What Is Cotard’s Syndrome?

Cotard’s syndrome is a mental disorder in which the person thinks he or she is dead without actually being. It is a type of delusion that is also known as nihilistic delusion or denial.

This syndrome is very rare, but several cases of it have been documented over the years.

Those who suffer from Cotard’s syndrome deny that their bodies exist and that they have nerves, a brain, blood and internal organs, as well as other body parts.

They think they live in an improbable and fictitious way. They may even think their organs are rotting and able to hallucinate the smell of decomposition.

Some facts about Cotard’s syndrome

Features of the syndrome

The person who suffers from it usually undergoes a change in the intensity of his emotions. In general, he loses vital energy and is dominated by negativity. This can then give way to Cotard’s syndrome.

In addition, there is often also:

• hyperactivity in the amygdala
• damage to the temporoparietal lobe
• inhibition in the left prefrontal part of the brain

In addition, a reduction of dopamine in the receptors of the brain can also be seen.

Etymology

The syndrome owes its name to the French neurologist Jules Cotard, who discovered this syndrome. The discovery was made after several patients with psychiatric disorders showed the delusions that characterize this syndrome.

However, it is important to note that the case presented by Dr. Cotard was not exempt from criticism and skepticism by the scientific community of the time.

Characteristic (pathological) symptoms

There are many symptoms associated with this condition, including:

• Depression
• Suicidal Thoughts
• The belief that the body does not exist
• The belief that the body no longer has blood
• Negative thoughts
• The belief that:
  • you are already dead (with olfactory delusions: someone can even smell that he is rotting)

• • there are worms under your skin
  • you are immortal
  • the body is rotting
  • you have no internal organs
• Analgesia or absence of pain
• self-mutilation

Remember that before this syndrome by Dr. Cotard was documented, these symptoms were simply related to human behavioral disorders. Many scholars associated them with culture, religion, ethnicity, or any other element outside the established moral and health norms of the time. This is an important fact.

Description of pathology in patients

This is a delusion typical of the most severe (psychotic or delusional) depression. However , it can also occur with other serious mental illnesses such as:

• dementia with psychotic symptoms
• schizophrenia
• psychosis due to medical or toxic diseases

On the other hand, it is important to note that patients even come to believe that their internal organs have completely stopped functioning. They are convinced that their guts have stopped working, that their hearts have stopped beating, that they have no nerves, blood or brains, and even that they are rotting. As a result, they begin to have some olfactory hallucinations confirming their delusions (unpleasant smells, like rotting flesh): they may even feel like worms are sliding across their skin.

Some ways to treat this syndrome

Unfortunately, these kinds of disorders are not easy to treat. This becomes even more complicated when the diagnosis also includes elements of other already classified and less controversial diseases.

However, here are some steps that doctors use, depending on the complexity and situation of each individual:

• A pharmacological combination (both pills and injections, sedatives, etc.)
• Antidepressants such as mirtrazapine, antipsychotics or olanzapine
• If the drugs are ineffective, this syndrome can also be treated with electroconvulsive therapies

Etiology or classification of the disease

Cotard’s syndrome is a disease of a neurological-mental character. It should therefore also be treated as such. The few cases diagnosed and the controversy between dementia and delusional disorder make this a very complicated area for professionals in this medical discipline.