Resource Near Hanging: Risks, Side Effects & Aftermath

[Emerita]

This is for educational reasons and is just from what I understand/know. Please do your own research to verify any information.

What is Near Hanging?

Near hanging refers to situations where an individual attempts suicide by hanging but survives long enough to reach the hospital. Hanging involves strangulation and is one of the most common methods of suicide worldwide, primarily due to its perceived accessibility, speed, and lethality.

Types of Hanging

There are two primary types of hanging in the case of suicide:

1. Partial Hanging: Part of the body remains in contact with the ground. This method is often attempted because it is easier to find a location. However, the pressure around the neck is typically less intense and less consistent, leading to a potentially slower loss of consciousness. Lower risk of brain damage if found in adequate time frame.

2. Complete Hanging: The individual is fully suspended, which normally results in a quicker loss of consciousness and a higher likelihood of death.

Factors Influencing Lethality

The lethality of hanging is influenced by multiple factors, with time being the most critical. The duration of hanging significantly impacts survival rates, followed by the degree of compression and obstruction. Emergency medical attention is the final factor that may affect outcome.

Medical Response to Near Hanging

When emergency medical responders arrive, they typically follow the ABC protocol:

A— airway: Ensuring the airway is clear.
B— breathing: Assessing and supporting breathing.
C— circulation: Monitoring blood circulation and pressure.

The first action is to safely release the ligature if it has not already been done. Then securing the airway, provide ventilation or oxygen, monitor heart/ BP and assess for any potential injuries, such as neck fractures (this is uncommon). At hospitalization possible neurological evaluation may be conducted to know the extent of injuries.

Physiological Effects of Hanging

1. Airway Obstruction: The airway becomes blocked, preventing oxygen from reaching the lungs.
2. Compression of Blood Vessels: Reduced blood flow and or congestion
The carotid arteries, supply blood to the brain
Jugular veins, drain blood from the brain
3. Vagal Nerve Stimulation: This can cause a change in heart rate and blood pressure, potentially leading to cardiac arrest.

These factors can result in unconsciousness within seconds, while death may take several minutes.

Causes of Near Hanging

- The position of the ligature
- The type of ligature used
- Inadequate knots
- Slipping or breaking of the ligature
- Timely intervention

Near hanging cases involve a hanging that was not long enough for fatal outcome, as time is the most critical aspect of survival.

Potential Side Effects

Survival of hanging can lead to potentially a range of side effects for various lengths, including but not limited to:

- Ligature marks
- Neck soreness
- Tissue damage in the neck
- Damaged voice box loss or change of voice
- Breathing difficulties, including aspiration pneumonia or ARDS
- Jugular injury
- Motor deficits
- Cognitive decline
- Memory issues
- Speech problems
- Brain damage
- Psychological effects
- Difficulty swallowing
- Changes in the digestive process
- Visuomotor
- Intellectual impairment
- Personality changes

Individuals may arrive at hospital initially in a coma, they may wake up but complications can arise after the initial survival, leading to death later.

Social Impacts

Survivors of near hanging may face various social challenge:

- Stigma associated with their attempt
- Difficulty finding stability in their lives
- Ongoing mental health issues
- Challenges in reintegrating into social and work environments
- Potential for substance abuse

It is not uncommon for someone to not be able to recall their attempt, especially right afterwards. Confusion when waking in the hospital, feeling of fear may be seen as well in some cases anger. This lack of insight of their attempt may cause issues possibly not seeking support.

Conclusion

The effects of near hanging is complex. Hanging is high risk of death and is considered to be a violent means of self-harm compared to other methods.

Severe neurological defects may be reversible if intervention is within half an hour of suspension, but before cardiac arrest has occurred. Most hangings are lethal before reaching hospital care. However, near hanging patients either survive with mostly favorable function neurologically and are discharged, or die in the hospital. Meaning survival with severe neurologic disability or in a vegetative state is rare, not impossible though. Yet multiple if not many cases of uncomplicated recovery have also been recorded. Also note this fails to mention failed attempts that are not hospitalized, leading to a lack of insight for those cases.

