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What Are Nihilistic Delusions?

Mary McMahon
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Updated: Mar 03, 2024
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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.

What Is Nihilism in Psychology?

In psychology, nihilism is a fundamental belief system based on disbelief. Patients who have nihilistic tendencies are also known to suffer from psychological disturbances. Once a nihilistic belief system is in place, patients also experience delusions that support “evidence” of non-existence.

Foundations in Philosophy 

Belief in non-existence can take many different forms. It can sometimes be based on the philosophical underpinnings of nihilism as established by prominent philosophers such as Camus and Kierkegaard. The belief that the world does not exist as it appears is a common nihilistic and philosophical belief.

When second-year students spend hours pondering existence and debating whether anything is confirmed, the cliche basis forms continuing nihilism psychology and philosophy in the academic realm. As collegiate scholars enroll in more advanced philosophical courses, nihilism enters the conversation. Philosophical nihilism is not typically accompanied by delusions or treatment; instead, it is part of an expected ongoing academic conversation.

Foundations in Psychology

Belief in non-existence in psychology is more problematic. Patients may believe that the world does not exist, they do not exist or are deceased, parts of the body or mind are missing or have been taken, or that people and places have ceased to exist. Despite concrete evidence that presents alternate information, such as the left leg being visually present when the patient suggests the left leg was previously amputated, the false belief holds firm.

The false beliefs or delusions that accompany nihilism primarily come as a result of profound unrest and trauma. Patients may create an alternate reality wherein people, places, and things no longer exist as they once did because they have had an intensive disconnect or break with reality. Psychological nihilism is also linked to:

  • Schizophrenia 
  • Depression 
  • Existential crises
  • Persistent fear 
  • Brain injuries 
  • Anxiety 
  • Personality disorders 

How Can You Tell if You Suffer From Nihilistic Delusions?

Nihilistic delusions have been described as the ultimate disconnect from the self and the world around you. If you are, in fact, experiencing irregular or concerning events in your life, you might be having delusions. As a result of experiencing delusions, it may be challenging to separate real life from one created around unrest or trauma in your life. When determining whether or not you suffer from nihilistic delusions, seeking professional medical help is the best option.

Delusions as a Symptom

If you have never been diagnosed with any mental illness or underlying condition, knowing when or how to seek help might be confusing. First, identifying delusions as a symptom is a starting point. However, other conditions aside from nihilism also have delusions as symptoms. If you communicate to your support system or health care professional that you are experiencing thoughts of disbelief in your assumed reality, you will likely get the help you need.

Cotard Delusions

Cotard delusion is a condition wherein the patient believes that their limbs or other body parts are dead or dying. Cotard delusions are often specific to extremities, referred to as the walking corpse syndrome, but patients might also believe their souls have gone missing.

Capgras Delusions 

Capgras is a psychological condition wherein the patient believes that someone they know, often a loved one, has been replaced with an imposter. Nihilistic delusions appear as Capgras delusions when shadowy figures or unnamed places replace reality in a person’s life. Patients might also experience alternate fantasies of imposter homes, pets, lives, and realities.

Other delusions that center on the disbelief of existence include being dead, decomposing, vaporizing, total annihilation, being only a shell of their former self with no internal organs or operation, or being invisible because they or other people are ghosts.

Is Nihilism a Form of Depression?

Depression is a prevalent and severe medical condition that negatively impacts your feelings, thoughts, and actions. While it is treatable, it causes deep sadness and profound disinterest that impacts daily life. Disinterest is the component of depression that fuels nihilism.

Parts of nihilism are founded on the idea that the stakes have to be lowered so far that neither the self, the body, or the environment can exist in such a way that they will ever be detrimental to the person anymore. Nothing is left to be interested in or harmed by after removing the element of existence.

Whether non-existence comes in the form of everything around the patient fading away or the patient themselves believing they are dead or nonexistent, it is typically a measure of protection through delusion. Nihilism is not a form of depression but a form of psychosis that can coexist alongside depression, complicating the conditions and making treatment and recovery more complex.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a The Health Board researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon992611 — On Sep 19, 2015

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.

By burcinc — On Apr 19, 2014

@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.

By discographer — On Apr 18, 2014

@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.

By SteamLouis — On Apr 18, 2014

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?

By Pippinwhite — On Apr 07, 2014

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.

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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