How do we know we’re alive? Is it the consumption of oxygen around? Or is it the constant rhythm of our heart? With more zombie movies being released than ever before, we know that the answer is complicated. To make things simpler, let me ask it this way; is it possible for you to believe that you are dead when you are still alive? And the answer is yes, you can. And we have a name for it; Cotard’s syndrome. I know this keeps getting weird.
So, how in the world is it possible for a person to believe that he/she is dead. The very fact that they can ‘believe’, or ‘think’ itself says that they’re still alive. The ‘variety’ of diseases is one of the many reasons I am drawn to psychology and not that much to physiology (that and the more difficult terms involved). In physical medicine, there is kind of a limit to the kind of diseases one can have because it has to be related to one or more parts of the body. And as we have a limited number of body parts, so is the number of diseases we can have. But things are different in the mental realm. Ranging from mild depression to werewolf syndrome, a person can have an unlimited number of mental illnesses. However, as some of these are so rare, they are not studied or treated specifically like the more prevalent ones.
Getting back to our ‘walking dead’, Cotard’s syndrome was first described in 1880 as the condition in which people believe they’re dead, never existed, or parts of their own body have spontaneously vanished or been destroyed. There hasn’t been much study on the topic because of its rare occurrence. However, the studies that have been conducted really helped psychologists understand more about how our brain creates what we consider as reality.
People with Cotard’s syndrome usually have no regard for socialising, self-care, and even eating. In a case in 2009 of that of an 88-year-old, the patient was admitted as a result of severe depression and when asked why responded that he was depressed as he had passed away recently, but none of the people he knew had bothered to bury him. In another case from the same study, a 46-year-old woman explained that she was ‘a body without content’- that her brain and intestines had vanished and that she was translucent. She refused to bathe because she believed that she was soluble, and her body might wash away if she did.
Even though the symptoms and characteristics of Cotard’s Syndrome are very distinctive, you still won’t be able to find the name in DSM (Diagnostic and Statistical Manual for mental disorders). Instead, it falls under the category of somatic delusions. And it usually comes along with some other distinct mental disorders like depression or psychosis. One study looked at two years of general psychiatric admissions to hospitals in Mexico and found that only around 0.62% of patients exhibited Cotard’s. Another, which looked at the elderly population in Hong Kong, found that around 3.2% of those with severe depression showed symptoms of Cotard’s.
The actual root of these rare and unusual symptoms is still largely unknown. However, recent researches suggest that the symptoms likely come from problems with the parts of the brain associated with facial recognition and emotional response, where the person find no emotional connection with his/her face or outward appearance. And when mixed with depression or psychosis, the person might reach the irrational conclusion that he/she has passed away.
Cotard’s might be just a rare piece of thread in the fabric of psychological disorders. However, solving this mystery would enable us to understand the very nature of our existence; what makes us alive? Or, how do we feel alive?
