Catatonia

Key Takeaways

• Catatonia is a brain-related condition that causes irregular movements, unusual behaviors, or absence of reaction. It can occur with psychiatric disorders, medical conditions, or as a condition on its own.

• There are three official types of catatonia, with symptoms of withdrawn catatonia including a lack of movement, while excited catatonia presents as restlessness. Malignant catatonia includes symptoms of both withdrawn and excited catatonia, and is the most life-threatening subtype.

• First-line treatment for catatonia involves benzodiazepines like lorazepam, which can quickly relieve symptoms in most cases. In those whose symptoms do not respond to medication, electroconvulsive therapy (ECT) is often used and is highly effective.

Understanding Catatonia

Catatonia is a group of symptoms that affects how a person moves and communicates in a number of ways. Three types of catatonia recognized in scientific literature, along with a fourth type that is considered unofficial but still clinically significant. These include: ^[2]

• Withdrawn (akinetic) catatonia: The most common form of catatonia, characterized by immobility, staring, and decreased response, although the individual remains aware.

• Excited catatonia: In contrast to akinetic catatonia, excited catatonia is marked by restless, impulsive, or aggressive movements that may lead to injuries.

• Malignant catatonia: Severe and fast-progressing, malignant catatonia can involve both a lack of movement or agitation and can be fatal.

• Periodic catatonia (unofficial): This form of catatonia manifests as episodes of either withdrawn or excited catatonia, making it difficult to diagnose.

In light of this, an individual with catatonia might stop moving or speaking, seem confused, or appear agitated and restless. While the condition is widely considered to be linked to mental health issues like bipolar disorder or schizophrenia, catatonia can also occur with medical conditions or be induced by certain drugs. ^[2]

Additionally, catatonia can manifest as a standalone health condition, without any connection to either mental or physical illnesses. Catatonia is not always easy to identify (particularly when medical issues are present), yet early diagnosis is key to appropriate treatment, which can prevent life-threatening complications from arising and even result in a full recovery. ^{[1] [2]}

How Common Is It?

While a wide range of both physical and mental health conditions are linked to catatonia, a 2023 review found that the majority of research regarding its prevalence focuses on psychiatric patients. In studies that analyze existing records, catatonia has been identified in approximately 0.5% to 2% of all psychiatric patients. ^[1]

That said, some studies that tracked patients over time have reported rates in mental health patients as high as 17%. Of these, catatonia appears more frequently in people with mood disorders, with percentages ranging from 13% to 27%. Overall, most research shows that catatonia affects approximately 5% to 20% of patients in acute psychiatric hospital settings. ^[1]

Catatonia Symptoms

The symptoms of catatonia range dramatically depending on factors including the severity, specific subtype, and individual differences. For this reason, some individuals with catatonia may present with only a handful of symptoms, while others have more. Additionally, in some cases, individuals experience episodes where symptoms fluctuate. ^[1]

In light of this, individuals may experience periods of immobility as well as periods of heightened activity. The common thread seen in all types of catatonia is that it occurs when certain parts of the brain that control key functions become disrupted, leading a person to enter a “catatonic state.” The affected brain networks result in symptoms linked to: ^[1]

• Movement

• Senses

• Attention span

• Thought processing

• Memory

• Motivation

• Emotions

• Judgment

• Self-control

Physical Symptoms

According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), there are twelve symptoms of catatonia, and an individual must experience at least three of these to be diagnosed with the condition. ^{[1] [2] [3]}

• Stupor: This occurs when a person is awake but unresponsive to their surroundings. For instance, a person with catatonia might not react if someone speaks loudly to them or waves a hand in front of their face.

• Catalepsy: This refers to a state in which a person maintains a body position that they are placed in (in some cases despite discomfort), though their body remains flexible enough to be repositioned into a different pose.