 

[Yonlux]

Could give us the fount? Thank you for the informations.

 

[Emerita]

Could give us the fount? Thank you for the informations.

These are the websites I visited:

https://emedicine.medscape.com/article/826704-overview?form=fpf
https://pubmed.ncbi.nlm.nih.gov/27693068/
https://www.researchgate.net/profil...al-and-postural-neck-compression-injuries.pdf
https://medcraveonline.com/JACCOA/the-effective-factors-on-survival-in-near-hanging.html
https://aasem.org/does-hanging-yourself-hurt-the-truth-about-the-pain-of-suicide-by-hanging/
https://emedicine.medscape.com/article/826704-treatment?form=fpf
https://epmonthly.com/article/clinical-focus-strangulation-and-hanging-injuries/
https://journal.chestnet.org/article/S0012-3692(20)32184-X/fulltext
https://www.entuk.org/_userfiles/pages/files/guidelines/guidelines_acuteemergency_feb241.pdf
https://secure.jbs.elsevierhealth.c...g/article/S2058-5349(23)00075-6/fulltext&rc=0
https://www.diagnostichistopathology.co.uk/article/S1756-2317(19)30102-1/fulltext
https://www.bmj.com/content/341/bmj.c3222
https://academic.oup.com/ije/article-abstract/34/2/433/747066?redirectedFrom=fulltext
https://www.cambridge.org/core/jour...tative-study/EB259F432B70A1B4C71E1B842CC13347
https://www.psych.ox.ac.uk/publications/168342
https://www.evawintl.org/wp-content/uploads/StrangulationInjuries.pdf
https://www.sadvtreatmentcentres.ca...angulation Discharge Instructions_English.pdf
https://pmc.ncbi.nlm.nih.gov/articles/PMC2900131/
https://www.floridaforensicscience.com/what-are-the-different-types-of-strangulation/
https://www.psychologytoday.com/us/basics/suicide/surviving-a-suicide-attempt
https://pmc.ncbi.nlm.nih.gov/articles/PMC6058448/

Sorry idk if there was a better way to have done that.

 

[QueenOfSpades]

A strong reminder why it's so important not to fail your attempt. Especially the (possible) side effects from failure.

 

[PapaYeehaw]

There's also the chance of bursting the capillaries in your face, causing red spots for a while. Happened to me a few months ago after a partial hanging attempt and i was so scared they'd never go away.

 

[quietbird]

Thank you for sharing this information. I am scared of this method and wish I weren't.

 

[AreWeWinning]

There might be risks with hanging, but this summary just confirms what those risks are and that they are relatively easy to deal with.

As listed under "Causes of Near Hanging" in the original post, most risks come from a failing setup (Inadequate knots, Slipping or breaking of the ligature) or being found prematurely (Timely intervention). Regarding the type of ligature, OP didn't specify what this exactly means, but finding a suitable rope that is safe to use is not a difficult task. Regarding the "position of the ligature", it is supposed to be at the back of the neck, which is again, easy to do.

However, near hanging patients either survive with mostly favorable function neurologically and are discharged, or die in the hospital. Meaning survival with severe neurologic disability or in a vegetative state is rare, not impossible though.

In my interpretation, what's important here is that hanging is relatively risk-free. We most likely either die or survive without injuries. If we consider that most of the factors that affect our survival and the lethality of the method (the knots, the rope, the anchor point, and not being found) are in our control, it's clear to me that hanging is a highly effective method.

To be exact, "Complete Hanging", or full suspension hanging is highly effective. "Complete Hanging: The individual is fully suspended, which normally results in a quicker loss of consciousness and a higher likelihood of death."

It's also worth noting that OP did his/her research, and still, there was no mention of pain in his/her post. "not be able to recall their attempt" and "confusion" are mentioned, but not pain.

