Scariest Psych Disorders,The Finale

Scariest Psych Disorders, the finale

Hello, people… welcome back to the blog! Last week, we talked about more of the strangest and scariest psych disorders, and this week, we’ll finish that off before we take a break for the holidays. Let’s get right to it.

Kluver-Bucy Syndrome

Ever had a food craving? Maybe you want a piping hot pepperoni and mushroom pizza, with extra cheese. Sounds good, right? How about you add some dryer lint? Yum! Or maybe a little shredded phone book? Still sound good? No? How about sex… ever had a craving for that? Of course, everyone has, right? How about sex with a truck? Not in a truck… WITH a truck. Hmmm…. Maybe not so much.

Well, imagine craving the taste of that phone book, or wanting to have sex with a car. It sounds unreal, but those things are reality for people with Kluver-Bucy Syndrome, a very scary neurological disorder associated with damage to the temporal lobes of the brain, resulting in the desire to eat inedible objects, sexual attraction to inanimate objects, and memory loss. 

First described by neuropsychologist Heinrich Klüver and neurosurgeon Paul Bucy- hence the name- the story of Klüver-Bucy syndrome begins with a monkey and a cactus. Actually, it begins with mescaline, which is a chemical derived from a cactus, that causes vivid hallucinations. It was studied very thoroughly- and quite personally- by psychologist Heinrich Klüver, who noticed that monkeys that were given mescaline often smacked their lips, which reminded him of behaviors exhibited by patients with ​seizures arising from the temporal lobe of the brain. Unsure if this was due to mescaline or not, this made the two of them curious as to all of the functions of the temporal lobe, so they designed an experiment on a monkey named Aurora, who happened to be particularly aggressive. They removed a large part of Aurora’s left temporal lobe to investigate it under a microscope, and noted that when she woke, her previously aggressive demeanor had vanished, and she was instead placid and tame. 

Apparently, this drew their interest more than the mescaline, so they focused solely on the temporal lobe, performing bilateral temporal lobe surgery on a series of 16 monkeys, and afterwards noted the following symptoms:

Psychic blindness- this indicates a lack of recognition or understanding of a person, place, or thing being viewed. After the surgery, the monkeys would look at the same object over and over again, unable to recognize the form or function of the object. Even things they should fear, like a hissing snake, they didn’t recognize, much less fear. 

Oral tendencies- like a very small child, the monkeys evaluated everything around them by putting it all into their mouths, rather than using their hands, as they normally would. They would even attempt to push their heads through the bars of their cages in order to touch things with their mouths, instead of their hands. 

Dietary changes- prior to the temporal lobe surgeries, these monkeys usually ate fruit, but afterwards, the monkeys began to accept and consume large quantities of meat.

Hypermetamorphosis- this meant that anything that crossed the monkeys’ field of vision required their full and immediate attention.

Altered sexual behavior- after the procedure, the monkeys become very sexually interested, both alone with themselves, and with others.

Emotional changes- the monkeys became very placid, with reduced or even absent fear. Facial expressions were also lost for several months, but those did return after a period of time.

Not surprisingly, people with Kluver-Bucy syndrome often have the same symptoms: trouble recognizing people and/ or objects that should be familiar to them, and excessive oral tendencies, with the urge to put all kinds of objects into the mouth, whether food items or not. Hypermetamorphosis is also common, the irresistible impulse or need to explore everything that comes into view. Other symptoms include memory loss, emotional changes, extreme sexual behavior, indifference, placidity, and visual agnosia, which is difficulty identifying and processing visual information. A nearly uncontrollable appetite for food is often noted, and there may be dementia type symptoms as well. 

Klüver-Bucy syndrome is the result of damage to the temporal lobes of the brain. This can be the result of trauma to the brain itself, or the result of other degenerative brain diseases, tumors, or some brain infections, most commonly herpes simplex encephalitis.

Thankfully, this type of extreme damage is rare. The first full case report of Klüver-Bucy syndrome was reported by doctors Terzian and Ore in 1955, when a 19-year-old man had sudden seizures, behavioral changes, and psychotic features. First the left, and then the right, temporal lobes were removed. After the surgery, he seemed much less attached to other people, and was even quite cold to his family. At the same time, he was hypersexual, frequently soliciting people who happened by, whether they were men or women. He also wanted to eat constantly, regardless if the items were food or not. 