• Waxy flexibility: This describes a condition where an individual shows slight resistance when someone attempts to move their body. However, after a short while, the individual’s muscles gradually relax, and their limbs bend slowly in a wax-like manner.

• Mutism: This refers to a state where a person is extremely or completely silent, and is considered a symptom only if there is no other medical reason that accounts for their lack of speech.

• Negativism: This describes a state in which a person does not respond to external events or intentionally resists instructions without a rational explanation.

• Posturing: Unlike in catalepsy, this refers to when a person voluntarily maintains a particular posture (often one that is uncomfortable) without being positioned that way by someone else.

• Mannerism: This occurs when a person performs movements or gestures that could be done in a normal fashion but instead are carried out in an unusual or exaggerated manner.

• Stereotypy: These are repeated movements that appear to serve no clear purpose, such as fidgeting with one’s fingers or rubbing parts of the body.

• Grimacing: This involves maintaining fixed, unusual facial expressions, often with tight or rigid facial muscles. In some cases, it may appear as smiling at inappropriate times.

• Agitation: This refers to excessive, purposeless physical or verbal activity that appears without an identifiable trigger and may include pacing, shouting, or sudden aggression.

• Echolalia: Repeating or copying what someone else says.

• Echopraxia: Copying or mimicking someone else’s movements.

Types of Catatonia

Catatonia is often misunderstood as a state of complete stillness or lack of movement. However, this condition can also involve extreme agitation, repetitive or bizarre behaviors, and sudden shifts between silence and hyperactivity. Catatonia presents in several distinct forms, each with its own features, severity, and clinical challenges.

Withdrawn Catatonia

Also known as akinetic catatonia, this type of catatonia is the most common, with individuals who experience akinetic catatonia typically exhibiting prolonged staring and seeming unresponsive. People with this type of catatonia also display reduced reactions to both verbal prompts and pain, yet in reality, their brains are fully conscious and aware of external stimuli. ^[2]

Excited Catatonia

Scientifically referred to as “hyperkinetic” catatonia, this form of catatonia is characterized by excessive movement that appears impulsive and aimless. The degree of movement presenting in those with excited catatonia can pose a risk of injury to the individual or to those around them. Individuals with excited catatonia may appear restless, aggressive, or severely confused. ^[2]

Malignant Catatonia

Individuals with malignant catatonia typically either have a serious underlying medical problem, have taken toxic amounts of drugs (such as unregulated substances or medications), or have difficulties with brain function due to chemical imbalances. ^[4]

Malignant catatonia can involve features of both withdrawn and excited catatonia, and presents with additional physical symptoms that make it the most severe and dangerous form of catatonia. ^[4]

These include: ^{[2] [4]}

• Fever

• Increased heart rate

• Dangerously high blood pressure

• Delirium or confusion

Malignant catatonia is marked by rapid onset and worsening of symptoms, and is often triggered by a life-threatening health condition. Because it can lead to mortality, malignant catatonia requires urgent medical attention and treatment of the underlying cause. ^[2]

Periodic Catatonia

Although not officially classified as a distinct subtype, periodic catatonia is worth mentioning as it is clinically recognized. This rare form of catatonia shows up in repeated episodes, where symptoms present in phases, with periods of complete recovery in between. While the exact cause of periodic catatonia is still unknown, treatment shows promising results. ^[2]

Causes

Although the cause of catatonia remains unknown, research has revealed that the condition is linked to a wide range of psychiatric disorders, various illnesses, brain chemical imbalances, genetic influences, and may even be rooted in extreme fear or stress.