 

[Emerita]

There might be risks with hanging, but this summary just confirms what those risks are and that they are relatively easy to deal with.

As listed under "Causes of Near Hanging" in the original post, most risks come from a failing setup (Inadequate knots, Slipping or breaking of the ligature) or being found prematurely (Timely intervention). Regarding the type of ligature, OP didn't specify what this exactly means, but finding a suitable rope that is safe to use is not a difficult task. Regarding the "position of the ligature", it is supposed to be at the back of the neck, which is again, easy to do.



In my interpretation, what's important here is that hanging is relatively risk-free. We most likely either die or survive without injuries. If we consider that most of the factors that affect our survival and the lethality of the method (the knots, the rope, the anchor point, and not being found) are in our control, it's clear to me that hanging is a highly effective method.

To be exact, "Complete Hanging", or full suspension hanging is highly effective. "Complete Hanging: The individual is fully suspended, which normally results in a quicker loss of consciousness and a higher likelihood of death."

It's also worth noting that OP did his/her research, and still, there was no mention of pain in his/her post. "not be able to recall their attempt" and "confusion" are mentioned, but not pain.

I didnt do research on pain because it didn't mention pain for patients after the attempt, they most likely had pain medication. A sore neck and weakness in the body would be seen but Im unsure about pain. If your talking about pain associated with in the moments of hanging everyone had different experiences:

people who have attempted have stated either intense initial pain before unconsciousness, painlessness, or (more commonly seen in partial hanging) prolonged feelings of discomfort/ distress before unconsciousness.

As there is only information on pain felt for people whom have survived, it is unclear how those who succeed feel in their last moments.

Relatively, from my research I would say that hanging is a method that if failed you most likely wont face lifelong averse effects. Hanging is a highly effective method if time is sufficient.

 

[cait_sith]

As I have said before, if people becoming vegetables from hanging attempts was a common occurrence we would see a lot more news stories about it in order to scare off people from attempting, but I am only able to find like 3 stories in total on google. still people in Reddit will act like it's the norm..

 

[AreWeWinning]

I didnt do research on pain because it didn't mention pain for patients after the attempt, they most likely had pain medication. A sore neck and weakness in the body would be seen but Im unsure about pain. If your talking about pain associated with in the moments of hanging everyone had different experiences:

people who have attempted have stated either intense initial pain before unconsciousness, painlessness, or (more commonly seen in partial hanging) prolonged feelings of discomfort/ distress before unconsciousness.

As there is only information on pain felt for people whom have survived, it is unclear how those who succeed feel in their last moments.

I was mainly thinking about the pain we feel before losing consciousness. What I was trying to communicate is that, contrary to what many people believe, intense pain must not be a significant factor or a common experience with hanging if it doesn't even get mentioned.

As you say in your reply, some people feel intense pain, and some just describe it as discomfort and distress. Hanging is probably not the most comfortable method, but I don't believe it's excruciatingly painful either. I have read a good few experiences from attempters too, and some don't describe it as very painful, even with full suspension hanging. And there is also that study (Factors influencing the decision to use hanging as a method of suicide: qualitative study) which clearly shows that some people choose hanging specifically because they expect it to be a rapid and painless way to die. Interestingly, it's also true that those who reject it, often do so because they think it's slow and painful. I guess, it's subjective, and depends on our personal level of pain tolerance. Or whether we are ok with some pain as long as it's quick.

It's also worth considering that pain or discomfort is just one factor, just one characteristic of a method among others. There are no methods that are painless, highly accessible, and highly effective and low-risk. It's always a trade-off, and the choice depends on what's more important for the individual. There are methods that are painless and very effective, but those won't be highly accessible. There are methods that are painless and accessible, but those won't necessarily be very effective or totally risk-free. And there are methods that are accessible and highly effective and relatively risk-free, but those won't necessarily be completely painless or comfortable. A good example of the latter is full-suspension hanging.

Relatively, from my research I would say that hanging is a method that if failed you most likely wont face lifelong averse effects. Hanging is a highly effective method if time is sufficient.

