Zombie syndrome or Cotard syndrome is a rare form of paranoia. People with this syndrome believe that they are dead, others strongly believe that their brains and internal organs have disappeared or rotted.
Cotard – What is zombie syndrome?
Cotard’s Syndrome (English: Cotard’s Syndrome or Cotard Delusion) is also known by other names as Cotard delusion or walking zombie syndrome. This term refers to a form of delusion where the person believes that he or she is dead, has no organs, has lost all blood, or has rotted away. Zombie syndrome does not appear on its own, but often occurs in people with major depression or other mental disorders.
Zombie syndrome is named after the neurologist Jules Cotard (1840 – 1989) – who first mentioned this syndrome in 1880. Since that time, only 200 cases have been recorded. received worldwide. This shows that the incidence of Cotard syndrome is not high.
Cotard syndrome is considered a serious mental disorder of unknown etiology. However, most cases will have marked improvement after treatment intervention. In the worst case scenario, the patient may fast because he believes he is dead and eventually leads to death.
Currently, walking zombie syndrome is not recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) or the International Statistical Classification of Diseases and Related Health Problems. (ICD) of WHO. However, this syndrome is still mentioned frequently due to the complex mechanism and the heavy impact that patients have to face.
Recognizing the walking zombie syndrome
Walking zombie syndrome is characterized by symptoms of negative delusions – that is, the patient always denies his own existence. The patient believes that he is dead or that his brain, internal organs have disappeared / have been destroyed and rotted. Symptoms of the disease are quite diverse, but in general, there are always negative delusion symptoms.
In fact, the incidence of Cotard syndrome is very low, but this syndrome can completely destroy the patient’s cognition. For timely treatment, the family can detect this syndrome through some signs such as:
People with Cotard syndrome have a strong belief that they are dead and no longer exist
- Have a strong belief that you no longer exist
- Some patients believe that the brain or internal organs have disappeared or have rotted
- The patient is less social or may not communicate because he thinks he has disappeared
- Most of the sick people refuse to eat because they think they are dead and that eating does not bring any benefit.
- In addition to the delusion that they are dead, some people also have hallucinations such as hearing the smell of decay from the body, hearing the voice of the dead or dying self.
- Have self-harming behaviors.
- Because they believe they no longer exist, they often neglect personal hygiene, not eating and exercising.
- Children and adolescents with Cotard syndrome may tell adults about their delusions, such as the world being destroyed, the self ceased to exist, etc.
- Some people with Cotard’s syndrome ask their families to send themselves to the morgue because of their strong belief that they are dead. In addition, there are also many cases where patients find themselves at the cemetery.
- The strong belief that he is dead causes the patient to have a strange, abnormal gait. This is also why Cotard syndrome is also known as walking zombie syndrome.
Symptoms of Cotard syndrome will get worse over time. According to research conducted by expert Yamada Katsuragi (Japan) in 1999, this syndrome will be developed through 3 stages:
- Germination stage: During the germination stage, patients often suffer from illness anxiety disorder (a state of fear that they have serious illnesses and this anxiety persists even after being diagnosed by a doctor). confirmed by the doctor to be perfectly healthy). At this stage, symptoms are often vague and often accompanied by signs of depression (feeling alone, loss of interest and interest in things).
- Developmental stage: During the developmental stage, the patient forms a strong belief that certain parts of the body have disappeared or are rotting. The sick person never changes his beliefs, even when those around him try to explain with the most convincing arguments. Many patients become irritable, angry when others say that body parts still exist.
- Chronic phase: In the chronic stage, the patient completely denies his own existence. Patients begin to have self-torture behaviors, lose the ability to recognize faces, do not communicate, refuse to eat, and neglect personal hygiene.
In addition to the above symptoms, the patient will also have other psychiatric symptoms depending on the comorbidities.
What causes Cotard’s syndrome?
Although mentioned since the 1880s, Cotard syndrome has not been studied much. To date, experts have not found the exact cause of this syndrome. However, experts have identified several factors that are associated with walking zombie syndrome.
Factors that cause walking zombie syndrome (Cotard):
- People in their 50s
- Being a female
- People with mental and psychological problems
- Physical damage to the brain
- People with Capgras syndrome have a higher risk of developing Cotard syndrome (Capgras syndrome is a delusion in which the patient believes that family and friends have all been impersonated and replaced)
A study conducted in 2011 showed that more than 89% of people with Cotard syndrome suffer from depression and most patients have psychological and psychiatric problems. Psychological or psychiatric problems that may increase the risk of developing Cotard’s delusional syndrome include:
- Depression
- Bipolar disorder
- Psychomotor disorders
- Schizophrenia
- Dissociative disorder
- Depersonalization disorder
In addition to psychological and psychiatric problems, walking zombie syndrome is also associated with a number of health problems such as:
People with neurological problems will have a high risk of walking zombie syndrome
- Epileptic
- Migraine
- Dementia
- Multiple sclerosis
- Parkinson disease
- Brain tumors
- Brain infection
- Brain damaged
When MRI brains of people with Cotard syndrome, experts found that the activity level of the parietal lobe, the frontal region was extremely low, on par with people who are in a coma or in a vegetative state. Low brain activity makes the patient lose judgment, perception and form false beliefs.
