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10 Case Reports of Cotard’s Delusion

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Cotard’s Delusion is a mental disorder where people suffer the nihilistic delusion that they are dead or no longer exist. First reported in the 1700s, the disorder is still largely a mystery today. The underlying cause isn’t understood; it’s been linked to bipolar disorder, depression and/or schizophrenia depending on the patient’s age. Here, ten people who went to their doctors and complained that they were dead.

1. In 1788, Charles Bonnet reported one of the earliest recorded cases of Cotard’s Delusion. An elderly woman was preparing a meal when she felt a draft and then became paralyzed on one side of her body. When feeling, movement, and the ability to speak came back to her, she told her daughters to dress her in a shroud and place her in a coffin. For days she continued to demand that her daughters, friends, and maid treat her like she was dead. They finally gave in, putting her in a shroud and laying her out so they could “mourn” her. Even at the “wake,” the lady continued to fuss with her shroud and complain about its color. When she finally fell asleep, her family undressed her and put her to bed. After she was treated with a “powder of precious stones and opium,” her delusions went away, only to return every few months.

2. Some 100 years after Bonnet met the old lady, French neurologist Jules Cotard saw a patient with an unusual complaint. Mademoiselle X, as Cotard called her in his notes, claimed to have “no brain, no nerves, no chest, no stomach and no intestines.” Despite this predicament, she also believed that she “was eternal and would live for ever.” Since she was immortal, and didn’t have any innards anyway, she didn’t see a need to eat, and soon died of starvation. Cotard’s description of the woman’s condition spread widely and was very influential, and the disorder was eventually named after him.

3. In 2008, New York psychiatrists reported on a 53-year-old patient, Ms. Lee, who complained that she was dead and smelled like rotting flesh. She asked her family to take her to a morgue so that she could be with other dead people. They dialed 911 instead. Ms. Lee was admitted to the psychiatric unit, where she accused paramedics of trying to burn her house down. After a month or so of a drug regimen, she was released with great improvement in her symptoms.

4. In 1996, a Scottish man who suffered head injury in a motorcycling accident began to believe he had died from complications during his recovery. Not long after he completed recovery, he and his mother moved from Edinburgh to South Africa. The heat, he explained to his doctors, confirmed his belief because only Hell could be so hot.

5. In 2012, Japanese doctors described a 69-year-old patient who declared to one of the doctors, “I guess I am dead. I’d like to ask for your opinion.” When the doctor asked him whether a dead man could speak, the patient recognized that his condition defied logic, but could not shake his conviction that he was deceased. After a year, his delusion passed, but he insisted on the truth of what happened during it. “Now I am alive. But I was once dead at that time,” he said. He also believed that Kim Jong-il was also a patient at the same hospital.

6. In 2009, Belgian psychiatrists reported the case of an 88-year-old man who came to their hospital with symptoms of depression. The man explained that he was dead, and was concerned and anxious that no one had buried him yet. His delusions subsided with treatment.

7. The same doctors also treated a 46-year-old woman who claimed to have not eaten nor gone to the bathroom in months, nor slept in years. She explained that all her organs had rotted, that she had no blood and that doctors who monitored her heart or took her blood pressure were deceiving her because her heart didn’t beat. After multiple admissions to the hospital and a lapse in taking her medication over the next 10 months, her condition gradually improved.

8. Greek psychiatrists received a patient in 2003 who believed he was literally empty-headed. He had attempted suicide years earlier because he thought it wasn’t worth living since he didn’t have a brain. He was not treated after the incident and simply returned to work. Once at the hospital he “claimed that he was born ‘without a mind,’ meaning that his head is empty without a brain and for this reason he is retarded.” He left against medical advice after several days, and was re-admitted the next year. This time he completed treatment and showed sustained improvement in a follow-up interview months later.

9. The Greek doctors also treated a 72-year-old woman who went to the ER claiming “all of her organs had melted; only skin had remained and that she was practically dead.” She was admitted to the hospital and her outcome not reported.

