What is Capgras syndrome, and how can it affect you?

Media often showcases family members forgetting their loved ones while dealing with dementia through conditions like Alzheimer's Disease. However, there are multiple reasons a person might forget or not recognize someone they love, including Capgras syndrome. 

This rare neurological and psychological condition impacts only 0.12% of the general population. Capgras syndrome can cause a person to see their loved ones as imposters. For this reason, it can significantly affect the person living with the condition and those in their life who love them.

What is Capgras syndrome?

Capgras syndrome involves the belief that someone in your life is not who they say they are and has been replaced by an imposter. An individual who experiences this condition may look at their partner and believe that the person in front of them is an imposter rather than the person with whom they may have long been in relationship. 

What causes Capgras syndrome?

For many people, Capgras is a side effect of Alzheimer's disease or dementia. These individuals might lose memories with their loved ones, and dementia's impact on their minds can distort their sense of reality. Not everyone with these age-related diseases also experiences Capgras syndrome, but it is a common cause of development. 

Schizophrenia may also be related to the development of Capgras syndrome. Schizophrenia is a mental illness that affects the mind and the areas of the brain that consider reality. Schizophrenia often affects a person's ability to engage with reality and might incite delusions and hallucinations, which could be a reason for Capgras syndrome.  

The final way that Capgras syndrome may develop is a brain injury or neurological condition like a tumor. This cause may be the rarest and often occurs after an injury or brain disease around the part of the brain impacting facial recognition processing. Damage to this area can make it more difficult for someone to connect a face to a memory of an individual. As a result, the individual may believe that the person in front of them is not who they say they are.

Treatment for Capgras syndrome

There is no cure for Capgras syndrome. However, there are methods used to alleviate symptoms and help individuals work with themselves rather than fighting their reality. Antipsychotic medications may sometimes be used to manage symptoms, and psychodynamic therapy has been used to help clients come to terms with their symptoms. Work with a psychiatrist or medical doctor before starting, stopping, or changing medication or medical treatments for any condition. 

One treatment method is to look at the underlying cause of the syndrome itself. If Capgras is due to schizophrenia, it may be treated by treating the symptoms of schizophrenia. For those with Alzheimer's disease or dementia, however, Capgras might not be as treatable, as dementia is a degenerative disease that ends in death. There may be ways to reduce the client's emotional or physical pain and help them live their last moments peacefully in these cases. 

Therapy may be another way to work with someone with this disorder. Working with a therapist or psychiatrist may help the person understand what's going on in their mind and try to come to terms with what it means for them. Capgras syndrome often affects the way a person interacts with others. Learning new ways of communicating and interacting with those they don't remember might be beneficial. Even if they can't believe the person in front of them is someone they know, they can learn to respect that individual and "get to know them" again for the "first time." 

How to support someone with Capgras syndrome 

If you know someone with this syndrome, you might wonder how you can support them without causing them distress. Some people with Capgras might not experience episodes all the time. For these individuals, it may help to keep them as calm as possible during an episode, which could mean removing the person they see as an imposter from the room until the delusion stops. Arguing with them, or trying to correct their feelings, during an extreme episode could cause further agitation. 

In addition, it may help to work with these individuals to learn new ways of recognizing people other than vision. If they can hear a voice before they see the individual, they may be able to develop pathways to associate the person in their mind with the person in front of them. They may be able to work around the perception that someone is an imposter if they can recognize the person through other methods. However, this method might be best done in the presence of a professional like a doctor or therapist. 

It may also help to find a professional who can help them work through the challenges of this syndrome. For someone with this syndrome, the difficulty may not only be about recognizing loved ones. They might experience grief or emotional pain, believing that their loved ones have passed, moved away, or abandoned them. In these cases, any attempt to tell them their loved one is in front of them might cause further grief. For this reason, professional guidance may be most effective.

Counseling options for Capgras syndrome 

Professional support may guide someone living with Capgras syndrome, or those who love them. With a therapist, this individual may receive an impartial view of the situation and an objective opinion on moving forward. Therapy may help them address thoughts, feelings, and ideas surrounding the person they believe they've lost. Over time, a therapist may help them find ways to "meet" or reconnect with someone they believe is an imposter. 

If leaving the house is difficult due to Capgras syndrome, online therapy can be convenient. Studies have found that online counseling can be as effective as in-person therapy, which tends to be more affordable than traditional therapy without insurance. With online platforms like BetterHelp, someone with Capgras syndrome can be matched with a therapist experienced with similar symptoms. They can communicate with their therapist via phone, videoconference, and in-app messaging as needed. 

If you're a family member or friend of someone with Capgras syndrome, you might also benefit from therapy with an online or in-person therapist. Talking about how it feels to be considered an imposter by someone you love might help you process any emotions that arise. Even if you understand the cause of their condition, you might also perceive that you have lost someone about whom you care deeply. A therapist can help you navigate these feelings.