Imagine waking up one day and you are dead. “Well, if I’m dead, then I won’t wake up,” is you’re likely response. But suppose you did wake up. And suppose that you --more or less-- still inhabited your living body of skin, bones, fat and muscle. You weren’t some ethereal spirit that floated above your own corpse, trying to resolve unfinished business, or otherwise tormenting middle class white families in suburban New England. Which is to say, you’re not a ghost. You’re just you, but dead. You can interact with other people and things, talk to people, and all the rest. But you know, deep down, for sure, you are dead. And because you’re dead, you don’t need to eat, right? Maybe your body begins to rot. You can see yourself decomposing and you’re disgusted. But nobody else seems to notice. What would you do?
This Kafkaesque nightmare is not the plot of a new sci-fi series; it’s an actual thing that can and has happened to actual people. Cotard’s Syndrome, also known as “Cotard Delusion”, is a rare and horrifying psychological disorder that causes a person to become convinced that they are dead. Not dying, but actually dead. It is commonly referred to by the more sensational epithet, "Walking Corpse Syndrome". Many of those who have been afflicted with Walking Corpse Syndrome believe that their bodies are putrefying --like a zombie-- and/or that their blood and organs are missing. Many patients stop eating, because they see no need to, and some even deny that they actually exist. Paradoxically, other patients see themselves as immortal; because they’re already dead, they can’t die again. It is a fascinating and disturbing mental illness.
15 Mademoiselle X
Cotard’s Syndrome is named for 19th Century French Neurologist Jules Cotard. Cotard’s 1880 dealings with a patient he called “Mademoiselle X” in his notes, lead to this psychological phenomenon being named for him. Mademoiselle X complained that she had no brain, no nerves, no chest, no stomach, and no intestines. A rather strange complaint. This lead Mademoiselle X to the conclusion that she was, in fact, immortal. How else could she live without all these vital organs? Despite Cotard’s attempts to make her see that she indeed still possessed all her organs, Mademoiselle X ceased eating, seeing it as a pointless endeavor given her immortality and lack of a digestive system. Horribly, this caused her to die of starvation. Imagine a delusion so powerful that it causes you to ignore the agonizing hunger pains of starvation.
14 The Logical Zombie
If a seemingly healthy (and alive) individual approached you and informed you that they were dead, what would you do? Well, assuming that this individual was not Bruce Willis and you’re not Haley Joel Osment, you’d probably point out that they couldn’t in fact be dead, because how else could they be talking with you. That’s just what some Japanese doctors did with a 69-year old man who presented with symptoms of Cotard’s Delusion in 2012. The man said, “I guess I am dead. I’d like to ask for your opinion”. The Doctors’ opinion was that he wasn’t dead, for that would be impossible. The man eventually conceded that his condition defied logic, but still persisted that he must be dead. After about a year, the man realized that he was alive, but still maintained that he had been dead, saying “Now I am alive. But I was once dead at that time”. This was not the only delusion he had; he also believed that deceased North Korean dictator Kim Jong-il was being treated at the same hospital.
13 Charles Bonnet’s Original Patient In 1788
About a century before Jules Cotard met Mademoiselle X, Charles Bonnet described the elderly woman that almost certainly suffered from Cotard’s Delusion. Bonnet described the woman in 1788, whose symptoms presented after she “felt a draft” and became paralyzed on one side of her body (likely a stroke). After her speech, feeling, and movement came back to her, she instructed her daughters to dress her in a shroud and place her in a coffin. She demanded that her daughters and maid deal with her as though she were dead. Her daughters eventually relented and dressed her in a shroud and “mourned” her. Even at her own wake, the lady complained about the color of her shroud and fussed about it. She eventually fell asleep, at which point the daughters put her to bed. After being treated with a “powder of precious stones and opium,” the lady’s symptoms disappeared, only to reappear intermittently every few months.
What would you do if you were dead? Would you go to a doctor? Would you go to the morgue? Or would you cut out all the middlemen and just head to the graveyard? Well, that’s what a New Jersey man did in 2013. Identified as “Graham” in an interview with New Scientist, this man felt as though he were brain dead after an unsuccessful suicide attempt. Graham felt that he had fried his brain in his attempt to electrocute himself because he had lost all sense of taste and smell. While Graham’s story is sad, he presented the medical community with an extremely rare chance to study this phenomenon. PET scans revealed that Graham's brain function resembled “that of someone during anesthesia or sleep,” a “pattern in someone who is awake” being “quite unique". "It seems plausible that the reduced metabolism was giving him this altered experience of the world, and affecting his ability to reason about it," Dr. Steven Laureys said. Because of his depressed state, it was all Graham could do to hang around graveyards. Thankfully, with treatment, he is feeling better now.
