COTARD SYNDROME: The Condition That Makes You Think You Are Dead

They believe they’re dead, decaying, or don’t even exist — Cotard Syndrome is a terrifying mental disorder that turns the living into the walking dead.

As heard in this Weird Darkness episode…

Imagine you have to call 911 because your family member insists they “are dead.” This distressing scenario occurred in 2008 when a 53-year-old Filipino woman living in the United States announced she had passed away, insisted she reeked of “rotting fish,” and needed to be taken to a morgue to be with other dead people.

This case described in the National Library of Medicine is a case of Cotard Syndrome, an extremely rare mental disorder.

Most of us have felt a temporary loss of feeling in a limb — when your foot “falls asleep,” for example. But individuals with Cotard Syndrome (also known as “Walking Corpse Syndrome”) truly believe they’re dead, that certain segments of their body don’t exist, or that they themselves don’t even exist at all.

This rare condition is named after the French neurologist Jules Cotard who first described the condition in 1880. He thought of it as a kind of depression, but it’s now understood to be, at least generally, a symptom of other health problems, not a disease itself.

Scientists don’t yet fully understand what causes Cotard Syndrome, but they’ve pinpointed a few risk factors. Pre-existing mental health conditions, such as bipolar disorder, severe depression, schizophrenia and dissociative disorders may heighten risk. Brain injuries caused by, say, strokes, tumors or infections can also bring on the condition. Some develop symptoms after having horrible migraines.

According to a 2018 study, some people suffering from Cotard Syndrome experience neurological problems such as reduced blood flow in certain parts of the brain, changes to the frontal lobe, or brain lesions. The most frequent connection is severe depression, which is seen in 89 percent of recorded cases.

Medical organizations don’t classify Cotard Syndrome as a standalone illness, and diagnosing it is difficult. This means no standard criteria exist for diagnosis.

The first recorded case was that of a patient of Jules Cotard, who became known as “ Mademoiselle X.” She denied that her body existed, believed she had no brain and no organs, and thought she was damned for all time. Convinced of her immortality, she ceased to eat and ultimately starved to death.

The UKВС reported the crashing into a tree at 60 mph by a former Royal and Electrical Engineer by the name of Warren McKinley in 2005. The accident left him using a wheelchair and in therapy for an injury to his frontal lobe that impaired his ability to control his emotions. He began to think he had died in the crash, surrounded by other injured soldiers. He ceased eating and drinking, losing 33 pounds, and did not cooperate with therapy, asking: “How could they make me better if I’m not alive?”

Haley Smith, a 17-year-old Alabama resident, had lived with the condition for nearly three years. She felt crippling anxiety and intense sensations of being dead. At one point, she felt compelled to be in a graveyard, close to “other dead people.” She related to zombie movies, which made her feel “like I’m with family.”

Cotard Syndrome can also be fatal. Those with this issue usually cease eating and drinking entirely, causing them to suffer acute malnutrition and dehydration. They may try to kill themselves, either to “prove” that they’re already dead or to “escape” feeling trapped in a body they think is dead.

Treatment is dependent on the underlying causes. A common prescription for cases related to mental health often include anti-psychotic medications and anti-depressants. Through psychotherapy, patients can make sense of and unwind their psychological condition.

Although Mademoiselle X’s story had a horrific outcome, modern treatments have seen many recover. Haley Smith used a psychiatrist, support from family, and watching Disney movies to help her get through the condition. Her condition seemed to be precipitated by emotional distress over her parents’ divorce. Warren McKinley was helped by another soldier who had recovered from the same condition and was able to explain and process his experience with him. The Filipino woman described at the beginning was doing much better after only one month of antipsychotic medication in a psychiatric unit.

Cotard Syndrome, as odd as it may sound, is a life-threatening illness. The good news is that those affected can recover with treatment — through medication, therapy or both.