Cotard delusion, also known as walking corpse syndrome, is a rare psychiatric condition that is characterized by a patient’s belief that he or she is dead. It is named after Dr. Jules Cotard, the French doctor who first described the syndrome in the late nineteenth century. Cotard delusion is not explicitly included in the modern DSM-5. However, it is considered to be a type of somatic delusion, which is a DSM-5 diagnosis.
People who suffer from Cotard delusion may believe that they do not exist at all, or they may be convinced that they are missing essential body parts. Sometimes they may also claim to be immortal, even though this obviously contradicts the idea that they are dead. In one famous case, a woman with Cotard delusion believed that she did not need to eat because she thought she was already dead. This woman, referred to in the literature as simply “Mademoiselle X,” ended up starving to death..
The syndrome has been described as having three stages, each with its own set of symptoms: the germination stage, the blooming stage, and the chronic stage. The germination stage usually involves depression and hypochondria. The blooming stage is marked by anxiety and delusional thinking. Finally, the chronic stage is a full-blown Cotard delusion.
Cotard delusion is extremely rare, affecting less than one percent of the population. However, it is also extremely serious. It is imperative that anyone exhibiting symptoms of it seek medical help early, as it can lead to self-harm or death if not properly diagnosed and treated. Treatment is usually done with medications and electroconvulsive therapy and can be very effective. The following are prominent symptoms of Cotard delusion:
1. Feeling Dead
The primary symptom of this disorder is the feeling that one is dead. If you have Cotard delusion, you are likely convinced that your body has died. This can manifest in many different forms with different consequences, depending on the patient. Some patients may deny that they have a physical form at all, even though they are obviously able to walk around and talk. Other patients may not deny that their bodies exist, but they may believe themselves to be in a zombie-like state.
Many patients believe that they have missing organs or that they have no need for food, sleep, or other basic human needs. No matter what form the feeling of death or nonexistence takes, the consequences are severe. The delusion can be so strong that the patient genuinely feels no need to take care of their basic needs. This means that they will not register sensations of hunger, thirst, or fatigue. Not eating or drinking can obviously kill someone, which turns this illness into a kind of self-fulfilling prophecy.
[nextpage title=“Next” ]2. Anxiety
Although it is mostly associated with the blooming stage(the second stage), anxiety is often one of the very first symptoms of Cotard delusion. Patients may feel anxious about nothing in particular, and this feeling may last from days to years before other symptoms fully appear. At the time of diagnosis, about 65 percent of patients have anxiety as a symptom. Anxiety alone cannot lead to a diagnosis of Cotard delusion, as it can have many different causes. However, it is a salient feature of the illness. A psychiatrist or psychologist can determine whether a patient’s anxiety is caused by Cotard delusion or something else.
[nextpage title=“Next” ]3. Hallucinations
Auditory hallucinations are a symptom in many cases of Cotard delusion. This is not surprising when you consider that many patients already have a mental illness that involves psychosis. A large percentage of people with Cotard delusion already had bipolar disorder, psychotic depression or schizophrenia. These illnesses can all involve hallucinations. When a person has an auditory hallucination, he or she hears music or voices that are not actually there. The hallucinated voices may be very negative and distressing to the person who is hearing them. In Cotard delusion, auditory hallucinations usually involve negativity that is brought on by depressed mood.
[nextpage title=“Next” ]4. Guilt
Around 63 percent of patients with Cotard delusion have delusions of guilt. They may be convinced that they have done something wrong and that they are being punished. Many people with Cotard delusion have expressed the belief that they are in hell. Others may believe that they have been cursed with immortality and cannot die naturally. The guilt felt by these patients is completely unfounded. Usually, they have done nothing wrong. It is just a part of the overall pattern of delusional thoughts that they experience. Sometimes, Cotard patients use their supposed wrongdoing as an explanation for why they are now dead.
[nextpage title=“Next” ]5. Hypochondria
Hypochondria is the unfounded belief that you may have a serious illness. People with Cotard syndrome often believe that they have died of a specific illness. For example, in the year 1990, a patient called WI strongly believed that he had died from AIDS or sepsis. Hypochondria can also be an early symptom of Cotard syndrome before the central symptoms (like feeling dead) appear. It is often a feature of the first stage of Cotard syndrome, the germination stage. During the germination stage, a diagnosis of Cotard syndrome usually cannot be given. However, hypochondria along with other psychiatric symptoms is still a cause for concern. If you or someone you know is experiencing this, talking to a professional is a good idea.
[nextpage title=“Next” ]6. Preoccupation With Hurting Yourself
Even though Cotard patients think that they are already dead, they commonly show a propensity for self-harm and suicidal behavior. This may seem contradictory, but remember that a delusion is not the product of a rational mind. Also, remember that Cotard delusion comes in stages. Nearly 90 percent of patients show symptoms of depression during at least one of these stages, and depression is associated with self-harm and suicidal thoughts. If a person has depression prior to their diagnosis of Cotard delusion, they are more likely to have symptoms such as self-harm and suicidal ideation. This is just one of many ways that Cotard delusion can lead to injury or death. Any symptoms of this illness should be taken seriously and dealt with by a professional.
