Catatonic depression is a sub type of depression that is characterized by not speaking and/or appearing in a daze for a prolonged period of time. The person does not respond to anything going on around them and stays silent and motionless.
Catatonic Depression: Symptoms
The most common symptoms associated with catatonia are not speaking and being in a daze. There are several symptoms that characterize catatonic depression and a doctor must be able to diagnose a minimum of three. See the list below:
- Agitation, displayed as anxiety or restlessness.
- Catalepsy, being in a trance-like state.
- Echolalia, senseless repetition of the words another person says.
- Echopraxia, the meaningless repetition of movements another person does.
- Grimacing, making a face that looks like a person is in pain.
- Mutism, the inability or refusal to speak.
- Negativism, adopting behaviors that are the opposite of their emotions. For example, feeling hungry but refusing to eat.
- Posturing, such as adopting a rigid or unnatural posture, often for extended time periods.
- Stereotypy, or ritualistic movements, such as rocking or crossing and uncrossing the legs repeatedly.
- Stupor, decreased response to stimuli, including when people talk to the person.
- Unusual mannerisms, such as irregular speech patterns or movements or staring.
Catatonic Depression: Causes
Currently, doctors don’t know what causes this disease but they do have some theories. One theory is that symptoms are due to the depletion of dopamine. Dopamine is a neurotransmitter in the brain associated with mood.
Other theories include:
- a family history of depression or other mental health conditions
- significant life changes, such as the death of a loved one or a divorce
- several additional medical conditions, such as problems sleeping, chronic pain, chronic illness, or attention-deficit hyperactivity disorder.
Keep in mind that a condition called neuroleptic malignant syndrome can occur if a person has an adverse reaction to antipsychotic medications. This condition mimics the symptoms of catatonic depression.
Imaging studies will be ordered to verify that a person does not have a brain tumor or some another condition that could cause catatonia.
A doctor will also observe a person’s posture, listen to any communication they may make, and watch their movements.
Catatonic Depression: Treatments
Doctors often prescribe benzodiazepines as the first-line treatment for catatonia. These drugs have anxiety-relieving and muscle-relaxing properties. The most often prescribed is lorezapam (Ativan).
In patients where Ativan is ineffective, electroconvulsive (ECT) shock may be used. Doctors perform this therapy under general anesthesia.
During ECT, doctors use electrical currents to induce a seizure. Although doctors do not fully understand how it works, many believe that the electro shock resets the brain’s chemistry and may help people with severe mental illness respond better to treatment.
According to an article in the World Journal of Psychiatry, ECT was effective in treating 80 to 100 percent of all forms of catatonia.
Doctors may also try deep brain stimulation, to reduce catatonia symptoms.
Once a person’s catatonia symptoms improve, antidepressants and psychotherapy to treat the underlying depression.
Catatonic Depression: Complications
Left untreated, catatonic depression can induce serious complications such as:
- blood clots
- shortening of muscles or tendons
Catatonic depression is a severe but treatable for of depression. The most effective treatments to date are either from the benzodiazepine class of drugs such as Ativan or electro-convulsive shocks to the brain. As improvement may be short lived, it is necessary to continue long-term treatments.