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Walking Corpse Syndrome

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No, I feel like Dead ….

When you know that something is dying inside you, one moment you are alive. The next you are dead. A few hours later and you are alive again.

What if actually u are a Walking Corpse?


Walking Corpse or Cotard delusion is a rare condition caused by the false belief that you or your body parts are dead, dying & not existing.

Symptoms:

One of the main symptoms of Cotard delusion is nihilism. Nihilism is the belief that nothing has any value or meaning. It can also include the belief that nothing really exists. People with Cotard delusion feel as if they’re dead or rotting away. They might feel like they’ve never existed.

Few people feel this way about their entire body, others only feel it in regard to specific organs, limbs, or even their soul.

Depression is also closely related to Cotard delusion.

Other symptoms include:

  • anxiety
  • hallucinations
  • guilt
  • preoccupation with hurting yourself or death.

Other mental health conditions that might increase someone’s risk of developing Cotard delusion include:

  • bipolar disorder
  • postpartum depression
  • catatonia
  • depersonalization disorder
  • dissociative disorder
  • psychotic depression
  • schizophrenia

Cotard delusion also seems to be associated with certain neurological conditions, including:

  • brain infections
  • brain tumors
  • dementia
  • epilepsy
  • migraines
  • multiple sclerosis
  • Parkinson’s disease
  • stroke
  • traumatic brain injuries

Diagnosis?

Diagnosing Cotard delusion is often difficult because most doctors don’t recognize it as a disease. This means there’s no standardized list of criteria used to make a diagnosis. In most cases, it’s only diagnosed after other possible conditions have been ruled out.

Some of the conditions that may increase the risk of Cotard’s syndrome include:

Epilepsy: A person may experience delusions because of epilepsy-related brain damage or in the post-seizure period.

Neurological diseases: Conditions that cause damage to the brain, such as dementia, stroke, and traumatic brain injury (TBI), may cause delusions.

Substance misuse: A person may develop delusions while under the influence of drugs or due to drug-related brain damage.

Psychiatric conditions: Mental health disorders such as depression

Infections: Infections, especially in the brain, may cause delusions and other neurological symptoms.

1)Blood test

2)CT scan (Computed tomography)

3)MRI (Magnetic Resonance Imaging)

4)SPECT (Single-photon emission computed tomography)

5)Electroencephalogram (EEG)

Case report: Walking Corpse Syndrome

Mrs. Lubna a 60-year-old woman was admitted to the psychiatric unit when her family called the doctor because the patient was complaining that she was dead, smelled like rotting flesh, and wanted to be taken to a morgue so that she could be with dead people. Upon interview in the hospital, the patient expressed fear that “paramedics” were trying to burn down the house where she was living with her cousin and her brother. She also admitted to hopelessness, low energy, decreased appetite, and somnolence.

Mrs. Lubna reported that she had been on antidepressants for a few years but could not recall the name of the medication.

After organic causes were ruled out, treatment with quetiapine and bupropion SR was started. The patient was initially reluctant to take medication. She subsequently developed an electrolyte imbalance (hypokalemia and hyponatremia), which necessitated intravenous electrolyte repletion. The patient was also isolated, spending much of the day in bed and neglecting her personal hygiene and grooming.

Subsequently, the patient’s medication regimen was bupropion SR and olanzapine (intramuscular if she refused the oral form). A few days later, the patient had a questionable syncopal versus seizure episode, necessitating transfer to a medical unit.

After three days, she returned to the psychiatry floor where her medication regimen included olanzapine, escitalopram (because of the questionable seizure on bupropion), and lorazepam (for agitation).

Ms. Lubna showed improvement in symptoms over one month on olanzapine 25mg daily, escitalopram 20mg daily, and lorazepam 2mg daily. At discharge she denied nihilistic or paranoid delusions and hallucinations and expressed hopefulness about her future and a desire to participate in psychiatric follow-up care.

Treatment:

Cotard delusion usually occurs with other conditions, so treatment options can vary widely. Electroconvulsive therapy (ECT) was the most commonly used treatment. It’s also a common treatment for severe depression. ECT involves passing small electric currents through your brain to create small seizures while you’re under general anesthesia.

However, ECT does carry some potential risks, including memory loss, confusion, nausea, and muscle aches. This is partly why it’s usually only considered after other trying other treatment options, including:

  • antidepressants
  • antipsychotics
  • mood stabilizers
  • psychotherapy
  • behavioral therapy

Complications?

Feeling like you’ve already died. For example, some people stop bathing or taking care of themselves, which can cause those around them to start distancing themselves. This can then lead to additional feelings of depression and isolation.

In some cases, it can also lead to skin and teeth problems

Others stop eating and drinking and can lead to malnutrition and starvation.

Suicide attempts are also common. Some see it to prove they’re already dead by showing they can’t die again. Others feel trapped in a body and life that doesn’t seem real. They hope that their life will get better or stop if they die again.