life, mental health, mental illness, neurology

People That Believe They are Dead / Cotard’s Delusion

Cotard’s  Delusion is a very rare mental illness where the sufferer does not believe that their body is alive in the way that normal people are alive. There are varying degrees of the illness from the person believing that parts of their body are dead to the person believing that they are dead.

This mental illness was named after the neurologist that first recognized this as a disorder.  Jules Cotard did case studies and research in the 1880’s and called the disease “The Delirium of Negation” which is to say that the sufferers thought of their body in a negative way to the point of believing parts did not exist.

In 1880, the neurologist Jules Cotard described the condition as Le délire des négations (“The Delirium of Negation”), a psychiatric syndrome of varied severity. A mild case is characterized by despair and self-loathing, and a severe case is characterized by intense delusions of negation and chronic psychiatric depression   Wikipedia

Jules_Cotard

Neurologist Jules Cortard

Image from Wikipedia

One of Cortard’s  patients, referred to in his research  Mademoiselle X  was a woman who believed that certain parts of her body did not exist. She did not believe that she needed to eat because she did not have the regular internal organs that normal people have. 

Mademoiselle X believed that she had been cursed to eternal damnation, to walk the earth as a dead person. There was nothing anyone could say to her, to convince her otherwise and in her mind she was a dead person walking the earth, and was destined to continue on that way.

She ended up dying from starvation, as no one was able to convince her to eat any food. 

There is a recorded case of what seems to be Cotard’s Syndrome, that was documented in, prior to the disorder being named after Cotard.

“In 1788, Charles Bonnet reported one of the earliest known cases of Cotard’s Delusion. An elderly woman was preparing a meal when she felt a draft and then became paralyzed on one side of her body. When feeling, movement, and the ability to speak came back to her, she told her daughters to dress her in a shroud and place her in a coffin.

For days she continued to demand that her daughters, friends, and maid treat her like she was dead. They finally gave in, putting her in a shroud and laying her out so they could “mourn” her. Even at the “wake,” the lady continued to fuss with her shroud and complain about its color.

When she finally fell asleep, her family undressed her and put her to bed. After she was treated with a “powder of precious stones and opium,” her delusions went away, only to return every few months. MentalFloss.com

Suffers of Cotard’s Delusion, believe that they are missing certain internal organs or that they do not have a digestive system, blood, or some other internal function. Depending on the person, their reasoning as to why they have lost organs, organs have been taken away, or organs are putrefying varies.

The first stage is called the Germination stage—the symptoms are psychotic depression,  and hypochondria 
Next is the Blooming Stage — the syndrome develops and the delusions of negation cause the person to negate / disassociate / deny that certain parts of their body exist, or that they are alive at all
The last stage, which often ends in death is the Chronic stage—characterized by continued, severe delusions and chronic psychiatric depression.

There have also been cases of Cotard’s delusion that have occurred in people who sustained a traumatic brain injury. In 1996 there was a man who sustained traumatic brain injury from a motorcycle accident and he believed that he had died in the accident.  

Once he was physically recovered, his mother moved with him to South Africa. He told people that he was dead and actually had gone to Hell. He did not believe that he had survived the accident and thought his mother was in spirit form, to escort him and show him around in Hell.

Another incident of this disorder was in New York in 2008. A woman asked her family to take her to the morgue because she had died and believed she should be with the dead people. She reported that her body was beginning to smell like rotting flesh.

Other incidents of this disorder include a woman who went to the ER believing that her internal organs had all melted and that she was almost dead. There was also a man who believed that he was dead and that his daughter’s were also dead.

If you want to read these stories, you can find them at this  LINK for MentalFloss.com

Suffers who do not die from starvation, sometimes commit suicide. They feel that only their body is still walking around and they do not belong here.

“Some people with Cotard’s have reportedly died of starvation, believing they no longer needed to eat. Others have attempted to get rid of their body using acid, which they saw as the only way they could free themselves of being the “walking dead”  New Scientists Health.com

Neurologists theorize that the cause of this disorder may have to do with the part of the brain that recognizes faces, called the fusiform. 

This distorted reality is caused by a malfunction in an area of the brain called the fusiform gyrus, which recognizes faces, and also in the amygdala, an almond-shaped set of neurons that processes your emotions. The combination is a lack of recognition when viewing familiar faces (even the face of the sufferer), leaving the person feeling disconnected with reality.  Scientific American

Overall the research I did shows that this disorder is still a mystery. Some people responded fairly well  to treatment with antidepressants, or anti-psychotic medication. Others were treated with electroconvulsive therapy, which is shock treatment.