Because it is so rare, like many classical neurological syndromes, Klüver-Bucy syndrome is really more important for historical and academic reasons, rather than for its immediate applications to patients. The reports of Klüver and Bucy got a lot of publicity at the time, mainly due to their demonstrating the temporal lobe’s involvement with interpreting vision, and their work added to the growing recognition that particular regions of the brain had unique functions which were lost if that region of the brain was damaged. Science is built on the work of others- the more we know, the more we learn- and while Klüver-Bucy syndrome isn’t very common, the work that went into describing it still has an impact felt in neurology to this day.

Aboulomania

To be or not to be… that is the question. At least, that’s one of the many questions someone with aboulomania is likely to ask themselves. From the Greek a-, meaning without’, and boulē, meaning will, aboulomania is a psych disorder in which the patient displays pathological indecisiveness. While many people have a hard time making decisions, it is rarely to the extent of obsession, and that’s exactly the case in aboulomania.

In most people, the part of the brain that is tied to making rational choices, the prefrontal cortex, can hold several pieces of information at any given time. But people with aboulomania quickly become overwhelmed when trying to make choices or decisions, regardless of the importance of that decision. They come up with all the reasons how and why their decisions will turn out badly, causing them to overanalyze every situation critically. It’s a classic case of paralysis by analysis, where a lack of information, difficulty in valuation, and outcome uncertainty combine to become obsession. Often associated with anxiety, stress, and depression, as you can imagine, aboulomania can severely affect one’s ability to function socially. 

As for etiology, it’s usually extremely authoritarian or overprotective parenting that leads to the development of aboulomania; when caretakers reward loyalty and punish independence. Sometimes there’s a history of neglect and avoidance of expressed emotion during childhood that contributes to it. If someone is a victim of humiliation or abandonment during childhood, the chances for aboulomania increase, as shame, insecurity, and lack of self-trust can all trigger it. It’s sad to see, when everyday tasks become deciding questions of peoples’ lives. Simple decisions… to see a movie or stay at home, and what movie? Do I want Mexican or Italian food? Should I call John or text him? These are questions that cannot be answered by people with aboulomania without an eternity of dilemmas. 

It’s common for people with aboulomania to avoid being alone whenever they know a decision has to be made, or feel like a dilemma might come up. But this doesn’t come from a fear of being alone, it comes from the need to have someone there to make the decision for them, and assume the responsibility for said decision. Here, the fear of being alone isn’t the root of the problem, it’s just a symptom of a bigger issue. It’s important to mention that this dependency on people makes it easier for others to manipulate or lie to people with aboulomania. Some people will take advantage of their indecisiveness and use that, while others will simply leave them for not being able to make choices or ever express disagreement. 

Many times, people with aboulomania don’t recognize it, or recognize it but try to play it off, but this is a pathological level of indecision, a mental illness, not just a self-esteem or insecurity issue, so diagnosis is important. Look, being indecisive when having to make an important decision is normal, but when it starts affecting your relationships, and it makes it impossible for you to live your life, it’s a problem, so it’s time for an evaluation. Once diagnosed, the process really consists of dealing with any of the underlying anxiety, depression, or stress that usually goes with it. The idea is to then help the person develop more autonomy, self esteem, and social skills, like assertiveness. 

Paris Syndrome

Ah Paris… the beautiful city of lights, croissants, funny mimes, the Champs-Elysées, macarons, the Eiffel Tower, and art at the Louvre. Sounds fabulous. That’s what most people think of, that view that I just described, so the reality can come as a shock… McDonald’s on every corner, crime, graffiti, and rude taxi drivers and waiters, irritated by tourists who don’t speak the lingo. I mean, every place has its pros and cons, but people seem to have romantic expectations of Paris, right? Hence Paris syndrome, an extremely odd, but thankfully temporary, mental disorder that causes one to become completely overwhelmed while visiting the city of Paris. And to be clear, not overwhelmed by the beauty, but rather by the reality of Paris. 

