Cotard Delusion(A guide)

Cotard Delusion
JuanitaHFNE

Juanita Agboola is the editor in chief of HFNE and an expert in mental health online. She has been writing about online behaviour, mental health and psychology issues since 2012. All Guides are reviewed by our editorial team which constitutes various clinical psychologists, PhD and PsyD colleagues.

In this article, we are going to comprehensively overview the potential contributing factors of cotard delusion, symptoms, treatment options and self-help techniques.

Cotard Delusion(A guide)

What is Cotard delusion?

Cotard delusion is a condition that can be recognized by its victim’s tendency to latch on to the false notion that they themselves, they’re body parts or their organs are dead, dying, or have never existed. It usually occurs alongside various other psychotic disorders and is also accompanied by severe depression in many cases. You may also hear it be referred to as Corpse syndrome, Cotard’s Syndrome or Nihilistic delusion.

Historical Background

“Dr. Jules Cotard (1840-1889) was a Parisian neurologist who first described the délire des négations. Cotard’s syndrome or Walking corpse syndrome comprises of a series of delusions ranging from the firm belief that one has lost all their organs, blood, or body parts to believe that one has lost their soul or spiritual self. In its most bizarre form, the delusion takes the form of a professed belief that one does not exist. Encountered primarily in psychoses such as schizophrenia and bipolar disorder, Cotard’s syndrome has also been described in organic lesions of the nondominant temporoparietal cortex as well as in migraine. Cotard’s delusion is the only uniquely identifiable syndrome of delusional psychosis with its own underlying mechanics. Jules Cotard, a Parisian neurologist and psychiatrist and former military surgeon, was one of the first to induce cerebral atrophy by the experimental embolization of cerebral arteries in animals and a pioneer in studies of the clinicopathologic correlates of cerebral atrophy secondary to perinatal and postnatal pathologic changes. He was the first to record that unilateral cerebral atrophy in infancy did not necessarily lead to aphasia and was also the pioneer of studies of altered conscious states in diabetic hyperglycemia.

Cotard Delusion(A guide)

Symptoms of Cotard Delusion;

Nihilism is one of the primary symptoms of Cotard’s delusion. It is the belief that nothing in the realms of reality, including, life, humanity, and individuality are of any worth, meaning, and value. People suffering from the symptoms of this delusion also, in some cases, hold the belief that nothing actually exists. They can be of the view that their body is decaying. In rare cases, they will believe that they have never existed at all.

Many patients have this false notion of decay and nonexistence towards their entire body, but others may feel it towards a specific body part, organ, or perhaps even their soul. Depression is quite closely related to Cotard’s delusion, especially manic depression. A review published in 2011 of existing research about Cotard delusion suggests that in 89% of documented cases of patients suffering from the disorder, depression was also a prominent and prevalent symptom.

There are various other symptoms of Cotard delusion such as;

  • Anxiety
  • Hallucinations
  • Hypochondria
  • Guilt
  • Preoccupation with a desire to inflict harm upon self or suicidal tendencies.

How do you get Cotard Delusion?

With regard to what exactly causes this delusion, researches are unsure. Although some risk factors are known to be involved in someone’s susceptibility to developing this mental disorder. Studies suggest that the average age of people who fall victim to Cotard delusion is around 50 years. It is also possible for it to occur in children and adolescents, though in most cases where people under 25 years of age have developed this mental disorder, the patients have also been diagnosed with Bipolar Disorder, also referred to as Manic Depression. According to the same studies, women, on average, are more likely to fall victim to Cotard Delusion than men.

Research into the matter has further revealed that people who are of the view that their personal characteristics cause their behavior rather than their environment. Those who believe in the inverse of the previous statement tend to develop Capgras Syndrome. Capgras syndrome leads people to believe that members of their family or someone close to them has been replaced by an imposter who looks exactly like whom they have replaced. Though there is a difference between the profiles of the people who get Cotard Delusion and Capgras Syndrome, it is possible for someone to develop both mental disorders at once. There are some mental illnesses that can either indicate or cause someone’s risk of developing Cotard Delusion. These are;

Cotard Delusion(A guide)
  • Bipolar Disorder
  • Postpartum depression
  • Catatonia
  • Depersonalization disorders
  • Dissociative disorder
  • Schizophrenia 
  • Psychotic Depression

Some neurological conditions can, at times, be associated with Cotard Delusion as either the cause of it or caused by it. These are;

  • Brain infection 
  • Brain Tumour
  • Dementia
  • Parkinson’s disease
  • Migraine
  • Multiple sclerosis
  • Stroke
  • Traumatic Brain Injury

How to Diagnose Cotard Delusion?

IT can be a cumbersome task to diagnose this particular mental disorder since most organizations do not consider it to be a separate medical condition; due to this, there can be no universal set of criteria on which basis one can make a diagnosis. In most cases, Cotard Delusion is diagnosed only after the possibility for all other conditions have been ruled out completely.

If you think that it is possible for you to be suffering from Cotard Delusion, you should write down in a diary, the symptoms you experience, and the duration for which you experience them. Doing this can make it much easier for your doctor to reach a diagnosis this way. Keep in mind, since Cotard Delusion normally occurs alongside other mental illnesses or is aided in development by them, you might receive more than one diagnosis.

