Cotard’s syndrome is one of the strangest psychological disorders , among other things because it is complicated to put oneself in the shoes of those who experience it first hand.

Because the symptoms of this phenomenon are defined neither by personality changes, nor by sensory or motor alterations, nor do they have their roots in changes to very extreme moods. Instead, everything is based on a sensation: the feeling of having died.

In this article we will see what Cotard’s Syndrome is, what its symptoms are, and what its possible causes are, among other things.

What is Cotard’s Syndrome?

It is quite common to think that people interpret reality only from data that comes directly to them through the senses. According to this point of view, when we see a rectangular body from whose corners four extensions descend, we come to the conclusion that what we are looking at is a table, provided that we have first learned that concept.

The same would happen with landscapes, people and animals: we would perceive each of these physical elements through our senses and we would identify them automatically , in a clean and predictable way, as long as we did not lack data. The truth is that, although most of the time there is a very clear relationship between the raw data that comes to us through the senses and what we interpret to be real, this is not always the case. The stranger Cotard’s Syndrome is an example of this.

Cotard’s syndrome is a mental disorder in which the subject perceives himself as something that, in some way, does not exist or is separated from reality.

People with this syndrome are capable of sensing their own body (for example, they can see themselves in a mirror, just like all people without vision impairment) but they notice it as something strange, as if it did not exist. A significant number of people with Cotard syndrome, for example, believe they are dead, literally or figuratively , or in a state of decomposition. This is not a metaphorical way of saying how they feel, but a strong belief, which is taken literally.

This is a psychological phenomenon similar to depersonalization, in which one experiences a disconnection between oneself and everything else . The alteration appears in the way in which one emotionally experiences that which is perceived through the senses, not in the way in which the senses provide information. Technically, everything that is seen, heard, touched and tasted or smelled seems to be real, but does not feel real.

In Cotard’s Syndrome, this emotional disconnection goes hand in hand with a more specific idea and that is a pseudo-explanation to what it feels like: one is dead, and therefore the person who presents this alteration no longer has a strong interest in remaining linked to the world.


Although this symptom picture may be called nihilistic delirium , it has nothing to do with the person’s philosophical or attitudinal positioning. Someone with Cotard’s Syndrome tends to sincerely believe that the plane of reality in which their body is located is not the same as that in which their conscious mind is, and acts accordingly.

What people with Cotard syndrome experience is very similar to the way some people strongly influenced by a certain culture or religion may come to think about their body, other people and the environment they inhabit; the difference is that people with the syndrome always perceive things this way, regardless of the context, because of an abnormal functioning of some of their brain structures .

Cotard’s Syndrome is named after French neurologist Jules Cotard, who in the late 19th century coined the term Denial Syndrome to describe the case of a woman who believed she was dead and had all her internal organs rotten. This person, believing that she was suspended somewhere between Heaven and Hell, did not believe it was necessary to eat, as the planet Earth had lost all meaning for her.

The fundamental idea is unrealization

The concept of de-realization implies the idea of perceiving the data that reach us about the environment as something alien to the reality of the one who perceives it . You can experience something similar, for example, if you are in a room with little light and you place one of your hands in front of your eyes. You will see the silhouette of one of the parts of your body, which is something you have already memorized throughout your life, and you will notice that its movements correspond to those you want it to make. However, the darkness may cause you to feel that, although all the data you have about the hand corresponds to that which you associate with your own body, you have the feeling that the hand is not yours or is dissociated from you in some way.

People with Cotard’s Syndrome experience something like this: all the sensory information about themselves and their surroundings seems to be in order, but despite this, the feeling persists that none of it has any meaning or is unrealistic. Moreover, this delirium is wide enough to be able to take different ways of manifesting itself . Some people believe they are dead, others have the feeling of being immortal, and there are even cases of patients who only perceive some parts of their body as something strange or that it is decomposing.

Possible causes

Cotard’s syndrome is complex in its manifestations and in its causes, which are found in the functioning of the brain. As we have seen, the information processing coming from the outside is correct, what is lacking is the emotional response that should accompany this processing, since everything is meaningless . Therefore, it is believed that the main root of nihilistic delirium is found in the abnormal functioning of the part of the brain associated with the processing of emotions: the limbic system, at the base of the brain.

In any case, Cotard’s Syndrome teaches us that the human brain carries out very complex and varied tasks so that we can comfortably perceive and interpret reality. The fact that this process is automatic and most of the time goes well does not mean that any of these pieces cannot fail, leaving us with eyes, noses and mouths that inform correctly about a world without meaning.

Bibliographic references:

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  • Sogomy, V. (2012). Depersonalization and the Sense of Realness. Philosophy, Psychiatry, & Psychology. 19 (2).
  • Yarnada, K.; Katsuragi, S.; Fujii, I. (2007). A Case Study of Cotard’s syndrome: Etapas y diagnóstico. Acta Psychiatrica Scandinavica. 100 (5): 396 – 398.
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