What Does It Mean To Have Cotard’s Syndrome?

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

It is a very rare syndrome, but some cases have been documented over the years.

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

They think they are living in an improbable and fictitious way. They may even believe that their organs are suffering from decay and are capable of hallucinating the smell of decomposition.

Some facts about Cotard’s syndrome

Characteristics of the syndrome

The individual usually suffers from a change in the intensity of emotions. In general, the person loses vital energy and is dominated by negativity. This can lead to Cotard’s syndrome.

In addition, there is also hyperactivity in the amygdala, damage to the temporoparietal lobe, inhibition in the left prefrontal part of the brain, among other aspects. Similarly, there may be a reduction in dopamine in the brain’s receptors.

Cotard’s Syndrome: Etymology

The syndrome got its name thanks to the French neurologist Jules Cotard, who was the person who discovered it. The finding was made after several patients with psychiatric disorders showed the delusions that characterize it.

J. Cotard’s first patient was a 43-year-old woman. She was sure she “had no brain, nerves, breasts or intestines, only skin and bones.”

The patient, presented at a conference in Paris in 1880 under the pseudonym Mademoiselle X, denied the need to feed himself. She also believed that she was eternally doomed since she could not die a natural death.

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

Characteristic (pathological) symptoms

There are many symptoms that come with this disorder, including:

• Depression

• Suicidal thoughts
• To believe that the body does not exist
• To believe that the body runs out of blood
• Negative thoughts
• To believe that:
  • They are already dead (with foul-smelling delusions: they can even smell rotten)
  • Worms under the skin
  • They are immortal
  • They break down
  • They have no internal organs
• Analgesia or absence of pain
• Self-harm

Remember that these symptoms were associated with human behavioral disorders before they were documented by Dr. Cotard. Many scholars associated them with culture, religion, ethnicity or other elements outside the established moral and health that were standard at that age. This is an important fact.

Description of the pathology in patients

This is a delusion 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 medical or toxic illnesses).

On the other hand, it is important to note that patients believe that their internal organs have stopped functioning completely. They think that the gut is not working, that the heart is not beating, that they do not have nerves, blood or brain, and even that they are rotting.

As a result, they begin to have odor hallucinations that confirm the delusion (unpleasant odors, such as rotting flesh); they may even feel like they have worms moving on and under the skin.

Cotard’s Syndrome: Treatments

This type of disease is not easy to treat, and even less so when the diagnosis involves elements of other already classified and less controversial diseases.

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

• A pharmacological combination (pills, injections, sedatives, etc.)
• Antidepressants such as mirtazapine, antipsychotics or olanzapine;
• If the medication is not effective, it can be treated with electroconvulsive therapy.

Etiology or classification of the disease

Cotard’s syndrome is a disease of a neurological-mental nature, treatment and specialization. The few diagnosed cases and the controversy between dementia and a delusional disorder make it a huge abyss for professionals in this medical discipline.