What is Catatonic Depression?
Catatonic depression is a condition in which, an individual remains both motionless and speechless for a long time. Also known as catatonia, catatonic depression may not be a separate mental illness but is considered a part of other mental illnesses like post-traumatic stress disorder, depression and bipolar disorder, by the American Psychiatric Association.
A person with catatonic depression is unable to move normally and may stay still for hours. The causes of catatonic depression can be many. Understanding the symptoms of catatonic depression will help to treat this condition effectively.
Symptoms of Catatonic Depression
Symptoms of catatonic depression may vary from person to person. While not all symptoms may be present, many people with catatonic depression exhibit combinations of such symptoms.
Following are the major symptoms of catatonic depression which when noted can raise a suspicion that the person may be experiencing catatonic depression and earliest treatment can be given.
Changes in Movement – An Important Symptom of Catatonic Depression
A person with catatonic depression often shows inability to move normally and may remain still for a long time. Some may exhibit unusual movements, abnormal or fast movements or show difficulty in staying still. Some people may show extremely slow movements in any activity, if at all performed. Other symptoms of catatonic depression related to movements include
- Maintains an uncomfortable position or a same posture for several hours at a stretch.
- Purposeful, non-purposeful and repeated movements, which are not relevant to the situation.
- Sudden stopping of activity or pausing the body movement in the middle of an activity.
- Any posture, if changed by others may be maintained for long without any movement. Seems excessively flexible can be moved to other position, but does not move on own.
- Sometimes, person may resist any movement made by others too. Resents being moved from one place to another.
- Remains in the same position for several hours, performs repetitive movements like rocking or swinging.
Altered Behavior – A Symptom of Catatonic Depression
A person with catatonic depression can exhibit different kind of behavior, which is another common symptom of catatonic depression. The behavior pattern, the eating or sleeping routine, the way the person talks and other interactions may be affected. Some of the common changes in behavior noted in catatonic depression include
- Lack of speech
- Has difficulty speaking because of excess anxiety
- Tries to imitate another person's movements or speech
- Obeys all the instructions given to him without any questions
- Refuses to drink or eat
- Alterations in appetite
- Sudden weight loss or weight gain
- Finds it difficult to get sleep
- Difficulty in moving out of bed
- Finds it difficult to complete daily tasks
- Grasps the psychiatrist's hand with a lot of force when offered to
- Cooperates with the psychiatrist for a while and then resists him later on
- Turns away when spoken to .
Emotional Changes – Symptom of Catatonic Depression
Catatonic depression affects a person at various levels and can cause changes in the emotional state, thinking and daily life. Some of the emotional symptoms of catatonic depression include
- Feeling of sadness, which is felt regularly
- Feels restless and/or worthless all the time
- Loses interest in most activities
- Excess fatigue
- Irritability and agitation
- Feels guilty without reason
- Finds it difficult to concentrate, think and/or make decisions
- Has suicidal thoughts and may attempt suicide
- Feels extreme anxiety and fear.
Causes of Catatonic Depression
Various studies suggest that irregular production of neurotransmitters can be a cause of catatonic depression. These neurotransmitters are actually chemicals found in the brain which help cells to communicate with one another. Serotonin and norepinephrine are the 2 neurotransmitters associated with depression.
Irregularities in the gamma-aminobutyric acid or GABA, dopamine and glutamate neurotransmitter systems in the brain, can be one of the major cause of catatonic depression. In most cases, these irregularities are accompanied by physical, neurological or psychiatric illness. Understanding the main causes of catatonic depression helps doctors to treat this depression rapidly before it turns into a major illness.
Treatments for Catatonic Depression
Treatments for catatonic depression mainly depends on the causes and symptoms of catatonic depression in every case. Some of the medicines used to treat most of the symptoms in catatonic depression include,
Being a class of psychoactive drugs, benzodiazepines help to improve the effect of GABA or gamma-aminobutyric acid neurotransmitter. Such medications have been proven to be quite effective in relieving symptoms of catatonic depression such as insomnia, anxiety and spasms in muscles. However, this medication can be quite addictive in nature and should be used as a short-term treatment method only.
NMDA or N-Methyl-D-Aspartate is an upcoming treatment option for catatonic depression. Being an amino acid derivative, it mimics the way a glutamate neurotransmitter behaves and aims to cure depression. However, there may be side effects of this treatment option and should be discussed with the physician.
Electroconvulsive Therapy (ECT)
This is one of the most effective treatments for catatonic depression. In this method, electrodes are attached to the head of the patient which send electrical impulses to his brain thereby causing a mild seizure. A stigma still surrounds this treatment method even though it has been proven to be safe and effective in treating several mental illnesses and mood disorders. In many severe cases, a combination of ECT and benzodiazepine are used to treat catatonic depression.
Other Treatment Options for Catatonic Depression
Repetitive Transcranial Magnetic Stimulation (rTMS) and the use of atypical antipsychotics have also been proven to be helpful in curing catatonic depression to a large extent and are being used by many physicians, as appropriate. The best treatment option of catatonic depression depends on the condition and severity of each case, hence it is best to follow medical advice. Counselling and psychotherapy for catatonic depression may also be considered in addition to regular treatment for catatonic depression.
Watch out for the symptoms of catatonic depression and seek medical help for your loved ones. This kind of a depression is fully curable in most cases but only with early intervention and proper care and treatment. New research and several studies are being done in this field and many new treatments for catatonic depression are being discovered in America. It is advisable to seek help from a trained and certified psychiatrist to ensure proper treatment of catatonic depression.
A patient suffering from catatonic depression needs adequate support and love of the people around him. Empathizing with the person helps to give the strength to overcome this problem even faster.