What Are Nihilistic Delusions?

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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 20 October 2016
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Nihilistic delusions are persistent beliefs that a subject does not exist or is dead. Like other delusions, these beliefs endure even when patients are presented with information that contradicts them, such as a recognition from a third party that the patient is alive and appears to exist. This psychological phenomenon was first described in the 19th century by Jules Cotard, a French researcher, and is sometimes known as a Cotard delusion in reference to this. It can be observed in patients with certain mental health conditions as well as people with brain injuries.

Patients with nihilistic delusions may express them in several different ways. Some patients simply believe they themselves do not exist, and in some cases, have never existed. They do not recognize information that invalidates this claim and may think they are invisible or inaudible to the people around them. Others think they are dead, and some experience vivid hallucinations to accompany the delusion, believing they are rotting corpses, for example, or thinking that limbs are missing.

If a care provider questions the patient, he or she may often reveal no personal information. Patients who think they do not exist believe they have no names, ages, or parents, for example. They may not recall anything from their past. Those who believe they are dead may tell care providers how they died and could offer information about their lives.


Cotard believed that nihilistic delusions were the result of “negativism.” The actual psychology behind them may be somewhat more complex. Patients with conditions like schizophrenia, bipolar disorder, and borderline personality disorder can develop a feeling of disconnect from the world around them. This may manifest in the form of delusions which seem quite logical to the patient, even if they appear bizarre to bystanders. Thus, a patient may develop nihilistic delusions after being ignored or silenced, in an attempt to explain those experiences.

In the case of brain injuries, the delusions can be the result of damage to parts of the brain involved in self perception. Such patients can be challenging to treat, as they may not respond to therapy and medications in the same way that those who have mental illnesses do, because the problems with the brain are very different. After an injury, the brain can gradually remap connections and build new associations, but this could take time. During this process, the patient may need supportive care to perform tasks of daily living and slowly erode these delusions.


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Post 5

I had a severe case of nihilistic delusions eight years ago. For me, it felt as if my body was transparent and people could walk by or through me without seeing me. I couldn't maintain a conversation -not because I didn't hear it, but because I thought I didn't exist so they wouldn't receive my reply. I hallucinated and thought I was in the past. I wasn't sure what physical objects were real, or if I was real. It felt like a complete break with reality. The only reason I didn't commit suicide was because I felt I was dead already.

My body wasn't participating in life. I lost over 30 pounds in two months. I was able to talk

and dress myself, but that was the extent of it. I had never heard of anyone experiencing these symptoms with depression until now. I have now been stable for six years. But for health workers and concerned family and friends: pay attention to those around you who are depressed with nihilistic tendencies. Avoid normal day-to-day conversations; it makes it worse/doesn't help. Stay by their side; don't leave them alone. Be careful with touching; sometimes it helped anchor me, sometimes it scared me.

When you have these traits in your head, your world turns upside down. It took years of therapy to reverse my head mantras, but it's possible to be "normal again" if the person stays with it, and their brain doesn't relapse. Medication was a life-saver for me. Remember that logic is flipped and you lose a grasp on reality. What seems logical to you, isn't to me, so try to understand. It's a very scary time and you often feel alone which makes matters worse. Like I said, I've never met anyone who experienced nihilistic delusions. I thought I was the only one. It's a hard concept to grasp because it's the antithesis of the will to live, but if you find a person experiencing these signs: hold on to them. You are their link to reality.

Post 4

@discographer-- No, nihilistic delusions or Cotard's Syndrome is rare, very rare. It affects men and women equally but age increases the risk of developing it.

Post 3

@SteamLouis-- I'm no expert on this subject but I don't think that this condition is rare or common.

As far as I know, it results from a brain dysfunction and this can happen even without injury. The dysfunction causes the person to disassociate with themselves, meaning that they can't recognize themselves and their appearance. Because of this disassociation, the person develops the feeling that this body is not theirs, their body is deteriorating or they don't exist. So nihilistic delusion is scientifically explainable.

I think that there are also psychological causes of the disorder though. I think that a fear of death also plays a role. For example, there was someone who developed nihilistic delusions after a severe traffic accident. He almost died and after survival, that fear of death seems to have triggered his delusions.

Post 2

This is the first time that I'm hearing about nihilistic delusion. Is nihilistic delusion rare in comparison to other types of delusions?

I often hear about people with mental health disorders who believe that their dead relatives are alive. Others think that they are a different person and start to act that way. But I have never heard of anyone thinking that they are dead or that they do not exist. It's a very odd and interesting notion.

In cases where the condition is not due to brain injury, do past grievances and traumas explain them fully? Do we have any experts here who can shed more light on this condition?

Post 1

I suppose nihilistic delusions are the opposite of Truman Syndrome, where someone feels his every move is being watched by everyone -- probably on TV.

This must be an absolutely miserable way to exist -- I certainly wouldn't call it "living," per se. There's no quality of life, in any case.

Barring a mental illness like schizophrenia, I have to wonder if some sufferers are victims of abuse, where just not being there was the preferable option, and that became the way the person functioned -- he or she simply wasn't there.

The article does not address how common this disorder is. I'd be interested in finding out.

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