Why do people begin to «go crazy» in the mountains
An article from the German newspaper Süddeutsche Zeitung, the author Stefan Wagner (Stefan Wagner). Translation INOSMI.
Phantom satellites, the smell of food, road noise: at high altitude feelings climbers are often deceived some strange illusions. Doctors believe these symptoms are a special kind of psychosis that occurs separately from the classic altitude sickness.
He appeared suddenly. As if from nowhere. Jeremy Windsor (Jeremy Windsor) exchanged a few encouraging words from a man who introduced himself as Jimmy, and then slowly went on. Here, at an altitude of 8200 meters, with the rise in the South-Eastern slope of mount Everest, there is no desire to waste oxygen talking.
The rest of the day, the American climber Windsor saw in his peripheral vision, his companion, always a few metres behind, over your right shoulder. Later, during the descent, Jimmy was gone as suddenly as it had appeared. Only when Windsor returned to broken below the camp, he realized that in fact, no Jimmy was not.
«Described in 2008, Jeremy Windsor typically,» says Katharina hufner (Katharina Hüfner), neurologist and psychiatrist at the University clinic in Innsbruck. Together with Hermann Brugger (Hermann Brugger), Director of the Alpine Institute of emergency medicine in Bolzano, she studied 83 message from the climbers.
Scientists from Italy and of Austria has examined this phenomenon from the records of such great climbers like Hermann Buhl (Hermann Buhl) and Reinhold Messner (Reinhold Messner), evidence of the writer Jon Krakauer (Jon Krakauer), as well as stories of other, less well-known climbers.
As climbers «pursue», they begin to communicate with imaginary people, hear the noise of cars or music, see colorful stars or change your route to get to mountain huts, which they think is in front of them.
Until now, scientists explained these hallucinations, as described by Jeremy Windsor «third man syndrome», organic reasons, first of all well-known and life-threatening brain edema caused by rapid ascent to altitude, as well as dehydration and infections.
The first symptoms of acute altitude sickness are strong headache, dizziness or disequilibrium. But in a good quarter of the studied messages now climbers only described the psychosis without any accompanying physical symptoms.
«We found that there is a group of symptoms that are purely psychotic, which means that they are connected with height, but not related to swelling of the brain or other organic factors,» explains Brugger.
Innsbruck scientists call this phenomenon an «isolated psychosis due to height». This new form of the disease usually manifests at a height of 7000 meters, continues hufner, but it can develop into «ordinary canadian» the height of 4000 meters.
After the publication of the study in the medical journal «Psychological medicine» (Psychological Medicine)the authors asked a lot of climbers. 52-year-old Italian climber Sergio Zigliotto (Sergio Zigliotto) also gained experience in proving a point scientists.
«It was the hour of the night. I only made four camps on Manaslu, up to about 200 meters and was at the height of 7600 meters, he says. — Then I got the feeling like I’m camping at home, in Trentino. I saw the forest, then at home, just like those that I have at home. Then even the smell of food, and I was talking with someone in Italian about my frozen feet.»
Although Ziliotto and was extremely emaciated, he had no painful physical manifestations. «Definitely signs of altitude sickness was not only these visions,» he says.
His friend was climbing a similar experience in the same ascent at the height of 7500 meters, the stories of Ziliotto. «He hails from Tuscany and saw the Tuscan hills. In The Himalayas!» Some time on the ice the height of his friend, «accompanied by» the dog.
The authors of the study, 65-year-old Brugger and 41-year-old hufner, and they themselves are avid climbers. Many years in conversations with friends, such as Italian extremely climber Hans Kammerlander (Hans Kammerlander), they heard about the phenomena and hallucinations at high altitude. Then during the joint sessions of ski mountaineering in Tajikistan they decided to conduct a scientific anecdotal observations.
«As often happens, the best ideas come for a beer at the campfire,» says hufner. First of all, the fact that the manifestations of the psychosis completely disappeared during the descent the climbers returned to camp below, broken physically healthy, were given to understand that it could go on about some new disease that is not related to altitude.
«What mountains are really beautiful, we both always knew, continues Hermann Brugger, but we didn’t know what they can and we can plunge into madness.»
The cause of high-altitude psychosis is unclear. «We have no evidence,» says Brugger. — «Of course, can influence factors such as lack of oxygen, cold, fatigue and the feeling of a climber that he remained absolutely alone. For future research it is important that, apparently, no consequences of such a psychosis to the health not diagnosed». «This allows us more accurately to study temporary psychosis in otherwise healthy people,» says Katharina hufner.
This can give important information for the understanding of such mental illness, such as schizophrenia.
The results of this study are important because they shed light on the mysterious causes of accidents in the mountains. It is obvious that this syndrome increases the risk of an accident.
Well-known Slovenian climber and doctor Iztok tomazin (Iztok Tomazin) reported an incident that occurred in 1987 in the Himalayas, the dhaulagiri height 8167 meters. Tomazin recalls how during the climb left route and heard the voices of «conductors», who asked him to jump off a cliff with a height of 2000 meters to get to the «smooth, safe surface».
At the last second before jumping to his mind came the thought: what if the guides are wrong? Then he made a test jump located on the two meters below the ledge. Feeling the pain from the injury, he was able to correctly assess the situation, «voice guides» ceased, and he resumed the search of the correct route.
In this lies the practical value of the study. «Mountaineers, extreme should know that there is an isolated high-altitude psychosis is that it occurs without any other signs of illness and that it is temporary,» says Brugger.
The number is not included in the statistics of accidents and deaths associated with such disorders of perception can be very high. Suddenly the inexplicable and irrational erroneous actions of climbers at high altitude appear in a different light.
«To reduce the number of accidents it is very important to distribute cognitive treatment strategies that are climbers themselves or with their partner will be able to apply directly to the mountains,» says Katharina hufner.
Here are simple questions to a partner to check the perception of reality, for example: «You too?» or «do You hear what I hear?»
In may at the base camp of mount Everest, scientists want together with several Nepalese doctors to examine the many climbers before and after the course. The purpose of, among other things, is to find out how often the illness occurs, to gather first-hand experience of cases and to classify them.
Next year the mountain will be somewhat easier to obtain the data. In Bolzano at the beginning of 2019 the Institute of Alpine emergency care will open the «terraXcube», the largest climate chamber in the world. Brugger enthusiastic about the opportunities.
«We can put in the conditions prevailing in the death zone in the Himalayas, up to 15 people: the oxygen content as 8000 meters, minus 40 degrees, a hurricane». Then the doctors in the laboratory will also simulate the conditions under which there is a high altitude psychosis. «Bring the madness in Bolzano», says Brugger.