Interestingly, Paris syndrome seems to be most common among Japanese travelers. The theory is that they’re used to a more polite and helpful society in which voices are rarely raised in anger, and the experience of their dream city turning into a nightmare can simply be too much. Of the approximately 6 million Japanese visitors to Paris each year, one to two dozen experience overwhelming anxiety, acute delusions, hallucinations, feelings of confusion and disorientation, nausea, paranoia, dizziness, sweating, and feelings of persecution that are Paris syndrome. Researchers really just speculate as to cause; because most people who experience this syndrome have no history of mental illness, the leading thought is that it’s triggered by the language barrier, physical and mental exhaustion, and the reality of Paris as compared to the idealized version.

So what can one do to prevent Paris syndrome? Simple: adjust your expectations. Ultimately, it’s like any modern metropolis- dirty, crowded, loud, and often indifferent… but beautifully so. Just don’t expect the furniture to spring to life and help you get ready for your dance with the Beast, and a trip to Paris will be exciting, and, most importantly, free of debilitating anxiety and hallucinations.

Cotard Delusion

It seems like there have been so many iterations of The Walking Dead, and like every generation sees a new zombie trend, but this isn’t all movie magic. Imagine feeling IRL that you are dead already, that your body and all of your internal organs are rotting, and that you are ceasing to exist. Well, that’s how it is for people with this very strange- and incredibly frightening- neuropsych disorder also known as nihilistic delusion, as well as walking corpse syndrome. Boy, that last one pretty much says it all, right? Named for neurologist Jules Cotard, who first described it in 1880 as “The Delirium of Negation,” Cotard delusion typically occurs in conjunction with severe depression, some psychotic disorders, and other neurological conditions.

One of the main symptoms of Cotard delusion is nihilism- the belief that nothing has any value or meaning- but can also include the belief that nothing really exists. And in fact, in some cases, people with Cotard delusion feel like they’ve never existed, never lived. But it does have a flip side, the feeling of being immortal. As for other symptoms, depression is numero uno, with anxiety a close second. Hello, I think I’d be depressed and anxious too if I thought I was rotting and my very soul didn’t exist. But depression is in fact very closely linked to Cotard delusion, with a review indicating that 89% of documented cases cited depression as a symptom. Aside from anxiety, other common symptoms include hallucinations, hypochondria, guilt, and a preoccupation with hurting oneself or with death. 

Researchers aren’t sure what causes Cotard delusion, but there are a few potential risk factors. Being female is one, as women seem to be more likely to develop Cotard delusion. Age is a factor. Several studies indicate that the average age of people with Cotard delusion is about 50, but it can also occur in children and teenagers. Interestingly, people with Cotard delusion that are under the age of 25 tend to also have bipolar depression, so that’s a risk factor. In addition, Cotard delusion seems to occur more often in people who think that their personal characteristics, rather than their environment, cause their behavior. People who believe the opposite- that their environment causes their behavior- are more likely to have a related condition called Capgras syndrome. That should sound familiar from the first installment of this series, as the syndrome causes people to think their family and friends have been replaced by imposters. Notably, Cotard delusion and Capgras syndrome can also appear together. Imagine that… believing that your body is rotting away, you are ceasing to exist, and all of the people and places in your life have been replaced by imposters! Jump on the empathy train, people. 

In addition to bipolar disorder, other mental health conditions that might increase one’s risk of developing Cotard delusion include postpartum depression, psychotic depression, schizophrenia, catatonia, and dissociative disorder. Cotard delusion also appears to be associated with certain neurological conditions, including dementia, brain infections, brain tumors, multiple sclerosis, epilepsy, migraines, stroke, traumatic brain injuries, and Parkinson’s disease.

As you can imagine, feeling like you’re ceasing to exist- or like you’ve already died- can lead to some gnarly complications. For example, some people stop bathing or taking care of themselves, which can lead to skin and dental issues. All of that can cause people around them to start distancing themselves, which then usually leads to additional feelings of isolation and depression for the patient. Others stop eating and drinking because they believe their body doesn’t need it, and in severe cases, this can lead to malnutrition and starvation, even death by starvation. Unfortunately, suicide attempts are very common in people with Cotard delusion. Some see it as a way to prove they’re already dead by showing they can’t die again, while others simply feel trapped in a body and life that feels hopeless and doesn’t seem real. They hope that their life will get better or that their condition will stop if they die again.

