Written by Kerem Müldür
Think of a belief; your hands, your arms, your legs, and you and the world and all of the universe never existed. You are a walking dead. Jules Cotard discovered this delusion in 1880 (1). Known as Cotard delusion, it is also referred to as the Delusion of Nihilism or Walking Corpse Syndrome. This rare syndrome has an estimated 200 cases worldwide according to research in Hong Kong, the incidence of Cotard delusion is 0.57 percent (2). Fortunately, this strange delusion is often cured by treatments.
If we want to learn the awkwardness level of Cotard delusion, we can examine Cotard syndrome patients. For instance, a patient stated that he had not felt that his leg belonged to him since he was 7 years old and that when he was a child, he used soil to get infected and amputated his leg, but when he grew up, he had this leg amputated and felt relieved. In another case, a man in Japan told doctors he doubted he was dead and asked if they could confirm it. When the doctors told the patient that a man who could walk and come to the hospital could not be dead, the patient said that this was a game of his brain. Although the patient responded to treatment, he began to think that he had died in his previous life (3). As we see in the examples, Cotard’s delusion patients can have several complications because they believe that they already have died. They can stop bathing or care about themselves because they are dead for themselves. Some of them spend almost all of their time in cemeteries because they think It’t better to approach death and interwine. Others stop eating and drinking because they believe their body doesn’t need it. In severe cases, this can lead to malnutrition and starvation. In some severe cases even commit suicide to show people that they cannot die anymore because they are already dead.
Individuals with Cotard syndrome exhibit very low brain activation. A doctor who worked with a Caprgas patient named Graham wrote in New Scientist: "I have been studying PET scans for 15 years, and I would not have expected such abnormal results from someone like Graham, who stands on two legs and can communicate with people. Graham's brain functions are very close to those of someone asleep or under general anesthesia." "It's pretty amazing to see these results in someone in action.". Individuals' brains appear to be asleep and they have very low metabolism in much of the frontal cortex.
There are too many opinions about the reasons for Cotard's delusion, but there are a few possible factors. Several studies indicate that the Cotard is about 50. It can also occur in children and teenagers. People under the age of 25 with Cotard delusion tend to also have bipolar depression. Women also seem to be more likely to develop Cotard delusion. In addition, Cotard delusion seems to occur more commonly in people who think their characteristics, rather than their environment, cause their behavior. People who believe that their environment causes their behavior are more likely to have a related condition called Capgras syndrome. This syndrome causes people to think their family and friends have been replaced by imposters. Cotard delusion and Capgras syndrome can also appear together (5). Other mental disorders that might increase the risk of developing Cotard syndrome are Bipolar disorder, Catatonia, Schizophrenia, etc. Cotard Delusion is also related to certain neurological conditions such as brain infections, brain tumors, dementia, epilepsy, Migraines, etc.
Image Credit: https://www.deviantart.com/knightmaresquirrel/art/Cotard-s-Delusion-604721231.
There is no definitive treatment for this syndrome, as it has multiple causes and is associated with different diseases. However, a 2009 review found that electroconvulsive therapy (ECT) was the most widely used treatment. It’s also a common treatment for severe depression. ECT involves passing small electric currents through your brain to create small seizures while you’re under general anesthesia. However, ECT carries potential risks, including memory loss, confusion, nausea, and muscle aches. This is partly why it’s usually only considered after trying other treatment options, including antidepressants, mood stabilizers, psychotherapy, etc.
In conclusion, Cotard syndrome is one of the most imprevalence and interesting syndromes. This syndrome, also called Nihilism delusion or Walking corpse, which has a broad definition and varies from patient to patient, is the delusion of people who think that their organs and limbs or their entire body are dead. In this syndrome, which is more common in women over the age of 50, some patients have resorted to methods such as death fasts and suicide to prove that they are dead. Examinations of the patients revealed that their brain activity was very low and they appeared to be asleep. Although this syndrome, which is associated with many different diseases, does not have a single treatment for this reason, electroconvulsive therapy is the most common treatment.
References:
(n.d.). PubMed. https://pubmed.ncbi.nlm.nih.gov/12011289/
Rath, L. (2020, January 23). Cotard's syndrome: What is it? WebMD. https://www.webmd.com/schizophrenia/cotards-syndrome
Aslıhan Yeşilyurt. (2019, November 2). Yaşarken Ölü Olduğunuza İnanmak: Yürüyen Ceset (Cotard) Sendromu Nedir? Evrim Ağacı. https://evrimagaci.org/yasarken-olu-oldugunuza-inanmak-yuruyen-ceset-cotard-sendromu-nedir-8026
Gent University. (2011, January). ResearchGate | Find and share research. https://www.researchgate.net/publication/234082044_Cotard%27s_syndrome
The Healthline Editorial Team. (2018, September 18). Cotard delusion or walking corpse syndrome: Definition. Healthline. https://www.healthline.com/health/cotard-delusion#causes-and-risk-factors
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