Mobius what symptoms do you have that are not associated with Cotard delusion? I'm guessing that you don't neglect your appearance or absolutely unquestioningly believe that you're dead, either. When I am dead, I hope my spirit lingers someplace nice, too. And people bring me flowers and so on.
Hm. I'm glad I read that explanation of Cotard delusion, though. Because it seems to describe partially how I experience derealization, which is my primary problem, depersonalization is secondary. Of course I don't have it, but it seems relevant. Especially because I often feel as if I don't really exist. In the beginning (1995), I thought everyone else was dead too... like we were all floating around in some kind of afterlife. I first experienced it after reading about murderers in a bookstore. I walked out of the bookstore and I was dead. It's never gone away.
The facial recognition problem with Cotard's make sense, I feel as if I can't "see." I can see, but it sort of bounces off of my eyeballs or goes straight to an unconscious processing, so I can function, instead of registering in my consciousness with associated emotions of being "known" or "existing" or being familiar. There is little to no connection to my sense of self, my sense of self is kind of absent, things (emotions, reactions) happen without me. It's as if an anesthetic were injected into my consciousness.
Then of course there are the sensory problems: palinopsia, visual snow, halos, trails, loss of depth perception, fisheye lens effect, distortions in dimensions, disintegration of recognition of objects (objects are a group of shapes instead of a recognized whole), problems locating the origin of and priority of sounds, etc.
I think mine was more OCD than delusion-- because I don't actively have a delusion that I am dead. Yet, I was completely fixated on the possibility that I was, since everything appeared so. Also, OCD can perpetuate derealization and depersonalization.
I think a previous poster mention acceptance as important. It has been really important to accept that this is how things look now, and that I am alive. It's heartbreaking, frightening, tragic, but it's how life looks now.
I do think this is related to trauma for me. If someone has ever been afraid for her life, either via neglect or shocked by a sudden occurrence, I can see how the lines can become blurred.
In depersonalization/derealization there are generally no anatomical changes to the brain. There are functional changes, but not anatomical ones. Same with OCD I think. But with Cotard delusion, the Wikipedia article says there are anatomical changes correlated with the incidence of it. I don't think it has to be one or the other, though, maybe there is some in-between shade.