I agree, and this is an important point in my opinion. There are other effective methods too, e.g. jumping or using a gun, but there is a much higher risk of suffering a lifelong severe injury from those if our attempt fails for whatever reason. On the other hand, with hanging, most likely we either die or escape without severe injuries. There are exceptions, but those are extremely rare, and can be prevented with some planning. The only realistic scenario when this can happen is if we are found prematurely. If there are other issues, e.g. our setup fails or we manage to escape it, we very likely survive without permanent injuries.

 

[Emerita]

As you say in your reply, some people feel intense pain, and some just describe it as discomfort and distress. Hanging is probably not the most comfortable method, but I don't believe it's excruciatingly painful either. I have read a good few experiences from attempters too, and some don't describe it as very painful, even with full suspension hanging. And there is also that study (Factors influencing the decision to use hanging as a method of suicide: qualitative study) which clearly shows that some people choose hanging specifically because they expect it to be a rapid and painless way to die. Interestingly, it's also true that those who reject it, often do so because they think it's slow and painful. I guess, it's subjective, and depends on our personal level of pain tolerance. Or whether we are ok with some pain as long as it's quick.

I agree with that hanging may not always be excruciatingly painful. Pain perception is subjective, so varied reports are understandable. In cases where unconsciousness isn't immediate due to anatomical differences, the method of hanging, or other factors it's possible that the brain's stress response SI could amplify or dull the sensation of pain. This is speculatory but possible with what we know about the brain's response to threat. Shock may suppress pain but there's the other side of that where panic can increase pain perception.

It's also worth noting that there are documented instances of people engaging in hanging or asphyxiation as a form of sexual gratification, ie., autoerotic asphyxiation. Which can cause lightheadedness, euphoria, and sometimes arousal likely due to both oxygen deprivation and stimulation of the vagus nerve or other sensitive areas in the neck. These practices have sometimes led to accidental death. This suggests that hanging does not always result in overwhelming pain at least not immediately which complicates the assumption that it's intensely painful.

The drop hanging method, historically used in executions, is considered more "humane" because it is designed to cause a rapid neck fracture and spinal cord injury, leading to quicker loss of consciousness and death. However, its use may also have been about exerting control and ensuring reliability in executions, rather than solely reducing suffering.

In light of this, it's difficult to assert that hanging is intensely painful by default, more likely it is not inherently unless there is some flaw in technique or something else. Pain might also be influenced by the type of ligature used for example, a thin wire or sharp material could dig into or damage the skin, bringing a separate source of pain beyond the asphyxiation itself.

I have practiced this method and found it not painful but other experiences are possible. I also did not have pain after but pain may be more pronounced for someone who injured themselves from falling (like if ligature slipped or broke) while unconscious.

 

[quietbird]

I agree with that hanging may not always be excruciatingly painful. Pain perception is subjective, so varied reports are understandable. In cases where unconsciousness isn't immediate due to anatomical differences, the method of hanging, or other factors it's possible that the brain's stress response SI could amplify or dull the sensation of pain. This is speculatory but possible with what we know about the brain's response to threat. Shock may suppress pain but there's the other side of that where panic can increase pain perception.

It's also worth noting that there are documented instances of people engaging in hanging or asphyxiation as a form of sexual gratification, ie., autoerotic asphyxiation. Which can cause lightheadedness, euphoria, and sometimes arousal likely due to both oxygen deprivation and stimulation of the vagus nerve or other sensitive areas in the neck. These practices have sometimes led to accidental death. This suggests that hanging does not always result in overwhelming pain at least not immediately which complicates the assumption that it's intensely painful.

The drop hanging method, historically used in executions, is considered more "humane" because it is designed to cause a rapid neck fracture and spinal cord injury, leading to quicker loss of consciousness and death. However, its use may also have been about exerting control and ensuring reliability in executions, rather than solely reducing suffering.