Psychiatric Disorders

Psychiatric disorders are the most common causes of catatonia, and autistic people and individuals living with schizophrenia, bipolar, depression, or a combination of psychiatric disorders are at an increased risk of developing the condition. It is particularly prevalent in people with schizophrenia, and an estimated 35% of individuals living with schizophrenia show catatonic symptoms at one point in their lifetime. ^{[1] [2]}

This is significant as catatonic symptoms may be mistaken for worsening schizophrenia or neuroleptic malignant syndrome, which is caused by certain antipsychotic medications used to treat schizophrenia and is a medical emergency that requires immediate medical investigation and treatment. ^[2]

Medical Conditions

Although psychiatric illness is the most frequent cause of catatonia, approximately 20% of catatonia cases are due to underlying medical conditions, with around 29% caused by infections (bacterial, viral, or fungal) or autoimmune diseases. One such autoimmune condition, known as NMDAR encephalitis (where the immune system mistakenly attacks the brain), is responsible for 72% of all autoimmune-related catatonia cases. ^[2]

Additionally, catatonia is linked to the following medical conditions: ^{[1] [2]}

• Neurological issues (such as strokes, brain tumors, or blood clots in the brain)

• Autoimmune disorders (like NMDAR encephalitis or lupus)

• Infections (including meningitis or encephalitis)

• Neurodegenerative diseases (such as Parkinson’s)

• Metabolic problems (such as imbalances in the body’s chemistry, like low sodium)

• Certain drugs or poisonings

The exact mechanism by which medical conditions cause catatonia is not fully understood. However, three main theories have been proposed, including a direct effect on brain cells caused by a medical condition, a psychological reaction to severe illness, or the influence of inflammatory chemicals released during the body’s immune response. ^[2]

Neurotransmitter Dysfunction

Catatonia is associated with disruptions in the brain’s chemical messengers, which are known as neurotransmitters. In particular, imbalances in gamma-aminobutyric acid (GABA), glutamate, and dopamine systems appear to play a key role in the unusual movements, emotional withdrawal, or agitation seen in individuals with catatonia. ^[2]

• GABA-A receptor activity: One of the key brain chemicals linked to catatonia is called GABA, which works to calm down brain activity. More specifically, a type of GABA receptor known as the GABA-A receptor plays a role in the brain becoming overstimulated, which can lead to symptoms such as freezing, stiffness, or emotional withdrawal.

• Glutamate and NMDAR: Another brain chemical involved in catatonia is glutamate, which typically supports brain cells in sending signals to one another. However, too much glutamate activity can lead to the overstimulation seen in catatonic symptoms. One specific type of glutamate receptor, the NMDAR, is strongly linked to catatonia.

• Dopamine dysfunction: Imbalances in dopamine may worsen catatonia or provoke severe forms such as malignant catatonia. A delicate balance between dopamine and GABA-A activity is essential for healthy movement and motivation, and disruption in these brain functions may increase vulnerability to the condition.

Genetic Influences

Catatonia appears to run in families, with an approximately 27% risk of the syndrome presenting in individuals with an affected close family member. One gene that has been linked to catatonia is known as the CNP gene, which is responsible for supporting the protective coating around nerves, called myelin, and brain cell function. ^[2]

When this gene is missing or not working optimally (as seen in experiments with mice) catatonia-like and depressive behaviors were found in the rodents. People with schizophrenia who develop catatonia are also more likely to have less of this gene, suggesting that problems in how brain cells send and receive messages may play a role in causing catatonia. ^[2]

Fear-Based Theories

An additional theory proposes that catatonia may be caused by extreme fear. This idea stems from the understanding of the autonomic nervous system and the concept that in ancient times, humans and animals “froze” when facing predators that attacked based on movement. This "freeze response" may potentially have evolved into a modern catatonic state that emerges when the brain is overwhelmed by fear. ^[2]

Who Is Likely to be Affected by Catatonia?

