One might be indifferent to others’ presence anytime and anywhere but have you heard of people missing to recognize their own existence in this world? There are a rare group of people who live with a delusional belief that they are dead or non-existent in this world. Medically termed as Cotard’s Syndrome (CS) this condition remains as one of the strangest and rarest medical disorders.
Also called as Walking Corpse Syndrome this is a rare neuropsychiatric disorder commonly seen in people suffering from serious depression or psychotic disorder. Cotard’s syndrome is most frequently reported in females and those belonging to an older age group rarely witnessed in adolescents. When the syndrome occurs in young people it is generally witnessed in those suffering from bipolar disorder. The delusion is most common in those who feel that its their character and not the environment that causes their behavior. And, when people think of it the other way round, they are likelier to suffer from another syndrome called Capgras syndrome. In Capgras syndrome the affected individual considers all of his/her friends, family and neighbors as imposters. Rarely we witness cases of both Cotard’s syndrome and Capgras syndrome present in the same individual. Capgras syndrome is also a rare mental illness that has debilitating side effects on the patient and for more details please visit the website www.firsteatright.com.
Nihilism is a common symptom of this syndrome in which the affected individual believes that there is nothing in this world that has any value or meaning and they consider themselves too to have never existed or assume to be dead. Some people feel this way about their entire body while some others feel that some of their body parts, limbs or their soul are dead. A review of more than 100s of cases showed depression to be the root cause behind the problem in more than 89% cases. Other major symptoms include anxiety, hallucination, hypochondria, guilt or a constant motive to end life.
Common medical conditions that increase the risk of Cotard’s delusion include bipolar disorder, postpartum depression, catatonia, depersonalization disorder, dissociative disorder, psychotic disorder and schizophrenia. Neurological conditions such as epilepsy, migraines, dementia, brain tumors, brain infections, Parkinson’s disease, stroke and traumatic brain injuries are also associated with Cotard’s syndrome.
As Cotard’s delusion is a very rare disease present among the population physicians find it difficult to diagnose as most organizations don’t recognize it as a disease. There are no set of criteria used to make a diagnosis and the doctor tries to come to a conclusion by ruling out other causes. Meanwhile, the affected person can also maintain a diary keeping track of his/her symptoms, their duration and frequency which would help the doctor. It is also beneficial to remember that Cotard’s delusion occurs alongside other mental illnesses.
As the syndrome occurs along with other diseases or conditions treatment options vary. Electroconvulsive therapy (ECT) is the most commonly used treatment and this is the same used to treat severe cases of depression too. Physicians think twice before suggesting this as it carries potential risks including memory loss, confusion, nausea and muscle aches. Most of them prefer to go with other treatment options such as antidepressants, antipsychotics, mood stabilizers, psychotherapy and behavioral therapy before choosing ECT as the treatment option.
There are not one or two but several complications involved when a person feels that he/she has already died and doesn’t exist. Such people stop taking care of themselves, stop taking baths or keeping themselves clean which makes others around them to start maintaining a distance from these people. This in turn makes the person feel even more isolated and depressed. Sometimes, this can lead to skin and teeth problems too.
Some people refrain from eating as they believe that their body doesn’t need food which can lead to malnutrition mostly. Few others try to commit suicide just to prove that they are already dead and cannot die again.
Cotard’s delusion remains a rare mental illness which needs to be diagnosed carefully but treatment can help the patient live a better life.
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Dietitian & Nutritionist Dr. Nafeesa Imteyaz.