Fortunately, Cotard’s delusion is very rare, with about 200 cases known worldwide, and while the symptoms are extreme and it can be hard to get the right diagnosis, most people get better with treatment. That generally entails a mix of therapy and medication, often a combination of meds to find something that works. If nothing seems to work, ECT- electroconvulsive therapy- may be used as a last resort. Done under general anesthesia, ECT passes small electric currents through the brain; this induces a generalized seizure and causes changes in brain chemistry that may quickly reverse or resolve symptoms of certain mental health conditions. While it sounds horrifying, ECT is not the procedure depicted in old B movies, and it can be a real game changer for some people with refractory conditions… I’ve seen a single ECT session change a person’s life. 

There are descriptions of several Cotard’s cases available on the interwebs. One of the earliest recorded cases occurred in 1788, when an elderly woman was preparing a meal and felt a sudden draft, and then became totally paralyzed on one side of her body. When feeling, movement, and the ability to speak eventually 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 even complained 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.

Some 100 years later, Cotard himself saw a patient he called Mademoiselle X, and she had an unusual complaint. She claimed to have “no brain, no nerves, no chest, no stomach and no intestines,” yet despite this predicament, she also believed that she “was eternal and would live forever.” Since she was immortal, and didn’t have any innards, evidently 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.

But Cotard’s delusion isn’t strictly confined to the history books. In 2008, a New York psychiatrist reported on a 53-year-old patient 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. Thankfully, they dialed 911 instead, and the patient was admitted to the psychiatric unit, where she accused paramedics of trying to burn her house down. After a month or so on a strict drug regimen, her symptoms were greatly improved, and she was well enough to be released to her loving family.  

That seems like a good place to stop. We’ll be taking a break for the holidays, so the next blog will be in 2022! I hope you enjoyed this week’s blog and found it to be interesting and educational. Please feel free to share it with family and friends. Be sure to check out my YouTube channel with all of my videos, and I’d appreciate it if you would like, subscribe, leave comments, and share those vids! As always, my book Tales from the Couch has more educational topics and patient stories, and is available in office and on Amazon. 

Happy holidays! Be well people!

MGA

Learn More

The 15 Scariest Mental Disorders of All Time

The 15 Scariest Mental Disorders of All Time

Imagine having a mental disorder that makes you believe that you are a cow; or another that you’ve somehow become the walking dead. Pretty freaking scary, eh? Well, while relatively rare, these disorders are all too real.

Worldwide, 450 million people suffer from mental illness, with one in four families affected in the United States alone. While some mental disorders, like depression and anxiety, can occur organically, others are the result of brain trauma or other degenerative neurological or mental processes. Look, having any mental illness can be scary, but there are some disorders that are especially terrifying. Below, I’ve described the 15 scariest mental disorders of all time.

‘Alice in Wonderland’ Syndrome

In 1865, English author Lewis Carroll wrote the novel Alice’s Adventures in Wonderland, commonly shortened to ‘Alice in Wonderland.’ Considered to be one of the best examples of the literary nonsense genre, (seriously, who knew they even had a nonsense genre?) it is the tale of an unfortunate young girl named Alice, who falls through a rabbit hole into a subterranean fantasy world populated by odd, anthropomorphic creatures. That’s your vocabulary word for the week… anthropormorphic. Popular belief is that Carroll was tripping when he penned it. Regardless if that’s true or not, what is true is that one of Alice’s more bizarre experiences shares its characteristics with a very scary mental disorder. Also known as Todd Syndrome, ‘Alice in Wonderland’ Syndrome causes one’s surroundings to appear distorted. Remember when Alice suddenly grows taller and then finds she’s too tall for the house she’s standing in? In an eerily similar fashion, people with ‘Alice in Wonderland’ Syndrome will hear sounds either quieter or louder than they actually are, see objects larger or smaller than what they are in reality, and even lose sense of accurate velocity or textures they touch. Described as an LSD trip without the euphoria, this terrifying disorder alters one’s perception of their own body image and proportions. Fortunately, this syndrome is extremely rare, and in most cases affects people in their 20’s who have a brain tumor or history of drug use. If you need yet another reason to not do drugs… well, there ya go. 

