Mental health is a topic that is continuously progressing as more and more research takes place. With some mental health topics being not as talked about, Connor brings to light a rare mental illness called Capgras Syndrome that can cause a strange and unusual confusion in affected patients.
By Connor Upshaw
Image from Woman's Bar Association
Throughout history, the concept of imposters replacing the people around us has remained a common fear. The idea of a person being hollowed out and replaced with something worse, something malevolent, is the concept that makes zombies and demonic possessions so frightening. While many have this fear to some degree, those with Capgras Syndrome live this terrifying fiction as if it is reality.
First classified in 1923 by psychiatrist Joseph Capgras, Capgras Syndrome is described as a mental disorder in which a person believes someone they know has been replaced with an imposter. Their anxiety can lead to paranoia and distrust between the patient and their family or friends. The patient may even believe something other than a person was replaced, such as a pet, a house or an object. According to the National Institute of Health (NIH,) the syndrome is “widely regarded as the most prevalent of the delusional misidentification syndromes,” meaning it is, while rare, fairly common among delusions. Capgras was first believed to only be present in women; however, this has been proven false. The illness can occur in anyone, though it is most likely in those with pre-existing mental illnesses or trauma. It is likely to manifest in those diagnosed with schizophrenia, accounting for 32% of patients, a Karger article states. Other neurodivergent or psychological conditions can also cause delusion, including physical impairments such as brain damage.
Changes in a patient’s brain are believed to cause the illness. According to an article from the American Psychological Association, a healthy person’s brain uses the visual cortex, which “relays information through two routes, one that goes to the frontal lobe, where facial recognition occurs, and one that goes to the limbic system, which registers emotional reaction.” This system is what allows the brain to identify different people, objects, and emotions they invoke. When a patient has Capgras Syndrome, it has been found that the route from the cortex to the limbic system is damaged. Patients can identify the face of a family member, but they lose the emotions associated with said person. While they may recognize the person, the sense of familiarity is gone. This may cause them to believe that the people around them have been replaced with imposters.
Image from PBS
The Capgras delusion is often confused with Fregoli Syndrome; while similar, there is a definite difference between the two delusions. Capgras Syndrome is when an individual believes imposters have replaced those close to them. On the other hand, a Science Direct article states that Fregoli is when someone thinks an individual’s mind is present in more than one body. These illnesses are both categorized among the four delusional misidentification syndromes, which all involve a confusion of identities.
Unfortunately, those with Capgras Syndrome can pose a danger to themselves and those around them. While most patients never become violent, 6% of cases result in homicides, according to an article from the NIH. When a person truly becomes convinced that everyone around them is an imposter, their mania may cause them to lash out. If a loved one shows symptoms of Capgras Syndrome, it is not recommended to try and convince them they are wrong, a Healthline article states. This may only infuriate them. Some patients never get past their delusions. The best way to help as a caregiver is to try and understand what they are going through. Acknowledge their emotions and help them feel trusted and safe. When possible, therapies such as reality orientation and behavior therapy can help overcome or reduce delusions. Medication prescribed by a doctor, primarily some dementia drugs, can also help reduce symptoms.
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Despite no cure, treatment of Capgras Syndrome has come a long way since the 1920s. From the NIH, the first reported case of the delusion was noted in France in 1923, when a woman became convinced that identical doubles had replaced everyone she knew. She was also convinced that there was a copy of herself out there. She and other early instances of the illness were locked away due to a lack of psychiatric knowledge, according to an article from a hospital. Others were attempted to be cured based on archaic and often dangerous methods, including lobotomies and electric shock therapy. This shows how much our understanding of such mental illnesses has increased. Modern therapy is far more beneficial for a patient than locking them in an asylum.
Capgras Syndrome is an often terrifying and confusing delusion for the patients affected. It has the potential to affect every aspect of a person’s life to the point where they do not trust anyone. While the effects may be severe, a healthy support network and psychiatric aid can make a huge difference for someone going through this frightening mental illness.
