How Does Solitary Confinement Alter Prisoners?

After 41 years in solitary confinement, Herman Wallace was freed last week. Three days later, he died from complications from liver cancer in his sleep.

Wallace, 71, was one of the "Angola Three" convicted of the 1972 murder of a prison guard at the Louisiana State Penitentiary, also known as Angola. He maintained he was innocent. On Oct. 1, a federal court judge said he had not received a fair trial, overturning Wallace's grand jury indictment.

Regardless of the politics of the case, Wallace's death shows that years of isolation have a profound effect on the body and mind.

"Consider Herman Wallace's liver cancer," said Dr. Terry Kupers, a psychiatrist at the Wright Institute with a background in psychoanalytic psychotherapy, forensics and social and community psychiatry.

"I understand he had lost over 40 pounds in the months prior to the diagnosis of his cancer, and by the time it was diagnosed it was untreatable and his prognosis was very grave. With adequate medical care, for example in the community, liver cancer would be diagnosed very much earlier and treated intensively so it would much less likely become fatal."

Common physical effects include cardiovascular and gastrointestinal issues, migraine headaches and profound fatigue.

While in solitary confinement in Louisiana prisons, Wallace probably fared better than most prisoners in isolation, experts said, because of his political awareness.

"What impresses me repeatedly is how little anger many prisoners express about their situation," Kupers said. "I think this is especially true of very bright and politically sophisticated prisoners like Herman Wallace.

"I discussed this issue with (freed Angola Three member) Robert King, who agrees with me that when prisoners understand the social dynamics and injustice of their harsh treatment in prison, they don't feel as much anger as they do resolve to survive and change the system that is so abusive and discriminatory. This must explain why someone like Herman Wallace can survive (almost) 42 years of torture in solitary confinement and remain ... clear-headed, politically aware and committed to justice."

Dr. Stuart Grassian, a psychiatrist who studies solitary confinement, visited the Angola Three in the early 2000s at Angola.

"The conditions there were particularly abhorrent," he said. "I've been to many prisons, and I've never been scared except there. Camp J (an area of Angola reserved for solitary confinement) is a miserable dungeon, with small dirty cells, leaking water, mold, enormously hot in summer. The mosquitoes are unbearable. But these men were of tremendous strength and intelligence, and they never succumbed to some of the more dramatic symptoms of isolation."

Those dramatic symptoms include one of the most common, which is rarely seen in the general population, which Grassian calls florid psychotic delirium. Symptoms include hyperresponsivity to noises and other stimuli, hallucinations, panic attacks, trouble concentrating and remembering, and paranoia.

Studies that use electroencephalography (EEG) to measure the brain's reactions to stimulation show that after just a few days of solitary confinement, people experience more stupor and delirium. And one study found that the symptoms can last long after release from confinement.

Eventually, Kupers said, a general numbness often sets in.

"I find that prisoners who have spent decades in solitary confinement give up trying to communicate, for instance not even bothering to speak to the officer who delivers their food tray, or not saying good morning to the prisoner in the next cell," Kupers said.

"Then, in order to suppress the anger that evolves, they start suppressing all feelings so they begin to feel numb, then lifeless, then dead. A large number of prisoners in many states have described this hyper-isolation, even in the context of solitary confinement, and this numbing into a dead state."

Half of successful suicides in prisons are prisoners in solitary confinement, Kupers pointed out -- even though that's only 4-6 percent of prisoners.

The United Nations lead investigator on torture, Juan Mendez, has urged the United States to ban the use of prolonged solitary confinement, citing its mental and physical toll.

Supporters of Wallace hope that his case will spark changes in the penal system.

"This was never just about Herman," friend Ashley Wennerstrom, told NOLA.com. "This is about a much larger movement to make the criminal justice system actually just."

On May 2, 2013, North Korea sentenced a Korean-American tour operator to 15 years' hard labor for "attempting to "topple the DPRK."

Despite the nation's secrecy, its prison camps are notorious for human rights violations.

Out of all the camps within the system, Camp 22 might be the worst. Entire families, political prisoners, are held their for life. Prisoners at this maximum facility are often malnourished, maimed, deformed, diseased and worse.

