Doctor explains causes of painful ‘suicide disease’ that smiling can trigger

Warning: This article contains discussion of suicide which some readers may find distressing.

There are many medical conditions that you should dread being diagnosed with, from all forms of cancers to life limiting and debilitating issues like multiple sclerosis or COPD.

But if you were to pick one health problem that you wouldn't even wish on your worst enemy, it's probably trigeminal neuralgia, also known as tic douloureux, or more terrifyingly, the 'suicide disease'.

It is not something often ranked in medical circles, due to people's subjective experience of pain, but this condition is often described as being the most painful ailment known to modern science. And it's clear why.

An expert in anaesthesiology and pain management in Maryland, Dr Kunal Sood, has explained exactly what causes this condition, as well as how to treat it, in a public information video about this disorder - which causes terrifying shooting pains in your head when you smile, eat, or even speak.

Trigeminal neuralgia is a chronic pain condition that affects the lagest nerve which runs through your face and controls everything from your pain response to your mouth's movements when chewing, talking, or smiling.

Dr Sood explained: “The nerve has three branches reaching the eye, cheek and jaw. And pain can be felt anywhere in the face, depending on which branch is irritated.”

This condition develops when your trigeminal nerve starts to misfire and triggers bouts of extreme and sudden facial pain which can last from a couple of seconds to a couple of minutes. The pain is so unbearable that frequent attacks have been sadly linked with increased suicidal ideation.

Tic douloureux is caused when something like a blood vessel presses on the trigeminal nerve, or as the result of diseases like multiple sclerosis which damage the myelin sheath that usually protects your nerves from this debilitating condition.

There are not always obvious causes for this condition and anyone could develop it, however, it typically affects people over the age of 50 and is more likely to trigger in women than in men.

An attack can triggered by any movement of the muscles in your face associated with chewing, smiling, talking, shaving, brushing your teeth, or even by a gust of wind.

Which, for sufferers, is almost impossible to avoid.

While it can be hard to define something that maxes out the pain scale, Dr Sood described it as: “The pain is often described as electric shocks or severe burns, typically affecting one side of the face.”

This might be experienced just once per day, or happen multiple times, with many sufferers experiencing more frequent attacks over time.

“While not life-threatening, its debilitating nature can severely impact mental health and erode quality of life," Dr Sood explained.

There are no 100 percent cures for trigeminal neuralgia, though many of its triggers can be managed with anti seizure medication, it will often require another stage of medical intervention to prevent recurring episodes.

That includes a number of tricky cranial procedures, with surgeons able to either separate a pressing blood vessel from the nerve, or failing that, destroy the nerve with a surgical intervention or using a gamma knife - a targeted blast of high dose radiation.

If you or someone you know is struggling or in a mental health crisis, help is available through Mental Health America. Call or text 988 or chat 988lifeline.org. You can also reach the Crisis Text Line by texting MHA to 741741.