10. In 2005, Iranian doctors described what may be the most unusual case recorded. A 32-year-old man arrived at their hospital saying that not only was he dead, but that he had been turned into a dog. He said that his wife had suffered the same fate. His three daughters, he believed, had also died and had turned into sheep. He said that his relatives had tried to poison him, but that nothing could hurt him because God protected him even in death. He was diagnosed with Cotard’s and clinical lycanthropy, treated with electro-convulsive therapy and relieved of his major symptoms. (You can read more about this case at my website.)

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5 Tips for Becoming A Morning Person
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You’ve probably heard the term circadian rhythm. Your circadian rhythm is an internal clock that influences your daily routine: when to eat, when to sleep, and when to wake up. Our biological clocks are, to some extent, controlled by genetics. This means that some people are natural morning people while others are night owls by design. However, researchers say the majority of us fall somewhere in the middle, which is good news if you want to train yourself to wake up earlier.

In addition to squeezing more hours out of the day, there are plenty of other good reasons to resist hitting the snooze button, including increased productivity. One survey found that more than half of Americans say they feel at their best between 5 a.m. and noon. These findings support research from biologist Christopher Randler, who determined that earlier risers are happier and more proactive about goals, too.

If you love the idea of waking up early to get more done, but you just can't seem to will yourself from out under the covers, here are five effective tips that might help you roll out of bed earlier.

1. EASE INTO THE HABIT.

If you’re a die-hard night owl, chances are you’re not going to switch to a morning lark overnight. Old habits are hard to break, but they’re less challenging if you approach them realistically.

“Wake up early in increments,” Kelsey Torgerson, a licensed clinical social worker at Compassionate Counseling in St. Louis suggests. “If you normally wake up at 9:00 a.m., set the alarm to 8:30 a.m. for a week, then 8:00 a.m., then 7:30 a.m.”

Waking up three hours earlier can feel like a complete lifestyle change, but taking it 30 minutes at a time will make it a lot easier to actually stick to the plan. Gradually, you’ll become a true morning person, just don’t try to force it to happen overnight.

2. EXERCISE IN THE MORNING.

Your body releases endorphins when you exercise, so jumping on the treadmill or taking a run around the block is a great way to start the day on a high note. Also, according to the National Sleep Foundation, exercising early in the morning can mean you get a better overall sleep at night:

“In fact, people who work out on a treadmill at 7:00 a.m. sleep longer, experience deeper sleep cycles, and spend 75 percent more time in the most reparative stages of slumber than those who exercise at later times that day.”

If you don’t have much time in the morning, an afternoon workout is your second best bet. The Sleep Foundation says aerobic afternoon workouts can help you fall asleep faster and wake up less often throughout the night. “This may be because exercise raises your body’s temperature for about four to five hours,” they report. After that, your body’s core temperature decreases, which encourages it to switch into sleep mode.

3. MAKE YOUR BEDROOM IDEAL FOR SLEEP.

Whether it’s a noisy street or a bright streetlight, your bedroom environment might be making it difficult for you to sleep throughout the night, which can make waking up early challenging, as you haven’t had enough rest. There are, however, a few changes you can make to optimize your room for a good night’s sleep.

“Keep your bedroom neat and tidy,” Dr. Nancy Irwin, a Los Angeles-based doctor of psychology on staff as an expert in sleep hygiene at Seasons Recovery Centers in Malibu, suggests. “Waking up to clutter and chaos only makes it more tempting to crawl back in bed.”

Depending on what needs to be improved, you might consider investing in some slumber-friendly items that can help you sleep through the night, including foam earplugs (make sure to use a vibrating alarm), black-out drapes, light-blocking window decals, and a cooling pillow

Another simple option? Ditch the obnoxious sound of a loud, buzzing alarm.