Alien Hand Syndrome

While most likely familiar from cheesy horror flicks, Alien Hand Syndrome isn’t limited to the fictional world of drive-in B movies. Those with this very scary, but equally rare mental disorder experience a complete loss of control of a hand or limb. The uncontrollable body part takes on a mind and will of its own, causing sufferers’ “alien” limbs to choke themselves or others, rip clothing off, or to viciously scratch themselves, to the point of drawing blood. Alien Hand Syndrome most often appears in patients suffering from Alzheimer’s Disease or Creutzfeldt-Jakob Disease, a degenerative brain disorder that leads to dementia and death, or as a result of brain surgery separating the brain’s two hemispheres. Unfortunately, no cure exists for Alien Hand Syndrome, and those affected by it are often left to keep their hands constantly occupied or use their other hand to control the alien hand. That last one actually sounds even worse- one unaffected arm fighting against the affected arm that’s trying to tear into the person’s own flesh. Yikes. 

Apotemnophilia

Also known as Body Integrity Disorder and Amputee Identity Disorder, Apotemnophilia is a neurological disorder characterized by the overwhelming desire to amputate or damage healthy parts of the body. I recall a woman with Apotemnophilia making worldwide news ages ago when she fought with her HMO to cover the amputation of one of her otherwise healthy legs. Good luck; they don’t even cover flu shots. I remember I was pretty shocked that she found a surgeon to agree to do the amputation in the first place, as it seemed to me that might violate that little thing called the Hippocratic Oath us docs took when we got our medical degrees, specifically that part about ‘do no harm’… and sparked a debate about the ethical dilemma of treating or “curing” a psychiatric disorder by creating what is essentially a physical disability. Though not a whole heck of a lot is known about this strangely terrifying disorder, it is believed to be associated with damage to the right parietal lobe of the brain. Because the vast majority of surgeons will not amputate healthy limbs based purely upon patient request, some sufferers of Apotemnophilia feel forced to amputate on their own, which of course is a horrifying scenario. Of those who have convinced a surgeon to amputate the affected limb, most say they are quite happy with their decision even after the fact.

Boanthropy

Those who suffer from the very rare- but very scary- mental disorder Boanthropy believe they are cows, and usually even go so far as to behave as such. Sometimes people with Boanthropy are even found in fields with cows, walking on all fours and chewing grass as if they were a true member of the herd. When found in the company of real cows, and doing what real cows do, people with Boanthropy don’t seem to know what they’re doing when they’re doing it. This apparently universal finding has led researchers in the know to believe that this odd mental disorder is brought on by possible post-hypnotic suggestion, or that it is a consequence of dreaming or a sleep disturbance, sort of kin to somnambulism, aka sleepwalking. I can buy the sleepwalking thing. I have a patient that is a lifelong sleepwalker who sleep-eats, sleep-cleans, sleep-cooks, sleep-destroys, sleep-online-shops, sleep-everythings. Some mornings she wakes up to very unpleasant findings of the house in total disarray, electronics dismantled and improperly and ridiculously fashioned together, every piece of furniture moved or a sink full of dishes and pots and pans with dried up food in them. Before setting up prevention measures, she even had single episodes of adult sleep-driving, and even sleep-biking at (eek!) age 9. In the middle of the night, her mother awoke to what she thought was the big garage door opening, and when she went to check, she saw her coasting out of the driveway on her bright yellow bike, heading right toward a very busy highway. She always has zero recall of the events afterwards. If she can do all of that while essentially sleeping, it would be comparatively easy to wander out to a pasture on all fours and stick around to munch on some grass. Curiously, it is believed that Boanthropy is even referred to in the Bible, as King Nebuchadnezzar is described as being “driven from men and did eat grass as oxen.” Or was it King Nemoochadnezzar? No? Okay, moooving on…

Capgras Delusion

Named after Joseph Capgras, a French psychiatrist who was fascinated by the effective illusion of doubles, Capras Delusion is a debilitating mental disorder in which a person believes that the people around them have been replaced by imposters. As if that’s not bad enough, these imposters are usually thought to be planning to harm the sufferer. It really sounds like a bad Tom Cruise movie. Oh, wait; that’s redundant. Anyhoo, in one case, a 74-year-old woman with Capgras Delusion began to believe that her husband had been replaced with an identical looking imposter who was out to hurt her. Fortunately, Capgras Delusion is relatively rare, and is most often seen after trauma to the brain, or in those who have been diagnosed with dementia, schizophrenia, or severe epilepsy.

