Cotard’s Syndrome
Cotard syndrome is considered a mental disorder, in which the person thinks they are dead. That is to say, whoever suffers it assures as an undeniable fact that their body has no life.
Of course, it is a delusion. Hence, it is also known as “nihilistic delusion” or “denial delusion.” Although it is very rare, several cases have been documented since the 19th century.
People with Cotard syndrome deny the existence of their own body. And, by extension, they do not admit that they have nerves, brain, blood or internal organs, etc. They think that life is like a fiction. They come to think that their organs are decomposing and, even, to feel the smell of the state of putrefaction.
Some facts about Cotard syndrome
Hyperactivity in the amygdala and damage in temperate-parental zones are characteristic. To the inhibition in the left prefrontal part of the brain, the reduction of dopamine in its receptors is added.
A little history
The discovery took place after consulting several patients with psychiatric disorders who showed the delirium described above. All of them had at least two of the characteristics that, after the discovery, is associated with this curious syndrome.
The first patient the French neurologist saw was a 43-year-old woman. He claimed to have no brain, no nerves, no chest, no entrails, just skin and bones. His case was presented at a kind of scientific congress in Paris in 1880. Despite the remoteness of the date, his identity did not transcend then. To refer to her, the pseudonym Mademoiselle X was used.
Well, this patient denied both the existence of God and the devil, as well as the need to feed. Perhaps even more curious is that she believed herself doomed for eternity. For her, it was a fact that she would not be able to experience a natural death.
As might be expected, the case presented by Dr. Cotard was harshly criticized by the scientific community at the time. It was not long before she was skeptical of such a rarity.
Characteristic symptoms of Cotard syndrome
- Depression
- Negative and even suicidal thoughts
- Belief that your body does not exist
- Belief that you have no internal organs
- Belief that they are running out of blood
- Belief that they are already dead (olfactory delusions lead them to think that they are in a state of decomposition)
- Belief that they are decomposing (they even feel the existence of worms under the skin)
- Belief that they are immortal
- Analgesia or absence of pain
- Self mutilation
It should be added that, before this syndrome was described by Dr. Cotard, these symptoms were associated with disorders of human behavior. It was then believed that they were determined by culture, religion and ethnicity. And they were treated like any other problem that was far from the moral standard and what was considered healthy at the time.
Etiology or classification
Cotard’s syndrome is a neurological-mental disease. This makes it a real challenge for professionals in this medical discipline.
On the one hand, it is fortunate that very few cases are diagnosed. On the other, however, this very fact fuels the difficulties of treating it today. And it is that for many, Cotard syndrome is halfway between dementia and a delirium-disorder.
Description of this pathology in patients
This is a typical delusion also of the most serious depressions, of a psychotic or delusional type. It could therefore be associated with other severe mental illnesses. Among them are dementia with psychotic symptoms, schizophrenia and psychosis. The latter could be due to other pathologies related to the excessive intake of toxic substances.
It should also be noted that these patients come to believe that their internal organs have been paralyzed. For example, they often believe that their intestines do not work, that their heart does not beat, that they have no nerves, no blood, and no brain. And, as already mentioned, they could even think that their body is decomposing.
As a result, they come to present some olfactory hallucinations that confirm their delirium. The supposedly unpleasant odors, such as rotting meat, could even lead you to believe that maggots are crawling under your skin.
Possible treatments for Cotard syndrome
Diseases of this type do not have a specific treatment, much less easy. Even less in the case of this syndrome, which involves symptoms present in other diseases. This often makes its correct diagnosis difficult.
Here are, however, some strategies with which specialists try to correct the problem:
- Drug combination (pills, injections, sedatives, etc.)
- Antidepressant drugs such as mirtrazapine or antipsychotics, such as olanzapine
The choice of one or another drug will depend on the complexity of both the clinical picture and the personal situation of each individual. However, if the chosen drug was not effective, other methods would have to be considered.