Essentially performing slave labor seven days a week for more than 12 hours a day, inmates are literally worked to death, and one former guard estimated that up to 2,000 people, including children, die every year at this camp alone.

In October, 2012, two members of the band Pussy Riot, Nadezhda Tolokonnikova and Maria Alyokhina, were transferred from their jail cells in Moscow to Russia's notoriously severe penal colonies. The members were arrested and sentenced to two years prison after the punk rock group ran afoul of Russian authorities earlier this year. They were charged with hooliganism following their performance in front of Cathedral of Christ the Savior of a song entitled Virgin Mary, which called for the ousting of Russian president Vladimir Putin.

As the Daily Beast's Anna Nemtsova explains, the two women will be making a big adjustment from their cells in Moscow, forced to cope with extreme cold, cramped conditions and worse at the penal colonies they've been sent to.

The surroundings may seem serene, but the ADX Florence Supermax in Colorado might be one of the worst prisons to find yourself as an inmate in the entire country.

The facility is the largest and most infamous of the 31 so-called supermax jails in the United States, detention centers with the tightest controls to house the most dangerous inmates. It is also the only federal supermax prison in the country, as noted by ABC News.

Inmates spend more than 22 hours a day in small cells with little or no sunlight in solitary for years at a time. The isolation can lead prisoners to break down psychologically.

Dubbed the Bangkok Hilton, Bang Kwang Central Prison in Thailand is one of the most notorious prisons on Earth. Every prisoner within Bang Kwang walls has been sentenced to at least 25 years behind bars.

An overcrowded facility, the Thai people call the prison the "Big Tiger," according to BBC News, due to the sheer number of executions that take place at the facility. Around 10 percent of the inmates in the facility are on death row.

Prisoners are kept in chains for at least their first three months in jail. Those on death row spend their entire prison terms in irons.

The detention facility at Guantanamo Bay, Cuba, might be the most controversial prison on this list.

Known to house terrorists and enemy combatants from the wars in Iraq and Afghanistan, the prison was meant to contain some of the most dangerous threats to U.S. security interests. Instead, the facility has become internationally synonymous with physical and psychological torture.

Unlike many other prisons on this list, this facility is administered by the military instead of civilian authorities.

Located in Sao Paolo, Brazil, Carandiru Penitentiary was closed in 2002 due to its reputation for brutality, echoed in the 2003 Brazilian film of the same name.

During its time, the facility housed some of the country's most violent criminals and had an extensive record for human rights violations. Around 1/5 of the inmates before the prison closed were HIV-positive, and medical care available to inmates was virtually non-existent.

The most famous incident at the prison occurred in 1992 when a riot led to the deaths of 111 inmates, most of whom were killed by police.

At The Hague, protestors demonstrate against human rights violations at Diyarbakir prison in Turkey. The efforts of these and other activists have proven successful, with the facility planned to be converted to a Museum of Shame, according to the Pulitzer Center on Crisis Reporting.

Even with its transformation, however, the prison is a symbol of torture and political repression. The overcrowded facility housed mostly Kurdish political prisoners who were methodically humiliated, tortured and worse.

With some 25,000 kept at La Sabaneta, Venezuela, and a prisoner-to-guard ratio of around 1-to-150, it should come as no surprise that the prison is one of the most violent in South America. The worst episode of violence occurred in 1994 when around 130 inmates were burned or hacked to death with machetes, according to TIME.com.

Although closed in 2001, Tadmor Prison in Syria was re-opened in 2011. Located in the middle of the desert, Tadmor was infamous for human rights violations and made no distinction between inmates held for political reasons versus those who actually committed crimes.

The worst incident at the facility took place in 1980, when Rifaat al-Assad, uncle of current Syrian president Bashar al-Assad, along with defense forces entered the prison and killed some 1,000 inmates.

The Gitarama region in Rwanda, seen here, is an area with a horrific history, and houses one of the most gruesome prisons on Earth. The prison in Gitarama City can house up to 20 times as many inmates as the facility was designed to hold. The overcrowded conditions have led prisoners driven by starvation to extremes, including cannibalism, to stay alive.