The Flying Walrus, February 2006
Don’t look now, but we are living amongst the dead. Do not panic. This is not Night of the Living Dead 4. They will not eat you; in fact, they want nothing to do with you. How does one go about recognising the living dead? Well, they are hard to identify in a crowd because they look alive, but if you were to ask them whether or not they exist, the answer would be a resounding ‘no’.
Alright, they’re not really dead. But those who suffer from Cotard’s syndrome believe otherwise, and that’s what matters.
Cotard’s syndrome, named after Dr. Jules Cotard, who discovered the disorder in the 1880’s, is a mental illness, whereby patients are convinced that they’re dead. Sufferers may claim to be missing internal organs, that there is no blood in their veins, or that they have lost their souls. Their death seems so real to them, that some believe they can actually smell their flesh decaying. In extreme cases, Cotard’s patients will declare that they do not exist at all, which is the ultimate manifestation of nihilism.
In one case study, a man from Scotland developed Cotard delusions after suffering a severe head injury in a motorcycle accident. His mother took him to South Africa after he was released from the hospital to give him a little R&R. The man believed she was taking him to hell and that he had already died. He was convinced that he had borrowed his mother’s spirit to show him around hell while his body was still in Scotland.
More recently, a homeless man diagnosed with schizophrenia began voicing delusional thoughts, claiming that his brain was rotting away, and that parts of his insides were gone. The man denied that he had any perceptual abnormalities; he thought he was mentally sound. He was extremely depressed, but showed no suicidal tendencies. Don’t you see? He didn’t want to kill himself because he thought he’d been dead for weeks! This shit is messed up.
Fortunately, it’s rare. Cotard’s syndrome is usually found in people with schizophrenia, bipolar disorder, or major depressive disorder; it’s an uncommon psychological response to severe depression. The patient becomes so miserable and out of touch, that her reasoning and perception are suppressed. Mechanisms in her brain actually shut down, and chemical levels that balance mood and self-awareness (such as serotonin) get extremely low. Even the limbic system — the part of the brain that deals with personality, emotions and memories — disconnects from sensory areas, leaving the patient feeling disembodied, delusional and emotionally unresponsive. Because Cotard’s patients have a reasoning deficit, they don’t know how to explain the changes in their bodies and, thus, decide that they must be dead. Sounds reasonable.
It’s weird because it doesn’t seem to matter what anyone says to convince Cotard’s patients that they’re really alive; they’ll just refute it, arguing with their own version of logic. They accept that they’re dead because they feel so disconnected from their bodies that they deny ownership of their personal experiences. Sufferers can recognize an event in passing, but they can’t concede that it has happened to them. They consider themselves as mere loci, as centres of thought that are occupying their non-living bodies. And as such, the Cotard’s patient feels immortal, or that nothing and nobody matters.
Clearly, this is a problem. I know it’s rare, and I don’t want to make this sound like there are people everywhere asking to be cremated, but we can’t just have people walking around thinking they’re not actually walking around — especially when we know it’s treatable. Doctors still perform the ol’ electroconvulsive therapy (you may have seen the procedure in One Flew Over the Cuckoo’s Nest) and apparently it works a lot better and faster than antidepressants. Rest assured that people with Cotard’s can re-enter society as functioning members. So, if you happen to run into someone claiming to be dead, which, I’m sure you won’t, kindly escort him or her to the nearest medical facility; that is, unless they look like they have actually died, spent some time down there and are back up for a snack. In such a case, run like hell.