UKH

/ High altitude psychosis

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Badgers - on 20 Dec 2017
Thought this may interest some folks on here. A new study describing the occurrence and associations of psychotic symptoms at high altitude in mountaineers.

Here's a summary article:
http://www.iflscience.com/brain/mountaineers-who-suffer-moments-of-psychosis-are-not-just-experienci...

And the original paper:
https://www.cambridge.org/core/journals/psychological-medicine/article/isolated-psychosis-during-exp...

It suggests that a high altitude psychosis may occur independently of other symptoms of cerebral oedema. The mean altitude was 7000m so may be more limited to the extremes of altitude. It's an interesting read.
atthedropofahat on 20 Dec 2017
In reply to Badgers:

Hallucinations and hearing voices are common symptoms that people in stressful situations after days without sleep experience. I certainly had them at sea level after being deprived of sleep for almost a week on army exercise. Maybe psychosis or maybe its just what happens when your brain starts dreaming while you are awake.
bensilvestre - on 20 Dec 2017
In reply to Badgers:

Psychotic symptoms I guess is the point. Sounds interesting
Annoying Twit - on 01 Jan 2018
In reply to Badgers:
If my memory serves, Stephen Venables gives a detailed description of hallucinations that he experienced on Everest in his (very interesting IMHO) book 'Everest, Kangshung Face.'

EDIT: According to this: https://www.himalayanclub.org/hj/45/5/four-against-the-kangshung/ it was Ed Webster that had the hallucinations and was 'losing [his] grip on reality.' (He turned around.) I don't know if my faulty memory has attributed the hallucinations that Webster had to Venables, or whether Venables also experienced same.
Post edited at 14:48
Badgers - on 01 Jan 2018
In reply to Annoying Twit:

Havn't read that, sounds interesting. Will search it out for a read, thanks.

It'd be interesting to know to what degree it's altitude, hypoxia, physical and psychological stresses or others that contribute to the phenomenon.

The low levels of oxygen measured in climbers over 8000m are stunningly low. Far below what we see in critically ill people in hospital.

Annoying Twit - on 01 Jan 2018
In reply to Badgers:
I can't find the book right now so can't check if my demonstrably unreliable memory is accurate in this case. But, I *THINK* that there were some pretty detailed and complex hallucinations mentioned. Note that most of the book is about forging the new route. It doesn't specialise in the psychological aspect.

And thanks for the article you recommended. What I read in Venables book makes more sense now. I assumed that it was just hypoxia. It was a bit of a WTF moment when I read it, and it makes me wonder how there aren't more people just walking off ridges in thrall to a hallucination. Then again, I've never had a hallucination, so I don't know what they are like.
Post edited at 22:27
Damo on 02 Jan 2018
In reply to Badgers:

I've read many of the media articles since this study came out.

I see here the IFLS article says "It was also noted that it only occurs at heights exceeding 7,000 meters" - whereas the source article says "...Episodes reported above 3500 m altitude with possible psychosis were collected."

That's a major difference, even though in a technical medical sense 'high' altitude usually starts at 10,00ft / 2800m or sometimes 3500m, as here.

I've had some pretty major hallucinations on a climb, the strongest of them after 30+hrs on the go, climbing up and down a 2300m new route in soft snow, single push. This article mentions the lesser ones I had on that climb, not the wildest ones: http://www.alpinist.com/doc/web07-08w/newswire-antarctica-omega-epperly-gps

But although some altitude - around 4000m - was a factor in that situation, I have always put it down to a combination of dehydration, exhaustion, stress etc. Other polar expeditioners have experienced some types of 'Third Man' syndrome, usually at low altitudes. Personally I doubt the primacy of 'high altitude' as a cause of such phenomena.

Badgers - on 02 Jan 2018
In reply to Damo:

Yeah, i agree. I think it's most likely a combination of factors. Anyone can hallucinate in the right/wrong settings as part of delerium. I have had visual hallucinations with high fever with a bacterial sore throat. I guess a combination of a range of factors would do it.

'Altitude' ends up being a proxy for a whole range of things, sleep deprivation, cold exposure, physical exhaustion, hyperventilation, hypoxia, fear, low calorie intake etc.. which could all contribute.

The altitude is a bit unclear as you say, but the mean altitude in the cases they report is over 7000m (although I would have thought it should be median). It's a hugely biased sample too as i guess people are more likely to write up higher altitude climbs or more difficult or challenging climbs.

Thanks for the link.

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