11 Schizophrenia and Cotard’s Syndrome
At this point, you’re probably thinking that Cotard’s Syndrome seems similar to other mental disorders that cause delusions. Schizophrenia, for example. Well, you’re not alone. Cotard’s Delusion is still a debated topic within the psychology and neurology communities. Is it its own neurological disorder caused by a specific part of the brain misfiring? Is it just a rare, but common enough, delusion that results from other mental disorders? Well, scientists got a little bit closer to the truth when they treated a 50-year old Peruvian man with schizophrenia who had also presented Cotard’s delusion. The man had had a family history of mental disorders and had himself shown symptoms of schizophrenia since the age of 13. He was treated with aripiprazole (an antipsychotic), and showed improvement after only two weeks of treatment, suggesting that medicines commonly used to treat schizophrenia and bipolar disorder can be effective against Cotard’s Delusion as well.
10 A Scottish Man Who Suffered A Motorcycle Accident In 1996
We’ve already seen how Cotard’s Delusion can seemingly be sparked by traumas such as strokes and electrocutions. Add to that list, motorcycle crashes. In 1996, a Scottish man crashed his bike and injured his head. It’s not hard to see how this could cause a mental problem. What is odd, however, is that the man did not present any symptoms of Cotard’s Delusion until after he completed his recovery. It was only then that he began to believe that he had actually died from complications of the surgery he had had after his crash. Compounding matters was that shortly after this whole ordeal, he and his mother moved from Edinburgh to South Africa. The significantly warmer climate caused the man to believe he was in hell, telling doctors that only hell could be so hot.
9 Ms. Lee
Ms. Lee’s case is one of the more disgusting manifestations of Cotard’s Syndrome. In New York in 2008, the 53-year old Ms. Lee became convinced she was dead and was hounded by the foul stench of rotting flesh; her own rotting flesh. Imagine being unable to escape such an odious stench. Of course, Ms. Lee’s body was not in fact putrefying, but she adamantly believed it was. She told her family to bring her to a morgue, where she felt she belonged. Her family, wisely, called 911 instead. Ms. Lee’s first days in the psychiatric unit did not go well. She continued to have delusions and accused paramedics of trying to burn her house down. Eventually, a drug regimen produced significantly improved results in Ms. Lee’s condition and her delusions went away.
8 A Depressed Belgian Man
Depression and anxiety are problems that plague many of us. It seems the majority of people’s lives will at some point be troubled with depression and/or anxiety. It’s understandable why. There are lots of things to be depressed about: the state of the environment, losing your job, getting divorced. And there are many things about which people get anxious: public speaking, dating, job interviews. But imagine being depressed because you were dead and anxious that nobody has buried you yet. Those were the problems facing an 88-year old Belgian man in 2009. Thankfully, his problems got solved. Not by his being buried, but rather by Belgian psychiatrists treating him until he eventually figured out that he wasn’t dead and all was well again. Mazel tov.
7 Cotard Syndrome Leading To Suicide
In 2011, the Indian Medical Gazette reported the case of a 55-year old Bengali woman who had presented symptoms of Cotard Syndrome. The woman had been treated by psychiatrists before in her life and had had episodes of depression triggered by traumas. When informed of her father’s untreatable lung cancer, she began to exhibit symptoms of Cotard’s Delusion. These symptoms worsened when her father died. She became very depressed, would “talk irrelevantly”, ate and slept very little, and claimed that her body was rotting on the inside and pointed to non-existent black specs in her sputum. She even claimed to have developed the lung cancer that killed her father. All this lead her to lock herself in her room and attempt to kill herself with a drug overdose. Thankfully, her family rescued her and brought her in for treatment that ultimately proved to be successful.
