What Is Cotard Syndrome?

Cotard syndrome is a mental disorder in which a person thinks they are dead. This is a type of delusion that is also known in English as  nihilistic delusion or denial.

Cotard syndrome is very rare, but some cases have occurred over the years. A person suffering from this denies that his body exists,  that he has nerves, brains, blood, internal organs and other parts of the body.

The patient feels living in an unlikely and fictitious way. He may even think he is suffering from organ decay and experience hallucinations from the smell of decay.

Facts About Cotard Syndrome

Background of the syndrome

A person then usually has a change in the intensity of their emotions. He loses his vitality and is dominated by negativity.

In addition, the person has, among other things,  hyperactivity in the tonsil nucleus as well as obstruction in the left frontal lobe area of ​​the brain, as well as some other phenomena. Similarly, a decrease in dopamine at brain receptors may occur.

History of the appointment

The syndrome gets its name from a  French neurologist named Jules Cotard, who once discovered the phenomenon.  The finding was made when observing several patients with psychiatric disorders that included delusions defining this syndrome.

The first patient treated by Cotard was a 43-year-old woman. He was sure he “had no brain or nerves or chest or internal organs, only skin and bones”. This patient (who was introduced at a conference in Paris in 1880 under the pseudonym Mademoiselle X) denied that she needed to feed herself. He also believed he was forever doomed because he could not die naturally.

This case, presented by Cotard, received criticism and skepticism from the scientific community at the time.

Pathological symptoms of Cotard syndrome

There are many symptoms associated with this syndrome:

• depression
• suicidal thoughts
• the belief that the body does not exist
• the belief that the body runs out of blood
• negative thoughts
• belief that:
  • the person is already dead (hallucinations: he may even smell his rot)
  • there are worms under the skin
  • the person is immortal
  • the body is likely to rot
  • there are no internal organs
• inability to feel pain
• self-mutilation

Before Cotard documented these symptoms, they were associated with behavioral disorders. Many scholars associated them with culture, religion, ethnicity, or other things that were beyond the prevailing morals and health standards of the time.

Description of pathology in patients

This is an illusion that is typical of the most severe (psychotic or delusional) depressions. However, it can also occur in other serious mental illnesses (dementia with psychotic symptoms; schizophrenia; psychosis due to medication or poisoning).

The patient believes that his internal organs have completely ceased to function. He believes the gut isn’t working, the heart isn’t beating, there are no nerves – like no blood or brain – and he thinks he’s rotting. He begins to experience hallucinations that reinforce delusion (unpleasant odors: rotting flesh), and he may even feel worms moving under the skin.

Treatments for Cotard syndrome

Diseases of this type are not easily treatable, and even less so when the diagnosis includes symptoms of other, classified, and less contradictory diseases.

However, there are treatments that doctors use for this syndrome, depending on the complexity of the individual’s situation:

• combination of drugs (tablets, injections, sedatives, etc.)
• antidepressants such as mirtazapine, antipsychotics or olanzapine
• if said drugs are not effective, the condition can be treated with electroconvulsive therapy

Causality and disease classification

Cotard syndrome is a neurological and mental illness. There are very few cases, and the similarities with dementia and delusions make this syndrome very difficult for professionals to diagnose.