Cotards Syndrome: The Living Dead

Despite recorded cases of Cotards Syndrome in the 21st Century, researchers (and experts) are not entirely sure what causes the syndrome to appear. However, they do believe there are certain “risk factors” that could increase a person's chance of developing it.

Research has shown that other health conditions are usually present in a person who is diagnosed with Cotards, such as Bipolar disorder, postpartum depression, dissociative disorder, and schizophrenia, (although it is still considered rare even with those with schizophrenia).

Cotards Syndrome has also been associated with traumatic brain injuries, such as strokes, brain tumors and infections, and even migraines.

A 2018 study of those diagnosed with Cotards Syndrome showed that people had underlying neurological issues, such as frontal lobe changes, decreased blood flow in parts of the brain, and lesions on the brain.

They also found that severe depression is the most common link in developing Cotard Syndrome, with 89% of documented cases including depression as a symptom.

Cotards Syndrome or “Walking Corpse Syndrome” has its issues regarding diagnosis.

Although people have been diagnosed with the syndrome, doing so is particularly difficult because most organizations don’t recognize it as a disease—this means no standard criteria are readily available to make a straightforward diagnosis.

The first patient diagnosed with “Walking Corpse Syndrome” was by the man himself, Jules Cotard. His patient, known as “Mademoiselle X” showed signs of “self-loathing” and denied the existence of her own body and believed herself to be eternally damned.

Mademoiselle X also believed she had no brain, nerves, or organs and that she could not die a natural death. The patient in her belief that she was immortal, did not eat and eventually, she died of starvation.

In 2005, a former Royal and Electrical Engineer, Warren McKinley, endured a horrific motorcycle accident in Watton, UK, when his motorcycle hit a tree at 60mph.

The crash confined him to a wheelchair for months and he was admitted to Headley Court Medical Facility in the UK, a facility used to treat wounded soldiers.

The medical staff suspected he also suffered a brain injury due to his wild mood swings. The medical staff were able to confirm this—Warren had suffered damage to his frontal lobe, a part of the brain that helps us control our emotions.

With his brain injury, and the fact he was also surrounded by wounded soldiers who had suffered horrendous accidents and had lost limbs, McKinley began to believe he had died in the accident; this caused him to stop eating and drinking, meaning his body weight dropped from 85kg to 70kg and refused therapy as he stated: “how could they make me better if I’m not alive?”.

Another case of Cotard Syndrome affected 17-year-old Haley Smith of Alabama, for almost three years. The teenager at the time described bouts of severe anxiety and random, overwhelming feelings that she was dead.

During one of her unsettling turns in school, Haley was sent home but described feeling the urge to enter a graveyard which she passed as she wanted to be close to other dead people.

She also took comfort in watching zombie movies as she felt “relaxed” seeing the undead creatures as they made her feel as though she was with family.

One of the main complications of those suffering from “Walking Corpse Syndrome” is danger to their life.

Sufferers of the syndrome are at high risk of causing harm to themselves; as they believe they are dead, they tend to stop eating and drinking, because they don’t see a reason to anymore. This can cause complications such as severe malnutrition and dehydration, which would eventually lead to death.

Due to their belief of being dead, or no longer existing, sufferers are highly likely to attempt suicide, by means to prove to others that they are dead and, therefore cannot die “again”, but also because they feel trapped in a dead body and believe killing themselves will somehow set them free.

Treatment for Cotards varies as many factors can cause Cotard Syndrome to surface. Depending on whether the sufferer has mental health issues that cause the syndrome to flare up, anti-psychotic medication and anti-depressants are prescribed, and the use of psychotherapy has been shown to help people better understand their condition and help them work through it.

In the case of Mademoiselle X, her story ended in tragedy due to starving to death (which may have been a failure of the time).

Haley Smith sought the help of a psychiatrist and with support from her family and her partner (and watching Disney films), she was able to overcome her condition.

At the time, her parents had just divorced, lending an explanation that her syndrome was brought on by the emotional distress caused by the breakdown of her parents' relationship.

McKinney, in another extraordinary feat, met another soldier in Headley Medical Center who also once suffered from Cotards syndrome, and helped McKinney understand and process the syndrome, even though his experience bloomed from brain injury.

Ms L had lived in the Philippines for 18 years before moving to the US just one month before the onset of Cotards Syndrome; she was treated at a psychiatric unit with a course of antipsychotic medication and showed improvement over just one month. 

Cotards Syndrome, although rare, does affect a small percentage of people, and whilst it may sound like a humorous concept, the syndrome can have deadly consequences.

However, it seems that with the right treatment, whether it be with medication, therapy, or a mixture of the two, a sufferer can make a recovery.