6 The Belgian Woman Who Didn’t Eat, Secrete, or Sleep
The same Belgian doctors who treated the 88-year old depressed man also treated a 46-year old Belgian woman. The woman claimed to have not eaten or gone to the bathroom in months and to have not slept in years. She claimed she had no organs, nor any blood. She accused doctors who withdrew blood for tests or who had monitored her heartbeat of lying to her, for unknown reasons. Over the course of months she must have eaten and drank something, which means she would have had to excrete something, in the bathroom or elsewhere. And while she may not have had a restful sleep in years, she must have been sleeping a little, otherwise she would have been clinically dead. Her treatment was bumpy at first, possibly due to her adversarial disposition toward the doctors, but eventually her condition improved with treatment.
5 A 72-Year Old Greek Woman Who Complained She Was “Rotting”
This is perhaps the most viscerally putrid (literally) case of Walking Corpse Syndrome we have seen. We know that some of those affected by Cotard’s Syndrome can come to believe that their bodies are rotting. This is what a 72-year old Greek woman believed, but only more so. Beyond simply rotting, she believed that her organs had actually melted. She believed that there was nothing left of her but her skin and that she was “practically dead”. The elderly Greek woman went to the emergency room to seek treatment. Doctors found her in poor condition and began treating her. Unfortunately, the outcome of this treatment is unclear. It remains a mystery if the woman made a recovery or if she died, and what, if anything, spurred on her condition.
Another Greek individual who presented with symptoms of Cotard’s Delusion came forward in 2003. His story is remarkably similar to that of “Graham’s” from New Jersey. Like Graham, this unidentified man attempted suicide and became convinced that his brain was not working. However, unlike Graham, who thought himself brain dead, this man thought his brain was literally gone; that he was actually empty-headed. It seems as though he tried to kill himself because of his empty-head. After his attempted suicide, he walked out of treatment after only a few days, and this led to further problems. He claimed that he was born without a mind. About a year after the first unsuccessful treatment, the man returned and completed treatment, showing sustained improvement.
3 A Teenage Girl Who Realized She Was Alive Thanks To Disney
In early 2015, 17-year old Alabama-native Haley Smith came forward with her struggles with Cotard’s Syndrome. Her case is rare even for Walking Corpse Syndrome given her tender age; it generally tends to affect the elderly and sometimes the middle aged. However, Smith’s case is common in that her first symptoms presented after an emotional trauma: her parents’ divorce. Smith also liked to spend time in graveyards. However, unlike many, who stop eating because they don’t see the point, Smith ate more, concluding that since she’s dead, she can’t possibly gain weight. Smith didn’t tell anybody for years, but eventually opened up to friends and family who urged her to seek therapy. With therapy, Smith recovered and no longer exhibits symptoms. It wasn't just therapy, though. Smith credits Disney films as being of great help. “How can I be dead when Disney makes me feel this good?”, said the teenager.
2 The Countess of Suffolk
This case is not verifiably one of Cotard’s Syndrome as it predates not only Jules Cotard, but also Charles Bonnet’s case. In 1715, apothecary William Lilly wrote about the Countess of Suffolk, Henrietta Howard. The Countess had been suffering from melancholy and lethargy. When Lilly began treating her, he noticed that she would sleep a lot, but then suddenly wake up and begin exclaiming that she was dead. These fits would last several minutes before she became exhausted and went back to sleep. Lilly also noted she was rarely urinating or defecating. Lilly’s response was to repeatedly bleed her, laid pigeons around her feet, and shaved her head. Thanks, Lilly. Shockingly, these measures failed to cure Lady Suffolk of her “melancholia” and “mania”. Lilly tried to persuade her husband, Lord Suffolk, to bring her down to London so he could keep a closer eye on her. Sadly, Lady Suffolk never made it, dying on August 10, 1715.
1 All Dogs Go To Heaven
I bet you thought it couldn’t get any weirder. But it does. In 2005, Iranian doctors described a man whom they had diagnosed with Cotard’s Syndrome. Okay, 32 is pretty young for Walking Corpse Syndrome, and it does more commonly affect women than men, but it’s not any weirder than anything else we’ve seen, is it? Except that the man didn’t claim to be merely dead, but also a dog. Somehow, the man had died and (naturally) become a dog. He lamented that his wife had suffered the same fate. His three daughters had also died, but luckily, they weren’t dogs; they were sheep. The man believed his relatives were trying to poison him, but that god was protecting him... even though he was already dead... and also a dog. The doctors diagnosed the man with Cotard’s Syndrome and clinical lycanthropy (the belief that one has transformed into an animal, such as a dog, or “werewolf”). They treated him with electroconvulsive therapy and this relieved his major symptoms. Woof.