Catatonia can affect anyone, regardless of race, gender, age, or background. That said, it is most often seen in people with psychiatric and medical conditions, along with those who stop using certain medications. ^{[1] [2]}

People with psychiatric disorders are the most likely to develop catatonia. In terms of specific mental health conditions, individuals with mood disorders such as depression or bipolar disorder are more vulnerable, but the highest risk is seen in people living with schizophrenia, where approximately 35%experience catatonic symptoms at some point. ^[2]

A number of general medical conditions also increase the risk of being affected by catatonia. Individuals with neurological problems, autoimmune disorders, infections, neurodegenerative diseases, metabolic imbalances, and those who have been exposed to certain drugs or poisons are more likely to develop catatonia. ^[2]

Additionally, people who suddenly stop taking medications such as benzodiazepines (commonly prescribed for anxiety or sleep) or clozapine (used to treat schizophrenia) are at a higher risk. These medications enhance calming brain chemicals like GABA, and their abrupt withdrawal may cause brain overstimulation and trigger the onset of catatonia. ^[2]

Prevention

Prevention of catatonia largely depends on healthcare providers screening for catatonia in vulnerable patients so that mental or physical health conditions can be managed. This may help to prevent the onset of catatonia, although it is not possible to prove whether catatonia would have emerged in those with illnesses that are treated successfully.

While it is not always possible to prevent catatonia entirely, in many cases it is possible to halt the condition from worsening when early warning signs are identified. Those close to at-risk individuals can keep an eye out for initial indicators so as to encourage medical support in the event of concern.

Preliminary signs could include any of the twelve symptoms of catatonia outlined in the DSM-5, but most commonly include: ^[5]

• Immobility

• Mutism

• Staring

• Withdrawal

• Refusal to eat

Additionally, part of prevention includes recognizing sudden withdrawal from medications such as benzodiazepines, the use of certain antipsychotic drugs, and more. Some researchers also believe that reducing brain inflammation and keeping the body’s metabolism stable may help prevent catatonia, although this idea is still being investigated. ^[6]

If an individual is showing early signs of catatonia or is known to be at high risk, acting with urgency can make a big difference. In many cases, existing pharmaceuticals are adjusted and medication for catatonia is administered immediately to soothe brain activity, prevent symptoms from worsening, and in the majority of cases, a full recovery is made.

Diagnosing Catatonia

Karl Kahlbaum was the first to identify and classify catatonia as a distinct condition in 1874. In years gone by, the condition was believed to be a symptom of schizophrenia or other psychiatric disorders, but with recent updates in the DSM-5 it is now seen as a set of symptoms that can appear alongside other medical or psychiatric conditions. ^{[2] [3]}

This means that catatonia is not listed as a standalone mental health diagnosis in the DSM-5, but rather is categorized in the manual as follows: ^[3]

• Catatonia associated with another mental disorder

• Catatonic disorder due to another medical condition

• Unspecified catatonia (used when the cause is not clear)

In order to be diagnosed with catatonia, a person needs to exhibit at least three of the twelve symptoms listed in the DSM-5. These diagnostic criteria are used for both adults and children, however, in children, catatonia is more likely to be triggered by physical health conditions or substance use. ^[2]

Diagnostic Challenges

In light of individual differences in those with catatonia, along with the various subtypes of catatonia (including akinetic, kinetic, malignant, and periodic) catatonia symptoms vary widely. While one person with catatonia might move much less than usual, another might exhibit restlessness or behave in manners that seem strange or out of character for them.

This can make catatonia complex to identify and diagnose, and to further complicate the matter, certain catatonic symptoms (such as mutism or agitation) can also be seen in other disorders, making catatonia difficult to diagnose accurately. For this reason, catatonia presents diagnostic challenges, and the condition is frequently underdiagnosed. ^[2]

Although uncommon, periodic catatonia is particularly difficult to diagnose and manage in light of the episodic nature of this unofficial subtype. Due to the fact that the symptoms of periodic catatonia continuously emerge before disappearing and reemerging again, presentations may resolve before a diagnosis can be made and treatment initiated. ^[2]

What Doctors Look for When Diagnosing Catatonia

Since catatonia is most commonly caused by an underlying mental health condition, doctors take note of a history of ongoing mental illness, along with worsening depression, mania, or psychosis. These symptoms can emerge as excitement, withdrawal, a combination of both, or in cases of malignant catatonia, alongside additional health complications. ^[1]

