How can a living person be sure that he is dead? It would seem absurd … However, this condition is well known to those who suffer from Cotard syndrome. There are only a few hundred such people all over the world.
How does Cotard syndrome manifest?
We are talking about mental illness, which doctors consider as a form of depression. The disease was named after the French neurologist Jules Cotard, who described the first such case in 1880.
With Cotard syndrome, a person has impaired perception of his own body or its individual parts. He may perceive his physical shell or, say, limbs as something alien, uncontrollable by the brain. These patients first develop anxiety, which then turns into a manic delusion with hallucinations. It seems to them that the body exists separately from themselves, from which they conclude that they are dead.
Not all patients present with Cotard syndrome in the same way. Some people simply cannot move, although there is no physical reason for this. Others are unable to eat. There are those who seek to harm themselves or commit suicide. There have been recorded episodes when people tried to burn themselves with acid, as it seemed to them that they would get rid of the "dead" flesh … Some individuals demand that they be buried, put on a shroud, put in a coffin … Many claim that they do not have heart, liver, lungs and other internal organs.
“Cotard's syndrome is the most common in the case of affective disorders: depression and bipolar disorder,” comments medical expert A. A. Portnov. "There are also cases where Cotard syndrome is detected, in particular, in schizophrenia, dementia, epilepsy, brain tumors, migraine, multiple sclerosis or traumatic brain injury."
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The living Dead
In most cases, Cotard syndrome is still relatively curable. In 2008, a 53-year-old New Yorker asked her family to take her to the morgue, as she died and smelled of rotting fish. The woman believed that she should be among the dead, and not living people. The unhappy woman was sent for psychiatric treatment. After a month in the clinic, she returned to normal.
Briton Graham Harrison decided to commit suicide by turning on an electrical appliance in the bathtub. But he was rescued and sent to the hospital. When he woke up there the next morning, he was sure that he had already passed away.
Graham wanted absolutely nothing: not to eat, not to smoke, not to see anyone or talk to someone. He even stopped smelling. His hair began to fall out and he stopped brushing his teeth. At the same time, the man realized that he was still alive. Then he began to constantly go to the cemetery, because there, among the dead, he felt best.
Harrison's relatives insisted that he see a doctor. In the end, he was sent for examination at the University of Liege. Arriving at the appointment with Professor Stephen Loreis, the first thing Graham told his secretary: his problem is that he is dead …
Loreis scanned Harrison's brain. It turned out that the frontal and parietal areas of his brain are characterized by low activity, as if he were sleeping. After several months of therapy, the patient's condition improved somewhat.
Causes of Cotard syndrome
Scientists from Cambridge conducted a study showing that out of 100 patients diagnosed with Cotard syndrome, almost all suffered from psychotic depression. At the same time, 86% of them were nihilistic about their bodies, 69% were characterized by denial of their own existence, and 55% believed that they are immortal.
According to Japanese experts, the occurrence of Cotard syndrome is associated with insufficient production of beta-endorphins hormones in the body, which are responsible for pain and behavior regulation.
One woman with Cotard's syndrome claimed that her left arm no longer belonged to her. This patient suffered from renal failure and was undergoing hemodialysis. In addition, she was also diagnosed with shingles, and she was prescribed a drug for herpes - acyclovir.
As statistics showed, in 1% of cases, the use of acyclovir led to certain deviations in the psyche. For example, Anders Hellden from the Karolinska Institute Hospital and Tumas Linden from the Salgren Academy (Sweden) found that in at least eight cases, patients taking acyclovir developed Cotard's syndrome. Moreover, seven of them had kidney problems. With a decrease in the dose of the drug or its removal from the body, the symptoms of the disease quickly weakened.
The researchers drew attention to the fact that all eight patients had an increased level of CMMG, one of the breakdown products of acyclovir. Apparently, due to renal failure, he was not excreted from the body in time and began to influence the brain. Since some of the patients had high blood pressure, Hellden suggested that CMMG constricts the cerebral arteries. And this is a fairly common cause of "glitches".
Scientists believe that this discovery will reveal the parts of the brain responsible for self-awareness, including the perception of one's own body. In the future, this will help develop effective methods of therapy for those suffering from Cotard's syndrome and similar diseases.
Daria Lyubimskaya