How Does Death by Hanging Work?

During an "ideal long drop," the prisoner's neck breaks and spine severs, blood pressure drops down to nothing in about a second, and the subject loses consciousness. Brain death then takes several minutes to occur, and complete death can take more than 15 or 20 minutes, but the person at the end of the rope most likely can't feel or experience any of it. In a less-than-ideal long drop, if the distance is miscalculated or some other factor misses the mark, the subject will die of decapitation (if the drop is too long) or of strangulation (if the drop is too short or the noose knot isn't in the correct position).

Strangulation can take several minutes and is a far more excruciating experience. The carotid arteries in the neck, which supply blood to the brain, are compressed, and the brain swells so much it ends up plugging the top of the spinal column; the Vagal nerve is pinched, leading to something called the Vagal reflex, which stops the heart; and the lack of oxygen getting to the lungs due to compression of the trachea eventually causes loss of consciousness due to suffocation. Death then follows in the same pattern as it does when the neck breaks, with the entire process ending in anywhere from five to 20 minutes.

For the person being executed, the actual experience of the hanging lasts anywhere from a few seconds to a few minutes — or at least that's the general belief by forensic scientists. In some countries where executions are carried out by hanging, though, other methods are used. In the short drop, which can be a few inches to a few feet, the subject invariably dies of strangulation and/or the compression of the arteries in the neck. The same type of death occurs in suspension hanging, in which the subject is jerked into the air instead of being dropped. And in a standard-drop hanging, the subject falls about 5 feet (4.5 meters).

Depending on the weight and build of the subject, this drop will either break the neck and spinal cord or cause death by strangulation, carotid-artery compression or Vagal reflex. In these older methods, unconsciousness still typically occurs in anywhere from a few seconds to a few minutes, but if it turns out to be a few seconds, it's blind luck (or bad luck, depending on how the country's legal system views the practice — if the point of the hanging is severe punishment for the subject and deterrence to other would-be criminals, a "good hang" may be the most gruesome experience possible).

Suicide by hanging is bizarrely popular considering how much potential there is for agonizing pain. We've already discussed how long drop hangings are designed to minimize drawn-out suffering and potential complications. By comparison, short drop hangings (as are typically done in suicides) usually cause the much slower and vastly more painful strangulation death, rather than a quick neck break.

Suicide by hanging is commonly classified as "suffocation," but hanging makes up the majority of such deaths. It is second in the U.S. (28.3 percent) only to suicide by firearm (50 percent), according to the Suicide Prevention Resource Center. Hanging is classified as a particularly lethal method of suicide, as it's more likely to actually result in death than other methods. By contrast, drug poisoning is more common among "attempters," rather than "completers."

According to a study out of Korea, although drug poisoning was the most common way to attempt suicide, hanging was the most "successful" method, as 52.2 percent of completers used this method. Only 1 percent of completers used drugs. This unfortunate success is probably causing the increased rates of suicide by hanging. In 2001, "only" 31.4 percent of suicides were by hanging, compared with 50.5 percent in 2012, according to the Korean study.

In the U.S., there was a 16 percent increase in suicide between 2000 and 2010, mostly because of the rise in hanging, according to a 2013 study. "Suicide by hanging/suffocation increased by 104% among those aged 45–59 years and rose steadily in all age groups except those aged ≥70 years," the study authors wrote. Death by hanging has also achieved mainstream glamorization thanks to the deaths of beloved celebrities, such as celebrity chef Anthony Bourdain, actor/comedian Robin Williams, designer Kate Spade and fashion icon Alexander McQueen. But it remains a painful way to go.

If you're experiencing suicidal thoughts, please call the National Suicide Prevention Lifeline at 1-800-273-8255.