The Cotard illusion and bipolar disorder: What’s the link?

The kottar illusion is when a person believes that they or parts of their body are dead or dying. While it is rare, it can appear in people with bipolar disorder.

The Cotard delusion, also known as the Cotard illusion or Cotard syndrome, is the misconception that you do not exist, are dead, or rot. It is also known as mobile body disorder.

Cotard’s delusion is a symptom of some mental health conditions or medical conditions, such as bipolar disorder, especially in women under 25 years of age. It is not listed as a separate diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

There is no clear cause for Cotard’s delusion, but treatment is available. You can learn more about what a Cotard delusion is and what treatment options are in this article.

A cotard illusion is the feeling that you or a part of you, such as a limb, an organ, or even your soul or spirit, is dead or dying. It is associated with depression and nihilism (belief that nothing is important or of value).

according to 2014 reportCotard’s delusion often develops in people with major depression. There are fewer recent reports of this delusion, possibly because people with severe depression and symptoms of psychosis are receiving treatment in institutions earlier than before.

a 2007 study It included 138 people who suggested that those with Cotard’s delusion were nine times more likely to have bipolar disorder.

However, because Cotard’s delusion is present in people without bipolar disorder, one is not a guarantee of the other. That is, a person can have Cotard’s delusion without having bipolar disorder, and someone can live with bipolar disorder without having a Cotard delusion.

People with bipolar disorder experience extreme mood swings, such as episodes of depression and episodes of mania or hypomania. Some people also have bipolar disorder with psychosis.

Psychosis occurs when your experiences or thoughts make it difficult to tell what is real, such as hallucinations or delusions (false beliefs).

Bipolar disorder with psychosis is more common than many people think. A 2000 study reported that more than half of people with bipolar disorder will experience psychosis, with grandiose thinking being the most common type.

Aside from the Cotard delusion, the types of delusions associated with bipolar disorder include:

Symptoms of a depressive episode include:

  • very sad
  • Despair
  • carelessness
  • irritability
  • low self-esteem
  • Loss of interest in activities you used to enjoy
  • Sleep changes (too many or too few)
  • Thoughts of self-harm or suicide

Symptoms of a manic or hypomanic episode include:

  • happiness or extreme excitement
  • Thinking, speaking, or moving faster than usual
  • Excitement or restlessness
  • blind trust
  • Sleep a lot less but don’t feel tired
  • Impulsivity and engaging in activities with unwanted consequences, such as drug use, speeding, or excessive spending

It is not entirely clear what causes the Cotard delusion. Gender or gender may play a role, as the diagnosis appears more commonly in women than in men.

Cotard illusion may also have links with health anxiety.

Aside from bipolar disorder, mental health conditions associated with an increased risk of developing Cotard’s delusion include:

The diagnosis of Cotard’s delusion occurs through the process of ruling out other conditions, such as Capgras syndrome. There is no formal set of diagnostic criteria.

electroconvulsive therapy

A review of the literature indicates that electroconvulsive therapy (ECT) is the best treatment modality for Cotard’s delusion.

ECT involves applying electric currents to the brain and is used in severe, treatment-resistant bipolar disorder and depression.


There are no approved medications to treat the Cotard delusion, but researchers suggest that treating the underlying bipolar disorder and the Cotard delusion with mood stabilizers may be beneficial.

Depending on the underlying condition contributing to Cotard’s delusion, different medications may be used. For example, there have been reports of successful treatment with:

If you have a Cotard delusion, ask your psychiatrist or mental health professional about antidepressants or antipsychotics that may work for you. This may help reduce the severity or frequency of delusions.

It is unusual to experience the Cotard illusion, but it does happen.

If you identify these symptoms in yourself or a loved one, especially if bipolar disorder runs in the family, consider reaching out for support from a healthcare professional or mental health professional as soon as possible.

Keep in mind that there are treatment options, including ECT and medication, that may help you or a loved one get relief.

In the meantime, coping strategies to help manage bipolar disorder and its related symptoms may include things like:


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