Warning: This article contains discussion of suicide which some readers may find distressing.
Some diagnoses are universally feared, including every form of cancer as well as chronic, life-limiting conditions such as multiple sclerosis or COPD.
However, one disorder that many people say they wouldn’t wish on anyone is trigeminal neuralgia. It’s also known as tic douloureux and has earned the grim nickname the “suicide disease” because of how severe and relentless the pain can be for some sufferers.
Pain is difficult to measure and compare because it’s so personal, but trigeminal neuralgia is frequently cited by patients and clinicians as among the most extreme pain conditions encountered in modern medicine.
In an educational video, Maryland anaesthesiology and pain management specialist Dr Kunal Sood explained what’s happening in the body, why everyday actions can set it off, and what treatment options may help.
Trigeminal neuralgia is a long-term nerve pain disorder involving the trigeminal nerve, a major facial nerve that carries sensation and influences functions tied to the mouth and face, including chewing, speaking, and 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.”
When the trigeminal nerve malfunctions, it can fire off sudden, intense bursts of facial pain. These episodes may last seconds or minutes, appearing without warning and sometimes returning repeatedly. Because attacks can be frequent and disabling, the condition has been associated with increased suicidal ideation in some cases.
One common mechanism is compression—such as a nearby blood vessel pressing against the nerve. It can also occur in connection with illnesses like multiple sclerosis, which can damage the myelin sheath that normally insulates and protects nerves.
In other instances, there may be no clear underlying cause. While it can happen to anyone, it’s more commonly diagnosed in people over 50, and it appears more frequently in women than in men.
Triggers can be surprisingly ordinary: eating, talking, smiling, shaving, brushing teeth, or even a light breeze over the face. For many people, avoiding those triggers entirely simply isn’t realistic, which can make day-to-day life feel unpredictable.
Describing the sensation, Dr Sood said: “The pain is often described as electric shocks or severe burns, typically affecting one side of the face.”
Some people experience isolated attacks, while others have multiple episodes per day. Over time, attacks may become more frequent or more easily triggered for certain patients.
“While not life-threatening, its debilitating nature can severely impact mental health and erode quality of life,” Dr Sood explained.
There isn’t a guaranteed cure for trigeminal neuralgia, but treatment can reduce symptoms and help prevent repeat attacks. Anti-seizure medications are commonly used to calm the nerve activity, though some people may need additional interventions if symptoms persist or worsen.
In more severe or treatment-resistant cases, doctors may consider procedures that address the nerve directly. Options can include surgery to relieve pressure from a blood vessel, or approaches that intentionally damage or disrupt the nerve to stop pain signals—such as targeted radiation using a gamma knife.
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.