Cotard's syndrome, or the walking dead syndrome, is an extremely rare mental disorder characterized by the presence of specific delusions. The sick person considers himself dead - a "corpse walking" whose body rots and gradually disintegrates. What are the causes and other symptoms of Cotard's syndrome? What is the treatment for this disorder?
Cotard's syndrome , otherwisewalking dead syndromeordelusion of death , is a mental disorder, which is characterized by the presence ofnihilistic delusions- the patient is convinced that he is dead and can no longer die a natural death, andnegative delusions(renunciation self) - the sick person completely negates their physicality, considers themselves non-existent.
The name "Cotard's syndrome" comes from the name of the 19th-century French neurologist, Jules Cotard, who first described the disorder.
Cotard's syndrome - causes
The belief that you have died most often appears in the course of schizophrenia or severe (psychotic) depression. In the latter case, suicide attempts are frequently noted. Not all of them are successful. However, the patient may be convinced that his attempt to take his own life was successful and that he is dead.
The delusion of death may also occur in patients with structural defects or brain damage, especially in the neural pathways that connect the facial recognition center with the limbic system, responsible for associating recognized objects with emotional states. Other researchers argue that the disease may be the result of atrophy of the basal ganglia (they perform functions related to, among others, cognitive processes, emotions), changes in the parietal lobes, or diffuse brain damage.
Others argue that Cotard's syndrome may be the result of intoxication or metabolic disorders.
Cotard's syndrome - symptoms
The dominant conviction in Cotard's team is that you are a "dead man". The sick person has no sense of his own identity, he denies his own existence. He may also believe that nothing exists - himself, the world and the people around him. In addition, the patient:
- has a reduced perception of his own body (he cannot feel his own heart beating, for example);
- claims his body succumbspostmortem decay - it rots and is additionally fed by worms that slowly eat the body inside and out. As a result, he has a sense of organ loss and eventually lack of organs. Although he does not know how he can talk and move without his brain, heart and other organs, he is absolutely convinced that he does not have any;
- is psychomotorally agitated - he moves very specifically, which may resemble the movements of "living dead" movies;
- can feel a bond with the dead and often walk around cemeteries that seem to be the most appropriate place for him;
- has a lowered pain threshold that increases the risk of auto-aggressive behavior. A sick person may mutilate himself to convince those around him that he is dead (if he is dead, his wounds will not bleed). He may even attempt suicide to prove his claims (if he is dead, he cannot die again). Suicide is also a way to get rid of the dead body that the patient is allegedly condemned to;
- doesn't wash, eat or drink (eating and drinking doesn't make sense since you're dead). Hunger and exhaustion are the second causes of true death of a sick person after suicide.
These symptoms are accompanied by severe fear and guilt. The sick man looks for an explanation why he is still on earth, since he is no longer alive. Eventually, he concludes that death is the pen alty for his sins and disobedience. He is a stray soul, doomed to stay forever in a dead body.
Cotard syndrome may coexist with Capgras syndrome (the patient is convinced that people he knows have been replaced by doubles). It is assumed that both Cotard's syndrome and Capgras syndrome arise as a result of damage to the neural pathways that connect the facial recognition center with the limbic system, responsible for associating recognized objects with emotional states.
Cotard's syndrome - treatment
The patient should be under the constant care of a psychiatrist (due to the risk of mutilation and suicide attempts). Treatment includes antipsychotic tablets and electroconvulsive therapy. The chances of curing the patient depend on the severity of the disorder.