In excited catatonia, patients frequently display unusual behaviors such as performing actions without a clear purpose or at inappropriate times (for example, saluting). They may be restless, hold strange postures against gravity, engage in repetitive movements (such as picking at their clothes), repeat themselves, or echo words or movements. ^[1]

On the otherhand, in withdrawn catatonia, individuals tend to be stuporous, maintain unusual postures, show no response, actively resist external stimuli, or speak very little. These symptoms can fluctuate over time, appear together, or vary in intensity. In cases of an underlying medical condition, other psychiatric symptoms like mania or psychosis may manifest. ^[1]

Individuals with malignant catatonia may present with both excited and withdrawn symptoms, along with what is known as “autonomic instability,” which means abnormal or unpredictable functioning of automatic body processes. These include a high fever, high blood pressure, severe confusion, and unresponsiveness.^[4]

Periodic catatonia involves repeated episodes of catatonic symptoms that typically last between four and ten days and can come and go over many years. These symptoms can include both withdrawn and excited symptoms, often alternating between them during different episodes or even within the same episode. ^[4]

When to Seek Treatment

Individuals at risk for catatonia should be treated for underlying medical or psychiatric conditions and monitored for the emergence of catatonia. This is due to the fact that early interventions can improve outcomes significantly and prevent serious complications. In individuals exhibiting any of the symptoms of catatonia, it is imperative to seek medical help immediately.

This is particularly important when catatonia occurs in the context of schizophrenia during childhood, as it carries a higher risk of poor outcomes. Additionally, if a person with catatonia shows signs of sudden changes in automatic body functions (such as heart rate, blood pressure, or temperature), this raises the risk of serious complications or even death. ^[2]

Tests and Assessments

While mental illness is often the cause of catatonia, doctors will check for physical illnesses that may be at the root of the catatonic symptoms, particularly if an individual’s psychiatric history does not fully explain the symptoms. This typically involves a physical examination, and may also include various scientific tests. ^[1]

Additionally, healthcare providers typically use a screening tool known as the Bush Francis Catatonia Rating Scale, which not only supports the early detection of catatonia but also allows doctors to track the severity of symptoms, which is important for preventing serious complications or relapses.

Physical Examination

A physical exam can serve to identify whether catatonia or another health condition is causing the catatonic symptoms. By gently moving an individual’s limbs and observing their response, doctors can identify specific signs that point to different disorders. If the patient shows waxy flexibility or holds an unusual posture after being moved, catatonia is more likely. ^[1]

Diagnostic Tests Used to Identify Underlying Causes of Catatonia

The diagnosis of catatonia is primarily clinical and does not require specific laboratory tests or imaging for confirmation. However, these investigations can be valuable in identifying underlying causes. This may take the form of an electroencephalogram (EEG), which is a test that records the electrical activity of the brain using small sensors placed on the scalp. ^[1]

An EEG can show general brain slowing in people with catatonia from a psychiatric condition, and it can also help rule out seizures, since seizures can sometimes trigger catatonia. Brain imaging techniques such as MRI or CT scans cannot identify catatonia itself, but may reveal other brain dysfunctions that have links to catatonic symptoms. ^[1]

Scans of other body parts can also reveal tumors that might be triggering catatonia. Additionally, blood and urine tests can check for medical problems such as uncontrolled diabetes, liver issues, kidney problems, or serious infections that might lead to catatonia. Doctors might also test for signs of autoimmune diseases by checking certain antibodies or inflammation levels. ^[1]

Bush Francis Catatonia Rating Scale (BFCRS)

The BFCRS is the most widely used assessment for diagnosing catatonia and closely aligns with the DSM-5 criteria but also includes additional signs that may manifest. The scale includes 23 different catatonic manifestations, which are designed to capture the wide range of behaviors seen in catatonia beyond the basic criteria. ^[2]

These are scored to assess the severity of the condition, although symptoms may vary between assessments. A few of the additional symptoms in the BFCRS include hesitant or indecisive movements, compliance with commands (even if harmful), and physical signs like strong involuntary grasping or increased muscle stiffness. ^{[2] [7]}

The BFCRS can be used to monitor catatonia symptoms and should be used in conjunction with a full clinical assessment.

