Ways to start the Zombie Apocalypse: Cotard’s Syndrome

While I was watching “Scrubs” (on accident) I saw a patient on there with something called “Cotard’s Syndrome“. A syndrome of mental depression where a person thinks that he or she has died and become a zombie. They even go as far as to say they can smell their own rotting flesh and feel worms crawling through themselves. The patient complains of having lost everything: possessions, part of or entire body, often believing that he or she has died and is a walking corpse. This delusion is usually expanded to the degree that the patient might claim that he can smell his own rotting flesh and feel worms crawling through his skin. The latter phenomenon is a recurring experience of people chronically deprived of sleep or suffering amphetamine/cocaine psychosis. Paradoxically, being “dead” often gives the patient the notion of being immortal.

So it got me to thinking that we all know what to do in the Zombie Apocalypse but what we don’t discuss a lot are the ways in which it could start. Let’s discuss “Cotard’s Syndrome” and how it could be used to start… A ZOMBIE APOCALYPSE!


A 20-year-old male was diagnosed as having a bipolar disorder because of three manic episodes suffered during the year prior to admission. No previous depressive episodes were detected. He had a family history of bipolar disorder in a second-degree relative. While he was on treatment with lithium carbonate 800 mg/day, the patient suffered a short period of overactivity. Progressively over a 2-week period he became more isolated; he had a depressed mood, lost his appetite, and started to lie in bed most of the time, presenting a severe psychomotor retardation. Two days before his admission he showed nihilistic delusions concerning his body (“my liver and stomach are being destroyed,” “my heart doesn’t beat,” “I don’t have muscles”) and concerning existence (“I am dead”). The family brought the patient to our emergency room.

Imagine if suddenly say… 50 million people woke up with Cotard’s Syndrome all across America. Everyone suddenly thinking they are zombies would be a disaster of epic proportions. The FAA, public transportation, the stock market, police, fire and ambulance services would screech to a halt. People in your neighborhood and even in your own house would be semi-catatonic or at least be unwilling to feed or take care of themselves. People stumbling across freeways and those driving on them would suddenly stop caring which direction they were driving. 10’s of thousands of people in your general vicinity would suddenly be stumbling through the streets and even though they weren’t trying to eat you would seriously gum up the works. Imagine trying to wrangle 50,000,000 people into camps across the U.S…. the amount of money and effort would be nearly insurmountable.

Creating the Outbreak of Cotard’s Syndrome

Cotard’s syndrome is encountered primarily in psychoses such as schizophrenia and bipolar disorder.It can arise in the context of neurological or mental illness and is particularly associated with depression and derealization. Cotard delusion has also been the result of adverse drug reactions to (val)aciclovir. The symptoms were associated with high serum concentrations of CMMG, the principal metabolite of aciclovir. Patients with impaired renal function seem to be at risk even after dose reduction; in the cited case. Aciclovir is one of the most commonly used antiviral drugs, it is primarily used for the treatment of herpes simplex virus infections, as well as in the treatment of varicella zoster (chickenpox) and herpes zoster (shingles). With a little tinkering with it’s molecular structure and if it could be released in gas form along with a drug similar to the Scarecrow’s “Fear Toxin” from “Batman Begins” or a release into the water supply of a major metropolis it could affect millions.

The Cure:

Haemodialysis has been shown to cure the delusions in a few hours. In medicine, hemodialysis (also haemodialysis) is a method for removing waste products such as creatinine and urea, as well as free water from the blood when the kidneys are in renal failure. So the idea of hooking 50,000,000 people up to a dialysis machine seems insurmountable. People with Cotard’s Syndrome have an inability to feed or take care of themselves and the threat of dying of either thirst or hunger, exposure to the elements and accidents caused by the sudden zombification would make this process nearly impossible to overcome.

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One comment on “Ways to start the Zombie Apocalypse: Cotard’s Syndrome

  1. He said he knew he was dead for several reasons he felt dead he could not see people or things as he used to he felt he was blind in some way he could not see his feet as he walked and had many other unusual perceptual problems. Ketamine can cause some people to experience what is commonly called a near-death experience. In some individuals the feeling may linger beyond the drug experience.

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