How a bump on the head can make you think you’re a ghost

AFTER a horrific motorcycle accident, Warren McKinlay, 35, was convinced he was dead. He didn’t think he had gone to heaven. He believed he was marooned on Earth as a walking corpse. The mechanic, former soldier and father of two from Braintree, Essex, was utterly gripped by the notion he was a ghost.

‘I genuinely believed I’d died in the crash, but for some reason my spirit hadn’t moved on. I refused to eat because there was no point,’ he says. ‘I’d sit for hours in a room refusing to talk to anyone.’

Warren’s injuries in the crash included a broken back and pelvis. Unbeknown to him, he had also sustained an injury to his brain when his head smashed against a tree.

It was only after 18 months of being plagued by symptoms that he learned he wasn’t going mad — he was in the grip of a delusion called Cotard’s syndrome.

A delusion is usually a false belief that someone thinks is true — even if logically it doesn’t make sense or if experience shows it can’t be real.

There is a wide range of them. One leaves people convinced their loved ones have been replaced by impostors. Another convinces people that everyone they meet is actually the same person. These aren’t all mental illnesses, per se — instead they are often the result of injury or disease.

Cotard’s syndrome is the result of dysfunction in two areas of the brain that process our sense of reality: the fusiform gyrus, which recognises faces, and the amygdala, which regulates emotions.

Patients genuinely believe they are deceased or that parts of their body no longer exist.

Other delusions include Capgras syndrome, says Dr Trevor Turner, a consultant psychiatrist at the East London NHS Foundation Trust.

Patients are convinced that identical looking impostors have replaced close acquaintances such as spouses and close relations.

It tends to affect people who have suffered a brain injury, are developing dementia or who have schizophrenia.

In one case, a 40-year-old woman named Mary was referred to psychiatrists after claiming on numerous occasions that her nine-year-old daughter had been taken and replaced by an impostor. One day, she arrived at her daughter’s school, but refused to pick her up, screaming: ‘Give me my real daughter; I know what you’ve done.’

When no form of treatment helped Mary, social services sadly had to put her daughter in care.

One of the earliest medically recorded delusory illnesses — glass delusions — is, according to reports, making a comeback. Patients believe themselves to be made of glass and in mortal danger of shattering.

First described in the 15th century, Charles VI of France was an early sufferer. However, Professor Edward Shorter, a medical historian from the University of Toronto, says the novelty of clear glass in medieval Europe is key to the disorder — people thought it had magical properties.

Meanwhile, epileptic seizures can trigger gender delusion. The first reported case involved a 37-year-old woman in Germany in 2006. She told doctors that during epileptic fits she felt her voice becoming husky and her arms growing muscular and hairy.

‘The patient never experienced a similar phenomenon outside the seizures,’ neuroscientist Burkhard Kasper wrote in the journal Epilepsy & Behaviour. Scans revealed a benign tumour next to her right amygdala — which is also thought to regulate our feelings of personal identity.

DR KASPER said the tumour was not a threat and treatment with anti-epileptic drug carbamazepine stopped the delusions recurring. Another example is Anton’s syndrome, which causes people to hold a belief that defies all logic: they have become blind, but are adamant they can see. It usually occurs after a stroke or head injury that robs patients of their sight.

No one knows why this delusion occurs. It may be that the permanently visual region of the brain still sends out confused electrical messages. In response, the brain makes up images — convincing the patient they can see.

Psychiatric delusions may be treated with antidepressants, anti-psychotic drugs and mood-stabilising drugs.

The breakthrough for Warren McKinlay came during specialist treatment at the Headley Court military rehabilitation centre in Surrey in 2007.

There, he encountered another patient with Cotard’s syndrome.

‘He had come to the conclusion he was such a different person that the old him was dead. So he started again with a new identity,’ says Warren.

‘Talking through it and seeing how he came to terms with it helped me with what I’d gone through. With therapists, I was able to move on and live again.’