How to Treat Cotard Delusion?

Cotard delusion can occur alongside or due to many other mental disorders, so treatment methods applied between cases can vary greatly. Although, A review published in 2019 on Cotard Syndrome suggests that Electroconvulsive therapy was the most commonly employed method of treating the disorder. (ECT) involves passing small currents through the patient’s brain to create small, controlled seizures while the patient is under the influence of general anesthesia.

ECT can prove to be beneficial, but it carries some serious risks such as confusion, nausea, muscle aches, and even memory loss. These risks are partly the reason why professionals prefer to exhaust all other treatment options before this method has to be utilized. These methods include treatments such as;

  • The prescribing of antidepressants
  • Being prescribed antipsychotic medication
  • Mood stabilizer drugs
  • Psychotherapy
  • Behavioural Therapy
Cotard Delusion(A guide)

What Complications can Cotard Delusion Cause for its Victims?

If a person holds the firm belief that they are already dead, it can lead them to completely halt taking care of themselves and their hygiene. They will not take baths or appropriate their appearance. This can cause people to distance themselves from the patient. The social isolation created, in turn, depresses them even further, making matters much worse. The lack of care of self can also cause skin and teeth issues in many cases.

Other patients, due to believing they are dead, will feel no need to feed or nourish a dead or decaying body. In extreme cases, it can cause the patient to become malnourished or even starve to death.

Suicide is also a prevalent problem among the patients of Cotard Delusion. Many individuals will feel that it is the best way to convince others that they have already died. They believe they are doing this by showing people that someone who is dead cannot die again. Their delusion leads them to be aloof, and they feel as if nothing will happen if they attempt to kill themselves since they are already no longer alive. Others may simply feel trapped inside of their bodies and feel as if reality is not real. They will attempt suicide in hopes that it will make their life stop completely, or it will become better.

Some Helpful Resources

Conclusion

Cotard Delusion is rare, but a very serious condition. It is quite difficult to reach a proper diagnosis, yet a fine mix of medication and therapy has been found to be very beneficial in treating this disorder. Many people, however, will need to get through several medications, or a combination of them before they arrive at a point where the treatment begins to work for them. In cases where nothing seems to be working, ECT tends to be an effective method of treatment. If you feel you suffer from Cotard Delusion, you should find a mental health professional who is open to listening to your symptoms and will work with you to diagnose what you are going through.

Frequently Asked Questions.

Q1. Is Cotard Syndrome in the DSM?

Cotard Syndrome is a rare disorder in which the patient holds nihilistic delusions concerning their own being. It is not recognized as a separate mental disorder by the American DSM-IV because it is considered to be an aspect of other underlying mental disorders. Regardless it is necessary to at least recognize this syndrome as it has some specific underlying mechanisms which are unique to it.

Q2. What are the Causes of Cotard Syndrome?

Research is still not exactly sure why Cotard Syndrome is caused, but it can be associated with other underlying mental disorders. People who develop Cotard Syndrome are, on average, 50 years of age, but in cases where the patient is less than 25 years of age, they will mostly also be suffering from Bipolar Disorder. In 89 percent of all cases of Cotard Delusion, the patients have been reported to have depression. Other illnesses which can cause or relate to the occurrence of Cotard Delusion are;

  • Postpartum depression
  • Catatonia
  • Depersonalization disorder
  • Dissociative disorder
  • Psychotic depression
  • Schizophrenia

Q3. How Rare Is Cotard Syndrome?

Cotard Syndrome is extremely rare. It is so rare, in fact, that no formal estimate has been made as to how many people are affected by it. Also, the neurological process involved the development, and the thoughts and beliefs that arise while experiencing the disorder, are still poorly understood. Though there are some well-documented case studies. One such notable study is based on a woman named, Esme Weijun Wang – She suddenly developed Cotard Delusion in 2013. Reports say that she slowly became scatter-brained and lost touch with reality. The woman took a flight during which she believed that she had passed away.

Q4. Can You Die From Walking Corpse Syndrome?

While the disease may not kill you by itself, the thought and other mental disorders associated with it can likely cause the patient to behave ina self-harming way. Patients with walking corpse Syndrome will often stop taking care f themselves and develop skin and teeth problems and can even die of malnutrition and or starvation if not treated timely.

Q5. Who Discovered Cotard Syndrome?

Cotard Syndrome was Discover by a French neurologist, Jules Cotard, in 1882. He described it as a strange new syndrome, which leads the patient to firmly believe that they were dead as if it were fact-even if provided with evidence to the contrary.

Q6. What Defined Cotard Syndrome?

Cotard Syndrome is named after the French Neurologist, who first coined the term in 1882. It can be recognized by its victim’s nihilistic view toward their own physical and or spiritual self. The patient can feel as if they are trapped inside their body or as if they are stuck in a ‘fray’ of sorts between life and death and cannot escape to either side. The underlying feeling of being stuck can lead patients to attempt suicide in hopes of making their lives better or ‘dying properly.’

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