Fresh Outlook Foundation

THE CHOKING GAME: A Growing Threat to Teen Mental Health & Survival

Fresh Outlook Foundation

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Have you ever done something you regret? Or experienced a time where you had your own life in your hands, and took a gamble? If you have, then you can undoubtedly relate to this… a story of courage and vulnerability from my friend Justin about his encounter with the choking game.

“Pressure got to me… I became overwhelmed by all the situations happening in my life. It was when I was 14, my parents were newly divorced, and I think that was the reason I was unhappy for so long. This led me to stop eating; I ate barely once a day, sometimes not even. I must have lost 20 pounds. During this time I did not see a tangible future where things would be better, which made what I did to myself seem pointless.”

Like many young folks in turmoil, Justin resorted to the choking game, sometimes called the blackout game, to deal with his angst. Children as young as 10 play by tightening a belt, strap, cable, or chain around their necks to restrict oxygen and reduce blood flow to the brain. The goal is lightheadedness or euphoria. Brain damage (lack of concentration, memory loss, lifelong mental disability) or death are probable when there is no one to relieve pressure or reintroduce the flow of oxygen.

One study found that since 1985, at least 82 American children and youth between six and 19 have died from the game. Of these, about 87 percent were male, the mean age being 13.3 years. Incidental, or indirect, injuries include concussion, bone fractures, tongue biting, and hemorrhaging of the eyes, and are caused by falling or uncontrolled movements and crushing by an assistant.


Living to Tell His Story

Like many young people in vulnerable circumstances, Justin was introduced to the game by someone he trusted. His brother tightened the strap around Justin’s neck until he reached unconsciousness. In his words, “It was definitely a low point for me, yeah. I just wish that I could have understood from the get-go how much of a mistake I was making.” As participating in the activity alone is associated with a much higher mortality rate, Justin is now grateful that a bystander was present, potentially saving his live.   

Justin is a longtime friend who only recently felt comfortable sharing his story, which broke my heart. From Justin’s somber narrative, it was a reality check that child and youth mental health issues can escalate to such extremes. It’s unsettling to realize how oblivious I was. I never noticed how prevailing this phenomenon is, how much impact it has, and how closely it’s affecting my community of peers and friends.

After the act, Justin decided he needed help, and has since made a full recovery from his mental health struggles. He says he never registered how life-threatening it was until he “gained some sanity back” and reached out to his uncle for advice about recovery. After his parents separated, Justin’s uncle was someone he grew closer to.

Seeing the situation Justin was in, his uncle recommended changes to Justin’s day-to-day life choices. These varied from a highly nutritious diet, to exercising multiple times a week, to getting out in nature, to even finding a new hobby… chess! Justin quickly regained a sense of identity and continually improved.


The Game’s History and Causes

It’s difficult to understand how the choking game attained popularity, except that it may have been seen as a way to lower psychological strain and provide a brief moment of euphoria. Origins of the game date back to the 1930s, with youth today playing adaptations of the game.

Speaking on behalf of teenagers, I know we are constantly looking for ways to be entertained or to prove to ourselves and others that we’re doing well. Sometimes we get too caught up looking for those short-term bursts of dopamine (known as the “feel good” hormone) without considering the possible long-term harm. After all, we think we’re invincible!

Research shows that another factor can be suicidal ideation and substance abuse. In a 2008 Oregon Healthy Teens survey about participation in the game, it was discovered that involvement was higher by about four percent among Grade eight students who reported mental health risk factors, eight percent by students who abused substances, and 16 percent by students who experienced both. Youth may use the strong sensation provoked by the choking to temporarily distract themselves from what they are mentally or physically going through. Or, even worse, with the true intention to end their lives.


Teen Brains Set the Stage for Risk-taking Behaviour

Along with Justin’s suicidal tendencies, he faced urges from his own lack of judgement. This is common and due to the underdeveloped prefrontal cortex (PFC) of teens. The PFC plays a significant role in cognitive control functions like impulse inhibition. A young person with underdeveloped PFCs will have blunted emotional thinking and could act on whatever they please, with no self-control. This leads to various ventures of curiosity, one of which is the choking game.


Social Media Influences

On TikTok, used by a billion users worldwide, a trend called the “Blackout Challenge” is now circulating the app’s algorithms. It’s another name for the choking game and has already taken four children’s lives according to People. A 12-year-old boy attempted the challenge and sustained severe brain injuries.

In Justin’s case, social media and YouTube videos his brother showed him only exacerbated his interest in the game. Even though generations of people have played pass-out or fainting games, there is fresh and serious concern in the Internet age. With endless online resources on the Web, this can heighten pressure and make the game appear like a common way to get high. So, what can be done about this?


Parents Beware!

If you are a parent or guardian, there are specific symptoms to familiarize yourself with. Physical and behavioral signs include bloodshot eyes, visible contusions on the neck, zoned-out attitude after being alone, and frequent need for privacy. More subtle signs can be more rope/cable/belt/cord-like items around the house, unusual Internet searches related to the game, and wear marks on furniture or doorknobs.

It’s likely when struggling to cope with certain health difficulties, teens sometimes stray toward harmful behaviors rather than reaching out for help. A reason could be not wanting to surrender and be perceived as weak by others, or not wanting to feel ashamed of the situation.

If you suspect someone you know is playing the choking game or other dangerous pursuits, talking to them about it should be the priority. Get to the root of their problems. Seek therapy from professionals if need be. Justin is living proof that reaching out is key to recovery and, perhaps, even survival.


Not all Risk-taking is Bad!

Though the choking game is cause for definite concern, not all teenage risk-taking is bad. Trying new things is healthy as long as the challenges are safe. Taking risks forces us to broaden our comfort zones, which triggers growth and innovation. Examples of positive risk-taking include talking to new people, trying out for a school team, or applying for a job.

There are many activities like these that produce a natural endorphin high; the choking game is not one of them!


References and Resources

Bruce Yang is a Grade 11 student who is passionate about local community involvement and research projects pivoted towards mental health, taking opportunities to grow in these areas. He hopes to pursue a business degree in post-secondary after completing his senior years of high school. Most days, he can be found playing table tennis or hiking in the early afternoon.

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