Worried You're Dead, But Aren't? You Might Have Cotard's Delusion

The one hard, constant truth of existence is that life, in and of itself, is a gradual counting down to death. Living is dying. But there are those rare few who insist they've already left, that they're merely walking corpses.

TK Cotard's delusion, a neuropsychiatric disorder involving the "fixed and unshakable belief" that one is rotting, has lost organs, blood or other body parts, or is already dead in this life. In its most profound manifestation, according to the National Institutes of Health, the "delusion takes the professed form that one does not exist" or, in even rarer cases, that one is immortal.

The délire des négations (negation deliriums) were first described during a lecture in Paris in 1880 by French neurologist Jules Cotard. He spoke of one pseudonymous Mademoiselle X, the walking corpse case study No. 1, who had apparently renounced the existence of God, the Devil and some of her body parts. She was convinced, curiously, of her eternal damnation, so she stopped eating. Naturally, she starved to death.

There have been more cases since Mlle X. — most have trended toward depressed middle-aged or elderly people. A few cases have been documented in younger nihilists with 90 percent of these being female, according to the International Journal of Mental Health Systems.

It's believed that Cotard's stems from a division between fusiform face areas and the amygdala and other limbic structures, between those regions of the brain linked with facial recognition and those associated with the emotions those regions stroke, respectively. (There's some speculation, however, that adverse reactions to antiviral drugs used to treat shingles and chickenpox – and herpes – may be what smothers the soul.)

The walking corpse syndrome, then, is not unlike the Capgras syndrome, or the delusional insistence that someone close to you – a parent or sibling, friend or spouse – has been swapped by a doppelgängerish imposter. Should the afflicted see his own face in another, his brain disconnect may sever any ties between it and his sense of being. He has ceased existing, or so the thinking goes.

Still, I can't help but liken the notion that you're putrefying or a bumbling cadaver with, say, alien-hand and foreign accent syndromes or triskaidekaphobia, the crippling fear of 13. Even as the cases steadily accumulate and as rapidly improving brain imaging techniques allow us to peer ever deeper into all our fleshy mind masses, these bizarre disorders still seem to straddle the boundaries between legit psychoses and bunk head games.

With that, a thought experiment: If you came down with Cotard's – and even if you're non-religious – would you at least try and eat your own brain?

Reach this writer at brian@motherboard.tv.