Why are you trying to convince me you’re my wife and where is she?
Imagine your husband (or the person who you feel really close to), the man you think you know the best getting into a coma after suffering a brain injury; after you worry for days and can’t sleep at night he finally wakes up, allowing yourself and the rest of the family to feel relieved, ecstatic even. But soon, as you realize that he doesn’t think that you’re his real wife, all the happiness vanishes. This is a classic scenario involving a patient suffering from Capgras delusion.
Even though it’s not a common disease, Capgras delusion occurs in extreme cases when the individual has been diagnosed with Schizophrenia, Alzheimer’s, psychiatric or neurological disorders in general. Also, patients who suffered brain lesions are at risk at developing Capgras delusion, as well some hallucinogenic drug consumption (like ketamine), but in this case the symptoms disappear along with the effect of the substances used.
What is really happening to the patient is unclear, but one of the most dominant theories claims that a normal brain is able to identify distinctive faces and to associate them with a certain emotion or feeling. A damage in the amygdala, the area responsible for generating these kind of responses, might trigger the patient to recognise their close friends, but being disturbed regarding their capacity of feeling any familiar affection towards them.
In their book “Pimozide in the treatment of Capgras’ syndrome. A case report” Passer and Warnock bring into question the case of a female patient, age 74, who fought her husband was a pretender, repeatedly asking him is he hurt her real husband. The woman refused to share their bedroom and locked herself in. She threaded him several times and even asked their son for support. (1)
I can imagine that being absolutely horrifying from both sides, but luckily for most of us Capgras delusion is highly unlikely to occur among young individuals, so until then…cheer up!
Sources: Passer, K.M.; Warnock, J.K. (1991). “Pimozide in the treatment of Capgras’ syndrome. A case report”.Psychosomatics 32 (4): 446–8