Brett Waggoner
There are many people today who enjoy zombie films and television series like The Walking Dead. If you are one of those people, a certain question may have crossed your mind more than once: What would it be like to walk around dead? You may be surprised to know that there are a small group of people who have got closer to this experience than you might think possible. Are these people really brain-eating zombies? No, they are not. Rather, they are people who have suffered from a rare psychological disorder called Cotard’s Syndrome.
People diagnosed with Cotard’s Syndrome (also known as the Walking Corpse Syndrome) hold to the delusion that they are dead or no longer exist. Patients who have this delusion also report that their internal organs (heart, intestines, brain, etc) are gone. Some even report that they can smell their flesh rotting. If being absolutely convinced you are dead isn’t bad enough, they usually suffer from depression or schizophrenia before the delusion that they are dead sets in. Cotard’s Syndrome can be considered a nihilistic delusion, which is another way of saying that people who suffer from the delusion feel that there is no purpose or meaning to life.
One man who was diagnosed with Cotard’s Syndrome, Warren McKinley, was interviewed by Good Morning Britain about his experience with the condition, where he explained that he experienced deep feelings of meaninglessness to life. Experiencing the world in such a bleak way must be terrifying.
There are many fascinating and troubling descriptions of what people who have suffered from the delusion have experienced. One 46-year-old woman reported that her brain and intestines were gone, and also that she as a “self” no longer existed. A case study of an 88-year-old man found that he not only suffered from severe depression, but also experienced high anxiety due to the fact that he believed he was dead and hadn’t been buried yet. Some people with the delusion report that they wanted to visit the graveyard, as they felt they belonged in the company of the dead. The fact that people with Cotard’s Syndrome experience not just delusions concerning the existence of their self, but also delusions about their body, makes the condition quite dangerous to the wellbeing of those affected by the condition. This can lead to instances of self-harm, such as self-mutilation or even suicide. Many will feel no compulsion to eat or bathe since they believe they are deceased, and hence consider such behaviours to be pointless. One report mentions that people who suffer from the delusion can be prone to voluntary starvation, given that they no longer believe that their body requires them to eat food to live.
Researchers have concluded that there are three types of Cotard’s Syndrome. The first type consists of depression with the main symptoms being anxiety, auditory hallucinations, deep feelings of sadness, and other symptoms. The second is Cotard’s Syndrome type 1, with symptoms like anxiety about health and nihilistic delusions, while lacking the depressive symptoms. The third type is Cotard’s Syndrome type 2, with the main symptoms being depression, hearing hallucinations, nihilistic delusions, anxiety, and surprisingly, delusions of immortality. You may find it interesting that someone with Cotard’s Syndrome could possess a belief that they are dead while simultaneously believing themselves to be immortal. How could someone believe they are dead while thinking they cannot die? This may result from the fact that if someone believes themself to be dead, they no longer perceive themself as being able to be killed, as potentially dying from injury or disease.
Such extreme experiences leave many people wondering what is going on in the brains of people with Cotards Syndrome. Research suggests that people with the condition have trouble in the part of their brain that recognises faces. This suggests that people with Cotards Syndrome experience this as an inability to recognise themselves, leaving them feeling as if they do not exist.
Given how frightening such a condition sounds, is there hope for anyone who has it? The good news is that ECT and some pharmacological treatments have been shown to be effective for people with Cotards Syndrome. This means that for people with this rare psychological condition, there is a way back from the dead.
Brett Waggoner is a first-year PhD student supervised by Dr. Jamin Halberstadt and Dr. Jesse Bering. He is studying experimental social psychology at the University of Otago (Dunedin, New Zealand).
References:
- Debruyne, Portzky, Eynde, & Audenaert (2009). Cotard’s Syndrome- A Review. Current Psychiatry Reports, 11, 197-202.
Brett,
Great work – do you think there are any other similar conditions, or possibly any associated underlying affects that may cause onset? Or is it strictly from damage / deterioration of the brain function(s).
Hi Jose,
Thanks for the question! One condition that might seem different but actually has similarities to Cotards Syndrome is Capgras Syndrome, aka the Imposter Syndrome. People who suffer from Capgras Syndrome tend to beleive that their relatives and friends have been replaced by imposters. The similarity between these two conditions is that people who suffer from them tend to show problems in a part of the brain called the fusiform gyrus, which deals with facial recogntion. Some researchers have argued that people suffering Capgras have an external attribution with the disorder (they cannot recognize the faces of people in the outside world), while people suffering from Cotard’s have an internal attribution (they cannot recognize themselves, therefore they don’t exist). Given how rare Cotard’s syndrome is, more research is needed to truly understand the details of the disorder.
Regarding onset, researchers are still not sure about what exactly causes Cotard’s syndrome, but some mental disorders (depression, schizophrenia, dissassociative disorder, and bipolar disorder), as well as neurological problems (brain infections, brain tumors, stroke, and traumatic brain injuries), increase the risk that someone may develop Cotard’s Delusion.