Clinical Lycanthropy

Like people with Boanthropy, people suffering from Clinical Lycanthropy also believe they are able to turn into animals; but in this case, cows are typically replaced with wolves and werewolves, though occasionally other types of animals are also included. Along with the belief that they can become wolves and werewolves, people with Clinical Lycanthropy also begin to act like the animal, and are often found living or hiding in forests and other wooded areas. Didn’t Tom Cruise play a werewolf in one of his many (vapid) movies? Or was it a vampire? Werewolf, vampire – tomato, potato.

Cotard Delusion

In a case of life imitating art, or life inspiring art, we have Cotard Delusion. In this case, the ‘art’ is zombies, a la The Walking Dead. Oooh, scary! For ages, people have been fascinated by the walking dead. Cotard Delusion is a frightening mental disorder that causes the sufferer to believe that they are literally the walking dead, or in some cases, that they are a ghost, and that their body is decaying and/or they’ve lost all of their internal organs and blood. The feeling of having a rotting body is generally the most prevalent part of the delusion, so it doesn’t come as much of a surprise that most patients with Cotard Delusion also experience severe depression. In some cases, the delusion actually causes sufferers to starve themselves to death. This terrifying disorder was first described in 1880 by neurologist Jules Cotard, but fortunately, Cotard’s Delusion, like good zombie movies, has proven to be extremely rare. The most well-known case of Cotard Delusion actually occurred in Haiti, circa 1980’s, where a man was absolutely convinced that he had previously died of AIDS and was actually sent to hell, and was then damned to forever walk the earth as a zombie in a sort of pennance to atone for his sins. 

Diogenes Syndrome

Diogenes Syndrome is a very exotic name for the mental disorder commonly referred to as simply “hoarding,” and it is one of the most misunderstood mental disorders. Named after the Greek philosopher Diogenes of Sinope (who was, ironically, a minimalist), this syndrome is usually characterized by the overwhelming desire to collect seemingly random items, to which an emotional attachment is rapidly formed. In addition to uncontrollable hoarding, those with Diogenes Syndrome often exhibit extreme self neglect, apathy towards themselves or others, social withdrawal, and no shame for their habits. It is very common among the elderly, those with dementia, and people who have at some point in their lives been abandoned or who have lacked a stable home environment. This is likely because ‘stuff’ never hurts you or leaves you, though most people with the disorder are unlikely to be able to make that connection. Fortunately or unfortunately, depending on how you look at it, this disorder is much more common than some of the others I’ve mentioned here.

Dissociative Identity Disorder

Dissociative Identity Disorder (DID), is the mental disorder that used to be called Multiple Personality Disorder. Another disorder that has inspired a myriad of novels, movies, and television shows, DID is extremely misunderstood. Generally, people who suffer from DID often have 2-3 different identities, but there are more extreme cases where they have double digit numbers of identities. There was a “reality” show a few years ago that centered on a young mother of two that supposedly had like 32 distinct personalities. All of them had names and ranged from a five-year-old child to an old grandpa; and according to her, a few of them were homosexual while the rest were not, so she was required to be bisexual. She claimed that many of the personalities knew everything about all of the others, and they would get mad at or make fun of the others at various times. What’s more, she would “ask” other personalities to come forward so that producers could ask them questions for the camera’s sake, and her voice and mannerisms changed, depending on the different characteristics of the personalities. It was all pretty difficult to buy to be honest, because I’ve seen a lot of people with DID, and none seemed like they were having as much fun with their illness as she did. In true DID cases, sufferers routinely cycle through their personalities, and can remain as one identity for a matter of hours or for as long as multiple years at a time. They can switch identities at any time and without warning, and it’s often nearly impossible to convince someone with DID that they actually have the disorder, and that they need to take medications for it. For all of these reasons, people with Dissociative Identity Disorder are often unable to function appropriately in society or live typical lives, and therefore, many commonly live in psychiatric institutions, where their condition and their requisite medications can be closely monitored. 

Factitious Disorder

Most people cringe at the first sniffle indicating a potential cold or illness, especially these days, but not those with Factitious Disorder. This scary mental disorder is characterized by an obsession with being sick. In fact, most people with Factitious Disorder intentionally make themselves ill in order to receive treatment; and this is what makes it different than hypochondria, a condition where people blow mild symptoms into something they aren’t, kind of like if you cough once and automatically think you have covid-19. Sometimes in Factitious Disorder, people will simply pretend to be ill, a ruse which includes elaborate stories, long lists of symptoms, doctor shopping, and jumping from hospital to hospital. Such an obsession with sickness often stems from past trauma or a previous genuinely serious illness. It affects less than .5% of the general population, and while there’s no cure, psychotherapy is often helpful in limiting the disorder. 

