What is Catatonia?

A variety of irregular movements—or a lack of movement—defines catatonia. While another person struggles to remain still, one can remain motionless, silent, fixed, and rigid for inhumanely long periods of time. It is accompanied by a variety of mental illnesses, including childhood disorders like autism, mood disorders like bipolar, depressive, and psychotic conditions like schizophrenia and schizoaffective. Due to its co-morbidity with post-traumatic stress disorder, one can experience catatonia after experiencing a horrific event or after losing a loved one. Additionally, it can be brought on by a variety of physiological illnesses like Parkinson's, dementia, severe head trauma, and autoimmune diseases like lupus and multiple sclerosis. In addition, psychogenic drugs including LSD, cocaine, ecstasy, and marijuana can cause catatonia. According to research, 20% of people with bipolar disorder have catatonia, which can range from exciting catatonia, which manifests as restlessness, agitation, and talkativeness, to akinetic catatonia, which manifests as lack of movement, speech, or remaining still in an uncomfortable position for an extended period of time. The schizophrenic disorder is the second most prevalent condition, with 5–15% of its population suffering from it.

It is a severely deteriorating condition that, if not treated in a timely manner can be fatal. Malignant catatonia, as it is also known, has the potential to deteriorate a person's quality of life by harming their heart, kidneys, and other vital organs irreparably. Dysautonomia, or improper operation of your autonomic nerve system, is a result of this condition. Your autonomic nervous system is in charge of managing bodily functions like heartbeat, blood pressure, and other automatic ones that you don't have to think about.

How is it diagnosed?

Sadly, there isn't a precise scientific test that can identify catatonia. A number of suggested laboratory and imaging tests have a constrained "diagnostic weight." A complete blood count and metabolic panel, erythrocyte sedimentation rate, blood urea nitrogen, creatinine, serum iron, and creatinine-phosphokinase, antinuclear antibodies, urinalysis, magnetic resonance imaging, electroencephalogram, and cerebrospinal fluid analysis are a few examples of possible laboratory tests, primarily to assess various underlying conditions. Finding NMDAR IgG antibodies in serum or CSF fluid is advised given the frequent relationship with anti-NMDAR-encephalitis. Some authors believe that low blood iron is a risk factor for developing NMS after using antipsychotics in a catatonic patient since serum iron levels were reported to be lower in NMS compared to catatonia. A drug test is required to find common illegal and prescribed drugs.

Catatonia is most often accompanied by other psychiatric disorders therefore typically, a neurological evaluation comes first. The doctor examines reflexes, reactions, and how one reacts (or don't reacts) to the environment.

The Bush Francis Catatonia Rating Scale is frequently used as a standardized assessment tool by healthcare professionals to determine whether catatonia is present and how severe it is. Healthcare professionals must next determine the reason for catatonia after identifying it because it is always accompanied by another psychiatric or medical illness. The aim is to rule out more significant underlying illnesses because catatonia can coexist with serious or even fatal conditions. If any of your family members are in a state of Catatonia, please consult the Best Clinical Psychologist in India in clinic consultation at Psychowellness Center best multi-location mental health clinic in Dwarka, Janakpuri, Delhi, Gurgram, NOIDA, Faridabad,  NCR.

Treatment

Irrespective of the individual’s nature of the disorder, catatonia is treated in the same way. If an individual has a history of catatonia, they have to be regularly monitored for the same. Best Online Psychiatrist Consultation is important for immediate treatment and a better prognosis.

Electroconvulsive therapy and prescription medicines are the two main approaches to treating catatonia. Other prospective therapies, such as transcranial magnetic stimulation (rTMS), are being researched upon the need to determine whether they are efficient enough for widespread application.

Pharmacotherapy-

Medications like benzodiazepines are the first choice to treat catatonia as they are found to be safe and effective. Research has shown that 60- 90% of the population with catatonia has improved with the usage of this drug. Other pharmaceutical drugs are lorazepam, clonazepam, diazepam and zolpidem. These drugs are either given through either an IV or in the form of pills.

These drugs boost GABA levels in the brain, supporting the idea that low GABA causes catatonia.

There are other medications such as mood stabilizers or antipsychotic drugs that are prescribed to treat underlying conditions as the catatonia improves. Do not give any medication without consultation and supervision of Online Psychiatrist.

Medical procedures-

Electroconvulsive therapy (ECT) is a procedure that involves sending small shocks to induce mild and short seizures. Individuals undergo this procedure under anesthesia so they don’t feel any pain. Research indicates that this form of treatment is majorly used for malignant catatonia and for individuals not responding to prescribed medications. However, ECT has been banned by the Honorable Court.

Road to Recovery-

Both of these treatments are effective and can improve the catatonic state within half an hour to 2 hours.

But depending upon the case one might require multiple sessions over a period of time till their symptoms improve.

Normal catatonia rarely poses a threat to life (except for malignant catatonia, which is deadly without quick treatment). However, it's linked to a higher chance of dying from illnesses like pneumonia and pulmonary embolism, which occur when people don't move around much. When catatonia lasts longer or occurs more frequently, it is also more challenging to cure. Fortunately, this disorder responds quite well to benzodiazepines and ECT, making treatment very effective.

Schizophrenia patients typically respond to treatment less favorably than do persons with mood disorders like bipolar disorder and major depressive disorder. If you are searching for online counseling for bipolar disorder, seek consultation with a “Counsellor near me“ and connect with TalktoAngel India’s no.1 Online Counselling platform.