Mind over mortality

Can the will to live triumph death and disease?

This is a difficult theory to test. Since it is impossible to predict exactly when someone will die, it is not possible to see if a will to survive will keep them alive longer.

A number of studies have looked at personality variables such as positivity and calmness on longevity. These have shown that contentedness, both early and late in life is linked to slightly longer life spans. Indeed mortality rates for the neurotic, unhappy and angry elderly people were often more than twice that of their contented peers.

It is possible that happier people have a stronger will to live. Or, conversely, that healthier people (who are more likely to live longer) are happier.

But happiness should not necessarily translate into a stronger will to live. Hasn’t everyone heard of the grumpy old grandfather hanging on just to spite the relatives? It could be that reduced mortality in the chirpy set is due to the health benefits of stress reduction.

So how could you test the will to live? Scientists have looked for occasions people may wish to live for. Religious, cultural or family-oriented days may provide a focal point – perhaps grandpa can will himself to live until his birthday so that he can see his family once again.

Thus a number of studies have looked at death rates before and after major events. These have included birthdays, Christmas, Passover and Chinese lunar celebrations. By testing specific events which are only important for a selection of the population at any one time, mortality rates can be compared between those for whom it may be important, and those for whom the date is irrelevant.

Many studies have demonstrated reduced death rates prior to such occasions, with a significant surge directly after the event. The importance of these events has apparently delayed deaths from diseases including cancer and heart disease.

No clear mechanism is obvious. Possible explanations have included reduced stress levels, better adherence to medication schedules, benefits of companionship or some psycho-biological process as a results of religious or emotional feelings.

There are confounding factors. Many of these events involve over-indulgence and high fat meals are known to cause heart attacks. Also, the holidays can be very stressful. This could lead to slightly higher death levels after the holiday. Only a few studies take into account the cause of death. Road deaths from drink driving or celebratory shootings (this is an American term relating to people accidentally killed when people shoot guns to celebrate holidays) and other such seasonally affected events may skew calculations.

Indeed reanalysis of the data presented in many of these accounts often alters the conclusions. Secondary research re-examining the spread of diseases covered, the specific time periods before and after an event and the calculation of the mortality percentages seems to deny any effects of willpower.

So, while tantalising, the evidence is not conclusive. Though, if I were a betting person, I would put money on willpower overcoming death in the short term. From personal experience I have seen the terminally ill hang on months beyond the best estimates of doctors, only to fade fast when they suddenly lose the will to survive.

References

Skala JA, Freedland KE (2004) Death takes a raincheck Psychosom Med. 66(3):382-6.

Danner DD, Snowdon DA, Friesen WV (2001) Positive emotions in early life and longevity findings from the nun study. J Pers Soc Psychol 80: 804–13

Lee P, Smith G. (2000) Are Jewish deathdates affected by the timing of important religious events? Soc Biol. 47(1-2):127-34.

Phillips DP, King EW (1988) Death takes a holiday: mortality surrounding major social occasions Lancet 2(8613):728-32.

Phillips DP, Smith DG (1990) Postponement of death until symbolically meaningful occasions JAMA 263(14):1947-51.

Smith G. (2004) Asian-American deaths near the Harvest Moon Festival.
Psychosom Med 66(3):378-81.

Wilson RS, Bienias JL, Mendes de Leon CF, Evans DA, Bennett DA (2003) Negative affect and mortality in older persons Am J Epidemiol. 158(9):827-35.

Wilson RS, Mendes de Leon CF, Bienias JL, Evans DA, Bennett DA (2004) Personality and mortality in old age J Gerontol B Psychol Sci Soc Sci 59(3):P110-6.

Young DC, Hade EM. (2004) Holidays, birthdays, and postponement of cancer death.
JAMA 292(24):3012-6.

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