Kluver-Bucy Syndrome

Imagine craving the taste of a book or wanting to have sex with a car. That’s reality for those affected by Kluver-Bucy Syndrome, a mental disorder typically characterized by memory loss, the desire to eat inedible objects, and sexual attraction to inanimate objects such as automobiles. I’ve seen a television documentary that featured people with strange fetishes, and they had two British guys that were sexually attracted to their cars. They gave them names and described their curves in the same manner that some men describe women. While one guy (supposedly) limited it to “just” caressing his car, the other actually also made out with his car; I’m talking about tongue and everything. Talk about different strokes! Because of the memory loss, not surprisingly, people with Kluver-Bucy Syndrome often have trouble recognizing objects or people that should be familiar. They also exhibit symptoms of Pica, which is the compulsion to eat inedible objects. The same wierd fetish documentary featured two young women that were “addicted” to eating weird stuff; one routinely ate her sofa cushions. She actually pulled the foam apart into bite sized pieces and ate them, many times a day. She became so used to doing so that she would get anxious if she went too long without eating it, so she started having to bring pieces of her sofa with her to work. I’m guessing she didn’t have to worry about co-workers stealing her food. She had started eating the cusions so long ago that she was actually on her second couch. Her family was so concerned about the potential medical ramifications of eating couch cushions that they made her see a gastro doc, who thought he was being punked when he asked why she was there. After imaging studies, she was in fact diagnosed with some intestinal issues and told to stop eating couch cushions, but the desire was too great for her to cease. She’s probably on her fourth couch by now. The other girl actually loved eating powder laundry detergent. She described the taste in the same dreamily excited way a foodie describes a chef’s special dish du jour. This terrifyingly odd mental disorder is difficult to diagnose, and seems to be the result of severe injury to the brain’s temporal lobe. Unfortunately, there is not a cure for Kluver-Bucy Syndrome and sufferers are typically affected for the rest of their lives.

Obsessive Compulsive Disorder

Though it’s widely heard of and often mocked, Obsessive Compulsive Disorder (OCD) is rarely well understood. OCD manifests itself in a variety of ways, but is most often characterized by immense fear and anxiety, which is accompanied by recurring thoughts of worry. It’s only through the repetition of tasks, including the well-known obsession with cleanliness, that sufferers of OCD are able to find relief from such overwhelming feelings. To make matters worse, those with OCD are often entirely aware that their fears are irrational, but that realization alone actually brings about a new cycle of anxiety. OCD affects approximately 1% of the population, and though scientists are unsure of the exact cause, it is thought that chemicals in the brain are a major contributing factor. I’ve discussed OCD and recounted OCD patient stories many times in this blog and in my book, Tales from the Couch.

Paris Syndrome

Paris Syndrome is an extremely odd but temporary mental disorder that causes one to become completely overwhelmed while visiting the city of Paris. Stranger still, it seems to be most common among Japanese travelers. Of the approximately 6 million Japanese visitors to Paris each year, one to two dozen of them experience the overwhelming anxiety, depersonalization, derealization, persecutory ideas, hallucinations, and acute delusions that characterize Paris Syndrome. Despite the seriousness of the symptoms, doctors can only guess as to what causes this rare and temporary affliction. Because most people who experience Paris Syndrome do not have a history of mental illness, the leading thought is that this scary neurological disorder is triggered by the language barrier, physical and mental exhaustion, and the reality of Paris as compared to the idealized version. Slam! I’ll bet the Paris Tourism Board hates to hear about this one! Huh houn, wee wee monsieur.

Reduplicative Amnesia

The Reduplicative Amnesia diagnosis was first used in 1903 by neurologist Arnold Pick, when he described a patient with a diagnosis of what we know today as Alzheimer’s Disease. It is actually very similar to Capgras Syndrome, in that it involves duplicates, but instead of believing that people are duplicates, people with Reduplicative Amnesia believe that a location has been duplicated. This belief manifests itself in many ways, but always includes the sufferer being convinced that a location exists in two places at the same time. Today, it is most often seen in patients with tumors, dementia, brain injury, or other psychiatric disorders.

