

drlisa said...

Truly fascinating Tara! I work with suicidal patients and often the plan to end life brings euphoria because there is a solution to their suffering (or so they think.).

Tara Deliberto said...

Thanks, Dr. Lisa!

It is certainly true that thinking of taking their own lives is comforting to many people.

I had never considered that a near-death experience could trigger euphoria before.

Thanks for your comment!

Tara