Catatonic schizophrenia: symptoms, causes, treatment & more

What is catatonic schizophrenia?

Catatonic schizophrenia is a subtype of schizophrenia with catatonia as the primary symptom. However, this term "catatonic schizophrenia" is obsolete as experts now consider schizophrenia distinct from catatonia. In fact, catatonia is often associated with many types of mental disorders, including depression and bipolar disorder.

While most people considered catatonia to be mostly associated with schizophrenia, we now know that it occurs more with bipolar disorder.

Catatonia is an important syndrome you must treat, especially when it occurs with schizophrenia.

What is catatonia?

Catatonia is a rare neuropsychiatric condition in which the patient experiences problems with moving and talking. In many instances, the patient completely freezes and cannot speak or change position for hours. 

Occasionally, the freeze can last up to days, weeks, or even years.

Symptoms of catatonia

• Agitation without reason
• Catalepsy (holding a position in which someone else placed you)
• Echoing the sounds or words of others
• Mimicking the movement of others
• Grimacing
• Overly quiet
• Act as though nothing is happening to/around you, even when in severe physical pain
• Holding a posture that's unusual and inconvenient
• Repetitive movements, such as rubbing your body
• Initial resistance to a push, before moving flexibly in response 

Are catatonic patients aware?

While people experiencing catatonia may act as though nothing is happening around them, many of them are aware, and they think during the whole experience, as researchers have discovered.  

For a person who stays frozen for hours, it's easy to believe they're unconscious throughout the episode. But recent research says the exact opposite.

Research shows that people mysteriously frozen by catatonia think while having the experience. These individuals often say they experience intense anxiety and sometimes feel overwhelmed by the feelings. So, perhaps, it could be that they have too many thoughts at once, which sort of paralyzes them.

Now the new question is, what could these thoughts be?

A Look into the minds of people with catatonia

To get a clearer grasp, some researchers have carried out a new study by looking into several past case notes of catatonia patients. Interestingly, they discovered that some have spoken about what they felt or were thinking at that very moment. Others didn't remember a jot of what had happened. They didn't even know where they were. But those that did, of course, stood out.

Some of these conscious ones stated that they experienced overwhelming fear, while some were very much aware of the pain of staying motionless for so long.

But even more interesting was that some of these patients had extremely lucid and rational explanations for going frigid.

One of them had kneeled with his forehead against the floor. When asked why he took that position, he claimed it was an attempt to save his own life as he felt his head was about to fall off.

Of course, when you think about it, it's not insensible to prevent your head from falling by holding it in place against the floor.

Others had claimed they heard voices compelling them to take certain positions. One stated that the voice told him his head would explode if he moved. For some, it was a heavenly being giving divine instructions.

A primal instinct?

Obviously, catatonia is a highly mysterious mental illness and neurological disorder. Patients' experiences are beyond bizarre. But is the symptom entirely unprecedented? Of course, not!

Catatonia is pretty similar to the "death feint," a defense mechanism some animals exhibit. They go completely still to avoid being seen and attacked by a predator.

Fundamentally, it's about avoiding death or a physical catastrophe, such as "having your head explode or fall off," as some patients said.

In short, one patient in the study claimed to have seen a snake. Perhaps, her body went into shock -- or a "death feint" --because of that.

What causes catatonia?

It's unclear what causes catatonia. It often happens to people with mood disorders like depression, bipolar disorder, and schizophrenia. Over 30% of people with catatonia also have bipolar disorder.

Catatonia treatment

Catatonia is usually treated with benzodiazepine or Electroconvulsive therapy (ECT). ECT sends electric current to the brain via electrodes placed to the patient's head.

Note that treating catatonia is not the same as treating schizophrenia, and there's no diagnosis as catatonic schizophrenia. Catatonia and schizophrenia are two different disorders, although they can occur together.

If you're experiencing symptoms of catatonia alongside schizophrenia, bipolar disorder, or any other mental illness, we can carry out tests to evaluate your situation to know the best course of action.

Talk to us today.

Author

Satu H. Woodland, PMHCNS-BC, APRN Satu Woodland is owner and clinician of Hope Mental Health, an integrative mental health practice located at Bown Crossing in Boise, Idaho. She sees children, adolescents, and adults.  Ms. Woodland with her background in nursing, prefers a holistic and integrative approach to mental health care that addresses the mind and body together. While Ms. Woodland provides medication management services in all her patients, she believes in long-lasting solutions that include a number of psychotherapies, namely cognitive behavioral therapy, exposure and response prevention therapy, attention to lifestyle, evidenced based alternative psychiatric care and spirituality. If you’d like to gain control over your mental health issues, call Hope Mental Health at 208-918-0958, or use the online scheduling tool to set up an initial consultation.