Syndrome that makes the living think they are dead

People with Cotard's syndrome think they are dead, have no organs or body parts, refuse to take care of their bodies and eat, and easily die from exhaustion.

The Walking Dead, a zombie-themed show, has been a hit on television since 2010. Zombies are not just a product of the imagination; they actually exist in real life under the name Cotard's syndrome. According to Medical Daily, people with this condition believe they have no internal organs, blood, or other parts; they are dead even though they are still breathing. In rare cases, they think they are immortal.

Cotard's syndrome, also known as the walking corpse syndrome, was discovered and named after French neurologist Jules Cotard. In 1880, Cotard published an article about a patient nicknamed Madame X. The woman claimed to have lost many body parts and internal organs including her brain, chest, stomach, and intestines. Madame X believed she was "cursed forever", refused to eat, and then starved to death. Cotard identified this condition as a form of paranoia combined with severe depression, "indicating a retardation of the mental apparatus, the presence of anxiety symptoms, and depression".

The most recent case of walking corpse syndrome was a man named Graham. His condition came after a battle with severe depression that lasted at least nine years. Eight months after he attempted suicide by putting an electrical appliance in his bathtub, he told doctors that his brain was dead or missing.

Cotard’s syndrome is rare, but its prevalence is unknown. A study in Hong Kong of 349 psychiatric patients found that 0.57% of the population had walking corpse syndrome. Another study in Mexico in 2010 found that 0.62% of 1,321 patients had the condition. In general, walking corpse syndrome occurs in people with mental disorders or multiple health problems.

Graham suffered from walking corpse syndrome for nine years and regularly visited cemeteries because he thought they suited him. Photo: AFP.

The manifestations of Cotard's syndrome are quite diverse. Researcher Yamada Katsuragi and colleagues in 1999 explained that the disease has three stages: germination, outbreak, and chronic.

The germination stage is characterized by hypochondriasis and severe depression. Patients may present with vague complaints, such as the case of a 28-year-old woman known as Mrs. S. Medical reports record her arrival at the hospital, complaining that her liver was “rotting” and her heart was “completely absent.” Prior to this, Mrs. S had suffered from insomnia and frequent loneliness due to a loss of interest in her surroundings. These are all classic signs of depression.

The acute phase is when patients experience symptoms such as denying the existence of certain body parts. In the chronic phase, these symptoms become more severe, interfering with the patient’s normal life. They neglect personal hygiene, self-harm, and lose the ability to recognize their own and other people’s faces.

Graham, who believes he has no brain or head, refuses to eat, smoke or socialize because he finds "nothing worth dying for". Graham also regularly visits the local cemetery because he feels it suits him. "I don't want to face anyone else," the man told New Scientist magazine. "I don't find joy in anything. I used to love my car but now I don't go near it. All I want to do is go far away."

Graham became the first Cotard's syndrome patient to undergo a brain scan. Doctors found that the level of activity in the frontal and parietal lobes, which are related to motor function, memory, and sensory information, was very low, similar to that of a person in a vegetative state. "I have been analyzing brain scans for 15 years and have never seen anyone with such low brain activity who can walk and communicate normally," said neuroscientist Steven Laurey at the University of Liege (Belgium). "Graham's brain function is similar to that of a person who is under anesthesia or asleep."

In addition, the brain's amygdala is underactive, causing Cotard's syndrome patients to lose the ability to recognize faces. This "may lead to a disconnect between the reflection and the sense of self, leading to the belief that one does not exist."

To treat walking corpse syndrome, doctors use electroshock therapy along with antidepressants and antipsychotics to control symptoms. A 2008 report concluded that patients respond better to electroshock therapy than to pharmacotherapy. To this day, Cotard’s syndrome remains a mystery as scientists continue to search for the true cause and cure.

According to VNE