There are indeed certain things that beat the imagination. There are
people who go through terrible sufferings and sometimes wish they were dead.
That’s explainable. But a situation where one thinks and strongly believes that
he is dead beats the imagination.
Imagine waking up to discover you were dead. A man identified as Graham
suffering from a rare condition that caused him to think he was dead has spoken
about the experience to NewScientist magazine.
The rare condition known as Cotard’s Syndrome, Cotard Delusion or
Walking Corpse Syndrome is a mental disorder in which people hold a delusional
belief that they are dead, do not exist, are putrefying, or have lost their blood
or internal organs. In rare instances, it can include delusions of immortality.
Some Reported Cases
In 1788, Charles Bonnet reported one of the earliest
recorded 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.
Some 100 years later, French neurologist Jules Cotard saw a
patient with an unusual complaint. Mademoiselle X, as Cotard called her in his
notes, claimed to have “no brain, no nerves, no chest, no stomach and no
intestines.” Despite this predicament, she also believed that she “was eternal
and would live forever.” Since she was immortal, and didn’t have any innards
anyway, she didn’t see a need to eat, and soon died of starvation. Cotard’s
description of the woman’s condition spread widely and was very influential,
and the disorder was eventually named after him.
In Graham’s case mentioned above, he felt like his “brain
didn't exist anymore.” He insisted that the tablets administered by the doctors
weren't going to do any good because he didn't have a brain. “I'd fried it in
the bath”, he said. The feeling prompted him on occasion to visit the local
graveyard. "I just felt I might as well stay there. It was the closest I
could get to death. The police would come and get me, though, and take me back
home”, he said
Symptoms
The central
symptom in Cotard's syndrome is the delusion of negation. Those who suffer from
this illness often deny that they exist or that a certain portion of their body
exists. Cotard's syndrome has been found to have three distinct stages. In the
first stage referred to as Germination, patients exhibit psychotic depression
and hypochondriacal symptoms. The second stage called Blooming is characterized
by the full blown development of the syndrome and the delusions of negation.
The third and Chronic stage is characterized by severe delusions and chronic
depression.
People with
the Cotard Delusion often become withdrawn from others and they tend to neglect
their own hygiene and well-being. The delusion makes it impossible for patients
to make sense of reality, which results in an extremely distorted view of the
world.
Neurologist took
a peek into the brain of Graham mentioned above, monitored metabolism across
his brain and found some explanation. It was discovered that metabolic activity
across large areas of the frontal and parietal brain regions was so low that it
resembled that of someone in a vegetative state.
Treatment
There are several reports of successful pharmacological treatment.
Monotherapeutic and combination strategies are both reported. Antidepressants, antipsychotics
and mood stabilizers are used. Many report positive effect with electroconvulsive
therapy, mostly in combination with pharmacotherapy
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