The Curious Case of Madamoiselle X And Warren McKinlay
The year was 1880. On one fine afternoon, Dr Jules Cotard was brought a perfectly healthy woman. He was a French physician who practised psychiatry and neurology. Upon seeing the woman, he became utterly confused. This woman, also known as Mademoiselle X, shared with him her feelings of despair and anxiety.
But it did not stop there. She told the doctor, “I am dead”. She claimed that she had no nerves, no brain and all her internal organs did not exist. She was also reported telling him that she was cursed to eternal damnation and had lived a life of a zombie. She tried to end her life various times but was unsuccessful. Finally, her belief ended her. Aside from feeling that her body was rotting away, she also did not believe that she would die so she stopped eating altogether. This led to her death.
This curious case did not stop there. In 2005, Warren McKinlay, an army veteran got into a severe motorcycle accident. The accident left him with a brain injury, fractured spine and pelvis as well as ruptured lungs. To add to the long list of injuries, he was also in a coma. The brain injury, in particular, is a frontal lobe injury. A lot of nerves in that area of the brain were affected. The frontal lobe of our brain is a vital part of memory processing, facial recognition and emotions. When he finally woke up from the coma, he became disassociated with reality. Similar to Mademoiselle X, he believed that he was dead, despite having been surrounded by other human beings.
At this point in this essay, you must wonder what is wrong with these people. They have a condition known as Cotard Syndrome. It was named after that doctor I mentioned above when he presented Mademoiselle X’s case in his report le délire des négations (The Delirium of Negation). A snippet from the show ‘Scrubs’ below summarizes this condition in less than two minutes.
The exact cause of Cotard syndrome is not well understood, but it is often seen in the context of other mental health disorders, such as depression, schizophrenia, or bipolar disorder. Neurological conditions, such as brain lesions or injury, have also been associated with Cotard syndrome.
Individuals who suffer from Cotard syndrome typically exhibit a range of symptoms and delusional beliefs related to their death or non-existence. Some common characteristics of sufferers of Cotard syndrome include:
- Delusions of death: They often believe that they are dead, don’t exist, or that parts of their body are dead or decaying.
- Neglect of self-care: Sufferers may neglect basic self-care activities like eating, bathing, or sleeping because they believe these actions are irrelevant to a deceased person.
- Denial of existence: Some individuals with Cotard syndrome may deny their own existence, thinking they have no consciousness or self-awareness.
- Belief in immortality: Paradoxically, they might also believe they are immortal, which can lead to risky behaviour. Remember Madam X when she refused to eat? Yes. That’s what I’m talking about.
- Emotional apathy: It is commonly associated with severe depression, so sufferers may display a lack of emotional responsiveness or emotional numbing.
Stages of Cotard Delusions
Like any other mental disorder, this type of mental illness involves several stages. The first stage is Germination. In this stage, a patient usually develops hypochondria AKA a state of severe anxiety and depression. The blooming stage is the second stage where they get into a deeper level of their delusions. In this stage, a patient denies the existence of certain body parts like lungs, brain etc. or they might deny their existence altogether. Finally, in the last stage which is the chronic stage, a patient falls deeper into their delusion and chronic depression. It is almost impossible to convince someone that they are alive once they get into this stage.
Treatment Available for This Delusion
Despite being one of the most mysterious mental illnesses, there are cures for Cotard Syndrome. The first treatment is Electroconvulsive Therapy (ECT). ECT is normally used for seizure patients. What this therapy does is transmit an electric current through your brain. However, some people believe that this treatment should be banned because it might cause serious and irreversible brain damage.
The other type of treatment that patients would go through is tamer than ECT. Cotard syndrome patients would have to take pills to heal. What type of pills? It depends on the doctor. They might get antipsychotic pills, anti depressant or mood stabilizer.
These pills are usually paired with therapy such as Cognitive Behavioural Therapy (CBT). The therapy is usually used to treat an array of mental health issues such as depression, anxiety, eating disorders and many more.
Conclusion
Despite being a rare disorder, this mental illness exists. From the videos and interviews with Cotard syndrome patients, I can conclude that most of them were unable to live a normal life. To a certain extent, one of them admitted that he could not come up with a proper sentence while he was in a job interview.
From most of my reading about this illness, most people were fascinated and entertained by it. Whilst this illness is indeed ‘interesting’ (as most would agree), I can’t help but feel sorry and grief-stricken for the patients. I mean, these people were adamant about their distorted reality and they felt helpless in it. What if, one day, one of your family members requested to be put in a coffin for days on end? There’s nothing fun and fascinating about that.
Anyway, I hope you learn something from this entry. ‘Till next time.