In light of this, it's difficult to assert that hanging is intensely painful by default, more likely it is not inherently unless there is some flaw in technique or something else. Pain might also be influenced by the type of ligature used for example, a thin wire or sharp material could dig into or damage the skin, bringing a separate source of pain beyond the asphyxiation itself.

I have practiced this method and found it not painful but other experiences are possible. I also did not have pain after but pain may be more pronounced for someone who injured themselves from falling (like if ligature slipped or broke) while unconscious.

You seem so well-versed in this. Can I ask what sort of rope/ligature you're using? And are you finding it possible to get your arteries and not windpipe? I can't seem to figure out how to avoid it. I don't want to suffocate as that seems like the flaw that caused pain... I'm not sure this is my method but I'd like to feel it out more. Again, any suggestions are very welcome. Thank you for sharing.

 

[Subhumano]

I just hope I dont end up mentally challenged or paralyzed. With the other complications I can always try again

 

[Emerita]

You seem so well-versed in this. Can I ask what sort of rope/ligature you're using? And are you finding it possible to get your arteries and not windpipe? I can't seem to figure out how to avoid it. I don't want to suffocate as that seems like the flaw that caused pain... I'm not sure this is my method but I'd like to feel it out more. Again, any suggestions are very welcome. Thank you for sharing.

Thicker ligatures distribute pressure over a larger area, reducing localized tissue damage. Potentially being more comfortable due to not digging into skin, but may require more force to achieve effective constriction of blood vessels and airway, leading to slower effects.

In contrast, thinner ligatures create concentrated pressure, resulting in rapid constriction of blood vessels and airway, this can lead to quicker loss of consciousness but also a possibility for an initial though short sense of significant pain and if failed increased risk of tissue damage. Thinner ligatures may cause faster airway constriction, while thicker ones may not be as effective, prolonging the experience.

That being said personal preference may be different. It's hard to say, I found a thicker ligature more comfortable and used this while practicing but thinner ones are supposedly more effective. While evidence of this could be the fact Im still alive; meaning possibly my ligature needs some tweaks before attempting.

Sorry that honestly didn't answer anything, Im still learning too. So much of this is subjective when it comes to the pain of it and with so many variables it's hard for me to give a straight answer.

 

[JesiBel]

And are you finding it possible to get your arteries and not windpipe? I can't seem to figure out how to avoid it.

Well, the knot (nooseknot), by tightening itself on your neck below your jaw, will compress everything. You won't be able to swallow or breathe either.

The entire weight of your body is being supported by the rope tied around your neck. If you look at forensic photos, you'll see the deep grooves left by the rope.

 

[AreWeWinning]

Thicker ligatures distribute pressure over a larger area, reducing localized tissue damage. Potentially being more comfortable due to not digging into skin, but may require more force to achieve effective constriction of blood vessels and airway, leading to slower effects.

Thinner ligatures may cause faster airway constriction, while thicker ones may not be as effective, prolonging the experience.

You won't be able to swallow or breathe either.

Why are you concerned about the constriction of the airway and not being able to breathe? Based on my tests, breathing doesn't even come into play. Anyone can hold their breath for about 10 seconds very easily, and after that, we lose consciousness anyway. As I understand it, it's about the constriction of blood flow, and constricting the airways is not something we even need to think about. We won't even be aware of it, and it's not the main cause of death either.

 

[JesiBel]

Why are you concerned about the constriction of the airway and not being able to breathe? Based on my tests, breathing doesn't even come into play. Anyone can hold their breath for about 10 seconds very easily, and after that, we lose consciousness anyway. As I understand it, it's about the constriction of blood flow, and constricting the airways is not something we even need to think about. We won't even be aware of it, and it's not the main cause of death either.

I answered what the user asked.

 

[quietbird]

Thicker ligatures distribute pressure over a larger area, reducing localized tissue damage. Potentially being more comfortable due to not digging into skin, but may require more force to achieve effective constriction of blood vessels and airway, leading to slower effects.

