Cotard syndrome: symptoms, causes and characteristics

Cotard Syndrome is one of the strangest psychological disorders, among other things because of how difficult it is to put yourself in the shoes of those who experience it in the first person.

Because the symptoms of this phenomenon are not defined neither by personality changes, nor by sensory or motor alterations, and neither are they rooted in changes to very extreme moods. Instead, everything is based on a sensation: the sensation of having died.

In this article we will see what Cotard Syndrome is, what its symptoms are, and what its possible causes are, among other things.

• Related article: "Neuropsychology: what is it and what is its object of study?"

What is Cotard Syndrome?

It is quite common to think that people interpret reality only from the data that comes directly to us through the senses. According to this point of view, when we see a rectangular body from whose corners four extensions descend we conclude that what we are looking at is a table, provided that we have learned before that concept.

The same would happen with landscapes, people and animals: we would perceive each of these physical elements through our senses and we would automatically identify them, in a clean and predictable way, as long as we do not lack data. The truth is that, although most of the time there is a very clear relationship between the raw data that enters us through the senses and what we interpret to be real, this is not always the case. The stranger Cotard syndrome is a sample of it.

Cotard's Syndrome is a mental disorder in which the subject perceives himself as something that, in a way, does not exist or is detached from reality.

People with this syndrome are capable of sensory perception of their own body (for example, they can see themselves in a mirror, like all people without vision disturbances) but they notice it as something strange, as if not existed. A significant number of people with Cotard Syndrome, for example, they believe they are dead, literally or figuratively, or be in a state of decomposition. It is not a metaphorical way of saying how they feel, but a strong belief, which is taken literally.

This is a psychological phenomenon similar to depersonalization, in which you experience a disconnect between oneself and everything else. The alteration appears in the way in which what is perceived through the senses is emotionally experienced, not in the way in which the senses provide information. Technically, everything that is seen, heard, touched, and tasted or smelled appears to be real, but does not feel as true.

In Cotard Syndrome, this emotional disconnection goes hand in hand with a more specific idea and that is a pseudo-explanation of what is feels: oneself is dead, and therefore whoever presents this alteration no longer has a strong interest in continuing to be linked to the world.

Symptoms

Although this picture of symptoms can be called nihilistic delusionIt has nothing to do with the philosophical or attitudinal positioning of the person. Someone with Cotard Syndrome tends to sincerely believe that the plane of reality in which they are finds your body is not the same as your conscious mind, and acts on consequence.

What people with Cotard Syndrome experience is very similar to the way some people strongly influenced by a certain culture or religion, they may come to think about their body, other people and the environment they they inhabit; the difference is that people with the syndrome always perceive things that way, regardless of the context, because of a abnormal functioning of some of your brain structures.

Cotard syndrome gets its name from the French neurologist Jules cotard, who at the end of the 19th century coined the term Denial Syndrome to describe the case of a woman who believed she was dead and had all internal organs rotten. This person, believing that she was suspended somewhere between Heaven and Hell, did not think it necessary to eat, since planet Earth had lost all its meaning for her.

The fundamental idea is derealization

The concept of derealization implies the idea of ​​perceiving the data that comes to us about the environment as something oblivious to the reality of those who perceive them. It refers to a psychological phenomenon that appears in certain psychological disorders (not in a exclusively in Cotard syndrome), as well as at specific moments that do not constitute an indication of psychopathology.

You can experience something similar, for example, if in a dimly lit room you place one of your hands in front of your eyes. You will see the silhouette of one of the parts of your body, which is something that you have already memorized throughout your life, and you will notice that its movements correspond to those you want it to do. However, the darkness can make that, although all the data you have about the hand corresponds to the that you associate with your own body, you have the feeling that the hand is not yours or is dissociated from you in some appearance.

Something like this is what people with Cotard Syndrome live: all the sensory information about themselves and the environment seems to be in order, but despite this the feeling persists that none of this has meaning or is unreal. Also, this delusion is wide enough to be able to take different ways of manifesting. Some people believe that they are dead, others have the sensation of being immortal, and there are even cases of patients who only perceive some parts of his body as something strange or decomposing.

Possible causes

Cotard Syndrome is complex in its manifestations and causes, which are mainly found in the functioning of the brain. As we have seen, the information processing that coming from the outside and is given from sensory stimuli is correct. What is missing is the emotional response of which this processing should be accompanied, since all lacks meaning. For this reason, it is believed that the main root of nihilistic delusion is found in the abnormal functioning of the part of the brain associated with the processing of emotions: the limbic system, at the base of the brain.

Thus, Cotard's Syndrome would be associated with dissociative alterations in which there is an abnormal way of feeling certain experiences, not sensory perception. It would be an incongruity between what our senses inform us about and the emotional reaction that we can consider "common sense".

In any case, Cotard Syndrome teaches us that the human brain carries out very complex and varied tasks so that we can comfortably perceive and interpret reality. That this process is automatic and most of the time it goes well does not mean that some of these parts are not may fail, leaving us with eyes, noses and mouths that correctly report on a world without meaning.

Bibliographic references:

• Debruyne H.; Portzky M.; Van den Eynde F.; Audenaert K. (2010). Cotard's syndrome: A Review. Current Psychiatry Reports. 11 (3): 197 - 202.
• McKay R1, Cipolotti L. Attributional style in a case of Cotard delusion. Conscious Cogn. 2007 Jun; 16(2):349-59. Epub 2006 Jul 18.
• Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J. (2015). "Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient". Case Reports in Psychiatry. 2015: 643191.
• Sogomy, V. (2012). Depersonalization and the Sense of Realness. Philosophy, Psychiatry, & Psychology. 19 (2).
• Yarnada, K.; Katsuragi, S.; Fujii, I. (2007). A Case Study of Cotard's syndrome: Stages and Diagnosis. Acta Psychiatrica Scandinavica. 100 (5): 396 - 398.
• Young AW1, Robertson IH, Hellawell DJ, de Pauw KW, Pentland B. Cotard delusion after brain injury. Psychol Med. 1992 Aug; 22(3):799-804.