Table of ContentsView AllTable of ContentsDefinitionCausesHospitalization for Severe SymptomsDiagnostic Catatonic Depression AssessmentTreatment PlanRecovery, Well-Being, and Ongoing Treatment
Table of ContentsView All
View All
Table of Contents
Definition
Causes
Hospitalization for Severe Symptoms
Diagnostic Catatonic Depression Assessment
Treatment Plan
Recovery, Well-Being, and Ongoing Treatment
Catatonic depression describes a syndrome in whichcatatonia(a span of disturbed activity) exists at the same time asmajor depressive disorder (MDD). People with this condition can have symptoms of both ailments.
Catatonic depression can cause many types of symptoms. These can range from decreased movement to odd actions. It can also involve low mood and other symptoms of MDD.
When found early, this syndrome is highly treatable with a good outlook. Without treatment, it can lead to severe problems. These can occur when a person stops eating or moving.
This article explains what catatonic depression means, its symptoms, and how it is found. It also describes treatments and what the future can involve for those with it.
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What Does Catatonic Depression Mean?
Catatonic depression is also called major depressive disorder with catatonic features. This describes the co-existence of catatonia with major depressive disorder.
Once thought to exist as a symptom ofschizophrenia, research shows that catatonia, or catatonic behavior, can occur alone or at the same time as several mental and physical conditions like MDD. It is a syndrome in which a broad range of symptoms affect your movement and actions, interfering with everyday life. Catatonia affects about 10% of people with psychiatric conditions.
Having catatonic depression means that you can experience symptoms of catatonia and major depressive disorder at the same time. An episode of catatonic depression can last for weeks, months, or even years.
Catatonic Behaviors, Types, Symptoms, and Treatments
Characteristic Symptoms
Research indicates that immobility andmutism(minimal or absent speech) are the two most common symptoms of catatonia, each occurring in over 90% of people with this condition.
Akinetic Characteristics of Catatonic DepressionThe most common type of catatonia is called akinetic catatonia. It involves extreme resistance to movement.Akinetic characteristics of this type of catatonia include persistent staring. The affected person may appear non-responsive, though they remain alert and aware of their surroundings. Their response to external stimuli and voice communication is typically decreased.
Akinetic Characteristics of Catatonic Depression
The most common type of catatonia is called akinetic catatonia. It involves extreme resistance to movement.Akinetic characteristics of this type of catatonia include persistent staring. The affected person may appear non-responsive, though they remain alert and aware of their surroundings. Their response to external stimuli and voice communication is typically decreased.
The most common type of catatonia is called akinetic catatonia. It involves extreme resistance to movement.
Akinetic characteristics of this type of catatonia include persistent staring. The affected person may appear non-responsive, though they remain alert and aware of their surroundings. Their response to external stimuli and voice communication is typically decreased.
Causes of Catatonic Episodes
The causes of catatonic episodes are not fully understood. Researchers have proposed that catatonic episodes may be linked to the following:
Risk Factors
Having one or more of the following risk factors can make you more likely to have a catatonic episode:
The onset of catatonic depression can lead to serious medical complications if treatment is not started in the early phases. Immobility and refusal to eat and/or drink can increase the risk of the following complications that may require hospitalization:
Getting a prompt and accurate diagnostic catatonic depression assessment is essential if you have symptoms of this condition. Misdiagnosis of catatonic depression can lead to improper medication. It can also result in potentially life-threatening outcomes.
A diagnostic catatonic depression assessment includes a thorough physical and psychiatric evaluation for identifying catatonic symptoms in people with major depressive disorder. While there is no laboratory test for catatonic depression, these tests can help identify causes or complications related to your symptoms.
Depending on your symptoms, this assessment can involve the following:
Also, a consideration of differential diagnosis for the following conditions:
Catatonic Depression Treatment Plan
A catatonic depression treatment plan combines therapies for catatonia and depression. However, since catatonia increases your risk of serious complications, treatment of catatonia typically takes priority.
A catatonic depression treatment plan can include the therapies below to address catatonic behavior.
Medication
ThebenzodiazepineAtivan (lorazepam)is generally the first-choice drug. It is the most frequently used and has an 80% remission rate in adults and 65% in children. Treatment can often be seen within the first 10 minutes after administering the medication.
