Catatonia

I sit on the ground, my breath rhythmic and steady. My breath is my sole attention, as I watch the world go by around me. My thoughts go by immeasurably slow. My breath is the only thing I can focus on. I am aware that there is a world outside myself, but it does not feel like a real world, I am withdrawn into myself like a hermit crab into its shell. My limbs are statues. All I am is breath.

The above describes my first catatonic stupor. A state of immobility or repetitive movements that can last anywhere from hours to years. I do not know how long it lasted, but based on the length of my other episodes I would suspect it was at least an hour. I would later be officially diagnosed with psychosis NOS, an inherently varying disease that includes many symptoms of schizophrenia. I have experienced auditory and visual hallucinations, depersonalization and derealization, and lack of focus to the point where I could not read a book, but the catatonia is still what frightens me the most.

What is Catatonia?

As mentioned previously, catatonia is an elongated period of immobility or repetitive movement. While catatonia is extremely debilitating, it is not, in itself, a disorder, rather, it is a symptom of an overlying disorder, often schizophrenia. People in a catatonic state may not react to external stimuli, or may suddenly become agitated or react to no stimuli at all. They may also maintain positions that they are put in, a trait called waxy flexibility, while others resist all efforts to be moved, called rigidity.

Catatonic Schizophrenia

Although removed as a diagnosis in the DSM V, the “Bible” of mental health, some people with schizophrenia acutely display catatonic symptoms. Formerly, these people were diagnosed not just with schizophrenia, but with catatonic schizophrenia. Note that not only do these people qualify for a diagnosis of schizophrenia (hallucinations, delusions, etc.), but they also have catatonic symptoms as described above.

Treatments

Catatonia can usually be treated successfully with anti-psychotics, and in some cases benzodiazepines. Most people respond well to these drugs and will quickly come out of a catatonic state within a few days. Some people may require ECT (Electro-Convulsive Therapy), and may even require regular rounds of ECT to stay out of catatonia. It is to be noted that ECT is not the horrible torture that movies often make it out to be. It is painless, and the movements seen during old time ECT is simply due to involuntary movements. During current ECT procedures, the patient is given a muscle relaxant to cease the movements.

Prognosis

Unfortunately, the prognosis for people with catatonia, in general, is not a good one. This is why I fear it most out of all my symptoms. According to one study, 14 of the 36 participants were in need of “continuous psychiatric care”, take from that what you will.

Conclusion

While I may have catatonic symptoms, which studies show makes my prognosis rather poor, and while my symptoms, as we speak, may be getting worse, I have not given up hope, and neither, I believe, should anyone else who has psychotic and/or catatonic symptoms. Life isn’t over till it’s over, and every life is worth living all the way through, even if the part of the path you’re on right now is in a scary forest with wolves all around you. One day after walking (or running) down that path for long enough you’ll come out to a field full of bright tulips, and the sun will shine.