“One great way to adapt to rising earlier is to have an alarm that is a pleasing sound to you versus an annoying one,” Dr. Irwin says. “There are many choices now, whether on your smartphone or in a radio or a freestanding apparatus.”

4. TAKE THE TIME TO PROPERLY WIND DOWN.

Getting up early starts the night before, and there are a few things you should do before hitting the sack at night.

“Set an alarm to fall asleep,” Torgerson says. “Having a set bedtime helps you stay responsible to yourself, instead of letting yourself get caught up in a book or Netflix and avoid going to sleep.”

Torgerson adds that practicing yoga or meditation before bed can help relax your mind and body, too. This way, your mind isn’t bouncing from thought to thought in a flurry before you go to bed. If you find yourself feeling anxious before bed, it might help to write in a journal. This way, you can get these nagging thoughts out of your head and onto paper.

Focus on relaxing at night and stay away from not just exercise, but mentally stimulating activities, too. If watching the news gets your blood boiling, for example, you probably want to turn it off an hour or so before bedtime.

5. GET YOUR DAILY DOSE OF LIGHT.

Light has a immense effect on your circadian rhythm—whether it’s the blue light from your phone as you scroll through Instagram, or the bright sunlight of being outdoors on your lunch break. In a study published in the Journal of Clinical Sleep Medicine, scientists compared the sleep quality of 27 subjects who worked in windowless environments with 22 subjects who were exposed to significantly more natural light during the day.

“Workers in windowless environments reported poorer scores than their counterparts on two SF-36 dimensions—role limitation due to physical problems and vitality—as well as poorer overall sleep quality," the study concluded. "Compared to the group without windows, workers with windows at the workplace had more light exposure during the workweek, a trend toward more physical activity, and longer sleep duration as measured by actigraphy.”

Thus, exposing yourself to bright light during the day may actually help you sleep better at night, which will go a long way toward helping you wake up refreshed in the morning.

Conversely, too much blue light can actually disturb your sleep schedule at night. This means you probably want to limit your screen time as your bedtime looms closer.

Finally, once you do get into the habit of waking up earlier, stick to that schedule on the weekends as much as possible. The urge to sleep in is strong, but as Torgerson says, “you won't want your body and brain to reacclimate to sleeping in and snoozing.”

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New Device Sanitizes Escalator Handrails While They're in Use
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If you have ever hesitated to touch a well-used escalator's handrails for fear of contracting some disease from the masses, LG Innotek has an answer for you. The company just released a handrail sterilizer that uses UV light to kill nearly every germ coating the rubber belts, according to The Verge.

As the railings move with the escalator, they pass through the UV light, which kills 99.99 percent of germs, according to tech developer LG Innotek. The sterilizer is placed just before escalator users hop on, ensuring the handrails are still relatively clean when you grab on at the bottom. The device is a little bigger than a regular hand sanitizer dispenser (around the size of a piece of paper) and starts automatically when the escalator begins moving. It runs on power generated by the movement of the escalator.

UV radiation is used to kill super-germs in hospitals (and one company wants to bring it to planes), but it's relatively easy to use on your phone, your toothbrush, or anywhere else in your house. You can already get handheld UV sterilizers online, as well as aquarium-specific ones. In April 2017, LG Innotek released a faucet that purifies water by UV-sterilizing it inside the aerator. However, the fact that escalator railings are constantly on the move makes them easier to clean automatically than subway railings, door handles, and other potentially germy public surfaces we touch every day.

Bear in mind that while nobody likes getting a cold, germs aren't always bad for you. Some types can even help protect you against developing asthma, as scientists found while researching the health differences between Amish children and their counterparts on more industrialized farms. Whether you touch the handrails or not, cities have their own unique microbiomes, and those ubiquitous bacteria are pretty much guaranteed to get on you whether you like it or not. On the bright side, if you are a germophobe, UV sterilization has been touted as a possible alternative to other antibacterial treatments that cause supergerms.

[h/t The Verge]

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