Treatment Options

Catatonia is best treated by a team of professionals, including a mental health nurse, psychiatrist, psychologist, general medical doctor, brain specialist, and even an eye doctor in some cases. In light of the fact that catatonia can lead to severe health complications or even death, it is imperative to seek treatment immediately should catatonic symptoms emerge. ^[1]

Even in cases that present with only a few mild symptoms, the sooner treatment begins, the better the chance of preventing serious problems. Malignant catatonia is not the only cause of severe health complications, and in individuals with withdrawn catatonia, it is common for blood clots to develop in the legs (due to prolonged periods of immobility), which can travel to the lungs and become dangerous. ^[2]

Other problems that can emerge include not getting enough nutrients, infections, and muscles tightening or locking up, especially in cases where an individual is not eating or moving. That being said, the majority of people with catatonic symptoms can recover with treatment in the form of medication or electroconvulsive therapy. ^[2]

Medication

The first step in treating catatonia is to stop any medications that may be causing it, after which the first-line treatment for catatonic symptoms is a group of medications that soothe the brain and nerves, known as benzodiazepines. In some cases, these may be combined with antipsychotic medications to control symptoms more effectively. ^{[1] [2]}

When catatonia is suspected, a test known as the “lorazepam challenge” is typically administered. This involves an injected dose of lorazepam and monitoring for symptom improvements, which are seen in 60% to 80% of individuals within 30 to 60 minutes, signaling the presence of catatonia, though in some cases the response may be slow and gradual. ^{[1] [2]}

With the correct lorazepam dosage, most people show improvement within three to seven days, and become alert and capable of interacting, despite the fact that the drug is often used to treat anxiety and insomnia. While adjusting the lorazepam dose, it is also important to treat the underlying cause of the catatonia. ^{[1] [2]}

For this reason, other benzodiazepines may be included in a treatment plan, particularly if an individual has medical or mental health conditions. In cases where catatonia is caused by substance use, a combination of lorazepam and diazepam has been shown to work effectively, often improving symptoms within a day. ^[2]

There is no clear consensus on how long benzodiazepines should be used to treat catatonia. However, in most cases, these medications are stopped once the condition causing the catatonia improves. However, reducing the dose too rapidly can trigger symptoms to return. In these cases, a provider will continue to monitor symptoms and benzodiazepine management. ^[2]

Electroconvulsive Therapy

In cases where a person’s catatonic symptoms do not improve with the use of benzodiazepines within approximately one week, and the underlying cause cannot be treated (or treating it does not help), electroconvulsive therapy (ECT) may be used to reverse the symptoms. The treatment involves brief electrical stimulation to the brain while an individual is under anesthesia. ^{[1] [2]}

Electroconvulsive therapy is considered a first-line treatment for more severe types of catatonia, such as malignant catatonia, or when severe delirium is present. ECT has been shown improve catatonic symptoms in 80% to 100% of individuals, particularly with early intervention, and in some cases is combined with benzodiazepines. ^{[1] [2]}

That said, it typically takes at least six treatment sessions to see these improvements, however, the total number of sessions required varies from individual to individual and cannot be predicted in advance. ECT can be stopped once a person has fully recovered or shows improvement after two sessions in a row. ^[2]

Individuals of a younger age and those who receive early daily ECT treatments have been found to respond more favorably to ECT. However, ECT is not safe for people who have had a recent heart attack, increased pressure in the brain, certain tumors, or brain aneurysms. Additionally, those with existing learning and memory difficulties are at higher risk of experiencing cognitive side effects, which are usually temporary but may last up to six months. ^[2]

