Health & Welfare: Helplessness, Self-Esteem, and Sudden Death

Self-esteem is the exact opposite of helplessness, the feeling of being out of control, of being unable to alter the adversities in one's life. Nearly everyone has experienced the feeling of helplessness at some time or another and knows how unpleasant and depressing it can be. Perhaps worst of all, the belief that one is helpless and impotent can become paralyzing self-fulfillment. Recent scientific research has uncovered some of the biochemical mechanisms underlying the helpless state and has provided valuable clues to increasing our control over our own feelings of confidence and avoiding the deleterious effects on health, long-term planning, action, and even life span that can result from feeling helpless.

Animals can suffer from helplessness, too. When experimental animals were repeatedly subjected to unavoidable mild electric shock, they became less able to escape an avoidable mild electric shock, even when they could do so by simply moving away a short distance. In animals and people, the perception of helplessness results in an inhibited ability to respond in new situations, less ability to perceive success, and a heightening of emotionality. When helplessness occurs as a result of a single session of unavoidable shock, this condition dissipates in time. But after a number of such events, the effect tends to persist, interfering with ability to learn the connection between actions and results.

The belief in helplessness is enough to cause these effects. In one experiment, people had to perform several tasks while listening to a loud, raucous noise. One group of the people were told that they could terminate the loud noise at any time by pushing a control button if they felt that they could not continue the experiment because of the clamor. Another group did not have this option. The result was that the group with the optional control button performed better even though they never used it and even though this button was a dummy that did not control anything. But the people's beliefs that they had control over the experiment prevented them from feeling helpless.

Even more startling effects occur. When rats are squeezed in the hand, then allowed to wriggle free and drop into water, they can swim many hours before sinking in exhaustion. When, however, rats are squeezed in the hand just as hard and long and not allowed to wriggle free but simply dropped into the water, they swim about frantically in a poorly coordinated and inefficient manner for only a few minutes, then sink under and drown. A reasonable interpretation is that the rats that wriggled free did not feel helpless because they had "escaped." In fact, some of the helpless rats died in the experimenter's hand before even reaching the water!

Among humans, sudden death from helplessness is not uncommon. For example, old people frequently die a short time after retiring or being moved into a nursing home. Sudden deaths may follow loss of a loved one or loss of status or self-esteem. Among 4,500 British widowers 55 years of age or older, there was a 40 percent higher than normal death rate during the six months following the deaths of their wives. Other studies suggest that the risk of contracting cancer and other diseases is also significantly increased by helplessness. It is likely that the well-documented sudden death of some voodoo victims results from helplessness.

An important physiological factor associated with helpless states is depletion of norepinephrine in the brain. Norepinephrine is an important chemical used by some brain neurons to communicate with each other. NE is important for learning and memory, primitive drives and emotions, motivation, and long-term planning. NE also causes the brain's pituitary gland to release growth hormone, which is required in adequate quantities for proper function of the immune system—the police force responsible for recognizing and destroying bacteria, viruses, cancer, and atherosclerotic plaques (a type of tumor). Giving rats chemicals that specifically deplete brain supplies of NE results in helpless behavior. On the other hand, giving rats chemicals that increase brain NE (such as the nutrient phenylalanine) seems to prevent helplessness under conditions that would otherwise cause it.

We know that depletion of NE can cause depression and that many forms of depression—including amphetamine abuse, schizophrenic, endogenous, and the depressive phase of manic-depression—can be alleviated with the amino acid phenylalanine, which increases brain levels of NE (the brain converts the phenylalanine into NE; Vitamins C and B-6 are required for this conversion). In one study, 100 to 500 mg. of phenylalanine a day for two weeks was effective for most subjects in entirely alleviating their depression. In some susceptible persons, high doses of phenylalanine (the exact dose depends on the individual) can increase blood pressure. Therefore, people with high blood pressure should start at a very low dose, perhaps 50 mg., while measuring their blood pressure at frequent intervals and increasing the dose gradually over a period of weeks. Phenylalanine should be taken either on an empty stomach just before you go to sleep or immediately upon awakening in the morning. Possible side effects (annoying but not dangerous) include insomnia, irritability, and headache; reduce dosage if any of these occur.

A deficiency of acetylcholine (Ach), another neurotransmitter, can also lead to depression. Ach is important in long-term planning, learning and memory, sleep, sexual function, and mood. Either choline (3 grams/day) or lecithin (80 grams/day) increase brain levels of Ach, and both have improved memory and learning in normal human subjects in clinical studies. Acetylcholine precursors seem to be particularly useful in helping to combat the lethargic depression that often accompanies advancing years. Vitamin B-5 (pantothenic acid or calcium pantothenate) is required for the conversion of choline to acetylcholine in the brain. The prescription drug Deaner R (Riker) also increases brain Ach and has been shown to reduce apathy and to increase motivation in senile people and to improve learning and memory in hyperkinetic children. Ach precursors should not be used in the depressive phase of manic-depressive psychosis because they can deepen this particular type of depression.

A good many political problems, such as the propensity of people to look to powerful governments and charismatic leaders to act for them, may be due to feelings of helplessness experienced by people in response to problems like pollution, wars, energy shortages, and pessimism and uncertainty about the future. When people perceive the outcome as being unaffected by their own efforts, helplessness results. Understanding how this process works, how helplessness is produced and how it can be unlearned, and, especially, the underlying biochemical mechanisms that control these feelings is an important start to overcoming the tragedy of human helplessness.

Sandy Shaw and Durk Pearson are consulting scientists, authors, and TV personalities. Copyright © 1981 by Sandy Shaw and Durk Pearson. References to this column are available. Send a stamped envelope to this publication and indicate the month of the column.