One day, a 52 year old Filipino woman was brought into a hospital. She claimed she was dead, based on the fact that she could smell her own flesh rotting, and requested to be taken to the morgue so that she could be with the other dead people. She also exhibited paranoia, expressing the fear that paramedics were going to attempt to burn down her house, and complained of hopelessness, low energy, decreased appetite, and excessive sleepiness. She recovered with treatment, but only after she was diagnosed with Walking Corpse Syndrome.
An uncommon neuropsychiatric disorder, Walking Corpse Syndrome (Cotard’s Syndrome) creates within patients the delusion that they are either dead, do not exist, are putrefying, or have lost their vital organs. In extreme cases, people claimed that they could smell their own flesh rotting, or, paradoxically, have delusions of immortality. Guilt, anxiety, and negativity tend to overtake all other emotions, and individuals with this disorder often show no interest in social life or pleasure, neglect their hygiene, have suicidal or self-harming tendencies, and sometimes fail to recognize their own faces.
The exact cause of Cotard’s Syndrome is not known, but there is an extremely high correlation between lesions on the frontal and temporal regions of the brain and this disease. It is also more common in older individuals that suffer from depressive disorders, and has been associated with other mental disorders such as schizophrenia, bipolar disorders, and dementia or conditions that affect the brain, such as brain atrophy, seizures, brain injuries, etc. Correlation has also been seen between the disease and a build-up of a metabolite of acyclovir (an antiviral drug) called CMMG, which is caused by an adverse drug reaction to acyclovir.
Since the symptoms vary greatly, and the more common and recognizable symptoms can be indicators of other mental disorders such as depression or anxiety, the disease was divided into three stages:
- Germination Stage – Characteristic features of hypochondria and depression arise; there is extreme worry and fear of illness, even when the patient is undergoing medical treatment.
- Blooming Stage – The characteristic features of Walking Corpse Syndrome emerge, such as the delusion of being dead or immortal. Negativism and anxiety are also often associated with this stage.
- Chronic Stage – As a result of the paranoia and emotional stress, patient begin to exhibit signs of severe depression, such as self-harm and suicidal thoughts.
Based on the patient’s history and symptoms, doctors can make the determination that the patient suffers from Walking Corpse Syndrome, but not until after they have run tests that will exclude other possibilities. These tests include:
- A Blood Test
- CT Scan
- SPECT (Single-photon emission computed tomography; a type of nuclear imaging test that uses a radioactive substance and a special camera to create 3-D images in order to show how internal organs are functioning)
- Electroencephalogram (EEG)
Electroconvulsive therapy accompanied by medication is the primary form of treatment when the disease is in full effect, but there are ways to treat risk factors and prevent the disease all together. Antidepressants, antipsychotics, and mood stabilizer medications help with depression and bipolar disorder symptoms, which means patients should be treated with a single drug or a combination of drugs. During electroconvulsive therapy, electrodes are placed on the patient’s head, and small pulses are administered. The level of treatment that patients receive, however, is based on the severity of the disorder; in some cases, there is nothing that can be done. In these instances, the patient may starve to death or commit suicide. In other cases, patients can make a full recovery with the proper administration of drugs and other treatment strategies.