There are no treatment standards on how long benzodiazepines should be continued. They are typically stopped when the underlying illness has resolved. When these drugs are given for long periods, the dosage is generally tapered off during withdrawal.
ECT
Electroconvulsive therapy (ECT)uses the benefits of inducing a seizure in your brain to “reset” it. Treatment involves brief electrical brain stimulations under anesthesia. It is often reserved as a second-line treatment for catatonia if benzodiazepines don’t work.
While ECT has a response rate of 80% to 100%, achieving the desired result can take several sessions. Some researchers suggest that ECT should be the treatment of choice for catatonia because of its effectiveness.
Repetitive Transcranial Magnetic Stimulation (rTMS)
Repetitive Transcranial Magnetic Stimulation (rTMS) is an emerging treatment for catatonic depression. rTMS uses a magnet placed on your forehead that releases pulses to your brain.
It provides stimulation to your brain, similar to ECT. However, rTMS does not require anesthesia or produce the cognitive side effects that occur with ECT. Treatment requires daily appointments for several weeks.
Why Do People Have Relapsing Catatonic Depression Episodes?It is not known why relapsing catatonic depression occurs. In some people, catatonic symptoms will emerge each time lorazepam is tapered off, causing a relapse into a catatonic state. This requires that benzodiazepines be extended for long-term maintenance treatment.
Why Do People Have Relapsing Catatonic Depression Episodes?
It is not known why relapsing catatonic depression occurs. In some people, catatonic symptoms will emerge each time lorazepam is tapered off, causing a relapse into a catatonic state. This requires that benzodiazepines be extended for long-term maintenance treatment.
Even if your catatonia symptoms resolve, you may still need other treatments to address the underlying cause.
Major depressive disorder is typically treated with medication, psychotherapy, or both. Research indicates that a combination of antidepressants and psychotherapy treatment is the most effective approach.
In addition to medication and psychotherapy, the following lifestyle habits may help you manage life with major depressive disorder:
Getting Help for Catatonic DepressionIf you or someone you know are having symptoms of catatonic depression, call 911 or go to your nearest emergency room for immediate care.If you or someone you know are having thoughts of suicide or another type of mental health crisis, call, text, or chat 988 to reach the988 Suicide and Crisis Lifeline.
Getting Help for Catatonic Depression
If you or someone you know are having symptoms of catatonic depression, call 911 or go to your nearest emergency room for immediate care.If you or someone you know are having thoughts of suicide or another type of mental health crisis, call, text, or chat 988 to reach the988 Suicide and Crisis Lifeline.
If you or someone you know are having symptoms of catatonic depression, call 911 or go to your nearest emergency room for immediate care.
If you or someone you know are having thoughts of suicide or another type of mental health crisis, call, text, or chat 988 to reach the988 Suicide and Crisis Lifeline.
A Word From VerywellIt’s important not to make abrupt changes or discontinue medication. If you’re noticing side effects of medication or have concerns about your treatment plan, reaching out to your care team is a great first step. Together, you can come up with a plan that works best for you.—MELISSA BRONSTEIN, LICSW, MEDICAL EXPERT BOARD
A Word From Verywell
It’s important not to make abrupt changes or discontinue medication. If you’re noticing side effects of medication or have concerns about your treatment plan, reaching out to your care team is a great first step. Together, you can come up with a plan that works best for you.—MELISSA BRONSTEIN, LICSW, MEDICAL EXPERT BOARD
It’s important not to make abrupt changes or discontinue medication. If you’re noticing side effects of medication or have concerns about your treatment plan, reaching out to your care team is a great first step. Together, you can come up with a plan that works best for you.
—MELISSA BRONSTEIN, LICSW, MEDICAL EXPERT BOARD
Summary
Catatonic depression is a type of depression that involves distorted speech, movement, and actions. It is a syndrome in which catatonia exists at the same time as MDD.
While catatonia is often assumed to be reduced movement, it can also involve extreme or odd motor symptoms.
This syndrome is also called major depressive disorder with catatonia. This describes the fact that catatonic behavior is linked to depression.
Catatonic depression can prevent you from eating, drinking, or moving. With early treatment, the outlook is good for most people. Without treatment, you increase your risk of severe health issues that can threaten your well-being.
19 Sources
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