simple explanations of interesting brain conditions

Cortard’s Syndrome: Help Me Doctor, I’m Dead!

In 2013, Iranian researchers were presented with a 42 year old woman who believed that she had been killed by a ghost [2]. The women said that she saw many souls, but especially ‘Aal’, a female ghost from Persian folklore who attacks women after they’ve delivered a baby. She reported that she had first seen Aal thirteen days after delivering her first son. She believed that Aal had dissected her abdomen and eaten her liver, which had then caused her to become sick and die. Yep, that’s right, she thought she was dead.

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The woman was diagnosed with Cotard’s syndrome. Patients suffering Cortard’s syndrome believe that they are dead, that their organs or limbs are missing, that they do not exist, or that they are immortal. Patients are generally treated with antidepressant or antipsychotic medication. Researchers attending to the woman above described her strange recovery:

“Two weeks after initiating treatment she said: “I am not dead now, but I am in a coma and under special care in ICU”. She was talking as if her body was in a coma confined to bed, and her soul was talking to us. The souls which she was feeling around her were less prominent at this time. Three weeks after the treatment, she said: “I have come out of the coma, but I feel that everything is strange and I am dreaming”. At this point she did not see any souls. She also said: “There is one more thing to do. I should return to my birthplace (in a rural area) where the grave of my brother is, and then I’ll take back my soul from him”.”

Another study describes the case of a 65 year old retired teacher, who had no history of mental illness, who experienced a year-and-a-half long episode of the disorder [1]. He first began experiencing depression, anxiety, feelings of worthlessness and guilt, and a loss of sleep and appetite. As his condition worsened he began developing delusions of catastrophe, nihilism and persecution. Eventually he began to claim that his organs had stopped working and that his brain had ceased functioning, he also claimed that his house was developing cracks and was about to fall down.

The patient eventually attempted suicide. His suicide note stated that he feared he was spreading a deadly infection which would give everyone cancer. He survived, but soon after became convinced that he had indeed died, and began refusing to eat. In the following period he attempted suicide another two times, a strange thing for a dead person to do, don’t you think? Thankfully the man received treatment and resolved his symptoms completely over a two-month period.

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What causes this strange syndrome, you ask? Neurologically Cotard’s delusions are thought to be related to the Capgras delusion (which I wrote about here). Both delusions are said to result from neural misfiring between the part of the brain that recognises faces (the fusiform gyrus) and the part which associates emotions with faces (the amygdalae). This means that patients recognize faces, but do not feel the same emotional response as they are used to. Patients interpret this as a subtle feeling that something is off, and often begin to doubt the identity of others (Capgras) or themselves (Cotard’s).

Although Cotard’s syndrome has been recognized for over a century, there is still a huge lack of literature on the topic. This is of course because, as with most conditions on this blog, the syndrome is exceedingly rare. It’s not all bad news though, researchers have found that the condition sometimes disappears all on its own, even in the most severe cases.

References

All images produced by the author unless otherwise specified.

  1. Debruyne, H., Portzky, M., Kathelijne, P., & Audenaert, K. (2011). Cotard’s syndrome.Mind & Brain, 2(1) Retrieved from https://search-proquest-com.ezproxy.otago.ac.nz/docview/881273509?accountid=14700
  1. Ghaffari Nejad, A., Mehdizadeh Zare Anari, A., & Pouya, F. (2013). Effect of Cultural Themes on Forming Cotard’s Syndrome: Reporting a Case of Cotard’s Syndrome with Depersonalization and Out of Body Experience Symptoms.Iranian Journal of Psychiatry and Behavioral Sciences7(2), 91–93.
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