Barriers to Treatment

Although electroconvulsive therapy (ECT) is effective in treating catatonia, there are several challenges beyond the potential side effects of the treatment. One major difficulty is obtaining informed consent, as patients in a catatonic state may not be able to fully understand or agree to the procedure. ^[2]

In the United States, legal guardians can make medical decisions for incapacitated patients; however, electroconvulsive therapy typically requires a court petition for approval. Similar challenges arise when treating adolescent patients, where healthcare providers must carefully weigh the potential risks against the benefits. ^[2]

Emerging Treatments

A promising treatment option for catatonia is Repetitive Transcranial Magnetic Stimulation (rTMS). Like electroconvulsive therapy, rTMS uses brain stimulation but does not require anesthesia and does not cause memory or thinking problems. It can potentially be used to treat catatonia that does not respond to other treatments, either for immediate relief or ongoing management. ^[2]

Self-Care and Management

As catatonia severely affects movement, self-care tends to be challenging for individuals with the condition, as many are dependent on others for assistance. Catatonia requires professional medical care, not only for symptom improvement, but to avoid further health complications and even death.

How Can I Help Someone with Catatonia?

The best way to help a loved one who may be developing (or is already living with) catatonia is by encouraging the person to seek treatment as quickly as possible. The sooner a person receives medication or electroconvulsive therapy, the better the chances of making a full recovery. With this in mind, here is how best to help during the treatment journey: ^[8]

Be Their Voice When They Can’t Speak

People with catatonia often struggle to speak, which can make sharing important details with healthcare providers challenging. If possible, offer information about the person’s medical history, recent behavior changes, or anything unusual you may have noticed. ^[8]

Offer Reassurance Through Clear Communication

Most individuals are aware of being in a catatonic state, which can be deeply unsettling. Calmly explaining where they are, what is being done to help them, and that they are safe can ease confusion and reduce fear. ^[8]

Help Them Understand What They’ve Been Through

After emerging from a catatonic state, a person might not recall much about the experience, and in some cases nothing at all. Gently sharing what happened during that time can help them to make sense of absent memories and feel more grounded. ^[8]

Remain Calm and Speak Gently

Even if an individual with catatonia seems unresponsive, it is common for those in a catatonic state to be aware of what is being said around them. A calm presence, soft voice, and comforting words can provide emotional support, even if it seems like they are not listening. ^[8]

Support Eating in Familiar, Gentle Ways

If your loved one is refusing food, it is a good idea to offer them meals or snacks that they particularly enjoy. Familiar tastes and a non-pressuring approach can help reintroduce eating in a way that feels safe and manageable. ^[8]

Is Catatonia Curable?

Catatonia is often treatable, especially when identified early and managed properly with medications like benzodiazepines or therapies such as electroconvulsive therapy (ECT). With appropriate treatment, 50% to 70% of individuals with catatonia see an improvement in symptoms, and the prognosis for recovery is good. ^[1]

While some people may recover fully and eventually stop medication under a doctor’s guidance, others may require ongoing treatment to manage underlying issues and prevent catatonia from returning. Outcomes vary from individual to individual based on the underlying cause and how quickly treatment begins. ^[1]

Final Thoughts

Catatonia is a brain-related condition that causes abnormal movements, behaviors, or a lack of responsiveness depending on which subtype is present. Symptoms can range from immobility (withdrawn catatonia) to restless movements (excited catatonia), and in life-threatening cases, a combination of both alongside physical health complications (malignant catatonia).

Prompt treatment with benzodiazepines is the first-line treatment, and for cases where medication is ineffective, electroconvulsive therapy (ECT) is a highly successful alternative. In fact, with timely diagnosis and appropriate medical care, the prognosis for people with catatonia is incredibly positive.