Stendahl Syndrome

Stendahl Syndrome is a very unusual psychosomatic illness; but fortunately, it appears to be only temporary. The syndrome occurs when the sufferer is exposed to a large amount of art in one place, or is spending time immersed in another environment characterized by extreme beauty; probably one of those places that “takes your breath away.” Those who experience this scarily weird mental disorder report sudden onset of rapid heartbeat, overwhelming anxiety, confusion, dizziness, and even hallucinations. It actually sounds a lot like a panic attack to moi. Stendahl Syndrome is named after the 19th century French author who described in detail his experience after an 1817 trip to Florence, which is evidently a beautiful place. I have it on good authority that Stendahl Syndrome has never happened to any visitor to Paris, which, oddly enough is Stendahl’s country of origin. 

So, we’ve learned a lot today: that there is a nonsense literary genre, that there are a bunch of freaky and frightening mental disorders out there, that some people might need to look up the word anthropormorphic, that illicit drugs are bad for yet another reason, that a lot of terrible B movies are actually based on some pretty obscure mental disorders, that people with Boanthropy probably get a lot of fiber in their diet, that the lives of people with Capras Delusion sound a lot like a bad Tom Cruise movie, that the term “bad Tom Cruise movie” is redundant, that Tom Cruise probably has Clinical Lycanthropy, that Tom Cruise is a tool, oops, sorry, everyone already knew that. We also learned that there is no longer such thing as Multiple Personality Disorder; it is now called Dissociative Identity Disorder, that Kluver-Bucy Syndrome is threatening to couches, and that if you have Kluver-Bucy Syndrome, co-workers will never steal your lunch. We learned that Japanese tourists hate Paris, and that Stendahl Syndrome never happens there. And we learned lots of other cool stuff, but that if you have so much stuff that you can’t walk through your house you likely have Diogenes Syndrome, probably because you have a deep seated knowledge that stuff never hurts you or leaves you. 

Please check out my videos on YouTube- better yet, hit that subscribe button, and share them with folks. And as always, my book, Tales from the Couch has lots more information and patient stories on various psychiatric diagnoses and is available on Amazon and in the office. Be well, everyone!

Learn More

Fugue State

A fugue state, formally dissociative fugue or psychogenic fugue (DSM-IV Dissociative Disorders 300.13), is a rare psychiatric disorder characterized by reversible amnesia for personal identity, including the memories, personality and other identifying characteristics of individuality. The state is usually short-lived (hours to days), but can last months or longer. Dissociative fugue usually involves unplanned travel or wandering, and is sometimes accompanied by the establishment of a new identity. After recovery from fugue, previous memories usually return intact, but there is complete amnesia for the fugue episode. Additionally, an episode is characterized as a fugue if it can be related to the ingestion of psychotropic substances, to physical trauma, to a general medical condition, or to psychiatric conditions such as delirium, dementia, bipolar disorder or depression. Fugues are usually precipitated by a stressful episode, and upon recovery there may be amnesia for the original stressor (Dissociative Amnesia).

Learn More

Psychogenic Amnesia

Psychogenic amnesia, also known as functional amnesia or dissociative amnesia, is a memory disorder characterized by extreme memory loss that is caused by extensive psychological stress and that cannot be attributed to a known neurobiological cause. Psychogenic amnesia is defined by (a) the presence of retrograde amnesia (the inability to retrieve stored memories leading up to the onset of amnesia), and (b) an absence of anterograde amnesia (the inability to form new long term memories). Dissociative amnesia is due to psychological rather than physiological causes and can sometimes be helped by therapy.

There are two types of psychogenic amnesia, global and situation-specific. Global amnesia, also known as fugue state, refers to a sudden loss of personal identity that lasts a few hours to days, and is typically preceded by severe stress and/or depressed mood. Fugue state is very rare, and usually resolves over time, often helped by therapy. In most cases, patients lose their autobiographical memory and personal identity even though they are able to learn new information and perform everyday functions normally. Other times, there may be a loss of basic semantic knowledge and procedural skills such as reading and writing. Situation-specific amnesia occurs as a result of a severely stressful event, as in post-traumatic stress disorder, child sex abuse, military combat or witnessing a family member’s murder or suicide, and is somewhat common in cases of severe and/or repeated trauma.

Learn More