Experts also expressed surprise about the brains of people with Cotard syndrome. Because with this level of activity, most people are unable to communicate and walk.
Is walking dead syndrome dangerous?
Walking zombie syndrome (Cotard syndrome) is actually a serious form of paranoia. Currently, this syndrome is not officially recognized in the ICD-10 and DSM-5. However, this does not mean that Cotard syndrome does not require treatment.
In contrast, Cotard syndrome can completely destroy a person’s consciousness and life. Because they always deny their existence, people with this syndrome often do not communicate, refuse to eat, do not interact socially, and neglect personal hygiene. Many people also intentionally perform self-destructive behaviors because they believe that they are dead, so they no longer have any feelings.
Walking corpse syndrome, if left untreated, will completely destroy the patient’s consciousness
If left untreated, the patient’s life and health will deteriorate completely. There have been many cases of death due to starvation because the patient believed that he was dead, so eating did not bring any benefit. In addition, this syndrome also causes the patient to lose the ability to perceive and judge, so it is almost impossible to work and study. Patients live completely dependent on the family right from the smallest things such as personal hygiene, cooking, …
The risk of suicide in patients with Cotard’s syndrome is relatively high. Patients are not driven by thoughts of death or delusions of self-incrimination like patients with depression. However, some people commit suicide to prove to those around them that they really don’t exist. Therefore, diagnosis and treatment should be done as soon as possible.
Cotard’s delusional diagnosis
As mentioned, Cotard syndrome is not officially recognized in the DSM-5. Therefore, there are currently no diagnostic criteria for this syndrome. However, if a family member shows signs of Cotard delusion, the family should force the patient to go to the hospital for early diagnosis and treatment.
Doctors will often rely on clinical manifestations and accompanying psychological and neurological health problems to determine the risk of this syndrome. In essence, walking zombie syndrome (Cotard) is paranoia with bizarre content. Therefore, this syndrome often occurs in cases of mental disorders with psychotic manifestations such as schizophrenia, alcoholism, paranoia, bipolar disorder with psychosis, etc.
Methods to treat walking zombie syndrome
As can be seen, walking zombie syndrome causes many complications and severe consequences. This syndrome is often accompanied by psychological and psychiatric disorders, so treatment will be different in each case.
The content of the article will only mention the methods applied to improve Cotard’s paranoia. Currently, electroconvulsive therapy (ECT) is the most effective method. In addition, pharmacotherapy and psychotherapy are also considered in some cases.
1. Electroconvulsive Therapy (ECT)
Electroconvulsive therapy is often indicated in the treatment of drug-resistant depression and bipolar disorder. This therapy is also considered for people with Cotard’s syndrome. Electroconvulsive therapy uses small electrical currents that are passed inside the brain to create small controlled vibrations. After this therapy, the neurotransmitters in the brain will return to a balanced concentration and the function of the parietal and frontal lobes will also be significantly improved.
Electroconvulsive therapy (ECT) is currently the most effective method in the treatment of walking corpse syndrome
ECT is highly effective in changing patients’ false beliefs. In the past, the risks of performing this therapy were relatively high, but with the development of medicine, ECT has now been improved and only causes some mild to moderate side effects such as confusion, nausea, headache…
2. Pharmacotherapy
In essence, walking zombie syndrome is a form of paranoia. Therefore, using drugs can improve paranoia in general and Cotard syndrome in particular. For this syndrome, patients are usually prescribed long-term and sometimes lifelong medication.
Medications used in the treatment of walking zombie syndrome:
- Antidepressants
- Sedative
- Antipsychotic drugs
Depending on the specific situation in each case, the doctor will prescribe the appropriate medication. Among them, antipsychotics are the main group of drugs. Sedatives and antidepressants are only used to improve some related symptoms such as anxiety, insecurity, stress, insomnia, distress, depression, etc.
3. Psychotherapy
In addition to the above two methods, some patients will be treated with psychotherapy. Among them, cognitive behavioral therapy (CBT) is considered to be the most effective method. In this therapy, the specialist will focus on changing the patient’s wrong thoughts and beliefs. At the same time, helping patients change inappropriate behaviors such as personal hygiene, not eating, self-destructive behaviors, etc.
Most people with Cotard syndrome will receive a combination of medication, psychotherapy, and electroconvulsive therapy (ECT). The degree of response to treatment will vary from patient to patient, but in general all patients have improved orgasm.
Cotard syndrome (walking zombie syndrome) is a severe mental disorder. Fortunately, the incidence of this condition is very low and most respond well to treatment. To control Cotard syndrome well, the doctor will require treatment in parallel with the accompanying psychological and psychiatric disorders.