In contrast, thinner ligatures create concentrated pressure, resulting in rapid constriction of blood vessels and airway, this can lead to quicker loss of consciousness but also a possibility for an initial though short sense of significant pain and if failed increased risk of tissue damage. Thinner ligatures may cause faster airway constriction, while thicker ones may not be as effective, prolonging the experience.

That being said personal preference may be different. It's hard to say, I found a thicker ligature more comfortable and used this while practicing but thinner ones are supposedly more effective. While evidence of this could be the fact Im still alive; meaning possibly my ligature needs some tweaks before attempting.

Sorry that honestly didn't answer anything, Im still learning too. So much of this is subjective when it comes to the pain of it and with so many variables it's hard for me to give a straight answer.

Thank you for sharing all of this. I'm sorry that we both feel pulled to this need. Anything I may do I'd want to do as safely and realistically as possible...also without causing lots of pain or a failure. Thank you for sharing. I do really appreciate it. We're all in stages of learning or education, I don't expect anyone to have all of the answers or anything.

Well, the knot (nooseknot), by tightening itself on your neck below your jaw, will compress everything. You won't be able to swallow or breathe either.

The entire weight of your body is being supported by the rope tied around your neck. If you look at forensic photos, you'll see the deep grooves left by the rope.

Oh, I've seen so many talk about finding the sweet spot with padding and angles so the windpipe isn't affected and you don't accidentally suffocate to death. But it does seem like it's very hard to do. Thank you for replying.

Why are you concerned about the constriction of the airway and not being able to breathe? Based on my tests, breathing doesn't even come into play. Anyone can hold their breath for about 10 seconds very easily, and after that, we lose consciousness anyway. As I understand it, it's about the constriction of blood flow, and constricting the airways is not something we even need to think about. We won't even be aware of it, and it's not the main cause of death either.

I am probably not doing it properly yet. Like some, I find my head about to explode in pain. I have read about hyperventilating before to aid this... Ideally we would pass out...I'm just doing some research, seeing about this method. Thank you for adding some info to consider

 

[siouxsie]

There's also the chance of bursting the capillaries in your face, causing red spots for a while. Happened to me a few months ago after a partial hanging attempt and i was so scared they'd never go away.

That's petechiae. They are a normal finding in most hangings and strangulations.

 

[AreWeWinning]

I am probably not doing it properly yet. Like some, I find my head about to explode in pain. I have read about hyperventilating before to aid this... Ideally we would pass out...I'm just doing some research, seeing about this method. Thank you for adding some info to consider

If you feel like your head is exploding, then you're doing something fundamentally wrong. I see many comments about people trying for several minutes, with different ligatures, etc., while the problem might be that they simply don't apply enough pressure. At least, based on my own experience, that's what I think the problem is. In my opinion, rope positioning, thickness of the rope, breathing techniques, etc., are far less important than people tend to believe. It's almost like they hardly matter at all. If you apply enough pressure, it takes about 5-10 seconds to lose consciousness. It happens very quickly, and, apart from the pressure on the neck caused by the ligature, it won't be uncomfortable at all. It'll be very obvious, and you'll have no doubts that it is the feeling you were looking for.

One reason people don't apply enough pressure might be that they don't know how to test properly! I think many people are trying to test passing out while the rope is attached to a fixed anchor point. This is a very bad idea, and it's impossible to test like this. The two most likely outcomes from such tests are: 1) Your test is successful, and as a result, you die. 2) Your test is unsuccessful. Knowing this, people are afraid to apply enough pressure. (For good reason, I must add!) It is totally pointless to test like this, and it's impossible to learn anything from such tests. This is just speculation though, because I'm not sure what anyone is doing.

The proper way to test is to not fix the rope to an anchor point, but to create a setup where the rope can freely slide, and hold the other end in your hand. So, when you pass out, you automatically release the rope, and thus release the pressure on your neck. Doing it like that, you can apply as much pressure as necessary, and you can experience what passing out really feels like.